TY - JOUR
T1 - Nice-Saint-Paul de Vence 2020 recommendations for clinical practice
T2 - Management of metastatic and/or relapsing endometrial cancer
AU - groupe ARCAGY-GINECO
AU - Alexandre, Jérôme
AU - Le Frere-Belda, Marie Aude
AU - Prulhiere, Karine
AU - Treilleux, Isabelle
AU - Leary, Alexandra
AU - Pomel, Christophe
AU - Chargari, Cyrus
AU - Ducassou, Anne
AU - Joly, Florence
N1 - Publisher Copyright:
© 2020 Société Française du Cancer
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Endometrial cancer is a common cancer in older women and is often associated with comorbidities. Management of metastatic disease and/or relapse requires a multidisciplinary approach. Recent advances in the understanding of oncogenesis and molecular classification of endometrial cancers offer new therapeutic perspectives. These first recommendations, established following the methodology of Nice-Saint-Paul recommendations for clinical practice (RPC), aims to integrate molecular advances in diagnostic and therapeutic management. In 2020, the histological diagnosis of endometrial cancer is based on morphology and immunohistochemistry, including at least p53, oestrogen and progesterone receptors. Deficiency in the DNA mismatch repair system (MMR) must be assessed in all advanced endometrial tumors for oncogenetic and theranostic purposes. It can be sought initially by an analysis in immunohistochemistry with the 4 markers (MLH1, MSH2, MSH6, PMS2). Medical treatment depends on histological type, presence of hormone receptors and patient's profile to refer to chemotherapy (carboplatin–paclitaxel) or hormone therapy (for example of the progestogen type); in the event of MMR-deficiency, immunotherapy trial is the best option. As part of overall management of advanced endometrial cancer, radiotherapy (and surgery in rare cases) must be discussed, in particular in the event of loco-regional only relapse or oligometastatic disease.
AB - Endometrial cancer is a common cancer in older women and is often associated with comorbidities. Management of metastatic disease and/or relapse requires a multidisciplinary approach. Recent advances in the understanding of oncogenesis and molecular classification of endometrial cancers offer new therapeutic perspectives. These first recommendations, established following the methodology of Nice-Saint-Paul recommendations for clinical practice (RPC), aims to integrate molecular advances in diagnostic and therapeutic management. In 2020, the histological diagnosis of endometrial cancer is based on morphology and immunohistochemistry, including at least p53, oestrogen and progesterone receptors. Deficiency in the DNA mismatch repair system (MMR) must be assessed in all advanced endometrial tumors for oncogenetic and theranostic purposes. It can be sought initially by an analysis in immunohistochemistry with the 4 markers (MLH1, MSH2, MSH6, PMS2). Medical treatment depends on histological type, presence of hormone receptors and patient's profile to refer to chemotherapy (carboplatin–paclitaxel) or hormone therapy (for example of the progestogen type); in the event of MMR-deficiency, immunotherapy trial is the best option. As part of overall management of advanced endometrial cancer, radiotherapy (and surgery in rare cases) must be discussed, in particular in the event of loco-regional only relapse or oligometastatic disease.
KW - Advanced
KW - Endometrial cancer
KW - Mismatch repair
KW - Molecular biology
KW - Multidisciplinary care
KW - Relapse
UR - http://www.scopus.com/inward/record.url?scp=85091257111&partnerID=8YFLogxK
U2 - 10.1016/j.bulcan.2020.06.006
DO - 10.1016/j.bulcan.2020.06.006
M3 - Article
C2 - 32958220
AN - SCOPUS:85091257111
SN - 0007-4551
VL - 107
SP - 1006
EP - 1018
JO - Bulletin du Cancer
JF - Bulletin du Cancer
IS - 10
ER -