While some academic centers perform molecular analysis on all endometrial cancer patients, widespread adoption is hindered by practical barriers. Institutions without in-house testing capabilities face logistical hurdles and costs for sending samples out, forcing them to be selective and creating disparities in care.
Clinicians increasingly re-biopsy recurrent or metastatic endometrial tumors, rather than relying on the primary tumor's profile. This is because biomarkers like HER2 can change or emerge as the disease progresses, opening up new targeted therapy options that were not previously available.
Despite patient interest and marketing, clinical experts are cautious about routine ctDNA use in endometrial cancer. They struggle with interpreting results, worrying that a positive test could lead to unnecessary anxiety and premature or excessive treatment without clear evidence of benefit.