Appointment sheet
Advanced or recurrent endometrial cancer
Prepared with OnCo (onco.cc/prep/advanced-recurrent-endometrial-cancer/). Orientation, not medical advice; your team knows your case.
My details
Name
Date of appointment
Hospital and clinician
Who is coming with me
What I know, what is unclear, changes to discuss
Saved in this browserWhat I know so far
What is unclear to me
Changes since last time
My questions
21 on the sheetNewly diagnosed
- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example MMR and MSI status, p53 and POLE, HER2 immunohistochemistry, Oestrogen and progesterone receptors, PD-L1), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
First line, dMMR
- 5.For my situation (first line, dmmr), which of the standard options do you recommend and why?
- 6.Am I a candidate for Dostarlimab, Pembrolizumab, Carboplatin or related drugs, and what side effects should I expect?
- 7.How do the results of RUBY / ENGOT-EN6 / GOG-3031 and NRG-GY018 / KEYNOTE-868 apply to someone like me?
First line, pMMR
- 8.For my situation (first line, pmmr), which of the standard options do you recommend and why?
- 9.Am I a candidate for Pembrolizumab, Dostarlimab, Durvalumab or related drugs, and what side effects should I expect?
- 10.How do the results of DUO-E / GOG-3041 / ENGOT-EN10 apply to someone like me?
After platinum, pMMR
- 11.For my situation (after platinum, pmmr), which of the standard options do you recommend and why?
- 12.Am I a candidate for Lenvatinib, Pembrolizumab, Trastuzumab deruxtecan or related drugs, and what side effects should I expect?
- 13.How do the results of KEYNOTE-775 / Study 309 and DESTINY-PanTumor02 apply to someone like me?
After platinum, dMMR without prior immunotherapy
- 14.For my situation (after platinum, dmmr without prior immunotherapy), which of the standard options do you recommend and why?
- 15.Am I a candidate for Dostarlimab, Pembrolizumab, and what side effects should I expect?
Isolated pelvic recurrence
- 16.For my situation (isolated pelvic recurrence), which of the standard options do you recommend and why?
Any stage
- 17.Are there clinical trials I could join, for example of Sacituzumab tirumotecan, Rinatabart sesutecan, RAINFOL-01 (Rina-S), Trastuzumab deruxtecan?
- 18.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 19.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 20.I read that “What to give after progression on first-line immunotherapy”. How does that affect my plan?
- 21.I read that “The small benefit and real toxicity of immunotherapy in proficient tumours”. How does that affect my plan?
The words I may hear
- Radiotherapy: Using high-energy X-rays or particles to damage the DNA of cancer cells in a precisely aimed volume of the body.
- Microsatellite-stable (MSS) / mismatch-repair proficient (pMMR): The 'normal' result on the mismatch-repair test: the tumour has intact DNA spell-checking and few mutations.
- Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR): Microsatellite instability is the mark of a broken DNA spell-checker (loss of MLH1, MSH2, MSH6 or PMS2) that leaves thousands of mutations, so the tumour displays abnormal proteins that T cells can recognise.
Tests and results to bring
Biomarker results to ask for: MMR and MSI status (drives the size of immunotherapy benefit), p53 and POLE (molecular class), HER2 immunohistochemistry (trastuzumab deruxtecan), Oestrogen and progesterone receptors (endocrine therapy), PD-L1 (not required), TROP2 and folate receptor alpha (antibody-drug conjugate trials), CA-125 for monitoring.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- First line, dMMR: Carboplatin-paclitaxel with dostarlimab (RUBY) or pembrolizumab (NRG-GY018), then maintenance immunotherapy for up to three years or two years respectively. (Dostarlimab, Pembrolizumab, Carboplatin, Paclitaxel / nab-paclitaxel, RUBY / ENGOT-EN6 / GOG-3031, NRG-GY018 / KEYNOTE-868, Chemotherapy + PD-1/PD-L1 blockade, first-line advanced endometrial cancer, Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR))
- First line, pMMR: Carboplatin-paclitaxel with pembrolizumab or dostarlimab, or durvalumab followed by durvalumab-olaparib maintenance (DUO-E); trastuzumab added for HER2-positive serous carcinoma. (Pembrolizumab, Dostarlimab, Durvalumab, Olaparib, DUO-E / GOG-3041 / ENGOT-EN10, Trastuzumab, Microsatellite-stable (MSS) / mismatch-repair proficient (pMMR))
- Isolated pelvic recurrence: Radiotherapy with brachytherapy for vaginal recurrence after surgery alone; exenteration in selected central recurrences after radiotherapy. (IMRT / IGRT (modern external beam), Brachytherapy, Radiotherapy)
- After platinum, pMMR: Lenvatinib with pembrolizumab (KEYNOTE-775); trastuzumab deruxtecan for HER2-expressing tumours; aromatase inhibitors or progestins for low-grade receptor-positive disease. (Lenvatinib, Pembrolizumab, KEYNOTE-775 / Study 309, Trastuzumab deruxtecan, DESTINY-PanTumor02, Letrozole (and other aromatase inhibitors), Progestins (megestrol acetate, medroxyprogesterone, levonorgestrel IUD))
- After platinum, dMMR without prior immunotherapy: Single-agent dostarlimab or pembrolizumab. (Dostarlimab, Pembrolizumab, Immune checkpoint inhibitors)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.
Answers and next steps
Saved in this browserWhat I was told
Agreed next steps, dates and who to call