Introduction To understand the utility of comprehensive genomic profiling (CGP) in endometrial cancer clinical trial enrollment

Methods This was a retrospective chart review of three hospitals (large urban, smaller urban, and large suburban) within one health system. All patients undergoing surgical staging between Jan 2016- Jan 2022 with pathologically confirmed endometrial adenocarcinoma were included. The primary outcome of this study was proportion of patients who were enrolled in a clinical trial. Secondary outcomes were proportion of patients who underwent CGP, and the proportion of patients with an actionable mutation who enrolled in a clinical trial.

Results Of 1099 patients included in this study, 45 (4.1%) patients were enrolled in a trial. 31 (68.9%) of those who were enrolled in a clinical trial had undergone CGP, compared to 14 (31.1%) who had not undergone CGP (p <0.001). Those who had CGP were more likely to be enrolled in a clinical trial compared to those who did not have CGP (OR 13.55, CI 5.82 - 31.56). Of the 31 patients enrolled in trials who had undergone CGP, 24 (77.4%) of patients had an actionable molecular finding on CGP (TP53, 14; HER2 positive, 4; MSI-H, 3; PIK3CA, 5; TMB-H, 2; CCNE amplification, 3; BRCA2, 1; BRCA1 0; POLE, 0). Of 114 patients (10.4%) who had CGP, 56 (49.1%) were White, while 36 (31.6%) were Black (p<0.001).

Conclusion/Implications Patients who have undergone CGP were more 13 times more likely to enroll in a clinical trial. Race may be a barrier to undergoing CGP.