Dr Pothuri on Open Questions and the Future of Endometrial Cancer Care

Bhavana Pothuri, MD, discusses the TroFuse-005 study (NCT06132958) of sacituzumab govitecan (sac-TMT) presented at ESMO 2026 and the questions the field still needs to sort out as the treatment landscape for endometrial cancer continues to grow and evolve. She notes that this will be the first antibody-drug conjugate (ADC) to enter the endometrial cancer landscape and the first TROP2-directed ADC in all of gynecologic oncology, which makes the data especially important for clinicians and patients.

Among the open questions, Pothuri asks whether TROP2 expression matters and whether patients with high expression derive better efficacy than those with low expression. She also wonders whether the same efficacy will be seen in earlier lines of therapy vs later lines, and whether the treatment will remain effective when given after another ADC.

Looking ahead to the next 5 to 10 years, Pothuri expresses excitement and hope for patients. She emphasizes that endometrial cancer is not one disease; there are 4 molecular subtypes, and each likely needs to be addressed in its own way. She points to hormonal therapy and combination hormonal strategies, such as a CDK4/6 inhibitor with a hormonal agent; further study of the PI3K pathway, where inhibitors remain of interest despite historical toxicity limits; and combinations that include bispecific antibodies and T-cell engagers. She believes this is just the start, and that an effective new treatment option will be incorporated into guidelines and prove practice changing.

Pothuri concludes that this is just the start, with more advances to come in a disease that has been very challenging. She says the progress gives everyone hope and that there is now an effective treatment option, which she expects will be incorporated into guidelines and prove practice changing. With so many new therapies emerging, she sees the field moving toward approaches tailored to each molecular subtype of endometrial cancer.