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Personalizing the treatment of patients with advanced endometrial cancer through artificial intelligence, machine learning and genomics to improve their prognosis is the goal pursued by a trans-European project from the oncology area of the Biomedical Research Center Network (CIBERONC), coordinated by Dr. Gema Moreno-Bueno, head of the Translational Research Laboratory at MD Anderson Cancer Center Foundation Spain, and Dr. Laura Muinelo from the Santiago de Compostela Hospital Complex as manager. The project started on February 1 and about 300 patients will participate over a period of three years. The aim is to generate a clinically useful algorithm (ECLAI) to predict the therapeutic response and risk of relapse in patients.
Endometrial cancer is the most common gynecological tumor in developed countries, with around 7,000 cases diagnosed a year in Spain, and the mutations of this cancer show a high degree of heterogeneity, which makes its treatment difficult. “When endometrial cancer is diagnosed confined within the uterus, the prognosis is very good: surgery and radiotherapy. The problem is when the disease spreads outside the uterus. In that case, patients are considered high risk, and their response rate to treatment is lower. This is the focus of our study since they are patients with a greater risk of relapse and of developing metastasis”, states the researcher, and at present their treatment window is small, therefore, their life expectancy and quality of life is significantly reduced. 
The project applies personalized medicine since it is expected that as such, each patient will be treated individually and that we will have data that predicts the evolution of the disease. “From the moment the tumor is diagnosed, a genomic study and follow-up with a liquid biopsy will be carried out to follow the evolution of the mutations. In addition, using a surgical sample, the aim is to generate a pre-clinical model of the tumor on which personalized treatments will be tested with the purpose of being “able to know the best treatment in case the patient relapses”, explains Dr. Moreno-Bueno.
Furthermore, “once all the genetic and clinical characteristics of each of the patients to be included in the study are known, using machine learning and artificial intelligence techniques, an algorithm will be designed to predict treatments that are most suitable for future patients”, explains Dr. Muinelo.
"Each patient is different and, therefore, each patient will be analyzed independently", points out Dr. Moreno-Bueno.
The importance of prevention in endometrial cancer
To date, conventional therapeutic options in the most advanced stages of endometrial cancer have not been shown to be effective and the 5-year survival rate drops from 90% to 17%1 when the tumor is not diagnosed in its early stages.
"Women should have a full annual check-up and not just go for a mammogram, because we must not lose sight of all the other gynecological cancers: ovary, endometrium and cervix," say the researchers. “And more so as time goes by, since the average age at which endometrial cancer is diagnosed is over 501”, points out Dr. Moreno-Bueno.
This trans-European PerMed project, called Personalized Clinical Management of Endometrial Cancer through Liquid Biopsy, Genomics and Artificial Intelligence (ECLAI), will take three years. It will involve three other European research centers in Lublin (Poland), Bergen (Norway) and Tartu (Estonia), in addition to the Spanish CIBERONC, Hospital Complex of Santiago de Compostela and Vall d'Hebron Research Institute.
It should be noted that the Spanish Cancer Association (AECC) and the Carlos III Health Institute are actively participating in this research, as well as the patient groups Association of Patients Affected by Ovarian Cancer and other Gynecological Tumors (ASACO) and the European Association of Patients with Gynecological Cancer (ENGAGe), along with the European Research Network on Endometrial Cancer (ENITEC), who will serve as assessors on the project, while at the same time, a pilot study had already been carried out and which has yielded positive results in a couple of patients.