Could emerging biomarkers help determine the best treatment approach for someone with endometrial cancer? Dr. Joshua Cohen explores the evolving science behind biomarker testing, explains why comprehensive testing matters, and highlights how clinical trials are driving innovation in diagnosis and treatment for endometrial cancer.
Dr. Joshua G. Cohen is a board-certified gynecologic oncologist and Medical Director of the Gynecologic Cancer Program at the City of Hope Orange County. Learn more about Dr. Cohen.
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Transcript
Katherine:
Dr. Cohen, are there emerging biomarkers that may help predict which treatments will work best for individual patients?
Dr. Josh Cohen:
I think emerging is something that I would say is in the sense of a clinical trial. So, I would say seek out clinical trials, but the test that you really should talk to your primary cancer team about are going to be MMR status, microsatellite instability, HER2 immunohistochemical staining of the tumor, P53 status. And then there are some other statuses that we are looking at. Folate receptor’s a new target we’re looking at in endometrial cancer, for example.
So, there are some different tests that we are using for new molecules in the setting of clinical trials. I mentioned with cervical cancer, in another question, that ctDNA is a blood test; ctDNA looks for broken fragments of tumor that circulate in the blood. This is experimental. It’s not the standard of care, but there is some growing data that, perhaps, using ctDNA in certain settings may augment or help what we, as the providers, talk to our patients about regarding risk of recurrence or if there has been cancer that’s come back.
Katherine:
So, that could be a test then used for patients who have endometrial cancer?
Dr. Josh Cohen:
It can be in the right setting. It’s still considered experimental. There is a growing body of literature, and I think in the right setting, it’s worth discussing with your provider whether there is a role for checking a ctDNA assay in the setting of recurring cancer or concern for recurring cancer.
Katherine:
Dr. Cohen, are there promising clinical trials for treatments that target specific biomarkers?
Dr. Josh Cohen:
It’s an extremely exciting time in endometrial cancer. And being a cancer doctor, for me, it’s been a very gratifying last even two to three years because I feel like every couple months, we have a new indication, a new drug that’s been developed, a new trial that’s opening. And so, if you’re someone especially who’s dealing with recurring endometrial cancer, seek out those clinical trials – Clinicaltrials.gov – get a second opinion at a National Comprehensive Cancer Network cancer center if you can. In the age of telemedicine, if you’re in the same state, you don’t necessarily even have to travel directly to that institution if it’s a long drive.
Maybe they can do a video visit with you but seek out a trial in the setting of recurring endometrial cancer. We have a growing body of exciting trials. There likely is a trial for you.