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Clear Cell Endometrial — SCE Medical Oncology MCQ

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HardGynaecological CancersClear Cell EndometrialSCE Medical Oncology

A 55-year-old woman with advanced endometrial clear cell carcinoma (a rare aggressive subtype) progresses on carboplatin-paclitaxel. Her tumour is pMMR/MSS, p53 wild-type. ECOG PS 1. What are the limited options for this specific subtype?

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Correct answer: D — Single-agent chemotherapy (doxorubicin, paclitaxel) or clinical trial — clear cell endometrial cancer has limited response to hormonal therapy and standard immunotherapy (pMMR/MSS)

Clear cell endometrial carcinoma is molecularly and clinically distinct from endometrioid carcinoma: it is typically HER2-negative, ER-negative (limiting hormonal therapy), and often pMMR/MSS (limiting ICI monotherapy). Treatment options after platinum failure are limited to single-agent chemotherapy and clinical trials. Lenvatinib + pembrolizumab has activity in pMMR endometrial cancer but is less effective in clear cell subtype. HER2 testing is worthwhile as some clear cell tumours are HER2-amplified.

Reference: ESMO 2024 Endometrial Cancer Guidelines