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Expert Discusses Treatment, Histogenesis of Gynecologic Cancers

Brandon Scalea
Published: Monday, Aug 06, 2018

Jianyu Rao, MD

Jianyu Rao, MD

Pathology in ovarian and endometrial cancer has evolved in recent years, but there is still work to be done, explained Jianyu Rao, MD.

While there is some overlap between endometrial and ovarian cancer, there are some key distinctions in the histogenesis of these tumor types, Rao said. Endometrial cancer can be classified as Type I endometrial tumors or Type II serous cancers. Testing for mismatch repair deficiency (dMMR) and microsatellite instability (MSI), which can be present in endometrial tumors, are recommended to determine whether patients will benefit from PD-1 inhibitor therapy.

For example, pembrolizumab (Keytruda) is the first agent to be FDA approved based only on tumor genetics, not the location of the tumor itself. The PD-1 inhibitor was granted an accelerated approval in May 2017 for the treatment of adult and pediatric patients with unresectable or metastatic, MSI-high (MSI-H) or dMMR solid tumors that have progressed after prior treatment and who have no satisfactory alternative treatment options, as well as for patients with MSI-H or dMMR colorectal cancer following progression on a fluoropyrimidine, oxaliplatin, and irinotecan.

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