How would you manage a POLE mutated, p53 abnormal IA myoinvasive carcinosarcoma of the endometrium with no LVSI?
Do you de-escalate treatment for POLE-mutated endometrial cancers?
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I would not change the management of IB and above non-endometrioid histology based on mutation analysis as almost all data is for endometrioid histology.
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We have a paper coming out next month showing that carcinosarcomas (UCS) that have POLE mutations do much better than the other subtypes and are statistically equivalent to survival of POLE endometrioid tumors. Having said that, I do not believe there is enough data to de-escalate POLE UCS and would...
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No data I am aware of for POLE status portending for better prognosis in non-endometrioid histologies.
For this patient, I would treat as per our institutional (and NCCN-supported) standard, which is chemotherapy + cuff brachytherapy.
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