Alexandre Jerome, Boudier Philippe, Lavit Elise, Asselain Bernard, Emambux Sheik, Berton Dominique, Babin Guillaume, Lescure Céline, Heudel Pierre-Etienne, Salaun Hélène, Delanoy Nicolas, Dawood Heba, Combe Pierre, Duliège Delphine, Selle Frederic, Hakmé Antoinette, Cagnan Lauren, Offner Nicolas, Niogret Julie, Pautier Patricia, Sellam Zineb, Gomes David Manuel, Monard Adrien, Hardy-Bessard Anne-Claire, Bellier Charlotte, Lortholary Alain, Chaix Marie, Follana Philippe, Deiana Laura, Gavoille Laurène, Manuceau Gregory, Djennaoui Sadji, Cancel Mathilde, Kalbacher Elsa, De Percin Sixtine
Université Paris Cité, Paris, Île-de-France, France
Hôpital Cochin, Paris, Île-de-France, France.
BMJ Open. 2025 Sep 4;15(9):e096837. doi: 10.1136/bmjopen-2024-096837.
Advanced or recurrent endometrial carcinoma (EC) represents a significant clinical challenge. This study aimed to evaluate patient (age and comorbidities) and disease (histological subtypes and stages) characteristics, treatment patterns and survival outcomes in a real-world French healthcare setting.
In this national, multi-centre, retrospective observational cohort study, 200 patients with advanced or recurrent EC receiving first- or second-line chemotherapy during the year 2019 were analysed. Data collected included baseline characteristics, treatment regimens, real-world progression-free survival (rwPFS) and overall survival (OS).
127 and 73 were included in the first and second lines, respectively. Endometrioid carcinoma was the most represented histological subtype (62.0%). Patients in the first line, of whom 31.5% had FIGO (Fédération Internationale de Gynécologie Obstétrique) IVB disease, mainly received a combination of carboplatin and paclitaxel (78.0%), while 131 patients receiving second-line therapy were mainly administered anthracycline (54.2%). Median rwPFS and OS were, respectively, 8.5 and 13.2 months for patients receiving first-line therapy and 4.0 and 9.4 months for patients receiving second-line therapy. In Cox analyses, a diagnosis of carcinosarcoma, the presence of liver metastases and stage IVB disease were associated with worse survival outcomes for patients recieving first-line chemotherapy. Non-platinum chemotherapy and liver metastases were associated with poorer survival in patients receiving second-line chemotherapy.
This study highlights the landscape of metastatic EC treatment in a real-world French setting before the availability of PD1 inhibitors, emphasising the discrepancy between clinical trial data and real-world outcomes. It underscores the necessity for further real-world studies to complement clinical trials for a comprehensive understanding of metastatic EC management.
晚期或复发性子宫内膜癌(EC)是一项重大的临床挑战。本研究旨在评估法国实际医疗环境中患者(年龄和合并症)及疾病(组织学亚型和分期)特征、治疗模式和生存结果。
在这项全国性、多中心、回顾性观察队列研究中,分析了2019年接受一线或二线化疗的200例晚期或复发性EC患者。收集的数据包括基线特征、治疗方案、实际无进展生存期(rwPFS)和总生存期(OS)。
一线和二线分别纳入127例和73例。子宫内膜样癌是最常见的组织学亚型(62.0%)。一线患者中,31.5%患有国际妇产科联合会(FIGO)IVB期疾病,主要接受卡铂和紫杉醇联合治疗(78.0%),而接受二线治疗的131例患者主要使用蒽环类药物(54.2%)。接受一线治疗的患者rwPFS和OS中位数分别为8.5个月和13.2个月,接受二线治疗的患者分别为4.0个月和9.4个月。在Cox分析中,肉瘤样癌诊断、肝转移的存在和IVB期疾病与接受一线化疗患者的较差生存结果相关。非铂类化疗和肝转移与接受二线化疗患者的较差生存相关。
本研究突出了在PD1抑制剂可用之前法国实际环境中转移性EC的治疗情况,强调了临床试验数据与实际结果之间的差异。它强调了进一步开展实际研究以补充临床试验,从而全面了解转移性EC管理的必要性。