Treatment options in the advanced and recurrent setting for endometrial cancer: an update

ABSTRACT

Introduction

Uterine cancer is the most common gynecologic malignancy in women and is projected to surpass ovarian cancer as the deadliest gynecologic malignancy in the United States in 2024. Additionally, rates of advanced and high-risk uterine cancer have been on the rise in the United States, demonstrating a need for innovation in treatment options. There have been multiple recent trials investigating the incorporation of novel agents in the treatment of advanced and recurrent endometrial cancer.

Areas Covered

This article will discuss the current landscape of the treatment of advanced and recurrent endometrial cancer, focusing on recent phase III trials published or presented on with the incorporation of immunotherapy and other novel therapeutics while also reviewing promising phase I and II trials in the field. Clinical trials were identified via clinicaltrials.gov and a PubMed literature search was performed (initially February 2024, updated May 2024).

Expert Opinion

The treatment field is promising for patients as many of these trials appear to offer progression free and overall survival benefits in a disease with a historically poor prognosis. Molecular profiling of endometrial cancer will be the backbone of treatment paradigms in the future.

KEYWORDS:

• Advanced endometrial cancer
• recurrent endometrial cancer
• immunotherapy
• cancer genome atlas
• targeted therapy

Article highlights

• The Tumor Cancer Genome Atlas classification of endometrial cancer has led to trials focusing on treatment and outcomes based on different molecular subtypes of endometrial cancer.

• Recent advances in endometrial cancer include multiple phase III trials demonstrating significant clinical benefit with immunotherapy in mismatch repair deficient patients.

• More work is needed to understand which patients with which biomarkers derive the most benefit from certain targeted therapies.

Declaration of interest

K. Tewari reports Grants: Merck, Astra Zeneca, Abbvie, Morphotek, Genentech. Consulting Fees: GSK Advisory Board, Merck Advisory Board, Eisai Advisory Board, Seagen Advisory Board. Honoraria: GSK Speaker’s Bureau, Merck Speaker’s Bureau, Eisai Speaker’s Bureau, Seagen Speaker’s Bureau. Data Safety Board: Chair of Iovance Data Safety Monitoring Board. The authors have no other 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 apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.