Wallis Jamie, Luhar Shammi, Tunaru Filipa, Carpenter Lewis, Wesselbaum Anthony, Schneider Dirk, Heffernan Kiera, Mascialino Barbara, Graham Kathryn, Tookman Laura, Roux Rene, Ang Joo Ern
Arcturis Data, Oxford Technology Park, Building One, Technology Drive, Kidlington, Oxfordshire, OX5 1GN, UK.
GSK, London, UK.
Oncol Ther. 2025 Sep;13(3):765-781. doi: 10.1007/s40487-025-00359-x. Epub 2025 Aug 1.
Robust real-world data (RWD) on endometrial cancer (EC) are lacking. In the United Kingdom (UK), molecular classification of EC based on tumour mismatch repair (MMR) status, either MMR-deficient (dMMR) or MMR-proficient (MMRp), has been recommended at diagnosis since 2020. This study characterised patients with advanced/recurrent EC, documented treatment pathways and evaluated clinical outcomes stratified by MMR status using RWD from National Health Service (NHS) trusts in England.
This retrospective, observational study captured electronic health records (EHRs) from seven NHS trusts from 2000 to 2023. Clinical outcomes included overall survival (OS) and time to next treatment (TTNT).
Data were retrieved from 731 patients with EC (79% advanced, 21% recurrent). Overall, 56.63% of patients received systemic treatment; most received platinum-based chemotherapy in first line (1L). MMR status was identified for 166 patients, with 25.30% being dMMR. Overall, 1L median TTNT was 1.22 years (95% confidence interval [CI] 1.02-1.37). Median OS from the start of 1L was 1.80 years (95% CI 1.59-2.16) in the whole cohort, 4.25 years (95% CI 1.67-not reached [NR]) in the dMMR group, 2.36 years (95% CI 2.10-2.36) in the MMRp group and 1.64 years (95% CI 1.32-1.98) in the unknown MMR group.
Although interpretation is hampered by small sample sizes, this analysis is suggestive of a difference in outcomes between MMR subgroups, underlining the importance of biomarker testing for patients with EC. Historic recording of MMR status was low; consistent testing and improvements in linking EHRs to biomarker data are needed to examine the relationship between outcomes and MMR status.
目前缺乏关于子宫内膜癌（EC）的可靠真实世界数据（RWD）。在英国，自2020年起，建议在诊断时根据肿瘤错配修复（MMR）状态对EC进行分子分类，即错配修复缺陷（dMMR）或错配修复 proficient（MMRp）。本研究对晚期/复发性EC患者进行了特征分析，记录了治疗路径，并使用来自英格兰国民健康服务（NHS）信托机构的RWD评估了按MMR状态分层的临床结局。
这项回顾性观察研究收集了2000年至2023年期间七个NHS信托机构的电子健康记录（EHR）。临床结局包括总生存期（OS）和下次治疗时间（TTNT）。
从731例EC患者中检索到数据（79%为晚期，21%为复发性）。总体而言，56.63%的患者接受了全身治疗；大多数患者一线（1L）接受铂类化疗。确定了166例患者的MMR状态，其中25.30%为dMMR。总体而言，1L的中位TTNT为1.22年（95%置信区间[CI]1.02 - 1.37）。整个队列从1L开始的中位OS为1.80年（95%CI 1.59 - 2.16），dMMR组为4.25年（95%CI 1.67 - 未达到[NR]），MMRp组为2.36年（95%CI 2.10 - 2.36），未知MMR组为1.64年（CI 1.32 - 1.98）。
尽管由于样本量小而妨碍了解释，但该分析表明MMR亚组之间的结局存在差异，强调了对EC患者进行生物标志物检测的重要性。MMR状态的历史记录较低；需要持续进行检测并改进将EHR与生物标志物数据的关联，以研究结局与MMR状态之间的关系。
