Adjuvant Therapy in Node-Positive Endometrial Cancer: A Focus on Chemotherapy

Dexter, Julia; Lips, Erin; DiSilvestro, Paul

doi:10.1007/s11912-022-01327-8

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…GOG 122 compared whole abdominal radiation to doxorubicin and cisplatin. Not only did chemotherapy treatment show improved progression free survival (PFS) and overall survival (OS), but whole abdomen abdominal irradiation had intolerable side effects and is appropriately no longer indicated [ 9 – 11 ].…”

Section: Review Of Management Options For Front Line Treatment Of Nod...mentioning

confidence: 99%

Treatment of node-positive endometrial cancer: chemotherapy, radiation, immunotherapy, and targeted therapy

Tubridy,

Taunk,

2024

Curr. Treat. Options in Oncol.

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Opinion StatementThe standard of treatment for node-positive endometrial cancer (FIGO Stage IIIC) in North America has been systemic therapy with or without additional external beam radiation therapy (RT) given as pelvic or extended field RT. However, this treatment paradigm is rapidly evolving with improvements in systemic chemotherapy, the emergence of targeted therapies, and improved molecular characterization of these tumors. The biggest question facing providers regarding management of stage IIIC endometrial cancer at this time is: what is the best management strategy to use with regard to combinations of cytotoxic chemotherapy, immunotherapy, other targeted therapeutics, and radiation that will maximize clinical benefit and minimize toxicities for the best patient outcomes? While clinicians await the results of ongoing clinical trials regarding combined immunotherapy/RT as well as management based on molecular classification, we must make decisions regarding the best treatment combinations for our patients. Based on the available literature, we are offering stage IIIC patients without measurable disease postoperatively both adjuvant chemotherapy and IMRT with carboplatin, paclitaxel, and with or without pembrolizumab/dostarlimab as primary adjuvant therapy. Patients with measurable disease post operatively, high risk histologies, or stage IV disease receive chemoimmunotherapy, and vaginal brachytherapy is added for those with uterine risk factors for vaginal recurrence. In the setting of endometrioid EC recurrence more than 6 months after treatment, patients with pelvic nodal and vaginal recurrence are offered IMRT and brachytherapy without chemotherapy. For measurable recurrence not suitable for pelvic radiation alone, chemoimmunotherapy is preferred as standard of care.

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Section: Review Of Management Options For Front Line Treatment Of Nod...mentioning

confidence: 99%

Treatment of node-positive endometrial cancer: chemotherapy, radiation, immunotherapy, and targeted therapy

Tubridy,

Taunk,

2024

Curr. Treat. Options in Oncol.

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“…In advanced-stage and high-risk endometrial cancer, adjuvant treatment is the standard of care and generally includes chemotherapy with or without radiotherapy. The best application of these 2 methods together or separately is still the object of study [55]. Moreover, according to the latest research, synergistic use of chemotherapy and immunotherapy is a promising alternative for standard chemotherapy.…”

Section: Radiotherapy Radiation Enhances Immune Responses By Promotin...mentioning

confidence: 99%

Dostarlimab as a promising immunotherapy for endometrial cancer treatment – literature review

Derlatka,

Tasior,

Kulczycka

et al. 2023

J Pre Clin Clin Res.

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Introduction and Objective. Endometrial cancer, a leading gynecological malignancy, is on the rise globally. Existing treatments for advanced cases have limited effectiveness and notable side-effects. Dostarlimab, a monoclonal antibody, enhances the immune response against tumuors by blocking the PD-1/PD-L1/PD-L2 interaction. This review examines dostarlimab's role, mechanism, clinical trials, and safety in endometrial cancer. Review Methods. A search was conducted using PubMed and Google Scholar databases to evaluate dostarlimab's therapeutic potential in endometrial cancer. The review encompasses studies detailing its mechanism of action, clinical trial outcomes, and safety data. Brief description of the state of knowledge. Endometrial cancer, the foremost gynecological malignancy in developed countries, has seen a surge in global incidence. Traditional treatments for advanced or recurrent cases exhibit limited efficacy and notable toxicity. Dostarlimab, an innovative monoclonal antibody, intervenes in the PD-1/PD-L1/PD-L2 axis, augmenting anti-tumour immune responses and fostering tumour regression. In April 2021, accelerated FDA approval was granted for dostarlimab in mismatch repair deficient recurrent or advanced endometrial cancer, post-platinum regimen. Subsequently, on 9 February 2023, FDA approval was extended to a broader patient cohort, encompassing those ineligible for curative surgery or radiation. Summary. Dostarlimab, targeting PD-1/PD-L1/PD-L2, shows promise in treating advanced endometrial cancer. Mechanism, trials, and safety are explored. FDA approvals highlight its potential. Ongoing trials and combination therapies suggest a dynamic role in management. Dostarlimab offers renewed hope for patients.

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“…5 However, although advanced or recurrent UCEC patients have been shown to benefit from adjuvant therapies like chemotherapy, radiotherapy, or endocrine therapy, the prognosis in such cases remains worrisome, and the 5-year survival rate of advanced UCEC patients is often as low as 17%. [6][7][8] Currently, the prognostic prediction for UCEC patients is still limited to some clinicopathological parameters, such as age, the International Federation of Gynecology and Obstetrics (FIGO) stage, and pathological subtypes. 9 Patients at the same clinical stage show different clinical features such that these features cannot be used to completely accurately judge the prognosis of UCEC patients.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological role of Cyclin A2 in uterine corpus endometrial carcinoma: Integration of tissue microarrays and ScRNA-Seq

Mo,

Liang,

Huang

et al. 2024

Int J Biol Markers

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Background The comprehensive expression level and potential molecular role of Cyclin A2 (CCNA2) in uterine corpus endometrial carcinoma (UCEC) remains undiscovered. Methods UCEC and normal endometrium tissues from in-house and public databases were collected for investigating protein and messenger RNA expression of CCNA2. The transcription factors of CCNA2 were identified by the Cistrome database. The prognostic significance of CCNA2 in UCEC was evaluated through univariate and multivariate Cox regression as well as Kaplan–Meier curve analysis. Single-cell RNA-sequencing (scRNA-seq) analysis was performed to explore cell types in UCEC, and the AUCell algorithm was used to investigate the activity of CCNA2 in different cell types. Results A total of 32 in-house UCEC and 30 normal endometrial tissues as well as 720 UCEC and 165 control samples from public databases were eligible and collected. Integrated calculation showed that the CCNA2 expression was up-regulated in the UCEC tissues (SMD = 2.43, 95% confidence interval 2.23∼2.64). E2F1 and FOXM1 were identified as transcription factors due to the presence of binding peaks on transcription site of CCNA2. CCNA2 predicted worse prognosis in UCEC. However, CCNA2 was not an independent prognostic factor in UCEC. The scRNA-seq analysis disclosed five cell types: B cells, T cells, monocytes, natural killer cells, and epithelial cells in UCEC. The expression of CCNA2 was mainly located in B cells and T cells. Moreover, CCNA2 was active in T cells and B cells using the AUCell algorithm. Conclusion CCNA2 was up-regulated and mainly located in T cells and B cells in UCEC. Overexpression of CCNA2 predicted unfavorable prognosis of UCEC.

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Adjuvant Therapy in Node-Positive Endometrial Cancer: A Focus on Chemotherapy

Cited by 4 publications

References 30 publications

Treatment of node-positive endometrial cancer: chemotherapy, radiation, immunotherapy, and targeted therapy

Treatment of node-positive endometrial cancer: chemotherapy, radiation, immunotherapy, and targeted therapy

Dostarlimab as a promising immunotherapy for endometrial cancer treatment – literature review

Clinicopathological role of Cyclin A2 in uterine corpus endometrial carcinoma: Integration of tissue microarrays and ScRNA-Seq

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