Hormone therapy for patients with advanced or recurrent endometrial cancer

Lee, Wen-Ling; Yen, Ming‐Shyen; Chao, Kuan-Chong; Yuan, Chiou‐Chung; Ng, Heung‐Tat; Chao, Hsiang‐Tai; Lee, Fa‐Kung; Wang, Peng-Hui

doi:10.1016/j.jcma.2014.02.007

Cited by 41 publications

(34 citation statements)

References 46 publications

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“…PR protein was primarily expressed in the cell nucleus ( Figure 2). PR expression was correlated to the difference in histologic type (77.6% type I vs. 25.0% type II) and FIGO stage I (81.1%) with statistical significance ( Table 2). PR expression showed no significant correlation in either histologic gradation or invasion status of the myometrium or cervix.…”

Section: Pr Expression With Clinicopathologic Featuresmentioning

confidence: 89%

“…As EC patients are generally of older age and are more likely to have comorbidities, the aversive side effects from chemotherapy are unable to justify the low response rate (less than 20%) [15,24]. Furthermore, 14% of all EC cases are found in women of child-bearing age [18,25]. As such, hormone therapy is an attractive treatment not only for its lower toxicity profile, but also for its use in preserving fertility among younger EC patients.…”

Section: Introductionmentioning

confidence: 99%

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Estrogen Receptor, Progesterone Receptor, and HER2 Receptor Markers in Endometrial Cancer

Wang¹,

Tran²,

Fu³

et al. 2020

J. Cancer

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Background: Endometrial cancer (EC) is a major gynecologic adenocarcinoma that arises from the endometrium. While the incidence of EC is on the rise worldwide, survivorship and clinical advancement have considerably lagged compared to other cancers. Given the sensitive nature of the endometrium and its high expression of hormone receptors, hormonal therapy has become a favorable alternative treatment compared to highly toxic chemotherapeutics and radiation therapy. Methods: Clinical samples from patients diagnosed with EC were obtained. ER and PR staining were performed according to the S-P kit, and HER2 staining was carried out according to the UltrasensitiveTM S-P immunohistochemistry kit protocol. Chi-square analysis was conducted using the SPSS. P-values of less than 0.05 were taken as an a priori value for statistical significance. Results: Immunohistochemical (IHC) analysis showed the overall positive expression rates of ER, PR, and HER2 to be 59.8%, 75.0%, and 71.1%, respectively. Significant co-expression was found among all three receptors, suggesting a cooperative, synergistic effect. More importantly, we found that ER expression was correlated with FIGO staging and cervical invasion, whereas PR expression was associated with histologic type. No clinicopathologic features were correlated with HER2 expression, but HER2 positivity was inversely associated with the degree of HER2 overexpression. Conclusions: These results suggest that EC is a heterogeneous disease that may not conform to traditional, prototypically defined subtypes. The status of ER, PR, and HER2 receptors may have the potential to serve as prognostic indicators for EC, but further analysis is needed to ascertain their prognostic significance.

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Section: Pr Expression With Clinicopathologic Featuresmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Estrogen Receptor, Progesterone Receptor, and HER2 Receptor Markers in Endometrial Cancer

Wang¹,

Tran²,

Fu³

et al. 2020

J. Cancer

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“…However, the study of targeted therapy for USC lags behind that of other cancer types. Hormonal treatment, which is the only targeted therapy approved by the US Food and Drug Cancers 2020, 12, 686 8 of 21 Administration (FDA) for EC, is only applied for hormone-dependent EEC [74]. Multiple clinical trials targeting advanced-stage ECs, including USC, have been launched (Table 2).…”

Section: Targeted Therapiesmentioning

confidence: 99%

“…Cancers 2020, 12, x 8 of 21 US Food and Drug Administration (FDA) for EC, is only applied for hormone-dependent EEC [74].…”

Section: Targeted Therapiesmentioning

confidence: 99%

Pathogenesis and Clinical Management of Uterine Serous Carcinoma

Zhang

Kwan

Wong

et al. 2020

Cancers

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Uterine serous carcinoma (USC) is an aggressive variant of endometrial cancer that has not been well characterized. It accounts for less than 10% of all endometrial cancers and 80% of endometrial cancer-related deaths. Currently, staging surgery together with chemotherapy or radiotherapy, especially vaginal cuff brachytherapy, is the main treatment strategy for USC. Whole-exome sequencing combined with preclinical and clinical studies are verifying a series of effective and clinically accessible inhibitors targeting frequently altered genes, such as HER2 and PI3K3CA, in varying USC patient populations. Some progress has also been made in the immunotherapy field. The PD-1/PD-L1 pathway has been found to be activated in many USC patients, and clinical trials of PD-1 inhibitors in USC are underway. This review updates the progress of research regarding the molecular pathogenesis and putative clinical management of USC. Keywords: endometrial cancer; uterine serous carcinomaPrecis: Uterine serous cancer, although rare, is the most lethal type of uterine cancer. It has distinct molecular features and pathogenic pathways compared with other uterine cancer types Cancers 2020, 12, 686 2 of 21 heterogeneity, grade 3 EEC displays dissimilar features. Although a large number of grade 3 EEC cases show a serous-like phenotype, others display unequivocally endometrioid morphology [6,7]. Type II tumors are typically detected in women 70 years or older and carry a poor prognosis, high recurrence frequency, and much lower 5-year survival rate compared with type I tumors. In addition, type II tumors usually lack estrogen/progesterone receptors and do not respond to hormonal fluctuations [5].Among the type II tumors, uterine serous carcinoma (USC) is the most common subtype. This highly aggressive variant accounts for only 10% of all ECs but 80% of all EC-associated deaths [8,9]. The 5-year tumor-specific survival rate is 74% and 33% for early-and late-stage USC patients, respectively (and 89% and 77% for low-and high-grade EEC) [10]. Unlike type I EC, the risk of metastasis and recurrence of USC does not rely on primary tumor size or grade; this trait contributes to a low overall survival rate of 18% to 27%. Complete surgical staging is performed, comprising total hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection, followed by carboplatin and paclitaxel. In light of poor patient survival and high recurrence rates, the development of targeted therapies specific to USC pathway aberrations would aid in its management. However, conducting studies that focus solely on this rare subtype has been a constant challenge, making it difficult to determine optimal treatment strategies [9].

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“…Some works consider the role of gonadotrophin-releasing hormone analogs (GnRHa). GnRHa cause a reduction of the gonadotrophin level by means of pituitary receptor down-regulation and, consequently, the suppression of ovarian activity and the reduction of the estrogen level [21,23,24].…”

Section: Hormonal Treatment In Advanced or Recurrent Ecmentioning

confidence: 99%