Revolutionary Study Shows Molecular Profiling Can Safely Reduce Radiation in Endometrial Cancer Treatment

Endometrial cancer, the most prevalent gynecological malignancy in developed countries, primarily affects women post-menopause. Fortunately, most cases are diagnosed early, allowing for effective treatment outcomes. Traditionally, women at higher risk of recurrence receive adjuvant radiotherapy—particularly vaginal brachytherapy—post-surgery to minimize the chance of cancer returning. However, not all patients benefit equally from this approach, leading to concerns about overtreatment and unnecessary exposure to radiation side effects. Conversely, some patients, who might need more aggressive therapy, are undertreated under current standards.

To address these challenges, researchers have focused on molecular profiling—an advanced technique that examines the genetic and biological traits of tumors—to personalize treatment plans. This method enables clinicians to identify which women with early-stage endometrial cancer are most likely to benefit from radiotherapy, and who can safely avoid it.

The pivotal PORTEC-4a trial, an international study involving 592 women across Europe, provides compelling evidence that molecular profiling can safely reduce the use of radiotherapy without compromising outcomes. The trial classified tumors into risk categories based on genetic and biological markers, guiding treatment decisions accordingly. Results showed that nearly half of the participants could skip radiotherapy entirely—avoiding potential side effects—while still maintaining excellent cancer control.

For women with unfavorable molecular profiles, a more intensive radiation approach, such as pelvic radiotherapy, proved to improve locoregional control, decreasing recurrence rates from 30.5% to 8.4%. Dr. Anne Sophie V.M. van den Heerik of Leiden University Medical Center highlighted that molecular profiling enhances personalized care, allowing clinicians to tailor radiation therapy precisely to each patient’s risk profile.

Prominent experts like Prof Matthias Guckenberger emphasize that this advancement marks a major step in precision oncology. The findings suggest a future where treatment is more effective, less invasive, and keeps side effects to a minimum. The success of the PORTEC-4a trial demonstrates that personalizing therapy based on tumor biology can optimize outcomes for women with endometrial cancer worldwide.

Overall, this research signifies a transformative shift toward tailored cancer treatment, ensuring that each patient receives the most appropriate and least burdensome therapy possible, based on their unique tumor characteristics.