Contrary to broad application, data suggests radiation's main benefit in endometrial cancer is for patients in the non-specific molecular profile (NSMP) group. This molecularly-defined approach refines adjuvant treatment decisions, moving away from a one-size-fits-all strategy based on stage alone.
Despite a plausible biologic rationale, adding PARP inhibitors to chemotherapy and immunotherapy for endometrial cancer has shown minimal benefit and potential for harm. Clinicians await final overall survival (OS) data before adopting this strategy, citing a lack of convincing evidence from recent trials.
For endometrial cancer patients stable on maintenance immunotherapy without symptoms, experts advocate against routine surveillance scans. Scans are reserved for the point when discontinuing therapy is considered, to establish a new baseline and monitor for rapid recurrence post-treatment, thus avoiding unnecessary radiation and patient anxiety.
In low-grade, recurrent endometrial cancer, patients who show stable or progressive disease on chemotherapy can surprisingly respond to hormonal therapies like progesterone. Although the response may be slow, it highlights an important, potentially overlooked option for this specific patient population.
While antibody-drug conjugates (ADCs) are an exciting frontier in endometrial cancer, a critical challenge is emerging: determining optimal duration for maintenance therapies. Experts are concerned about committing patients to long-term, potentially toxic treatments without clear stopping rules, a key question for future trials.