Why is Inoperable Endometrial Cancer Relevant at the 2026 ACRO Summit?

Among the many topics discussed at the 2026 American College of Radiation Oncology (ACRO) Summit, Dominique Rash, MD, took the stage to highlight the intricacies of treating patients with inoperable endometrial cancer. Following that presentation, CancerNetwork® spoke with Rash about why her topic was so important and what she hoped the listening radiation oncologists would take away from it.

Rash, a radiation oncologist and an associate professor of Radiation Medicine and Applied Sciences at University of California San Diego, stated that the topic was likely chosen to be spotlighted because of its real-world, practical applications, especially as they may become more common. She emphasized that medically inoperable endometrial cancer represents a growing clinical challenge that many practicing radiation oncologists will increasingly encounter.

According to Rash, several converging trends are contributing to this shift. The overall incidence of endometrial cancer in the US continues to rise, and patients are, on average, being diagnosed at older ages. As life expectancy increases, more patients are living with significant medical comorbidities that may preclude surgical management. Additionally, rising rates of obesity, a known risk factor for endometrial cancer, further increase the likelihood that some patients will be deemed poor surgical candidates.

The session also addressed the evolving role of systemic therapy in this setting. Rash noted that there has been increasing discussion around incorporating systemic treatments for patients with more advanced disease, including stage III and IV endometrial cancer. For these patients, radiation therapy often serves as a cornerstone of local control, but multimodality management may be necessary to address the risk of distant disease.

Transcript:

Why was your topic important for a forum like ACRO?

I think the session organizers were wanting to present some challenging cases with real-world, practical applications for the providers that attend ACRO. Medically inoperable endometrial cancer is probably something that we’re going to be seeing a little bit more of in the future. The incidence of endometrial cancer in the US is rising. Patients are becoming older with additional medical comorbidities and living a longer time. There’s also a cohort of patients who are becoming a little bit more heavyset over time as well, and those are things that increase the probability of being diagnosed with medically inoperable endometrial cancer.

What were the key takeaways?

We tried to prioritize on how best to manage patients with either a combination of external beam radiation with brachytherapy or brachytherapy alone. How do [we] identify which patients benefit from monotherapy with—for example, brachytherapy alone—vs the combined modality therapy? Then, there’s been a lot of discussion of how to incorporate systemic therapy as well, particularly with patients with more advanced stage disease—stage III, stage IV—endometrial cancer.