ESR1 mutation in untreated EC: prevalence, characteristics and prognosis from the UTOLA trial 

Felix Blanc-Durand, MD, Institut Gustave Roussy, Villejuif, France, discusses his talk on the translational project within the Phase IIb UTOLA trial investigating olaparib versus placebo as maintenance therapy after platinum-based chemotherapy in patients with advanced/metastatic endometrial cancer. The translational project aimed to explore the prevalence and characteristics of ESR1 mutations in patients with endometrial cancer. Among 147 included patients, sequencing was completed for 135, revealing ESR1 mutations in eight cases. Intriguingly, these mutations were found exclusively in low-grade endometrial histology tumors with high estrogen and progesterone expression. All ESR1-mutated cases exhibited p53 wildtype and MMR profiles. While ESR1 mutations were present in only 5% of the overall cohort, they were significantly more prevalent (22%) in low-grade endometrial cancers. The study concludes that ESR1 mutations, frequently found in patients likely to benefit from aromatase inhibitors, indicate that these patients might not respond well to such treatment, necessitating the development of more effective therapeutic strategies. This interview took place at the ESMO Gynaecological Cancers Congress 2024 in Florence, Italy.
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