Biomarker-Driven Decisions: Insights on Selecting Treatments in Advanced and Recurrent Endometrial Cancer

Summary for Physicians:

Biomarker Testing in Practice:
In the article by J. Chan et al., titled “Biomarker guidance in selection among breakthrough treatment options in advanced and recurrent endometrial cancer”(Gyn Onc, 2024), the authors discuss the importance of using biomarkers to guide treatment decisions for patients with advanced or recurrent EC. As part of their practice, physicians are encouraged to use a variety of biomarker tests, including MSI and TMB, to identify which patients are most likely to benefit from immunotherapy. In clinical practice, testing for these biomarkers has become increasingly common to guide decisions regarding IO therapy, and some centers may also include HER2 testing to inform the use of targeted therapies.

Role of Biomarkers in Post-IO Therapy:
For patients who have undergone immunotherapy and are considering post- immunotherapy treatment, biomarkers such as TMB, MSI, and HER2 may still play an important role in guiding further treatment decisions. TMB and MSI are predictive of a favorable response to immunotherapies and could indicate the potential benefit of continuing or switching to other immune-based treatments. For patients with HER2-positive tumors, therapies targeting HER2 may be appropriate even after immunotherapy failure. The article suggests that a deeper understanding of how these biomarkers function in the post- immunotherapy setting will be essential to improving patient outcomes, as these tests can help tailor subsequent therapies based on the molecular profile of the tumor.