{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:50:51Z","timestamp":1790351451640,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    In this study, we identified prognostic biomarkers that predict treatment outcome in patients receiving fertility\u2010preserving high\u2010dose medroxyprogesterone acetate (MPA) therapy through comprehensive multigene panel testing. A total of 38 patients (20 atypical endometrial hyperplasia and 18 stage IA G1 without myometrial invasion) who received first\u2010line MPA therapy were enrolled. Genomic DNA was extracted from formalin\u2010fixed paraffin\u2010embedded samples, and PleSSision\u2010Rapid multigene panel testing was performed. Of the 38 patients, 31 (82%) achieved complete response (CR), 2 (5%) had stable disease (SD), and 5 (13%) had progressive disease (PD) following initial treatment. The median duration to achieve tumor disappearance was 7\u2009months (range: 4\u201314\u2009months). Following initial treatment, 25 of 32 patients (78%) experienced recurrence, with a median recurrence\u2010free survival (RFS) of 21\u2009months (range: 2\u201384\u2009months). The most frequently observed actionable gene mutations were\n                    <jats:italic>PTEN<\/jats:italic>\n                    (68.4%),\n                    <jats:italic>CTNNB1<\/jats:italic>\n                    (55.2%), and\n                    <jats:italic>PIK3CA<\/jats:italic>\n                    (33.3%). Patients harboring\n                    <jats:italic>PTEN<\/jats:italic>\n                    mutations in EMG1 required a significantly longer duration to achieve tumor disappearance (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.011). In addition, the presence of\n                    <jats:italic>PIK3CA<\/jats:italic>\n                    mutations in AEH was significantly associated with shorter RFS (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.048). Molecular classification identified 34 patients (89%) with no specific molecular profile (NSMP), 1 patient (3%) with POLE mutation, and 3 patients (8%) with deficient mismatch repair (d\u2010MMR). Most patients undergoing MPA therapy were classified as having NSMP. Genetic alterations, specifically mutations in\n                    <jats:italic>PTEN<\/jats:italic>\n                    and\n                    <jats:italic>PIK3CA<\/jats:italic>\n                    , were significantly associated with treatment outcomes, highlighting their potential as prognostic biomarkers.\n                  <\/jats:p>","DOI":"10.1111\/cas.70240","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T07:03:09Z","timestamp":1762758189000},"page":"236-245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic Biomarker of Fertility\u2010Preserving Hormonal Therapy Based on Multigene Panel Testing for Endometrial Cancer"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1175-1614","authenticated-orcid":false,"given":"Takuro","family":"Hirano","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Keio University School of Medicine  Tokyo Japan"},{"name":"Department of Obstetrics &amp; Gynecology, Saiseikai Yokohamashi Tobu Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1406-086X","authenticated-orcid":false,"given":"Kensuke","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9919-1692","authenticated-orcid":false,"given":"Takuma","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8214-2242","authenticated-orcid":false,"given":"Tatsuyuki","family":"Chiyoda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5162-7132","authenticated-orcid":false,"given":"Kohei","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Genomics Unit, Keio Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2749-654X","authenticated-orcid":false,"given":"Eriko","family":"Aimono","sequence":"additional","affiliation":[{"name":"Genomics Unit, Keio Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0353-4246","authenticated-orcid":false,"given":"Miho","family":"Kawaida","sequence":"additional","affiliation":[{"name":"Surgical Pathology, Ito Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5460-8703","authenticated-orcid":false,"given":"Hiroshi","family":"Nishihara","sequence":"additional","affiliation":[{"name":"Genomics Unit, Keio Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3537-7161","authenticated-orcid":false,"given":"Nobuyuki","family":"Susumu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology International University of Health and Welfare Narita Hospital  Narita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9596-8326","authenticated-orcid":false,"given":"Daisuke","family":"Aoki","sequence":"additional","affiliation":[{"name":"Akasaka Sannou Medical Center  Minato Japan"},{"name":"International University of Health and welfare Graduate School  Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3925-6057","authenticated-orcid":false,"given":"Wataru","family":"Yamagami","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; 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