Updates on adjuvant chemotherapy and radiation therapy for endometrial cancer

Matthew Cowan, Jonathan B. Strauss, Emma L. Barber, Daniela Matei*

*Corresponding author for this work

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Purpose of reviewThis article will provide an opinion on adjuvant treatment of stage I-III endometrial cancer based on existing and evolving evidence.Recent findingsFor early-stage (I and II) intermediate risk endometrial cancer, vaginal brachytherapy reduces the risk of locoregional relapse. Recent studies have investigated the use of chemotherapy in early stage, high-risk patient population, but did not demonstrate a survival benefit. As such, chemotherapy is only recommended for selected patients at high risk for distant recurrence. On the other hand, for stage III disease, chemotherapy has a well established role. A landmark trial recently reported confirmed that chemoradiation improves recurrence-free survival compared with radiation alone in stage III endometrial cancer. However, in another randomized phase III trial, chemoradiotherapy was not superior to chemotherapy alone in this group, raising questions as to whether addition of radiation is necessary. Therefore, improved risk stratification using molecular markers in addition to traditional pathological criteria is critically needed to better predict the risk of local and systemic recurrence and to assist therapy decision-making.SummaryEndometrial cancer care is evolving and recent pivotal trials highlight the significance of chemotherapy to the treatment of stage III endometrial cancer and not to the approach for stage I and II cancer. The role of radiation therapy for stage III disease is raised into question.

Original languageEnglish (US)
Pages (from-to)31-37
Number of pages7
JournalCurrent Opinion in Obstetrics and Gynecology
Volume31
Issue number1
DOIs
StatePublished - Feb 1 2019

Fingerprint

Adjuvant Chemotherapy
Endometrial Neoplasms
Radiotherapy
Drug Therapy
Recurrence
Radiation
Survival
Brachytherapy
Chemoradiotherapy
Neoplasms
Decision Making
Therapeutics
Population

Keywords

  • chemotherapy
  • endometrial cancer
  • immunotherapy
  • molecular markers
  • radiation therapy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

@article{669c664433f041da94091615baaddd05,
title = "Updates on adjuvant chemotherapy and radiation therapy for endometrial cancer",
abstract = "Purpose of reviewThis article will provide an opinion on adjuvant treatment of stage I-III endometrial cancer based on existing and evolving evidence.Recent findingsFor early-stage (I and II) intermediate risk endometrial cancer, vaginal brachytherapy reduces the risk of locoregional relapse. Recent studies have investigated the use of chemotherapy in early stage, high-risk patient population, but did not demonstrate a survival benefit. As such, chemotherapy is only recommended for selected patients at high risk for distant recurrence. On the other hand, for stage III disease, chemotherapy has a well established role. A landmark trial recently reported confirmed that chemoradiation improves recurrence-free survival compared with radiation alone in stage III endometrial cancer. However, in another randomized phase III trial, chemoradiotherapy was not superior to chemotherapy alone in this group, raising questions as to whether addition of radiation is necessary. Therefore, improved risk stratification using molecular markers in addition to traditional pathological criteria is critically needed to better predict the risk of local and systemic recurrence and to assist therapy decision-making.SummaryEndometrial cancer care is evolving and recent pivotal trials highlight the significance of chemotherapy to the treatment of stage III endometrial cancer and not to the approach for stage I and II cancer. The role of radiation therapy for stage III disease is raised into question.",
keywords = "chemotherapy, endometrial cancer, immunotherapy, molecular markers, radiation therapy",
author = "Matthew Cowan and Strauss, {Jonathan B.} and Barber, {Emma L.} and Daniela Matei",
year = "2019",
month = "2",
day = "1",
doi = "10.1097/GCO.0000000000000506",
language = "English (US)",
volume = "31",
pages = "31--37",
journal = "Current Opinion in Obstetrics and Gynecology",
issn = "1040-872X",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

Updates on adjuvant chemotherapy and radiation therapy for endometrial cancer. / Cowan, Matthew; Strauss, Jonathan B.; Barber, Emma L.; Matei, Daniela.

In: Current Opinion in Obstetrics and Gynecology, Vol. 31, No. 1, 01.02.2019, p. 31-37.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Updates on adjuvant chemotherapy and radiation therapy for endometrial cancer

AU - Cowan, Matthew

AU - Strauss, Jonathan B.

AU - Barber, Emma L.

AU - Matei, Daniela

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Purpose of reviewThis article will provide an opinion on adjuvant treatment of stage I-III endometrial cancer based on existing and evolving evidence.Recent findingsFor early-stage (I and II) intermediate risk endometrial cancer, vaginal brachytherapy reduces the risk of locoregional relapse. Recent studies have investigated the use of chemotherapy in early stage, high-risk patient population, but did not demonstrate a survival benefit. As such, chemotherapy is only recommended for selected patients at high risk for distant recurrence. On the other hand, for stage III disease, chemotherapy has a well established role. A landmark trial recently reported confirmed that chemoradiation improves recurrence-free survival compared with radiation alone in stage III endometrial cancer. However, in another randomized phase III trial, chemoradiotherapy was not superior to chemotherapy alone in this group, raising questions as to whether addition of radiation is necessary. Therefore, improved risk stratification using molecular markers in addition to traditional pathological criteria is critically needed to better predict the risk of local and systemic recurrence and to assist therapy decision-making.SummaryEndometrial cancer care is evolving and recent pivotal trials highlight the significance of chemotherapy to the treatment of stage III endometrial cancer and not to the approach for stage I and II cancer. The role of radiation therapy for stage III disease is raised into question.

AB - Purpose of reviewThis article will provide an opinion on adjuvant treatment of stage I-III endometrial cancer based on existing and evolving evidence.Recent findingsFor early-stage (I and II) intermediate risk endometrial cancer, vaginal brachytherapy reduces the risk of locoregional relapse. Recent studies have investigated the use of chemotherapy in early stage, high-risk patient population, but did not demonstrate a survival benefit. As such, chemotherapy is only recommended for selected patients at high risk for distant recurrence. On the other hand, for stage III disease, chemotherapy has a well established role. A landmark trial recently reported confirmed that chemoradiation improves recurrence-free survival compared with radiation alone in stage III endometrial cancer. However, in another randomized phase III trial, chemoradiotherapy was not superior to chemotherapy alone in this group, raising questions as to whether addition of radiation is necessary. Therefore, improved risk stratification using molecular markers in addition to traditional pathological criteria is critically needed to better predict the risk of local and systemic recurrence and to assist therapy decision-making.SummaryEndometrial cancer care is evolving and recent pivotal trials highlight the significance of chemotherapy to the treatment of stage III endometrial cancer and not to the approach for stage I and II cancer. The role of radiation therapy for stage III disease is raised into question.

KW - chemotherapy

KW - endometrial cancer

KW - immunotherapy

KW - molecular markers

KW - radiation therapy

UR - http://www.scopus.com/inward/record.url?scp=85058914734&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058914734&partnerID=8YFLogxK

U2 - 10.1097/GCO.0000000000000506

DO - 10.1097/GCO.0000000000000506

M3 - Review article

C2 - 30571659

AN - SCOPUS:85058914734

VL - 31

SP - 31

EP - 37

JO - Current Opinion in Obstetrics and Gynecology

JF - Current Opinion in Obstetrics and Gynecology

SN - 1040-872X

IS - 1

ER -