An update on the current pharmacotherapy for endometrial cancer

ABSTRACT

Introduction: Endometrial cancer (EC) is the most common gynecologic malignancy in the developed world and is increasing in incidence. While the mainstay of treatment for EC is surgery followed by chemotherapy and/or radiation therapy, the available pharmacotherapies are rapidly and constantly evolving. Understanding these new therapies is an important part of the research and clinical care of women with EC. A review of available literature from MEDLINE (1879–2015) was conducted for the historic treatments and current therapies available for endometrial tumors.

Areas covered: This article reviews the current conventional therapies and discusses novel therapeutic agents, some of which are available to clinicians while others are currently being investigated in the preclinical setting.

Expert opinion: Genomic and immunohistochemical characterization of endometrial cancer may soon be the best approach for the identification of aggressive forms of tumor. Targeted therapies will soon be standard in the management of endometrial cancer.

KEYWORDS:

• Adjuvant therapy
• chemotherapy
• endometrial cancer
• endometrial pharmacotherapy
• hormone therapy
• targeted therapy
• uterine cancer

Article highlights

• Circulating tumor cells (CTCs) that are found more frequently in high-risk type I endometrial cancers (ECs) may help to identify patients more likely to require adjuvant chemotherapy.

• Chemotherapy is a cornerstone of adjuvant therapy for advanced International Federation Gynecology and Obstetrics stage disease as well as some high-risk histology cancers.

• Chemoradiation plays a role in reducing the risk of recurrence in advanced stage (stage III or IV) EC when compared to chemotherapy or radiation alone.

• An understanding of the molecular basis of EC has allowed for the development of novel targeted therapeutic agents for the treatment of recurrent disease refractory to standard treatment modalities.

• Circulating microRNAs have emerged as important biomarkers in cancer diagnostics.

This box summarizes key points contained in the article.

Declaration of interest

This work was supported in part by R01 CA154460-01 and U01 CA176067-01A1 grants from NIH, the Deborah Bunn Alley Foundation, the Tina Brozman Foundation, the Discovery to Cure Foundation and the Guido Berlucchi Foundation to ADS. This investigation was also supported by NIH Research Grant CA-16359 from the NCI. 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.