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Management of Metastatic Endometrial Cancer: Physicians' Choices Beyond the First Line. A MITO Survey.
Giannone, Gaia; Castaldo, Daniele; Tuninetti, Valentina; Scotto, Giulia; Turinetto, Margherita; Valsecchi, Anna Amela; Bartoletti, Michele; Mammoliti, Serafina; Artioli, Grazia; Mangili, Giorgia; Salutari, Vanda; Lorusso, Domenica; Cormio, Gennaro; Zamagni, Claudio; Savarese, Antonella; Di Maio, Massimo; Ronzino, Graziana; Pisano, Carmela; Pignata, Sandro; Valabrega, Giorgio.
  • Giannone G; Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.
  • Castaldo D; Department of Oncology, University of Turin, Turin, Italy.
  • Tuninetti V; Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
  • Scotto G; Segreteria Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) Group, Naples, Italy.
  • Turinetto M; Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.
  • Valsecchi AA; Department of Oncology, University of Turin, Turin, Italy.
  • Bartoletti M; Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.
  • Mammoliti S; Department of Oncology, University of Turin, Turin, Italy.
  • Artioli G; Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.
  • Mangili G; Department of Oncology, University of Turin, Turin, Italy.
  • Salutari V; Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.
  • Lorusso D; Department of Oncology, University of Turin, Turin, Italy.
  • Cormio G; Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
  • Zamagni C; Ospedale Policlinico San Martino - Department of Medical Oncology 1- L.go Rosanna Benzi, IRCCS, Genoa, Italy.
  • Savarese A; Oncologia Medica, Unità locale socio sanitaria n2 (ULSS2) Marca Trevigiana, Treviso, Italy.
  • Di Maio M; Obstet-Gynecol Department, San Raffaele Scientific Institute, IRCCS, Milan, Italy.
  • Ronzino G; Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
  • Pisano C; Department of Life Science and Public Health, Catholic University of Sacred Heart Largo Agostino Gemelli, and Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
  • Pignata S; Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy.
  • Valabrega G; Azienda Ospedaliero-universitaria di Bologna, IRCCS, Bologna, Italy.
Front Oncol ; 12: 880008, 2022.
Article in English | MEDLINE | ID: covidwho-1896725
ABSTRACT

Background:

Endometrial cancer (EC) therapeutic and diagnostic approaches have been changed by the development of a new prognostic molecular classification, the introduction of dostarlimab in microsatellite instability (MSI) high pre-treated advanced EC patients with further expected innovation deriving from lenvatinib plus pembrolizumab regardless MSI status. How this is and will be translated and embedded in the clinical setting in Italy is not known; this is why we developed Multicentre Italian Trials in Ovarian cancer and gynaecologic malignancies (MITO) survey on the current practice and expected future changes in EC.

Methods:

We designed a self-administered, multiple-choice online questionnaire available only for MITO members for one month, starting in April 2021.

Results:

75.6% of the respondents were oncologists with a specific focus on gynaecologic malignancies and 73.3% of the respondents declared the availability of clinical trials in second line treatment for advanced EC. The therapeutic algorithm in second line was heterogeneous, being the most frequent choice administering anthracyclines followed by endocrine therapy or enrolling in clinical trials. While more than half of the clinicians declared that they performed the molecular classification, only six/45 respondents (13.3%) ran all the tests needed for it. On the other hand, 80% of them declared regular assessment of MSI status with IHC as recommended. The therapeutic approach in MSI high advanced EC patients has changed since dostarlimab approval. Indeed the most frequent choice in second line has been chemotherapy (53.3%) before its availability, while dostarlimab has been preferred in more than three-fourths of the cases (75.6%) after its approval. As for MSS patients, 77.8% of clinicians would choose lenvatinib plus pembrolizumab for them in second line once approved.

Conclusions:

Despite the selected sample of respondents from Italian MITO centres showing good knowledge of diagnostic and therapeutic innovations in EC, these are not fully implemented in everyday clinics, except for MSI status assessment.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Observational study / Prognostic study Language: English Journal: Front Oncol Year: 2022 Document Type: Article Affiliation country: Fonc.2022.880008

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Observational study / Prognostic study Language: English Journal: Front Oncol Year: 2022 Document Type: Article Affiliation country: Fonc.2022.880008