Molecular classification, biomarker testing, and access to modern therapies in endometrial cancer across Latin America: an International Gynecologic Cancer Society survey.

Objective

To assess gynecologic oncology professionals' perspectives on biomarker testing and molecularly informed treatment for endometrial cancer across Latin America and to identify barriers to precision care adoption.

Methods

This was a secondary analysis of a multi-national, cross-sectional, web-based International Gynecologic Cancer Society survey of 679 oncology professionals from Argentina, Brazil, Colombia, and Mexico that was administered in Spanish and Portuguese using the Research Electronic Data Capture platform from March to August 2025. Endometrial cancer-specific items were completed by 506 respondents (74.5%), who formed the denominator for the results reported below; the items covered biomarker testing, interpretation and application of molecular results, access to systemic therapies, treatment delays, and institutional barriers.

Results

Biomarker testing was reportedly ordered by 54.7% to 84.7% of respondents across the four main country groups; in-house next-generation sequencing and POLE testing were limited (17.2% and 18.0% of respondents, respectively), with many centers relying on external laboratories, including somatic next-generation sequencing send-out rates of 49.3% in Argentina and 62.9% in Colombia. A gap between biomarker availability and clinical application was evident: only 28.0% to 58.2% across countries would add immunotherapy for advanced mismatch repair-deficient/microsatellite instability-high disease, and 29.3% to 54.9% would add human epidermal growth factor receptor 2-directed therapy for human epidermal growth factor receptor 2-positive advanced disease. Access to immunotherapy and lenvatinib was generally lower and more heterogeneous than access to standard treatments; time to initiation of primary treatment was most commonly 28 days to 3 months, but longer delays (>3 months) were reported in a substantial proportion of cases, particularly in Mexico (21.3%).

Conclusions

Among gynecologic oncology professionals surveyed in Latin America, the central challenge in endometrial cancer care is not only access to biomarkers but also integration of molecular classification into therapeutic decision-making. Closing this gap requires improved access to key tests (POLE and next-generation sequencing-based assays), practical education in result interpretation, and more consistent access to targeted therapies.