New therapies for advanced, recurrent, and metastatic endometrial cancers

Vicky Makker, Angela K Green, Robert M Wenham, David Mutch, Brittany Davidson, David Scott Miller, Vicky Makker, Angela K Green, Robert M Wenham, David Mutch, Brittany Davidson, David Scott Miller

Abstract

Endometrial cancer is the most common gynecologic malignancy in the United States, accounting for 6% of cancers in women. In 2017, an estimated 61,380 women were diagnosed with endometrial cancer, and approximately 11,000 died from this disease. From 1987 to 2008, there was a 50% increase in the incidence of endometrial cancer, with an approximate 300% increase in the number of associated deaths. Although there are many chemotherapeutic and targeted therapy agents approved for ovarian, fallopian tube and primary peritoneal cancers, since the 1971 approval of megestrol acetate for the palliative treatment of advanced endometrial cancer, only pembrolizumab has been Food and Drug Administration (FDA)-approved for high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR) endometrial cancer; this highlights the need for new therapies to treat advanced, recurrent, metastatic endometrial cancer. In this review, we discuss current and emerging treatment options for endometrial cancer, including chemotherapy, targeted therapy, and immunotherapy. The National Cancer Institute (NCI) and others are now focusing their efforts on the design of scientifically rational targeted therapy and immunotherapy trials for specific molecular phenotypes of endometrial cancer. This is essential for the advancement of cancer care for women, which is threatened by a severe enrollment decline of approximately 80% for gynecologic oncology clinical trials.

Keywords: Chemotherapy; Endometrial cancer; Immunotherapy; Targeted therapy.

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

Dr. Robert M. Wenham has received study grant support from Merck and honoraria from Tesaro, Genentech, Clovis, and Jansen. Dr. Vicky Makker has received an honorarium from Eisai, as well as study support from Lilly, AstraZeneca, and Kryopharm. Dr. David Mutch has served as speaker for Clovis. Dr. David Miller has received grant funding from Tracon, Arno, Tesaro, Aprea, AstraZeneca, Janssen, Aeterna Zentaris, and Millenium; honorariums from Clovis, Eisai, Tesaro, AstraZeneca, Gaurdant, Genentech, and Alexion; and speaks for Genentech and Clovis. The other authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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