Fertility-Sparing Management of Endometrial Adenocarcinoma

Dorais, Jessie; Dodson, Mark K.; Calvert, Jacob; Mize, Benjamin; Travarelli, Jennifer Mitchell; Jasperson, Kory; Soisson, Andrew P.

doi:10.1097/ogx.0b013e31822f8f66

Cited by 16 publications

(12 citation statements)

References 101 publications

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“…However, in a subset of patients with low-grade early stage disease such as women of reproductive age wishing to preserve their fertility or women who are poor surgical candidates, conservative management can be offered (23, 24). Although progesterone shows efficacy in the conservative management of Type I EC, 30–35 % of women with well-differentiated tumors fail to respond to therapy or recur with the exact mechanisms of resistance to therapy unknown (24–27). For this particular subset of patients additional treatment options are needed.…”

Section: Introductionmentioning

confidence: 99%

Imiquimod Induces Apoptosis in Human Endometrial Cancer Cells In vitro and Prevents Tumor Progression In vivo

et al. 2016

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Purpose The increasing incidence of endometrial cancer (EC), in younger age at diagnosis, calls for new tissue-sparing treatment options. This work aims to evaluate the potential of imiquimod (IQ) in the treatment of low-grade EC. Methods Effects of IQ on the viabilities of Ishikawa and HEC-1A cells were evaluated using MTT assay. The ability of IQ to induce apoptosis was evaluated by testing changes in caspase 3/7 levels and expression of cleaved caspase-3, using luminescence assay and western blot. Apoptosis was confirmed by flow cytometry and the expression of cleaved PARP. Western blot was used to evaluate the effect of IQ on expression levels of Bcl-2, Bcl-xL, and BAX. Finally, the in vivo efficacy of IQ was tested in an EC mouse model. Results There was a decrease in EC cell viability following IQ treatment as well as increased caspase 3/7 activities, cleaved caspase-3 expression, and Annexin-V/ 7AAD positive cell population. Western blot results showed the ability of IQ in cleaving PARP, decreasing Bcl-2 and Bcl-xL expressions, but not affecting BAX expression. In vivo study demonstrated IQ’s ability to inhibit EC tumor growth and progression without significant toxicity. Conclusions IQ induces apoptosis in low-grade EC cells in vitro, probably through its direct effect on Bcl-2 family protein expression. In, vivo, IQ attenuates EC tumor growth and progression, without an obvious toxicity. Our study provides the first building block for the potential role of IQ in the non-surgical management of low-grades EC and encouraging further investigations.

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Section: Introductionmentioning

confidence: 99%

Imiquimod Induces Apoptosis in Human Endometrial Cancer Cells In vitro and Prevents Tumor Progression In vivo

et al. 2016

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“…Yet, each patient does not respond the same way. In 30–35% of the patients, endometrial cancer recurs and recurrences may be fatal . In this study we aimed to review treatment outcomes of our patients diagnosed with endometrial carcinoma who desired fertility.…”

Section: Introductionmentioning

confidence: 99%

Fertility outcomes of patients with early stage endometrial carcinoma

Parlakgumus

Kılıçdağ

Şimşek

et al. 2013

J of Obstet and Gynaecol

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“…Response to treatment has been high (rates of 73%-81%), but not absolute [28][29][30][31] . Recurrence rates are also appreciable (18%-40% with follow-up times up to 357 months) [28][29][30][32][33][34] . Although progestin management of early endometrial carcinoma has shown success (recent pregnancy rates of 40% and subsequent live birth rates up to 47% 30 ), this management route is evidently not without risk.…”

Section: Progestins and Endometrial Cancermentioning

confidence: 99%

“…Although progestin management of early endometrial carcinoma has shown success (recent pregnancy rates of 40% and subsequent live birth rates up to 47% 30 ), this management route is evidently not without risk. Concurrent ovarian malignancy poses a risk estimated at 11%-29% in premenopausal women with endometrial carcinoma 28 . Additional drawbacks include a lack of consensus on progestin specifics, dose specifics, and length of treatment 29,35 .…”

Section: Progestins and Endometrial Cancermentioning

confidence: 99%

“…Although standard management would involve removal of the reproductive organs 28 , progestin agents have been used in effort to spare fertility in well-differentiated early disease with no evidence of progression 28,29 . Response to treatment has been high (rates of 73%-81%), but not absolute [28][29][30][31] . Recurrence rates are also appreciable (18%-40% with follow-up times up to 357 months) [28][29][30][32][33][34] .…”

Section: Progestins and Endometrial Cancermentioning

confidence: 99%

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Oncofertility in Canada: Gonadal Protection and Fertility-Sparing Strategies

Ronn

Holzer

2013

Current Oncology

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Background: Cancer can be a devastating diagnosis. In particular, malignancy and its indicated treatments have profoundly negative effects on the fertility of young cancer patients. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer therapies and to facilitate fertility preservation. In Canada, fertility issues are often inadequately addressed despite the availability of resources. The goal of this four-part series is to facilitate systemic improvements in fertility preservation for adolescent and young adult Canadians with a new diagnosis of cancer. Methods: Here, we review the fertility preservation measures currently available. Medical and surgical strategies are both outlined. Results: Fertility-preserving strategies and gonadal protection have demonstrated variable success in a number of approaches. The value of hormone suppression is still in question for women. Progestins for endometrial cancer and alternative chemotherapies are other medical approaches. Gonadal shielding and protective surgical approaches have also been attempted. Conclusions: The techniques discussed here may be selectively considered and integrated into patient care in an attempt to preserve future fertility before initiating cancer treatment.

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Fertility-Sparing Management of Endometrial Adenocarcinoma

Cited by 16 publications

References 101 publications

Imiquimod Induces Apoptosis in Human Endometrial Cancer Cells In vitro and Prevents Tumor Progression In vivo

Imiquimod Induces Apoptosis in Human Endometrial Cancer Cells In vitro and Prevents Tumor Progression In vivo

Fertility outcomes of patients with early stage endometrial carcinoma

Oncofertility in Canada: Gonadal Protection and Fertility-Sparing Strategies

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