Advertisement

Uterine Cancer pp 321-327 | Cite as

Systemic Treatment of Advanced Endometrial Carcinoma

  • Arun Warrier

Abstract

Endometrial cancer has shown a rising trend over the past 30 years. The incidence has gone up by 21 % since 2008, and the death rate has increased by more than 100 % over the past two decades [1]. Although there is strong data correlating hyperestrogenism and low-grade endometrial cancers, recently link with higher-grade/stage tumors also has been reported [2]. As the median age of endometrial cancer is 63 years, aging population with an increase in average life span also contributes to rise in incidence. In early-stage disease which comprises almost 85 % of case, advancements in surgical techniques as well as staging, focused/limited radiation, and incorporation of structured chemotherapy have dramatically improved outcomes. In developed countries, stage 3 comprises 12 % and stage 4 less than 5 % of endometrial cancers [4]. Depending on the histology, there is wide variation in response to systemic treatment. Systemic management encompasses chemotherapy, hormone manipulation, and molecularly targeted agents. In high-grade tumors with a rapid growth pattern and visceral metastases, chemotherapy is preferred. With the advent of molecular profiling, cancer signaling pathway mutations in endometrial carcinoma have been understood. Various agents to target these have been developed, and many are still in clinical trials.

Keywords

Endometrial Cancer Lynch Syndrome Endometrial Carcinoma mTOR Inhibitor Growth Factor Support 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Sorosky JI. Endometrial cancer. Obstet Gynecol. 2012;120(2 Pt 1):383–97.CrossRefPubMedGoogle Scholar
  2. 2.
    Weiss J, Saltzman B, Doherty J, et al. Risk factors for the incidence of endometrial cancer according to the aggressiveness of disease. Am J Epidemiol. 2006;164:56–62.CrossRefPubMedGoogle Scholar
  3. 3.
    Ferguson S, Olshen A, Levine D, et al. Molecular profiling of endometrial cancers from African American and Caucasian women. Gynecol Oncol. 2006;101:209–13.CrossRefPubMedGoogle Scholar
  4. 4.
    Sorosky JI. Review endometrial cancer. Obstet Gynecol. 2008;111(2 Pt 1):436–47.CrossRefPubMedGoogle Scholar
  5. 5.
    Fleming GF. Systematic chemotherapy for uterine carcinoma: metastatic and adjuvant. J Clin Oncol. 2007;25:2983–90.CrossRefPubMedGoogle Scholar
  6. 6.
    Hogberg T, Signorelli M, de Oliveira CF, et al. Sequential adjuvant chemotherapy and radiotherapy in endometrial cancer – results from two randomised studies. Eur J Cancer. 2010;46(13):2422–31.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Burke TW, Stringer CA, Morris M, et al. Prospective treatment of advanced or recurrent endometrial carcinoma with cisplatin, doxorubicin, and cyclophosphamide. Gynecol Oncol. 1991;40(3):264–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Muggia FM, Chia G, Reed LJ, et al. Doxorubicin- cyclophosphamide: effective chemotherapy for advanced endometrial adenocarcinoma. Am J Obstet Gynecol. 1977;128(3):314–9.PubMedGoogle Scholar
  9. 9.
    Randall ME, Filiaci VL, Muss H, Spirtos NM, Mannel RS, Fowler J, Thigpen JT, Benda JA. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2006;24(1):36–44.CrossRefPubMedGoogle Scholar
  10. 10.
    Miller D, Filiaci V, Fleming G, et al. Randomized phase III noninferiority trial of first line chemotherapy for metastatic recurrent endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2012;125:771–3.CrossRefGoogle Scholar
  11. 11.
    Fleming GF, Brunetto VL, Cella D, et al. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2004;22(11):2159–66.CrossRefPubMedGoogle Scholar
  12. 12.
    McMeekin DS, Filiaci VL, Thigpen JT, et al. The relationship between histology and outcome in advanced and recurrent endometrial cancer patients participating in first-line chemotherapy trials: A Gynecologic Oncology Group study. Gynecol Oncol. 2007;106:16–22.CrossRefPubMedGoogle Scholar
  13. 13.
    Dizon DS, Blessing JA, McMeekin DS, et al. Phase II trial of ixabepilone as second-line treatment in advanced endometrial cancer: Gynecologic Oncology Group trial 129-P. J Clin Oncol. 2009;27:3104–8.PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Westin SN, Broaddus RR. Personalized therapy in endometrial cancer: challenges and opportunities. Cancer Biol Ther. 2012;13(1):1–13.PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Nogami Y, Banno K, Aoki D. Current status of molecular-targeted drugs for endometrial cancer (review). Mol Clin Oncol. 2013;1(5):799–804.PubMedCentralPubMedGoogle Scholar
  16. 16.
    Dancey JE. Clinical development of mammalian target of rapamycin inhibitors. Hematol Oncol Clin North Am. 2002;16(5):1101–14.CrossRefPubMedGoogle Scholar
  17. 17.
    Oza AM, Elit L, Eisenhauer EA. Phase II study of temsirolimus in women with recurrent or metastatic endometrial cancer: a trial of the NCIC Clinical Trials Group. Clin Oncol. 2011;29(24):3278–85.CrossRefGoogle Scholar
  18. 18.
    Kamat AA, Merritt WM, Sood AK. Clinical and biological significance of vascular endothelial growth factor in endometrial cancer. Clin Cancer Res. 2007;13(24):7487–95.CrossRefPubMedGoogle Scholar
  19. 19.
    Aghajanian C, Sill MW, Darcy KM, Leslie KK. Phase II trial of bevacizumab in recurrent or persistent endometrial cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2011;29(16):2259–65.PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Tsuji K, Kisu I, Aoki D. Metformin: a possible drug for treatment of endometrial cancer. Open J Obstet Gynecol. 2012;2:1–6.CrossRefGoogle Scholar
  21. 21.
    Podratz KC, O’Brien PC, Malkasian Jr GD, et al. Effects of progestational agents in treatment of endometrial carcinoma. Obstet Gynecol. 1985;66:106–10.PubMedGoogle Scholar
  22. 22.
    Thigpen JT, Brady MF, Alvarez RD, et al. Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma: a dose–response study by the Gynecologic Oncology Group. J Clin Oncol. 1999;17:1736–44.PubMedGoogle Scholar
  23. 23.
    Banno K, Kisu I, Yanokura M, Tsuji K, Masuda K, Ueki A, Kobayashi Y, et al. Progestin therapy for endometrial cancer: the potential of fourth-generation progestin (review). Int J Oncol. 2012;40(6):1755–62.PubMedGoogle Scholar
  24. 24.
    Mortel R, Levy C, Wolff JP. Female sex steroid receptors in postmenopausal endometrial carcinoma and biochemical response to an antiestrogen. Cancer Res. 1981;41:1140–7. 25.PubMedGoogle Scholar
  25. 25.
    Fiorica JV, Brunetto VL, Hanjani P. Phase II trial of alternating courses of megestrol acetate and tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004;92(1):10.CrossRefPubMedGoogle Scholar
  26. 26.
    Ma BB, Oza A, Eisenhauer E, et al. The activity of letrozole in patients with advanced or recurrent endometrial cancer and correlation with biological markers: a study of the National Cancer Institute of Canada Clinical Trials Group. Int J Gynecol Cancer. 2004;14(4):650–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Asbury RF, Brunetto VL, Lee RB, et al. Goserelin acetate as treatment for recurrent endometrial carcinoma: a Gynecologic Oncology Group study. Am J Clin Oncol. 2002;25(6):557–60.CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2015

Authors and Affiliations

  1. 1.Aster MedcityKochiIndia

Personalised recommendations