a Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and Women's Health Institute , The Cleveland Clinic Foundation , Cleveland , Ohio.
Expert Rev Anticancer Ther. 2018 Sep;18(9):873-885. doi: 10.1080/14737140.2018.1491311. Epub 2018 Jul 4.
Endometrial cancer is the most common gynecologic malignancy in the developed world, and its incidence is increasing. Mortality from this cancer has not improved in recent decades and is primarily driven by high-grade carcinomas that are more likely to present at an advanced stage and ultimately are more likely to recur. The prognosis for recurrent endometrial cancer is poor, especially for the 50% of these women that present with extrapelvic disease recurrence. As a standard of care, recurrent disease has been treated with platinum-based chemotherapy; however, new therapies are emerging as we identify drivers of proliferation and metastasis at the cellular and molecular levels. Areas Covered: We review currently available data for the management of recurrent endometrial cancer, with a focus on systemic treatment of recurrent disease. We discuss the available evidence for first-line, second-line, and subsequent systemic therapy and discuss emerging therapeutic targets including their biologic plausibility and early clinical data. Expert Commentary: Endometrial cancer, though prevalent, remains underfunded and understudied. Recurrent and metastatic disease remains difficult to treat, and prospective randomized data are limited. Our ability to reduce mortality due to this cancer is dependent on identifying new and effective therapeutic strategies for recurrent disease.
子宫内膜癌是发达国家最常见的妇科恶性肿瘤，其发病率正在上升。近几十年来，这种癌症的死亡率并没有改善，主要是由于高级别癌更容易在晚期出现，最终更有可能复发。复发性子宫内膜癌的预后较差，特别是对于 50%出现盆腔外疾病复发的女性。作为一种常规治疗方法，复发性疾病已采用铂类为基础的化疗进行治疗；然而，随着我们在细胞和分子水平上识别增殖和转移的驱动因素，新的治疗方法正在出现。
我们回顾了复发性子宫内膜癌管理的现有数据，重点是复发性疾病的系统治疗。我们讨论了一线、二线和后续系统治疗的现有证据，并讨论了新兴的治疗靶点，包括其生物学合理性和早期临床数据。
尽管子宫内膜癌很常见，但它的资金和研究仍然不足。复发性和转移性疾病仍然难以治疗，前瞻性随机数据有限。我们降低这种癌症死亡率的能力取决于为复发性疾病确定新的有效治疗策略。
