Groupe d'Investigateurs Nationaux pour l'Etude des Cancers de l'Ovaire (GINECO), Centre Leon Bèrard, Lyon, France.
Honor Health Research Institute, University of Arizona, Creighton University, Phoenix, Arizona, USA.
Int J Gynecol Cancer. 2023 Dec 4;33(12):1943-1949. doi: 10.1136/ijgc-2023-004739.
Metastatic or recurrent endometrioid adenocarcinoma of the uterine corpus is often incurable with limited treatment options. First-line treatment often includes cytotoxic chemotherapy, which incurs significant toxicities for many patients. Endometrial cancer, specifically endometrioid cancer, is a hormone-sensitive disease and, while single-agent hormonal therapies have demonstrated clinical benefit, resistance to these agents often leads to the use of chemotherapy. There is a lack of approved endocrine treatment options in the metastatic setting for most recurrent endometrial cancers, representing an unmet clinical need. Emerging evidence suggests that hormonal therapy in combination with other targeted treatments, such as cyclin dependent kinase (CDK)4/6 inhibitors, is well tolerated and effective in select patient populations. We discuss the clinical evidence suggesting that the combination of CDK4/6 inhibitors and hormonal therapy has the potential to represent an important addition to the first-line treatment options for patients with low-grade advanced or recurrent endometrial cancer.
转移性或复发性子宫内膜样腺癌的子宫体通常无法治愈,治疗选择有限。一线治疗通常包括细胞毒性化疗,但许多患者会产生明显的毒性。子宫内膜癌,特别是子宫内膜样癌,是一种激素敏感性疾病,虽然单药激素治疗已显示出临床获益,但这些药物的耐药性常常导致化疗的使用。对于大多数复发性子宫内膜癌,转移性环境中缺乏获得批准的内分泌治疗选择,这是一个未满足的临床需求。新出现的证据表明,激素治疗联合其他靶向治疗,如细胞周期蛋白依赖性激酶(CDK)4/6 抑制剂,在某些患者群体中具有良好的耐受性和有效性。我们讨论了临床证据,表明 CDK4/6 抑制剂和激素治疗的联合有可能成为低级别晚期或复发性子宫内膜癌患者一线治疗选择的重要补充。