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Review

The role of fulvestrant in endometrial cancer

, , , , , , , , & show all
Pages 537-544 | Received 24 May 2016, Accepted 22 Sep 2016, Published online: 19 Oct 2016
 

ABSTRACT

Introduction: Endometrial cancer is the most common malignancy of the female genital tract in industrialized countries. The traditional treatment of endometrial cancer is based on a surgical approach. In recent years, systemic endocrine therapy has demonstrated good efficacy in recurrent or metastatic setting, delaying progression, ameliorating quality of life and palliating symptoms.

Areas covered: Phase I and II studies on selective estrogen receptor down-regulators used for the treatment of endometrial cancer treatment have been reviewed. The pharmacokinetic and pharmacodynamic features of selective receptor down-regulators have been also investigated.

Expert opinion: Selective estrogen receptor down-regulators may exhibit clinical efficacy in the treatment of gynecological malignancies due to their pure estrogen receptor antagonist properties. However, up to now data are still limited and some unsolved questions remain. Fulvestrant has poor oral bioavailability and low pharmacodynamic characteristics. Further trials are required to examine new selective estrogen receptor down-regulator agents with better pharmacodynamic and pharmacokinetic profiles.

Article highlights

  • Fulvestrant is the only compound among selective estrogen receptor down-regulators (SERDs) approved by FDA for clinical use in the treatment of endometrial cancer

  • At present only phase I/II clinical trials have been performed

  • Clinical trials showed that fulvestrant has a good tolerability profile

  • No sufficient data are available about the efficacy of fulvestrant for the treatment of endometrial cancer

  • SERDs may be clinically efficient for the treatment of gynaecological malignancies due to their pure estrogen antagonist properties, but further studies are mandatory

  • No Bio-markers are available to predict clinical response in patients treated with fulvestrant. The progesterone receptor might be a viable candidate.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.

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