Systemic therapy for the treatment of endometrial cancer

ABSTRACT

Introduction: Endometrial cancer (EC) is one of the most frequent gynecological cancers worldwide. The gold standard treatment of EC is most certainly surgery and may very well be the only therapy in the early stages of disease. To improve outcomes in non-early EC, adjuvant therapy is often employed but this is not standardized. Adjuvant options can include radiotherapy, chemotherapy or a combination of both. Adjuvant chemotherapy could be indicated in high-risk stage I and II or advanced stage EC. Several clinical trials are ongoing in an attempt to define the optimal adjuvant treatment. Furthermore, chemotherapy is the front-line therapy in advanced unresectable, metastatic or recurrent endometrial cancer.

Areas covered: Herein, the authors review the first-line chemotherapy for the treatment of endometrial cancer and provide their expert perspectives on these therapies.

Expert opinion: Chemotherapy is fundamental in advanced/recurrent EC. Further evidence is needed to characterize the role of adjuvant chemotherapy. Future studies should consider genomic and molecular heterogeneities to identify even more efficient tailored therapies.

KEYWORDS:

• Adjuvant therapy
• chemotherapy
• endometrial cancer
• systemic therapies
• target therapies

Article highlights

• The gold standard for treatment of endometrial cancer is surgery of resettable disease.

• Chemotherapy can be used as adjuvant treatment of high-risk recurrence endometrial cancer, improving progression-free survival.

• The optimal form of adjuvant treatment after surgery has yet to be established.

• Chemotherapy is the front-line therapy in advanced unresectable, metastatic or recurrent endometrial cancer.

• The milestone as first-line chemotherapy is the association carboplatin/paclitaxel.

• New clinical trials have to clarify the role of multimodal adjuvant treatment (radiotherapy/chemotherapy) and the use of molecular target therapies.

This box summarizes key points contained in the article.

Acknowledgments

The authors thank Kate Jenkins and Henrietta Maria Lewis for revising the English language of the manuscript. All the authors remember with affection, gratitude and esteem their colleague and friend, Dr. Marisa Orrù, who left us before the end of the study.

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.

Reviewer disclosures

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

Additional information

Funding

This manuscript has not been funded.