Skip to main content

Review: Clinical Trials Outcome for Chemotherapy in Endometrial Cancer

  • Chapter
  • First Online:
Recent Advances in Endometrial Cancer

Abstract

Endometrial cancer is one of the most common gynecological malignancy of the female genital tract in the Western countries. Surgery had been the mainstay of treatment for early stages previously, whereas women in advance stage required chemotherapy with or without radiotherapy. The success achieved with chemotherapeutic agents in advanced stages prompted researchers to put to test these drugs in the treatment of a subset of early-stage endometrial cancer, which had high incidence of recurrence and high mortality rates. Various clinical trials have been conducted in this regard, all aiming toward finding the most effective treatment option with least toxicity by working out various permutations, combinations of chemotherapeutic drugs, and even combinations of chemotherapy with radiation. The obvious change noticed in all these trials is the primary outcome measure that looks at the overall survival and not just curing the disease. This chapter is a review of all such researches with their setbacks, to apprise us and guide us to better management of the patient of endometrial cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. UCSF clinical trials: how clinical trials work. https://clinicaltrials.ucsf.edu/about/how-clinical-trials-work

  2. Worldwide cancer data/World cancer research fund. http://www.wcrf.org > diet and cancer.

  3. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34.

    Article  Google Scholar 

  4. Hamilton CA, Cheung MK, Osann K, et al. Uterine papillary serous and clear cell carcinomas predict poorer survival compared to grade 3 endometrioid corpus cancers. Br J Cancer. 2006;94(5):642–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Evans T, Sany O, Pearmain P, et al. Differential trends in the rising incidence of endometrial cancer by type: data from a UK population-based registry from 1994 to 2006. Br J Cancer. 2011;104(9):1505–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Keys HM, Roberts JA, Brunetto VL, et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a gynecologic oncology group study. Gynecol Oncol. 2004;92(3):744–51.

    Article  PubMed  Google Scholar 

  7. Creutzberg CL, van Putten WL, Kopper PC, et al. Surgery and postoperative radiotherapy versus surgery alone for patients with stage I endometrial carcinoma: multicentre randomised trial. PORTEC study group. Post operative radiation therapy in endometrial carcinoma. Lancet. 2000;355:1404–11.

    Article  CAS  PubMed  Google Scholar 

  8. Creasman WT, Morrow CP, Bundy BN, et al. Surgical pathologic spread patterns of endometrial cancer. A gynecologic oncology group study. Cancer. 1987;60(Suppl 8):2035–41.

    Article  CAS  PubMed  Google Scholar 

  9. Humber C, Tierney J, Symonds P, et al. Chemotherapy for advanced, recurrent or metastatic endometrial carcinoma. Cochrane Database Syst Rev. 2005;3:CD003915.

    Google Scholar 

  10. Blake P, Swart AM, Orton J, ASTEC/EN. 5 Study Group, et al. Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MR ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systemic review, and meta analysis. Lancet. 2009;373:137–46.

    Article  CAS  PubMed  Google Scholar 

  11. Johnson N, Bryant A, Cornes P, et al. Adjuvant chemotherapy for endometrial cancer after hysterectomy. Cochrane Database Syst Rev. 2011;10:CD003175.

    Google Scholar 

  12. Morrow CP, Bundy BN, Homesly HD, et al. Doxorubicin as adjuvant following surgery and radiation therapy in patients with high risk endometrial cancer, stage I and occult stage II: a gynecologic oncology group study. Gynecol Oncol. 1990;36:166–71.

    Article  CAS  PubMed  Google Scholar 

  13. Susumu N, Sagae S, Udagawa Y, et al. Randomized phase III trial of pelvic radiotherapy versus cisplatin-based combined chemotherapy in patients with intermediate- and high-risk endometrial cancer: a Japanese gynecologic oncology group study. Gynecol Oncol. 2008;108:226–33.

    Article  CAS  PubMed  Google Scholar 

  14. Maggi R, Lissoni A, Spina F, et al. Adjuvant chemotherapy vs radiotherapy in high-risk endometrial carcinoma: results of a randomised trial. Br J Cancer. 2006;95:266–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Gravin K, Winter K, Underhill K, et al. Final analysis of RTOG 9708: adjuvant postoperative irradiation combined with cisplatin paclitaxel chemotherapy following surgery for patients with high risk endometrial cancer. Gynecol Oncol. 2006;103(1):155–9.

    Article  Google Scholar 

  16. Hogberg T, Rosenberg P, Kristensen G, de Oliveira CF, et al. A randomised phase III study on adjuvant treatment with radiation (RT) +/− chemotherapy (CT) in early stage high risk endometrial cancer (NSOG – EC – 9501/EORTC 55991). J Clin Oncol. 2007;25(18S):5503.

    Article  Google Scholar 

  17. Hogberg T, Signorelli M, de Oliveria CF, et al. Sequential adjuvant chemotherapy and radiotherapy in endometrial cancer—results from two randomised studies. Eur J Cancer. 2010;46:2422–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Kuoppala T, Maenpaa J, Tomas E, et al. Surgically staged high- risk endometrial cancer: randomized study of adjuvant radiotherapy alone vs sequential radiotherapy. Gynecol Oncol. 2008;110(2):190–5.

    Article  PubMed  Google Scholar 

  19. Randall ME, Filiaci V, McMeekin DS, et al. Phase III trial: adjuvant pelvic radiation therapy versus vaginal brachytherapy plus paclitaxel/carboplatin in high-intermediate and high-risk early stage endometrial cancer. J Clin Oncol. 2019;37:1810. https://doi.org/10.1200/JCO.18.01575.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. de Boer SM, Powell ME, Mileshkin L, et al. Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2018;19(3):295–309.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Nout RA, Smit VT, Putter H, et al. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet. 2010;375:816–23.

    Article  CAS  PubMed  Google Scholar 

  22. Brunner DW, Barsevick A, Tian C, et al. Randomized trial of quality of life comparing whole abdomen irradiation versus combination chemotherapy in advanced endometrial carcinoma: a gynecologic oncology group study. Qual Life Res Int J Qual Life Asp Treat Care Rehab. 2007;16(1):89–100.

    Google Scholar 

  23. Maggi R, Cagnazzo G, Atlante G, et al. Risk groups and adjuvant therapy in surgical staged endometrial cancer patients. A randomized multicentre study comparing chemotherapy with radiation therapy. Int J Gynecol Cancer. 1999;(suppl 1):85.

    Google Scholar 

  24. Matei D, Filiaci VL, Randall M, et al. A randomized phase III trial of cisplatin and tumor volume directed irradiation followed by carboplatin and paclitaxel vs. carboplatin and paclitaxel for optimally debulked, advanced endometrial carcinoma. J Clin Oncol. 2017;35:5505.

    Article  Google Scholar 

  25. Wui-Jin KM, Abu-Rustum NM, Bradley KM: National Comprehensive Cancer Network. Uterine Neoplasms (Version 1.2019). Accessed November 22, 2018. Reference Source [Google Scholar].

    Google Scholar 

  26. Buhtoiarova TN, Brenner CA, Singh M. Endometrial carcinoma: role of current and emerging biomarkers in resolving persistent clinical dilemmas. Am J Clin Pathol. 2016;145(1):8–21.

    Article  CAS  PubMed  Google Scholar 

  27. Carcanglu ML, Chambers JT. Early pathologic stage clear cell carcinoma and uterine papillary serous carcinoma of the endometrium: comparison of clinicopathological features and survival. Int J Gynecol Pathol. 1996;14(1):30–8.

    Article  Google Scholar 

  28. Fader AN, Roque DM, Siegel E, et al. Randomized phase II trial of carboplatin-paclitaxel versus carboplatin-paclitaxel-trastuzumab in uterine serous carcinomas that overexpress human epidermal growth factor receptor 2/neu. J Clin Oncol. 2018;36(20):2044–51.

    Article  CAS  Google Scholar 

  29. Statement of the Uterus Committee of the Gynaecological Oncology Working Group (AGO) on the PORTEC-3 study. Geburtshilfe Frauenheilkd. 2018 Oct;78(10):923–6.

    Article  Google Scholar 

  30. Thigpen JT, Brady MF, Homesley HD, et al. Phase III trial of doxorubicin with or without cisplatin in advanced endometrial carcinoma: a gynaecologic oncology group study. J Clin Oncol. 2004;22:3902–8.

    Article  CAS  PubMed  Google Scholar 

  31. Van Wijk FH, Aapro MS, Bolis G, et al. European organization for research and treatment of cancer gynaecological cancer group. Doxorubicin versus doxorubicin and cisplatin in endometrial carcinoma: definitive results of a randomised study (55872) by EORTC gynaecological cancer group. Ann Oncol. 2003;14:441–8.

    Article  PubMed  Google Scholar 

  32. Flemming GF, Filiaci VI, Bentley RC, et al. Phase III randomised trial of doxorubicin + cisplatin versus doxorubicin + 24 h paclitaxel + filgastrim in endometrial carcinoma: a gynecological oncology group study. Ann Oncol. 2004;15:1173–8.

    Article  Google Scholar 

  33. Miller D, Filiaci V, Fleming G, et al. Breaking abstract I: randomised phase III non-inferiority trial of first line chemotherapy for recurrent endometrial carcinoma: a gynecological oncology group study. Gynecol Oncol. 2012;125:771.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Malakar, A., Grover, A., Khatuja, R. (2020). Review: Clinical Trials Outcome for Chemotherapy in Endometrial Cancer. In: Mehta, S., Gupta, B. (eds) Recent Advances in Endometrial Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-15-5317-2_8

Download citation

  • DOI: https://doi.org/10.1007/978-981-15-5317-2_8

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-5316-5

  • Online ISBN: 978-981-15-5317-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics