Outside of a clinical trial, do you currently incorporate the TCGA molecular classification into management decisions for patients with endometrial cancer?

I currently do not use the TCGA or ProMisE classifications to inform adjuvant therapy after surgery. Although exciting, it is premature to use this classification until we have the results of PORTEC-4a. These results will help us to better risk stratify patients and guide adjuvant treatment.

That being said, I do use molecular profiling to inform therapy in the case of serous histology and for recurrent disease. Patients with serous histology that overexpress Her2/neu would be candidates to add herceptin to carboplatin and paclitaxel (Fader et al., PMID 29584549).

Patients with recurrent disease that are MSI-low are candidates for pembrolizumab/lenvatinib (Makker et al., PMID 30922731).

Patients with recurrent disease that are MSI-high are c...

Currently, I incorporate MSI stable/loss or MMR intact/loss as well as HER2 status in management decisions for patients with endometrial cancer. Currently, these are the 2 factors that can impact treatment choices for endometrial cancer. However, the molecular classifications do overlap with MSI/MMR status.