Molefi Thulo, Mabonga Lloyd, Hull Rodney, Mwazha Absalom, Sebitloane Motshedisi, Dlamini Zodwa
Discipline of Obstetrics and Gynaecology, School of Clinical Medicine, University of KwaZulu-Natal, Durban 4002, South Africa.
SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP) Pan African Research Institute (PACRI), University of Pretoria, Hartfield, Pretoria 0028, South Africa.
Cells. 2025 Mar 5;14(5):382. doi: 10.3390/cells14050382.
The peremptory need to circumvent challenges associated with poorly differentiated epithelial endometrial cancers (PDEECs), also known as Type II endometrial cancers (ECs), has prompted therapeutic interrogation of the prototypically intractable and most prevalent gynecological malignancy. PDEECs account for most endometrial cancer-related mortalities due to their aggressive nature, late-stage detection, and poor response to standard therapies. PDEECs are characterized by heterogeneous histopathological features and distinct molecular profiles, and they pose significant clinical challenges due to their propensity for rapid progression. Regardless of the complexities around PDEECs, they are still being administered inefficiently in the same manner as clinically indolent and readily curable type-I ECs. Currently, there are no targeted therapies for the treatment of PDEECs. The realization of the need for new treatment options has transformed our understanding of PDEECs by enabling more precise classification based on genomic profiling. The transition from a histopathological to a molecular classification has provided critical insights into the underlying genetic and epigenetic alterations in these malignancies. This review explores the genomic landscape of PDEECs, with a focus on identifying key molecular subtypes and associated genetic mutations that are prevalent in aggressive variants. Here, we discuss how molecular classification correlates with clinical outcomes and can refine diagnostic accuracy, predict patient prognosis, and inform therapeutic strategies. Deciphering the molecular underpinnings of PDEECs has led to advances in precision oncology and protracted therapeutic remissions for patients with these untamable malignancies.
迫切需要规避与低分化子宫内膜上皮癌(PDEECs)相关的挑战,PDEECs也被称为II型子宫内膜癌(ECs),这促使人们对这种典型的难治性且最常见的妇科恶性肿瘤进行治疗性研究。由于其侵袭性、晚期发现以及对标准疗法反应不佳,PDEECs导致了大多数与子宫内膜癌相关的死亡。PDEECs具有异质性的组织病理学特征和独特的分子图谱,并且由于它们易于快速进展,带来了重大的临床挑战。尽管围绕PDEECs存在诸多复杂性,但它们仍以与临床上惰性且易于治愈的I型ECs相同的低效方式进行治疗。目前,尚无针对PDEECs的靶向治疗方法。对新治疗方案需求的认识通过基于基因组分析实现更精确的分类,改变了我们对PDEECs的理解。从组织病理学分类向分子分类的转变为深入了解这些恶性肿瘤潜在的基因和表观遗传改变提供了关键见解。本综述探讨了PDEECs的基因组格局,重点是识别在侵袭性变体中普遍存在的关键分子亚型和相关基因突变。在此,我们讨论分子分类如何与临床结果相关联,并可提高诊断准确性、预测患者预后以及为治疗策略提供依据。解读PDEECs的分子基础已推动了精准肿瘤学的进展,并为患有这些难治性恶性肿瘤的患者带来了长期的治疗缓解。
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