A Real-World Retrospective Observational Study of Patients with Advanced/Recurrent Endometrial Cancer Across England

Journal article

Introduction: 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. Methods: 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). Results: 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. Conclusions: 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.

Authors: Wallis, J; Luhar, S; Tunaru, F; Carpenter, L; Wesselbaum, A

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Oncology and Therapy
• Volume: 13
• Issue: 3
• Pages: 765-781
• Publication date: 2025-08-01
• Acceptance date: 2025-06-20
• DOI: 10.1007/s40487-025-00359-x
• EISSN: 2366-1089
• ISSN: 2366-1070
• Language: English
• Keywords: Chemotherapy; Radiotherapy; Biomarker testing; Real-world data; Endometrial cancer; DNA mismatch repair; Immunotherapy