Endometrial Cancer — SCE Medical Oncology MCQ

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ModerateGynaecological CancersEndometrial CancerSCE Medical Oncology

A 65-year-old woman with metastatic endometrial cancer (pMMR, p53-mutant, copy-number high) has progressed on first-line carboplatin-paclitaxel-pembrolizumab and second-line lenvatinib-pembrolizumab. She is ECOG PS 1. What treatment options remain?

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Correct answer: D — Doxorubicin (single agent) or clinical trial

After progression on platinum-based chemo-immunotherapy and lenvatinib-pembrolizumab, options for pMMR endometrial cancer are limited. Single-agent doxorubicin or paclitaxel are reasonable third-line options. Hormonal therapy (medroxyprogesterone, tamoxifen) can be considered for ER-positive disease with slow progression. Clinical trial enrolment should always be discussed. The p53-mutant subgroup has the worst prognosis and limited responses to available therapies, highlighting the need for novel approaches.

Reference: ESMO 2024 Endometrial Cancer Guidelines