Recent Advances in Endometrial Cancer Management

Donato, Violante Di; Giannini, Andrea; Bogani, Giorgio

doi:10.3390/jcm12062241

Cited by 49 publications

(26 citation statements)

References 12 publications

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“…Postoperative chemotherapy combined with radiotherapy is needed to maximize the therapeutic effect, and treatment needs to be individualized. 63 There is evidence that chemotherapy regimen using mTOR inhibitors in combination with VEGFR inhibitors may be beneficial for the treatment of this disease.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Malignant Perivascular Epithelioid Cell Tumors of the Uterus and Literature Review

Hu,

Miao,

Zhou

et al. 2024

IJWH

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Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors originating from perivascular epithelioid cells. In gynecological system, the uterus is one of the most common sites affected by PEComas. Most PEComas are benign, and patients usually have a good prognosis. However, malignant uterus PEComa is rare, and better comprehensive epidemiological investigations are needed. To date, there are a few reported cases of uterus PEComa. We herein report a rare case of malignant PEComa occurred in the uterine corpus and cervix, possibly accompanied by pulmonary lymphangioleiomyomatosis (PLAM). In addition, 55 cases of malignant uterus PEComa were picked out and collected in the data base of PubMed and Medline. On the one hand, the age of onset, population distribution, clinical manifestations, metastatic sites and routes of metastasis were analysed. On the other hand, a summary of the epidemiology, pathogenesis, diagnosis, and treatments of uterus PEComa was given.

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Section: Discussionmentioning

confidence: 99%

A Case Report of Malignant Perivascular Epithelioid Cell Tumors of the Uterus and Literature Review

Hu,

Miao,

Zhou

et al. 2024

IJWH

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“…Overtreatment or undertreatment may be reduced by tailoring adjuvant treatment to the risk of recurrence based on molecular characteristics. Furthermore, molecular profiling can predict the response of immune checkpoint inhibitors [ 38 ]. Similar to the investigation of new treatment modalities for other types of gynecologic cancer [ 39 40 ], potential targets may be selected from detailed molecular/genomic profiling to develop therapeutic strategies for endometrial cancers in the future era of precision medicine.…”

Section: Discussionmentioning

confidence: 99%

Impact of adjuvant treatment on survival in patients with 2023 FIGO stage IIC endometrial cancer: a retrospective analysis from two tertiary centers in Korea and Taiwan

Lee,

Lai,

Kim

et al. 2024

J Gynecol Oncol

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Objective In early-stage endometrial cancer, aggressive histologic types (grade 3 endometrioid, serous, clear cell, carcinosarcomas, undifferentiated, mixed, and other unusual types) are associated with an increased risk of distant metastases and worse survival. However, the optimal adjuvant treatment for these patients remains controversial. The present study investigated the outcomes of different adjuvant treatments in patients with 2023 FIGO stage IIC endometrial cancer. Methods We retrospectively identified patients with 2023 FIGO stage IIC endometrial cancer who underwent surgery followed by either adjuvant treatment or observation from 2000 to 2020 at two tertiary centers in Korea and Taiwan. Recurrence-free survival (RFS) and overall survival (OS) were evaluated using Kaplan-Meier estimates and Cox proportional-hazards models. We also analyzed recurrence patterns after different adjuvant treatments. Results A total of 272 patients were identified; 204 received adjuvant treatment postoperatively, whereas 68 only underwent observation. Adjuvant treatment was not associated with improved RFS or OS. Non-endometrioid histologic types (p=0.003) and presence of lymphovascular space invasion (LVSI, p=0.002) were associated with worse RFS, whereas only non-endometrioid histologic types impacted OS (p=0.004). In subgroup analyses, adjuvant treatment improved OS in patients with LVSI (p=0.020) and in patients with both LVSI and grade 3 endometrioid histologic type (p=0.007). We found no difference in locoregional and distant recurrence between patients undergoing adjuvant treatment or observation. Conclusion In this study, the addition of adjuvant treatment was associated with an OS benefit for patients with LVSI, especially those with grade 3 endometrioid tumors.

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“…), with the exception of microsatellite instability status, have emerged to determine the most appropriate and tailored treatment strategy in an adjuvant setting. 14,15 These markers will be used to determine the most appropriate treatment for recurrent or refractory settings in the future. We speculated that PFI is a useful clinical marker to determine the subsequent therapy of REC/AEC, as well as molecular and genomic markers.…”

Section: Discussionmentioning

confidence: 99%

“…After TCGA study, a variety of molecular and genomic markers (eg, L1 cell adhesion molecule expression, AT-rich interaction domain 1A abnormal expression, catenin beta 1 mutation, etc. ), with the exception of microsatellite instability status, have emerged to determine the most appropriate and tailored treatment strategy in an adjuvant setting 14,15 . These markers will be used to determine the most appropriate treatment for recurrent or refractory settings in the future.…”

Section: Discussionmentioning

confidence: 99%

Decision-making for Subsequent Therapy for Patients With Recurrent or Advanced Endometrial Cancer Based on the Platinum-free Interval

Yasunaga

Yahata

Okugawa

et al. 2023

American Journal of Clinical Oncology

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The aim of this study was to evaluate the progression-free survival (PFS) and overall response rate (ORR) of patients with recurrent endometrial cancer (REC) or advanced endometrial cancer (AEC) retreated with platinum-containing chemotherapy (PCC) based on the platinum-free interval (PFI). We compared our results with those reported in the KEYNOTE-775 study (that used pembrolizumab plus lenvatinib).Methods: A retrospective analysis was conducted of 65 patients with REC or AEC retreated with PCC between 2005 and 2020 at our hospital. Various clinicopathologic variables were analyzed: (1) age, (2) performance status, (3) histology, (4) history of pelvic irradiation in the adjuvant setting, (5) PFI, (6) chemotherapy regimen, (7) PFS and overall survival after retreatment with PCC, and (8) best ORR. Survival analyses were performed using Kaplan-Meier curves and log-rank tests. Results:The best ORR and PFS were 43.3% and 9.5 months, respectively, in patients with REC/AEC with a PFI ≥ 6 months. These results were comparable with those of patients treated with pembrolizumab and lenvatinib. The best ORR and PFS of patients with a PFI of <6 months appeared to be inferior to those of patients treated with pembrolizumab plus lenvatinib.Conclusions: Pembrolizumab plus lenvatinib seems to be a better treatment choice for patients with REC or AEC with a PFI of <6 months. For a PFI of ≥ 6 months, pembrolizumab plus lenvatinib or PCC can be used depending on the degree of residual side -effects associated with cytotoxic agents.

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Recent Advances in Endometrial Cancer Management

Abstract: In recent years, growing attempts have been carried out to improve the quality of care in the setting of gynecologic oncology, and, in particular, in endometrial cancer management [...]

Cited by 49 publications

References 12 publications

A Case Report of Malignant Perivascular Epithelioid Cell Tumors of the Uterus and Literature Review

A Case Report of Malignant Perivascular Epithelioid Cell Tumors of the Uterus and Literature Review

Impact of adjuvant treatment on survival in patients with 2023 FIGO stage IIC endometrial cancer: a retrospective analysis from two tertiary centers in Korea and Taiwan

Decision-making for Subsequent Therapy for Patients With Recurrent or Advanced Endometrial Cancer Based on the Platinum-free Interval

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