Real-world (rw) patient characteristics, treatment (tx) patterns, and clinical outcomes in advanced (adv) and recurrent (rec) endometrial cancer (EC) patients (pts) with known mismatch repair/microsatellite instability (MMR/MSI) status in Canada.
Notice bibliographique
Résumé
e23308 Background: Molecular characterization and treatments for adv/rec EC have evolved in recent years. Given limited biomarker-based data on EC reported in Canada, this rw study examined tx patterns and clinical outcomes in pts with adv/rec EC by MMR/MSI status. Methods: This retrospective study used de-identified patient chart data reported by Canadian physicians. Adult female pts included were diagnosed with adv (Stage III/IV) or rec (Stage I/II with advanced recurrence) EC from 01-01-2017 to 31-12-2022 with ≥2 clinical visits and underwent MMR/MSI testing. Follow-up was until 30-09-2024. Patient characteristics, tx patterns and clinical outcomes were descriptively analyzed for the overall cohort and MMR deficient (dMMR/MSI-H) and MMR proficient (pMMR/MSS) subgroups. Kaplan-Meier analyses estimated overall survival (OS) and progression-free survival (PFS) starting from first-line (1L) tx initiation. Results: 209 pts diagnosed with adv (79.4%) or rec (20.6%) EC were included. The pMMR/MSS and dMMR/MSI-H subgroups comprised of 67.5% and 32.5% of the cohort, respectively. The mean age was 63.6 years (range: 33-86), 54.5% had no comorbidities, 54.5% had BMI ≥30, 71.8% were ECOG performance status 0, and most common histology was endometrioid EC (58.9%). Only 44.0% of pts had MMR testing within 1 month of diagnosis (dx). Besides MMR, most common tested biomarkers were p53 (77.5%), estrogen receptor (73.7%) and progesterone receptor (58.4%). Of the 209 pts, 178 (85.2%) received tx, of which, 120 (67.4%) only received 1L tx. Mean duration of follow-up from 1L initiation was 30.0 months (SD: 20.0). Median time from dx to 1L was 4.1 months (IQR: 2.3-6.1). Pts spent an average of 4.0 months (SD: 4.5) on 1L and 5.8 months (SD: 5.5) on second-line (2L). Most common 1L tx among both subgroups was chemotherapy (CT) (90.2% in pMMR/MSS, 91.1% in dMMR/MSI-H) with carboplatin + paclitaxel as most common regimen. In 2L, most common tx in pMMR/MSS pts after CT (59.1%) was hormone therapy (HT) (15.9%), whereas in dMMR/MSI-H pts it was immunotherapy (IO) (50.0%) then HT (35.7%). Table shows rw survival outcomes. Conclusions: This multi-province study provides the first rw Canadian data in MMR/MSI profiled EC cohort. CT was the most common 1L tx irrespective of MMR/MSI status and in 2L, half of dMMR/MSI-H pts received IO while most pMMR/MSS pts received CT. While MMR/MSI testing is standard in Canada, faster turnaround times at dx may improve access to novel therapies, especially in pMMR/MSS pts who had slightly worse survival outcomes than dMMR/MSI-H pts. EC group n OS PFS 1 year (yr) 2 yr 3 yr 1 yr 2 yr 3 yr Overall pMMR/MSS 122 81.4% 71.5% 66.2% 62.9% 51.1% 45.1% Adv. 105 83.4% 74.3% 68.7% 67.0% 53.9% 47.3% Rec. 17 69.1% 50.4% 50.4% 35.6% 35.6% 35.6% dMMR/MSI-H 56 83.4% 75.3% 73.1% 61.1% 61.1% 58.9%
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».