The potential role of GLP-1 receptor agonist targeting in fertility-sparing treatment in obese patients with endometrial malignant pathology: a call for research

Violette, Caroline; Agarwal, Ravi; Mandelbaum, Rachel S.; González, José Luís; Hong, Kurt; Roman, Lynda D.; Klar, Maximilian; Wright, Jason D.; Paulson, Richard J.; Obermair, Andreas; Matsuo, Koji

doi:10.1080/14737140.2023.2194636

Cited by 7 publications

(4 citation statements)

References 99 publications

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“…[58][59][60][61] The levonorgestrel intrauterine device is often utilised in these patients. 62 There is an unmet need for a personalised treatment approach in cases of first-line progestin treatment failure. 62 In this context, there is growing interest in glucagon-like peptide 1 receptor agonists for fertility-sparing in patients with malignant endometrial pathology who are obese, and this area warrants further exploration.…”

Section: Fertility-sparing Management Of Young Females With Endometri...mentioning

confidence: 99%

“…62 There is an unmet need for a personalised treatment approach in cases of first-line progestin treatment failure. 62 In this context, there is growing interest in glucagon-like peptide 1 receptor agonists for fertility-sparing in patients with malignant endometrial pathology who are obese, and this area warrants further exploration. 41,62 ESGO, the European Society of Human Reproduction and Embryology (ESHRE), and the European Society for Gynaecological Endoscopy (ESGE) collaboratively published guidelines in 2023 for the fertility-sparing treatment of patients with endometrial carcinoma; however, the majority of the recommendations were supported only by observational data, professional experience, and consensus of the development group, rather than high-level, scientific evidence.…”

Section: Fertility-sparing Management Of Young Females With Endometri...mentioning

confidence: 99%

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Advancements in Endometrial Cancer Research in 2023

Scott

2024

EMJ Oncol

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Endometrial cancer is one of the most common gynaecological cancers in developed countries, and the incidence is rising significantly. The staging of this disease is evolving from anatomic staging and risk stratification to a more molecular-based stratification. Treatment of endometrial cancer is also evolving. Paclitaxel plus carboplatin is the standard first-line chemotherapy for endometrial cancer; however, there is new evidence that the combination of chemotherapy and immunotherapy has synergistic effects in the treatment of this disease. This article discusses the latest advancements in endometrial cancer research in 2023, including highlights from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancers 2023 in March, the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting in June, the 24th European Gynaecological Oncology (ESGO) Congress in September and October, and the European Society for Medical Oncology (ESMO) Congress 2023 in October. The article highlights the unprecedented progression-free survival (PFS) data from two Phase III randomised controlled trials evaluating first-line immunotherapy in combination with chemotherapy in patients with advanced or recurrent endometrial cancer: RUBY with dostarlimab, and NRG-GY018 with pembrolizumab, which created a buzz at SGO 2023 in the spring, and stimulated discussion throughout the remainder of the year. The overall survival (OS) results, the clinically meaningful benefits regardless of mismatch repair status, and health-related quality of life (QOL) in these studies are also discussed. Further topics covered in this year-in-review article include the implications of the results from RUBY and NRG-GY018 on first-line treatment and recurrent settings, and the effect of adding a poly adenosine diphosphate ribose polymerase (PARP) inhibitor to immunotherapy–chemotherapy combinations in the Phase III trial, DUO-E. Disparities in endometrial cancer care, research on fertility-sparing, and the importance of the multidisciplinary team (MDT) in endometrial cancer management are also explored. Following the announcement of practice-changing findings from RUBY and NRG-GY018 in March, data presented and published throughout the remainder of 2023 show that research in endometrial cancer continues at a pace.

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Section: Fertility-sparing Management Of Young Females With Endometri...mentioning

confidence: 99%

Section: Fertility-sparing Management Of Young Females With Endometri...mentioning

confidence: 99%

Advancements in Endometrial Cancer Research in 2023

Scott

2024

EMJ Oncol

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“…Considering this, as well as the fact that low-grade endometrial carcinoma commonly expresses these receptors it becomes understandable that future clinical trials are needed to evaluate the actual impact of those drugs in obese premenopausal women with endometrial cancer. A recent call for research paper was published to help establish research targets, however, to date clinical evidence is missing [47].…”

Section: Treatment and Follow-up Optionsmentioning

confidence: 99%

New boundaries for fertility sparing management in endometrial cancer

Rodolakis¹,

Pergialiotis²,

Thomakos³

2023

Current Opinion in Oncology

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Purpose of review The increasing rates of endometrial cancer in premenopausal women that accompanies modern lifestyle options that enhance the prevalence of obesity as well as the trend of delayed childbearing are expected to increase the need for fertility sparing techniques. Currently, the cornerstone of fertility sparing treatment is hormonal handling with progestin treatment and is reserved for women with well differentiated endometrioid lesions that are limited in the myometrial layer. Recent findings Innovative approaches in the surgical treatment of patients with the use of operative hysteroscopy seem to offer decreased intervals to remission of lesions and longer progression free survival. Recent small case series also dictate that patients with endometrioid lesions of medium differentiation as well as those with superficial myometrial invasion may be adequately treated with the use of operative hysteroscopy. Moreover, the novel classification system may help better understand patients that will likely respond better to hormonal treatment. Summary In the near future, further data from clinical trials will be available that will help optimize patient selection as well select surgical and medical options that will help establish a personalized approach of fertility preservation in endometrial cancer patients.

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“…et al explored the potential use of GLP-1 receptor agonists in f ertility-sparing treatment f or obese patients with malignant endometrial pathology. Their proposition entailed the potential enhancement of subsequent pregnancy chances through reductions in weight, inf lammation, and insulin resistance by these agonists 52 .…”

Section: Glp-1 Receptor Agonists (Glp-1ras)mentioning

confidence: 99%

Reproduction and Anti-Obesity Medications: A Review of Current Evidence

Saldívar Cerón

2023

TJOR

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Obesity, typified by the disproportionate accumulation of body fat, constitutes a burgeoning global health dilemma with far-reaching impacts on numerous facets of human well-being, prominently inclusive of reproductive health. The pervasive effects of this worldwide health predicament are both direct and indirect, having a compelling influence on fertility, thus underlining the exigency for efficacious therapeutic interventions. FDA-approved anti-obesity pharmaceuticals, comprising metformin, orlistat, phentermine, and glucagon-like peptide-1 (GLP-1) receptor agonists such as liraglutide and semaglutide, have been substantiated to facilitate weight loss and enhance metabolic indices. However, despite their promising roles in mitigating obesity, the extent of our understanding of these drugs' implications for reproductive health remains inadequate.This thorough review endeavors to aggregate and scrutinize the present corpus of evidence relating to the influence of these anti-obesity drugs on fertility. By exploring the prospective direct and indirect impacts of these pharmaceuticals on reproductive health, we aspire to illuminate their multifunctional roles extending beyond the sphere of weight regulation. In the female population, obesity has been correlated with menstrual abnormalities, infertility, and complications during gestation, frequently concurrent with an increased incidence of Polycystic Ovary Syndrome (PCOS). In the male counterpart, obesity has been associated with compromised semen quality and erectile function, often compounded by Metabolic Syndrome (MetS) and hormonal disequilibrium.This exhaustive analysis seeks to equip physicians with a framework for refining their therapeutic approaches, appreciating the intricate interplay between obesity treatment and reproductive health. We aim to afford a broader and more nuanced comprehension of the complex interrelations between obesity, anti-obesity medications, and reproductive well-being. The intention is to empower healthcare practitioners with the insights necessary to deliver bespoke care strategies to those grappling with obesity and attendant fertility complications. Ultimately, this initiative augments our evolving understanding of the complex mechanisms operating at the juncture of obesity and fertility, thereby paving the way for future investigations in this critical field of study.

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The potential role of GLP-1 receptor agonist targeting in fertility-sparing treatment in obese patients with endometrial malignant pathology: a call for research

Cited by 7 publications

References 99 publications

Advancements in Endometrial Cancer Research in 2023

Advancements in Endometrial Cancer Research in 2023

New boundaries for fertility sparing management in endometrial cancer

Reproduction and Anti-Obesity Medications: A Review of Current Evidence

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