Beyond the Update in Advanced/Recurrent Endometrial Cancer: How Evidence Is Shaping New Guidelines Authors: Nicole Concin, MD, PhD; Els Van Nieuwenhuysen, MD, PhD; Xavier Matias-Guiu, MD, PhD

https://www.medscape.org/viewarticle/beyond-update-advanced-recurrent-endometrial-cancer-how-2026a10006up?page=1?src=mkmcmr_reeng_recap_mscpedu_activity&sso=true&uac=148436CN thank you for your recent participation in the activity: Beyond the Update in Advanced/Recurrent Endometrial Cancer: How Evidence Is Shaping New Guidelines Below are some key learning points to help reinforce the impact of this activity. ☑ ESGO–ESTRO–ESP 2025 Guidelines (staging and risk classification) • Guidelines integrated FIGO 2023 staging and molecular classification (POLE, MMR status, P53) to refine risk groups and drive treatment selection ☑ Clinical trials • Four phase 3 trials (RUBY, NRG‑GY018, DUO‑E, AtTEnd) showed adding immune checkpoint inhibitors (ICI) to platinum‑based chemo greatly improves outcomes in dMMR advanced/recurrent endometrial cancer (HRs 0.28–0.42); however, the addition of PARP inhibitors did not offer an increased benefit (RUBY, DUO-E) • ​In non‑dMMR disease, ICI with chemo only provided moderate PFS benefit; adding PARP in maintenance (RUBY Part 2, DUO‑E) further improved PFS (HRs 0.57–0.63) with manageable additional toxicity ☑ ​ESGO–ESTRO–ESP 2025 Guidelines (therapy) • ​Key updated recommendation includes: ◦ ​First‑line dMMR = chemo + ICI, followed by ICI maintenance ◦ ​Non‑dMMR symptomatic disease chemo + ICI ± PARP maintenance ☑ Complete molecular testing should be performed at diagnosis (POLE, MMR IHC, P53 IHC/NGS if ambiguous) and retesting at progression when possible as the results guide treatment decisions