Current Evidence-Based Systemic Therapy for Advanced and Recurrent Endometrial Cancer

Abstract

Endometrial cancer (EC) is the most common gynecologic malignancy, with worldwide increasing incidence and disease-associated mortality. Although most patients with EC are diagnosed with early-stage disease, systemic treatment options for patients with advanced or recurrent EC have historically been limited. EC-focused clinical trials and the ensuing therapeutic landscape have expanded since The Cancer Genome Atlas (TCGA) identified 4 distinct EC subgroups associated with differential survival. This endeavor revolutionized our understanding of the genomic characterization of EC as well as molecular drivers of this heterogeneous malignancy, leading to precision oncology approaches to therapeutics and advancement in treatment options. This review describes the current status of and recent advancements in therapeutic options for patients with advanced and recurrent EC. The NCCN Guidelines for Uterine Neoplasms provide detailed recommendations regarding the diagnosis, workup, and management of EC.

Pelvic Exenteration for Recurrent Endometrial Cancer: A 15-Year Monocentric Retrospective Study

“…The effect of various comorbidities should also be taken into account as a prognostic factor for patient outcome. Obesity and a high burden of comorbidities are common in EC patients [2]. Di Donato et al ( 2021) calculated an age-adjusted Charlson Comorbidity Index (A-CCI) for EC patients receiving surgery.…”

“…Endometrial cancer (EC) is the gynecologic malignancy with the highest incidence in postmenopausal women, and its diagnosis has increased 130% within the last 30 years [1,2]. Unlike other gynecologic malignancies, EC is commonly diagnosed in an early stage due to the presence of symptoms (usually bleeding), which results in long-term survival for most patients.…”

“…In those cases, additional abdominal lymphonodectomy is performed and followed by radiotherapy or even chemoradiotherapy [1]. Even though tumor-specific pharmacological treatments focused on tumor biology and patient characteristics are getting more relevant, the first step in successfully treating EC is to achieve a complete cytoreduction (R0) [2,3].…”

“…As obesity is one of the strongest risk factors for EC, patients usually possess a high body mass index, an advanced age and are often multimorbid. All those characteristics turn them into unsuitable candidates for multivisceral surgery, resulting in low indication rates for PE [2,8]. Until now, only a few published articles have evaluated the outcomes of PE in the treatment of recurrent EC.…”

Construction of a mitochondria genes-based model for prognosis prediction, drug guidance and immune feature analysis in ovarian serous cystadenocarcinoma

“…The past few years have witnessed a signi cant increase in sequencing techniques and bioinformatics analyses utilized in clinical applications, specially in endometrial cancer (EC) [20]. It is now understood that the histological classi cation of EC cannot fully meet the clinical needs for predicting prognosis and guiding precise treatment due to the high heterogeneity of EC tissues and traditional histopathological diagnosis with low repeatability.…”