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AS04. Endometrial/Uterine corpus cancers
EP108/#409  Multiple classifier endometrial cancer: a multicenter study
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  1. Giorgio Bogani1,
  2. Jvan Casarin2,
  3. Ilaria Betella3,
  4. Fancesco Multinu3,
  5. Fabio Ghezzi2,
  6. Gabriella Schivardi4,
  7. Luigi De Vitis5,
  8. Roberto Berretta6,
  9. Giuseppe Vizzielli7,
  10. Marco Petrillo8,
  11. Flavia Sorbi9,
  12. Nicoletta Colombo10,
  13. Mariangela Longo11,
  14. Violante Di Donato12 and
  15. Francesco Raspagliesi1
  1. 1Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Gynecologic Oncology, Milano, Italy
  2. 2University of Insubria, Gynecologic Oncology Unit, Varese, Italy
  3. 3European Institute of Oncology, Gynecologic Oncology, Milan, Italy
  4. 4Mayo Clinic, Department of Obstetrics and Gynecology, Rochester, USA
  5. 5Mayo Clinic, Obstetrics and Gynecology, Rochester, USA
  6. 6University of Parma, Gynecologic Oncology, Parma, Italy
  7. 7University of Udine, Gynecologic Oncology, Udine, Italy
  8. 8University of Sassari, Gynecologic Oncology, Sassari, Italy
  9. 9University of Florence, Gynecologic Oncology, Florence, Italy
  10. 10University of Milan-Bicocca and Gynecologic Oncology Program, European Institute of Oncology IRCCS, Department of Medicine and Surgery, Milan, Italy
  11. 11Filippo Del Ponte Hospital, University of Insubria, Department of Obstetrics and Gynecology, Varese, Italy
  12. 12University La Sapienza, Gynecologic Oncology Unit, Rome, Italy

Abstract

Introduction The growing adoption of molecular and genomic characterization is changing the current landscape of treatment of endometrial cancer (EC) patients. Using the surrogate molecular classification EC patients are classified in four subgroups: POLE mutated, MMRd/MSI-H, p53 abnormal, and no specific mutational profile (NSMP). However, there are few patients (called multiple classifier) harboring two or more mutational patterns. Since the rarity of this occurrence, evidence regarding multiple classifier is still limited. Here, we described characteristics and outcomes of multiple classifier.

Methods This is a multi-institutional retrospective study. Apparent early-stage EC patients undergoing were evaluated via conventional pathological analysis and via immunohistochemistry and next generation sequencing.

Results Charts of 72 multiple classifier were reviewed. Median (range) follow-up was 9.8 (1.2, 37.5) months. Overall, 31 (43%) patients had a POLE mutation. Patients with POLE plus MMRd/MSI-H, POLE plus p53, and POLE plus MMRd/MSI-H, and p53 were 6 (8.3%), 20 (27.8%), and 5 (6.9%), respectively. Among those 31 patients, six had postoperative adjuvant therapies, and no recurrence occurred (median follow-up: 10.5 months (seven patients had at least 2-year follow-up)). Forty-one (56.9%) patients were diagnosed with tumors harboring both p53 plus MMRd/MSI-H. Adjuvant therapy was administered in 25/41 patients (60.9%). Four (9.8%) recurrence occurred after a median follow-up of 8.9 months (eleven non-recurring patients had at least 2-year follow-up).

Conclusion/Implications Multiple classifier EC are characterized by a good prognosis. POLE mutation seems confer protection in multiple classifier EC even in case of presence of MMRd/MSI-H and/or p53 abnormality. Prospective studies with long-term follow-up are needed.

https://doi.org/10.1136/ijgc-2023-IGCS.210

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