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Methods: Retrospectively reviewed 12 MSI-high endometrial cancer patients treated with pembrolizumab, stratified by MLH1 methylation analysis and Amsterdam Criteria into MLH1-hypermethylated, Lynch-like syndrome-associated, and Lynch syndrome-associated groups; efficacy evaluated using RECIST v1.1. Results: Response rates differed, and EPM2AIP1 IHC showed high sensitivity but limited specificity. Conclusion: Pembrolizumab may be more effective in Lynch-like and Lynch syndrome-associated 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were MSI-high endometrial cancer patients grouped in the study?","Question",{"text":63,"@type":64},"Patients were categorized into three groups based on MLH1 methylation analysis and the Amsterdam Criteria: MLH1 hypermethylated (sporadic), Lynch-like syndrome-associated, and Lynch syndrome-associated.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What outcome measure was used to evaluate pembrolizumab efficacy?",{"text":68,"@type":64},"Efficacy was evaluated using the response rate according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.",{"name":70,"@type":61,"acceptedAnswer":71},"What did the study find about EPM2AIP1 immunohistochemistry for MLH1 methylation?",{"text":72,"@type":64},"EPM2AIP1 IHC showed 100% sensitivity and a 66.7% positive predictive value for MLH1 methylation, suggesting it may be useful to rule out MLH1-methylation cases despite lower predictive power than methylation analysis.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},336991,1790033767,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":123,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144},1374391974468,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","J Gynecol Oncol. 2024 Nov;35(6):e103 [https://doi.org/10.3802/jgo.2024.35.e103](https://doi.org/10.3802/jgo.2024.35.e103)[ ](https://doi.org/10.3802/jgo.2024.35.e103)pISSN 2005-0380·eISSN 2005-0399  \nOriginal Article  \nReceived: Jan 26, 2024  \nRevised: Apr 3, 2024  \nAccepted: Apr 15, 2024  \nPublished online: May 1, 2024  \nCorrespondence to  \nTadaaki Nishikawa  \nDepartment of Medical Oncology, National Cancer Center, 5-1-1, Chuo-ku, Tokyo 104- 0045, Japan.  \nEmail: [tnishika@ncc.go.jp](tnishika@ncc.go.jp)  \n© 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://](https://)[ ](https://)[creativecommons.org/licenses/by-nc/4.0/](creativecommons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nORCID iDs  \nRisako Ozawa  [https://orcid.org/0000-0002-4722-2845](https://orcid.org/0000-0002-4722-2845)[ ](https://orcid.org/0000-0002-4722-2845)Tadaaki Nishikawa  [https://orcid.org/0000-0003-2606-4208](https://orcid.org/0000-0003-2606-4208)[ ](https://orcid.org/0000-0003-2606-4208)Hiroshi Yoshida  [https://orcid.org/0000-0002-7569-7813](https://orcid.org/0000-0002-7569-7813)[ ](https://orcid.org/0000-0002-7569-7813)Kouya Shiraishi  [https://orcid.org/0000-0002-5821-7400](https://orcid.org/0000-0002-5821-7400)[ ](https://orcid.org/0000-0002-5821-7400)Tatsunori Shimoi  [https://orcid.org/0000-0002-3603-8575](https://orcid.org/0000-0002-3603-8575)[ ](https://orcid.org/0000-0002-3603-8575)Tomoyasu Kato  [https://orcid.org/0000-0001-9561-1522](https://orcid.org/0000-0001-9561-1522)[ ](https://orcid.org/0000-0001-9561-1522)KanYonemori  [https://orcid.org/0000-0002-7624-7611](https://orcid.org/0000-0002-7624-7611)  \nUnveiling pembrolizumab effectiveness in diverse subtypes of MSI-high endometrial cancers  \nRisako Ozawa ,1 Tadaaki Nishikawa ,2 Hiroshi Yoshida ,3 Kouya Shiraishi ,4 Tatsunori Shimoi ,2 Tomoyasu Kato ,1 Kan Yonemori  2  \n1Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan 2Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan 3Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan 4Division of Genome Biology, National Cancer Center Research Institute, Tokyo, Japan  \nABSTRACT  \nObjective: The efficacy of pembrolizumab in patients with microsatellite instability (MSI) -high cancers has been reported; however, the differences in efficacy according to the subtypes of MSI-high endometrial cancers (ECs) remain unclear. MSI-high ECs are classified into at least 3 groups based on their molecular characteristics: MLH1 hypermethylated, Lynch-like syndrome (LLS)-associated, and Lynch syndrome (LS)-associated cancers. This study aimed to investigate whether the efficacy of pembrolizumab differs among these 3 groups, and if so, whether EPM2AIP1 immunohistochemistry (IHC), which correlates with MLH1 promoter methylation, can be used to rule out MLH1methylation cases.  \nMethods: This study included 12 patients with MSI-high EC who received pembrolizumab treatment. Patients were categorized into 3 groups based on MLH1methylation analysis and the Amsterdam Criteria: MLH1hypermethylated (sporadic [SP]), LLS-associated, and LS-associated. Patients’ medical records were retrospectively reviewed, and the efficacy of treatment was evaluated based on the response rate using the Response Evaluation Criteria in Solid Tumors version 1.1.  \nResults: The overall response rate was 75%(3/4) in the SP group, while it was 100% including one complete response patient in the LLS-associated and the LS-associated group, respectively. The sensitivity and positive predictive value of EPM2AIP1 IHC for MLH1 methylation were 100% and 66.7%, respectively.  \nConclusion: Pembrolizumab may b","cbCaicxLanIASVqp","https://ap.wps.com/l/cbCaicxLanIASVqp","pdf",4982518,"English","# Abstract\n## Objective\n## Methods\n## Results\n## Conclusion\n# Synopsis\n# Funding\n# Presentation\n# Conflict of Interest","[{\"question\":\"How were MSI-high endometrial cancer patients grouped in the study?\",\"answer\":\"Patients were categorized into three groups based on MLH1 methylation analysis and the Amsterdam Criteria: MLH1 hypermethylated (sporadic), Lynch-like syndrome-associated, and Lynch syndrome-associated.\"},{\"question\":\"What outcome measure was used to evaluate pembrolizumab efficacy?\",\"answer\":\"Efficacy was evaluated using the response rate according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.\"},{\"question\":\"What did the study find about EPM2AIP1 immunohistochemistry for MLH1 methylation?\",\"answer\":\"EPM2AIP1 IHC showed 100% sensitivity and a 66.7% positive predictive value for MLH1 methylation, suggesting it may be useful to rule out MLH1-methylation cases despite lower predictive power than methylation analysis.\"}]","Unveiling pembrolizumab effectiveness in diverse subtypes of MSI-high endometrial cancers | PDF",1790017339,25]