Uterine carcinosarcoma
Prepared with OnCo (onco.cc/prep/uterine-carcinosarcoma/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
16 on the sheet- 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 p53 immunohistochemistry, HER2 immunohistochemistry and in situ hybridisation, MMR immunohistochemistry, POLE, Percentage of sarcomatous component and heterologous elements), 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?
- 5.For my situation (surgery), which of the standard options do you recommend and why?
- 6.For my situation (adjuvant, all stages), which of the standard options do you recommend and why?
- 7.Am I a candidate for Carboplatin, Paclitaxel / nab-paclitaxel, Ifosfamide, and what side effects should I expect?
- 8.How do the results of PORTEC-3 apply to someone like me?
- 9.For my situation (advanced or recurrent), which of the standard options do you recommend and why?
- 10.Am I a candidate for Dostarlimab, Trastuzumab deruxtecan, Lenvatinib or related drugs, and what side effects should I expect?
- 11.How do the results of RUBY / ENGOT-EN6 / GOG-3031 and DESTINY-PanTumor02 apply to someone like me?
- 12.Are there clinical trials I could join, for example of Trastuzumab deruxtecan, Dostarlimab, WEE1, ATR?
- 13.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 14.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 15.I read that “No dedicated randomised trials for a tumour that behaves worse than the serous cancers it is grouped with”. How does that affect my plan?
- 16.I read that “Whether the sarcomatous component needs different drugs”. How does that affect my plan?
The words I may hear
- Hysterectomy: Removing the uterus (womb), often with the cervix, tubes and ovaries.
Tests and results to bring
Biomarker results to ask for: p53 immunohistochemistry (abnormal in most), HER2 immunohistochemistry and in situ hybridisation, MMR immunohistochemistry (deficient in a minority), POLE (rare, favourable), Percentage of sarcomatous component and heterologous elements, CA-125.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Surgery: Hysterectomy with bilateral salpingo-oophorectomy, sentinel node mapping or lymphadenectomy, and omental sampling. (Hysterectomy, Sentinel lymph node biopsy, Robotic & minimally invasive surgery)
- Adjuvant, all stages: Carboplatin-paclitaxel (GOG-0261), with pelvic radiotherapy and vaginal brachytherapy for stage I to III disease with risk factors; ifosfamide-paclitaxel is the older alternative. (Carboplatin, Paclitaxel / nab-paclitaxel, Ifosfamide, IMRT / IGRT (modern external beam), Brachytherapy, PORTEC-3)
- Advanced or recurrent: Carboplatin-paclitaxel with dostarlimab (RUBY included carcinosarcoma); trastuzumab deruxtecan for HER2-expressing disease; lenvatinib-pembrolizumab after platinum. (Dostarlimab, RUBY / ENGOT-EN6 / GOG-3031, Trastuzumab deruxtecan, DESTINY-PanTumor02, HER2, Lenvatinib, Pembrolizumab)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.