{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:06:50Z","timestamp":1789103210641,"version":"build-2803163510"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lynch syndrome-associated endometrial cancer (LS-EC) presents unique challenges for fertility preservation. Conventional progestin-based therapy may be less effective in mismatch repair-deficient (MMRd) tumors, whereas immune checkpoint inhibitors (ICIs) have shown promising activity. Meanwhile, preimplantation genetic testing for monogenic disorders (PGT-M) offers a way to prevent hereditary transmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A woman was initially diagnosed with complex atypical hyperplasia at age 28 and subsequently developed presumed FIGO 2009 stage IA endometrial cancer (EC) associated with a germline pathogenic variant in\n                      <jats:italic>MSH2<\/jats:italic>\n                      . After failing to achieve complete response (CR) following prolonged progestin therapy, she received multimodal fertility-sparing treatment comprising a programmed cell death protein 1 (PD-1) inhibitor (sintilimab 200 mg, 9 cycles) in combination with leuprorelin acetate and a levonorgestrel-releasing intrauterine system. This multimodal regimen achieved CR. After sustained remission was confirmed, PGT-M was performed and transfer of an embryo free of the familial pathogenic variant resulted in a healthy live birth.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case illustrates the feasibility of integrating immunotherapy-containing fertility-sparing treatment with PGT-M to achieve sustained oncologic control while preventing hereditary transmission in carefully selected patients with LS-EC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1942599","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:30:12Z","timestamp":1789101012000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Immunotherapy-containing fertility-sparing treatment integrated with preimplantation genetic testing resulting in live birth in Lynch syndrome-associated endometrial cancer"],"prefix":"10.3389","volume":"16","author":[{"given":"Yannan","family":"Zhao","sequence":"first","affiliation":[{"name":"Shenyang Clinical Medical Research Center for Assisted Reproduction, Shenyang Women\u2019s and Children\u2019s Hospital","place":["Shenyang, China"]},{"name":"Liaoning Key Laboratory of Assisted Reproduction","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhao","sequence":"additional","affiliation":[{"name":"Key Laboratory of Environmental Stress and Chronic Disease Control and Prevention, Ministry of Education, China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Hu","sequence":"additional","affiliation":[{"name":"Shenyang Clinical Medical Research Center for Assisted Reproduction, Shenyang Women\u2019s and Children\u2019s Hospital","place":["Shenyang, China"]},{"name":"Liaoning Key Laboratory of Assisted Reproduction","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Guo","sequence":"additional","affiliation":[{"name":"Shenyang Clinical Medical Research Center for Assisted Reproduction, Shenyang Women\u2019s and Children\u2019s Hospital","place":["Shenyang, China"]},{"name":"Liaoning Key Laboratory of Assisted Reproduction","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shenyang Clinical Medical Research Center for Assisted Reproduction, Shenyang Women\u2019s and Children\u2019s Hospital","place":["Shenyang, China"]},{"name":"Liaoning Key Laboratory of Assisted Reproduction","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuaishuai","family":"Guo","sequence":"additional","affiliation":[{"name":"Shenyang Clinical Medical Research Center for Assisted Reproduction, Shenyang Women\u2019s and Children\u2019s Hospital","place":["Shenyang, China"]},{"name":"Liaoning Key Laboratory of Assisted Reproduction","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41436-019-0536-8","article-title":"The proportion of endometrial cancers associated with Lynch syndrome: a systematic review of the literature and meta-analysis","volume":"21","author":"Ryan","year":"2019","journal-title":"Genet Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2018.12.011","article-title":"Hereditary colorectal cancer","volume":"36","author":"Hampel","year":"2022","journal-title":"Hematol Oncol Clin North Am"},{"key":"B3","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1002\/ijc.33763","article-title":"Endometrial cancer in Lynch syndrome","volume":"150","author":"Zhao","year":"2022","journal-title":"Int J Cancer"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/01.aog.0000154885.44002.ae","article-title":"Gynecologic cancer as a \"sentinel cancer\" for women with hereditary nonpolyposis colorectal cancer syndrome","volume":"105","author":"Lu","year":"2005","journal-title":"Obstet Gynecol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1038\/nature12113","article-title":"Integrated genomic characterization of endometrial carcinoma","volume":"497","author":"Kandoth","year":"2013","journal-title":"Nature"},{"key":"B6","doi-asserted-by":"publisher","first-page":"CD013111","DOI":"10.1002\/14651858.cd013111","article-title":"Fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer","volume":"7","author":"Fernandez-Montoli","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgc.2024.100024","article-title":"The prognostic impact of molecular classification in endometrial cancer that undergoes fertility-sparing treatment","volume":"35","author":"De Vitis","year":"2025","journal-title":"Int J Gynecol Cancer"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgc.2024.100016","article-title":"Performance of molecular classification in predicting oncologic outcomes of fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer","volume":"35","author":"Ferrari","year":"2025","journal-title":"Int J Gynecol Cancer"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/ijms242216114","article-title":"PGT-M, a useful tool to manage the Lynch syndrome transmission","volume":"24","author":"Listorti","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0038","article-title":"NCCN guidelines\u00ae Insights: uterine neoplasms, version 3.2025","volume":"23","author":"Abu-Rustum","year":"2025","journal-title":"J Natl Compr Canc Netw"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.948509","article-title":"Fertility-sparing treatment for endometrial cancer and atypical endometrial hyperplasia in patients with Lynch syndrome: Molecular diagnosis after immunohistochemistry of MMR proteins","volume":"9","author":"Catena","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1422006","article-title":"Progression of fertility-sparing treatment for atypical endometrial hyperplasia in a woman with lynch syndrome: a case report and review of the literature","volume":"14","author":"Hsu","year":"2024","journal-title":"Front Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2025.101768","article-title":"Clinical and fertility outcomes in lynch syndrome patients with endometrial carcinoma or endometrial intraepthelial neoplasia treated with fertility sparing management","volume":"59","author":"Reid","year":"2025","journal-title":"Gynecol Oncol Rep"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1500596","article-title":"PD-1 blockade in tumors with mismatch-repair deficiency","volume":"372","author":"Le","year":"2015","journal-title":"N Engl J Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1200\/jco.19.02105","article-title":"Efficacy of pembrolizumab in patients with noncolorectal high microsatellite instability\/mismatch repair-deficient cancer: Results from the phase II KEYNOTE-158 study","volume":"38","author":"Marabelle","year":"2020","journal-title":"J Clin Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2021-004338","article-title":"Phase II trial of efficacy, safety and biomarker analysis of sintilimab plus anlotinib for patients with recurrent or advanced endometrial cancer","volume":"10","author":"Wei","year":"2022","journal-title":"J Immunother Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2025.36.e59","article-title":"Fertility-sparing treatment outcomes using immune checkpoint inhibitors in endometrial cancer patients with Lynch syndrome","volume":"36","author":"Yang","year":"2025","journal-title":"J Gynecol Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1010490","article-title":"Case report: Reproductive organ preservation and subsequent pregnancy for an infertility patient with lynch syndrome-associated synchronous endometrial cancer and colon cancer after treatment with a PD-1 checkpoint inhibitor","volume":"13","author":"Cao","year":"2022","journal-title":"Front Immunol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1942599\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:30:35Z","timestamp":1789101035000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1942599\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":18,"alternative-id":["10.3389\/fonc.2026.1942599"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1942599","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"article-number":"1942599"}}