Endometrial Cancer Treatment Changes in Ireland
Endometrial cancer develops in the lining of the womb and stands as the most common gynaecological cancer in Ireland. Treatment strategies depend on the stage, grade, histological characteristics, molecular profile, and general health of the patient. For most patients diagnosed at an early stage, primary treatment involves surgery to remove the womb, ovaries, and fallopian tubes, sometimes accompanied by lymph-node assessment. Minimally invasive or robotic surgical techniques are utilised where appropriate. Following surgery, patients may require no further care, or they may need vaginal brachytherapy, external-beam radiotherapy, or chemotherapy depending on recurrence risk.
Specialist Multidisciplinary Care Centres
Care is planned by specialist multidisciplinary teams consisting of gynaecological surgeons, medical and radiation oncologists, radiologists, pathologists, and specialist nurses. Patients require referral to specialist gynaecological oncology services at major treatment centres. These designated facilities include St James’s Hospital, the Mater Misericordiae University Hospital, and St Vincent’s University Hospital in Dublin, alongside Cork University Hospital/Cork University Maternity Hospital, and University Hospital Galway. Specialist radiotherapy is delivered through networks such as the St Luke’s Radiation Oncology Network.
Molecular Testing Guides Systemic Drug Therapies
For women with advanced or recurrent endometrial cancer, systemic drug regimens become a central component of care. A commonly administered chemotherapy combination includes carboplatin and paclitaxel, which may also be given alongside radiotherapy in selected high-risk postsurgical patients. Treatment decisions increasingly rely on molecular testing of the tumour. Tumours classified as mismatch-repair deficient (dMMR) or microsatellite-instability high (MSI-H) display particular responsiveness to targeted immunotherapy.
National Cancer Control Programme Immunotherapy Access
The National Cancer Control Programme includes dostarlimab—an immunotherapy targeting the PD-1 pathway—in combination with carboplatin and paclitaxel for adults with dMMR/MSI-H primary advanced or recurrent endometrial cancer. The protocol starts with dostarlimab administered alongside chemotherapy, followed by maintenance immunotherapy. Dostarlimab may also be administered as a monotherapy for patients with dMMR/MSI-H advanced or recurrent disease whose cancer progresses during or following prior platinum-based chemotherapy. Evidence supporting this approach stems from the international RUBY Phase III trial, which demonstrated substantial clinical benefit over chemotherapy alone.
Irish Clinical Trials Evaluate New Cancer Therapies
Clinical trials across Irish centres, including St James’s, St Vincent’s, the Mater, and Cork University Hospital, evaluate new therapies, antibody-drug conjugates, and methods to reduce radiotherapy side-effects. While surgery remains the primary intervention for early-stage disease, molecular testing enables clinicians to match patients with advanced or recurrent cancer to newer immunotherapies alongside conventional chemotherapy.
Frequently Asked Questions About Endometrial Cancer Care
Which hospitals provide specialist gynaecological oncology services in Ireland?
Specialist care is centralized at major treatment facilities including St James’s Hospital, the Mater Misericordiae University Hospital, and St Vincent’s University Hospital in Dublin, as well as Cork University Hospital/Cork University Maternity Hospital and University Hospital Galway.
What is the role of dostarlimab in treating endometrial cancer?
Dostarlimab is an immunotherapy targeting the PD-1 pathway that is combined with carboplatin and paclitaxel, or used as a monotherapy, for adults with mismatch-repair deficient or microsatellite-instability high advanced or recurrent endometrial cancer.
Which clinical trial provided the primary evidence for dostarlimab combination therapy?
The international RUBY Phase III trial demonstrated substantial clinical benefit by comparing dostarlimab plus carboplatin and paclitaxel, followed by dostarlimab maintenance, against chemotherapy alone.
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