Lheureux Stephanie, McCourt Carolyn, Rimel B J, Duska Linda, Fleming Gini, Mackay Helen, Mutch David, Temkin Sarah M, Lynn Jean, Kohn Elise C
Princess Margaret Cancer Centre, Toronto, Canada.
Washington University St. Louis, MO, United States.
Gynecol Oncol. 2018 Feb 22. doi: 10.1016/j.ygyno.2018.02.005.
The incidence of endometrial cancer (EC) in the U.S. has been rising, from an estimated annual incidence of 49,560 in 2013 to 61,380 in 2017. Meanwhile, the SEER-based relative survival of women with EC in the U.S. has remained flat [82.3% from 1987 to 1989, 82.8% from 2007 to 2013] and our recent increased understanding of EC biology and subtypes has not been translated into therapeutic advances. The U.S. National Cancer Institute (NCI) therefore convened a Uterine Clinical Trials Planning Meeting in January 2016 to initiate and accelerate design of molecularly-targeted EC trials. Prior to the meeting a group of experts in this field summarized available data, emphasizing data on human samples, to identify potentially actionable alterations in EC, and the results of their work has been separately published. The Clinical Trials Meeting planners focused on discussion of (1) novel trial designs, including window-of opportunity trials and appropriate control groups for randomized trials, (2) targets specific to serous carcinoma and promises and pitfalls of separate trials for women with tumors of this histology (3) specific recommendations for future randomized trials.
美国子宫内膜癌(EC)的发病率一直在上升,从2013年估计的年发病率49560例升至2017年的61380例。与此同时,美国基于监测、流行病学和最终结果(SEER)的EC女性相对生存率一直持平[1987年至1989年为82.3%,2007年至2013年为82.8%],而且我们最近对EC生物学和亚型的深入了解尚未转化为治疗进展。因此,美国国立癌症研究所(NCI)于2016年1月召开了一次子宫临床试验规划会议,以启动并加速分子靶向EC试验的设计。会前,该领域的一组专家总结了现有数据,重点是人类样本数据,以确定EC中可能具有可操作性的改变,他们的工作结果已另行发表。临床试验会议策划者着重讨论了:(1)新颖的试验设计,包括机会窗试验以及随机试验的合适对照组;(2)浆液性癌特有的靶点以及针对该组织学肿瘤女性进行单独试验的前景与陷阱;(3)对未来随机试验的具体建议。