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Endocrine therapy in endometrial cancer: An old dog with new tricks. | LitMetric

Endocrine therapy in endometrial cancer: An old dog with new tricks.

Gynecol Oncol

Division of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. Electronic address:

Published: April 2019

AI Article Synopsis

  • The estrogen receptor (ER) and progesterone receptor (PR) pathways are key therapeutic targets for women with endometrioid endometrial cancer (EC), but current endocrine therapies often show limited effectiveness and resistance develops in many patients.
  • Various treatment options, such as progestins, selective ER modulators (SERMs), and aromatase inhibitors (AIs), are available and have a relatively favorable toxicity profile.
  • A deeper understanding of ER and PR biology could help identify which patients will benefit from treatment, as well as inform new strategies and enhance responses in future clinical trials, including options for younger women concerned about fertility.

Article Abstract

One of the most prevalent potential therapeutic targets for women with endometrioid endometrial cancer (EC) is the estrogen receptor (ER)/progesterone receptor (PR) pathway. Despite a high proportion of endometrioid ECs being ER and/or PR positive, endocrine therapy is only effective in a minority of women with EC and ultimately patients progress with resistance developing to treatment. A variety of treatment approaches with progestins, selective ER modulators (SERMs) and aromatase inhibitors (AIs) are available. Exploration of these agents is desirable given their favorable toxicity profile. Greater understanding of ER and PR biology may help identify patient populations who will derive benefit and strategies for new therapeutic options. Here we review the clinical efficacy of endocrine therapy in EC, discuss the role of ER and/or PR as prognostic biomarkers, describe disease-specific mechanisms of resistance to endocrine therapy and explore potential strategies to enhance response for the "next generation" of endocrine therapy clinical trials. We also describe the use of endocrine therapy in younger women seeking to pursue fertility sparing options for management of EC.

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Source
http://dx.doi.org/10.1016/j.ygyno.2018.12.018DOI Listing

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