Department of Medicine, Division of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
Curr Opin Oncol. 2011 Sep;23(5):494-500. doi: 10.1097/CCO.0b013e328348840a.
Endometrial cancer is the most common gynaecologic cancer in the western world. Systemic treatments for advanced disease have traditionally included hormonal therapy and chemotherapy. Responses to treatment are short-lived and advanced-stage disease remains incurable. Recent research has focused on optimizing chemotherapy regimens, the development of alternative hormonal therapy strategies and the introduction of targeted therapies. The most recent developments in these areas will be reviewed here.
Phase III trials continue to focus on the optimization of combination chemotherapy regimens. The elucidation of a hormonal pathway central to the control of oestrogen-stimulated cancer growth has led to the development of a new class of hormonal agents currently undergoing evaluation in the clinical trial setting. Increasing understanding of the molecular basis for malignant transformation continues to provide rationale for the development of many targeted therapies. Mammalian target of rapamycin inhibition, in particular, offers further encouraging results in this context.
The development of new hormone treatments and effective targeted therapies will provide new opportunities to improve therapy for women with advanced endometrial cancer. Optimization of therapy will require an approach to personalized therapy in order to guide choice and sequence of therapy and improve survival and quality of life.
子宫内膜癌是西方世界最常见的妇科癌症。晚期疾病的系统治疗传统上包括激素治疗和化疗。对治疗的反应是短暂的，晚期疾病仍然无法治愈。最近的研究集中在优化化疗方案、开发替代激素治疗策略和引入靶向治疗上。本文将回顾这些领域的最新进展。
III 期试验继续专注于优化联合化疗方案。阐明了一条对雌激素刺激的肿瘤生长起关键作用的激素途径，导致了一类新的激素药物的开发，目前正在临床试验中进行评估。对恶性转化分子基础的认识不断加深，为许多靶向治疗的发展提供了依据。雷帕霉素靶蛋白抑制，特别是在这方面提供了更令人鼓舞的结果。
新的激素治疗和有效的靶向治疗的发展将为晚期子宫内膜癌妇女的治疗提供新的机会。为了指导治疗的选择和顺序，提高生存率和生活质量，优化治疗需要采用个性化治疗的方法。
