The Cancer Genome Atlas (TCGA) has radically changed the history of endometrial cancer by outlining a new classification, based on its molecular characteristics. In the field of oncology, we are approaching the new era of molecular biology, particularly regarding endometrial cancer, with the increasing importance of targeted therapy. This paper is a review of phase III randomized controlled trials published in English between January 2019 and December 2023, comparing drugs of interest with standard adjuvant treatment and molecular subtypes in endometrial cancer. The use of immunotherapy alone or in combination with chemotherapy as therapy in patients with recurrent or advanced primary or metastatic endometrial cancer significantly improves the prognosis of these patients. The results show greater efficacy of all proposed treatments for mismatch repair deficiency (dMMR/MSI-H) patients compared to mismatch repair proficiency (pMMR) patients. Progression-free survival (PFS) and overall survival (OS) are better in dMMR patients in all studies analysed. Immunotherapy has the potential to revolutionize the gynaecological cancer treatment landscape, offering a new pathway and new hope for endometrial cancer patients, improving their outcomes in the future. Given the exciting results obtained in dMMR/MSI-H patients, MMR status should be investigated in every patient with advanced endometrial cancer at the time of diagnosis.
癌症基因组图谱（TCGA）通过基于分子特征提出全新分类体系，从根本上改变了子宫内膜癌的研究进程。在肿瘤学领域，我们正迈入分子生物学的新纪元，尤其在子宫内膜癌治疗中，靶向治疗的重要性日益凸显。本文系统回顾了2019年1月至2023年12月期间发表的英文III期随机对照试验，重点比较了目标药物与标准辅助治疗方案在子宫内膜癌不同分子亚型中的疗效。对于复发或晚期原发性/转移性子宫内膜癌患者，单独或联合化疗使用免疫疗法能显著改善其预后。研究结果显示，所有治疗方案在错配修复缺陷（dMMR/MSI-H）患者中的疗效均优于错配修复正常（pMMR）患者。在所有分析研究中，dMMR患者的无进展生存期（PFS）和总生存期（OS）均表现更优。免疫疗法有望彻底改变妇科癌症的治疗格局，为子宫内膜癌患者开辟新途径、带来新希望，从而改善其远期预后。鉴于dMMR/MSI-H患者取得的突破性成果，建议对所有晚期子宫内膜癌患者在确诊时进行错配修复状态检测。
肿瘤(癌症)患者之家