Human epidermal growth factor 2 (HER2) in early stage uterine serous carcinoma: A multi-institutional cohort study

HER2 Testing and Reporting in Endometrial Serous Carcinoma: Practical Recommendations for HER2 Immunohistochemistry and Fluorescent In Situ Hybridization: Proceedings of the ISGyP Companion Society Session at the 2020 USCAP Annual Meeting

Anti-HER2 therapy has recently emerged as an effective targeted treatment approach for patients with advanced stage and recurrent endometrial serous carcinoma, resulting in significantly prolonged progression-free and overall survival when combined with the standard chemotherapy regimen. Consequently, there is an increasing clinical demand in pathology laboratories for HER2 testing of these tumors. This article provides an overview of the unique characteristics of HER2 protein expression and gene amplification in endometrial serous carcinoma and summarizes the HER2 scoring criteria used for patient enrollment in the recent clinical trial. Following the experience of guideline-development in other tumor types, the trial criteria should serve as the basis for future endometrial carcinoma-specific HER2 testing and scoring recommendations, to ensure therapeutic response in new patient cohorts. Thus, based on the clinical trial, the author proposes a specific HER2 testing algorithm for endometrial serous carcinoma to guide the current clinical practice. Future studies are necessary to refine and adjust these criteria to allow for appropriate triaging of patients and maximize the clinical benefit from HER2-targeted therapy.

Uterine serous carcinoma: Molecular features, clinical management, and new and future therapies

Uterine serous carcinoma (USC) is an aggressive subtype of endometrial cancer. Multimodality treatment with surgery, radiotherapy, and chemotherapy is commonly used, given its propensity for extrauterine spread, distant recurrences, and poor prognosis. However, the use of molecularly-based therapy is expanding. Here, we review key molecular features of USC, discuss current management, and assess the landscape of novel therapies and combinations.

Histomolecular features of high-grade endometrial cancers

High-grade endometrial cancers (ECs) are an aggressive subset of ECs accounting for 70-80% of EC-related deaths. Currently, staging surgery, together with chemotherapy or radiotherapy, is the primary treatment strategy for these cancers. The widespread use of next-generation sequencing has led to a refined understanding of EC's genomics with important information for diagnosis and therapy for individual patients (precision medicine). However, advances in the genomics assessment of high-grade tumors have been slower due to their lower incidence than low-grade EC. This article will briefly introduce the current state of knowledge of the genomics of G3 endometrioid EC, serous uterine cancer, clear cell uterine carcinoma and uterine carcinosarcoma and discuss its implications for diagnosis and targeted therapy.