What is endometrial cancer?

Endometrialcancer (or endometrial cancer) is the most common gynaecological cancer. It usually occurs after menopause, but 25% of cases are also diagnosed in pre-menopausal women. It is often detected at a low stage and has a high treatment success rate, but in recent years, the mortality rate from this disease in Poland has been higher than in other European countries. According to experts, this may be due to inadequate therapeutic management and lack of proper diagnosis.

Approximately 1,800 women die annually from endometrial cancer in our country.

Endometrial cancer: what is it?, photo: panthermedia

Causes causing endometrial cancer

The development of endometrial cancer can be caused by prolonged stimulation of the endometrium by oestrogens (particularly when there is a deficiency of progestogens).

The following are also considered to be factors in the development of the disease:

obesity of patients aged 50-59 years,
lack of offspring,
infertility,
use of drugs with an agonist effect on the oestrogen receptor,
early onset of the first menstrual period,
late onset of last menstrual period,
occurrence of non-ovulatory cycles,
diseases such as hypertension and diabetes,
endometrial hyperplasia,
genetic conditions,
Lynch syndrome.

Treatment of endometrial cancer

The choice of treatment method is made by the doctor based on the stage of the cancer and its type. To date, the following have been used:

a surgical method in which the uterus and adnexa are removed (the most common method),
radiotherapy (either as an adjunct to surgery or as a stand-alone treatment) and brachytherapy,
combined treatment (chemotherapy - if the disease has spread to the abdominal cavity or has recurred, and hormone therapy).

Endometrial cancer: treatment options, photo: panthermedia

A promising treatment option for endometrial cancer - phase II study

The procedures by which clinical trials of drugs are conducted are strictly defined and monitored. This ensures that drugs are delivered to patients that have been refined, studied and described. Teams of scientists oversee the trials and check the results. Before a drug can enter circulation, it must pass through three phases.

A phase II study of a new treatment option for endometrial cancer is currently underway.

The new drug, which delivers chemotherapy directly to tumour cells in patients with endometrial cancer (advanced or recurrent), is progressing to the next phase III study, thanks to the fact that the results of the phase II trial have shown promise.

The drug is also being investigated for its usefulness in delivering chemotherapy to tumour cells of many types of metastatic solid tumours. In the phase II study, patients with different tumours, but sharing the same biomarker, were treated with 10 milligrams of the drug per kilogram of body weight on the first and eighth day of a 21-day cycle.

Results of a new drug trial for endometrial cancer

In patients with advanced, recurrent endometrial cancer, intensively treated previously with chemotherapy and immunotherapy, 22% responded to treatment; furthermore, 61% of patients had a reduction in target lesions.

Endometrial cancer: new treatment options, photo: panthermedia

In those who responded to treatment, tumours remained stable for an average of 8.8 months (without progression). 29% of patients are still in the treatment phase.

Minor side effects such as fatigue and nausea occurred during the study.

Personalised approach and molecular diagnostics hope for endometrial cancer treatment

During the 'Priorities in Healthcare 2024' conference, the panel 'Challenges and opportunities in the diagnosis and treatment of endometrial cancer in Poland in 2024', experts discussed ways to ensure the quality of treatment for endometrial cancer patients.

There is a breeze of optimism from the discussion and, according to conference participants, many changes are ahead of us in the topic of endometrial cancer treatment.

- According to Professor Jacek Szurkowski, MD, endometrial cancer is a molecularly diverse disease (and therefore the types of endometrial cancer are different); the quality of the treatment process could be improved by introducing diagnostics to identify the subtype of the disease at an early stage.

- Radosław Mądry, MD, PhD, argues similarly. According to him, a clear improvement in the results of endometrial cancer treatment would only be given by applying a comprehensive and individualised approach to each patient. During early diagnosis, a molecular profile should be created and the disease should be assigned to one of four basic groups.

- In turn, according to Professor Paweł Blecharz, MD, the latest recommendations recommend the use of immunotherapy, which significantly improves treatment outcomes. The professor points out that immunotherapy in this type of cancer is the future.

Endometrial cancer and molecular diagnostics, photo: panthermedia

- According to Lubomir Bodnar, MD, PhD, thanks to molecular profiling, appropriate forms of treatment can be selected with increasing precision. The presented research results confirm the higher effectiveness of treatment by combining immunotherapy and chemotherapy than by using chemotherapy alone already in the first line of treatment.

Refund

Another piece of good news for patients with endometrial cancer will certainly be the reimbursement of immunotherapy with the drug containing dostarlimab, in the second line of treatment.

At the same time, further steps should be expected on this topic, because, as Anna Kupiecka, President of the OnkoCafe-Razem lepiej Foundation, points out, according to the European registration, this therapy can already be used in the first line of treatment, in combination with chemotherapy.

All the indications are that experts, interested in the subject of endometrial cancer, are constantly looking for new ways to help defeat the disease and prolong the lives of patients.

way4cure.com

Promising prognosis in the treatment of endometrial cancer

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