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ESMO Asia 2025 | Biomarkers guiding treatment selection in endometrial cancer

Ka Yu Tse, MBBS, The University of Hong Kong, Hong Kong, China, discusses the importance of biomarkers in guiding treatment decisions for endometrial cancer, including MMR status, tumor mutational burden, and HRR gene mutations. Ongoing investigation of HER2-targeting agents are also underway and niraparib may have a role in patients with P53 wild-type tumors. This interview took place at 2025 European Society for Medical Oncology (ESMO) Asia Congress in Singapore, Singapore.

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Transcript

So your question is very good because nowadays, obviously, our treatments will be based very much on MMR status. And I think there are also some other markers that may already be used, for example, the tumor burden, tumor mutational burden as such. So this one for patients with TMB, I think immunotherapy is one of the drugs that is approved for this indication. And then for other biomarkers like the HRR genes mutation, P53 abnormality, then I think there’s still some signs showing that the additions of PARP inhibitor may be useful in this population...

So your question is very good because nowadays, obviously, our treatments will be based very much on MMR status. And I think there are also some other markers that may already be used, for example, the tumor burden, tumor mutational burden as such. So this one for patients with TMB, I think immunotherapy is one of the drugs that is approved for this indication. And then for other biomarkers like the HRR genes mutation, P53 abnormality, then I think there’s still some signs showing that the additions of PARP inhibitor may be useful in this population. But then I think that these are just some analyses showing that there’s some signals, but then I think that we still need to have better phase-through trials to prove its efficacy. And then HER2, well, HER2 at the moment, according to NCCN guidelines, we can consider adding like the Herceptins in this situation, but then it’s based on phase three trial only. So there’s one now ongoing phase three trial trying to look at this scenario, but then we still need to wait for the results of that. PD-L1 is not very useful in endometrial cancer, unlike cervical cancer. So this one, we don’t usually check that as well. And then there’s another quite attractive new drug called niraparib. I’m not sure if you have heard of that or not. So there’s already some preliminary data showing that the addition, the use of niraparib in P53 wild-type patient may provide some benefits, PFS benefits. So I think this may give another hope for those patients who have PMMR and also P53 wild type.

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