new article out today in OncologySTAT on endometrial cancer

lindaprocopio

It's so RARE to have new research published on endometrial cancer, that I wanted to share some of the highlights of this new article that came out today. If anyone wants to read the whole article, I saved it since the URL was password protected and I wasn't sure you would be able to access it without OncologySTAT membership. You can email me lindapro@ptd.net if you want me to email you the whole article. I must warn you that, unless you are an 'eyes wide open' kind of girl, several statements in this article may keep you awake at night. But some of it was hopeful and I will post those excerpts here:

(treatment ideas mostly for those with recurrent uterine cancers):

A newer chemotherapeutic agent with activity is ixabepilone, an epothilone B analog. In the GOG 129-P study, ixabepilone resulted in an overall response rate of 12% as second line treatment in advanced endometrial cancer, while stable disease for at least 8 weeks was noted in 30 (60%) patients. Another phase III trial (IXAMPLE2) that is currently recruiting participants randomizes patients to receive second line treatment every 3 weeks with either ixabepilone or standard chemotherapy (paclitaxel or doxorubicin) (ClinicalTrials.gov Identifier: NCT00883116).

The activation of the PI3K/AKT/mTOR signaling pathway induced by the loss of function of PTEN gene, suggests a therapeutic role for the mTOR inhibition. Chemotherapy-naïve patients with advanced, recurrent or metastatic endometrial carcinoma treated with temsirolimus, an mTOR inhibitor, achieved RR of 26% but the result was not correlated with PTEN immunohistochemical expression. Early clinical data of other mTOR inhibitors, including RAD001 (everolimus) and AP2357, have shown promising clinical activity, mainly in the form of disease stabilization [88], [89], [90]. A recent phase II trial of temsirolimus in heavily pretreated patients with advanced endometrial cancer reported a 7% partial response rate and a 44% stable disease rate [91]. Combinations of mTOR inhibitors with hormonal therapy, chemotherapy or other targeted therapies such as epidermal growth factor receptor (EGFR) inhibitors and antiangiogenic agents have been studied and preclinical evidence is encouraging. Early clinical trials are currently underway to evaluate the combination of temsirolimus with topotecan in advanced endometrial cancer. Of note, exposure of endometrial cancer cell lines to an mTOR inhibitor increases progesterone mRNA expression and inhibits ER mRNA expression suggesting a cross-talk between the mTOR pathway and hormone receptor-dependent signal transduction.

Overall, progestins remain a valid option with favorable toxicity profile for patients with well-differentiated (low grade) endometrioid adenocarcinomas with positive progesterone receptors who are not suitable for chemotherapy. In a recent systematic review, 11–56% of grade 1 and 2 tumors were shown to respond to progestins, while RR for PgR positive tumors was usually greater. Toxicity was remarkably low with a rate of grade 3 and 4 events less than 5% [29]. However, it remains unclear why many hormone receptor positive tumors fail to respond to progestins, while a minority of ER/PgR negative tumors actually respond to progestin therapy. Interestingly, a minority of patients treated with progestins can achieve long-term responses exceeding 2 years.

Critical Reviews in Oncology / Hematology
Volume 79, Issue 3 , Pages 278-292, September 2011
Developments in the systemic treatment of endometrial cancer

Ro10

Linda thanks for sharing
I never heard of the drugs mentioned here. I will do more research on them. I appreciate you sharing what you have found with your research.

Glad to hear you are still living your life to the fullest. Hope the fatigue gets better for you soon. Glad you still have minimal side effects from all you have been through. In peace and caring.

carolenk

Ro10 said:

Linda thanks for sharing
I never heard of the drugs mentioned here. I will do more research on them. I appreciate you sharing what you have found with your research.

Glad to hear you are still living your life to the fullest. Hope the fatigue gets better for you soon. Glad you still have minimal side effects from all you have been through. In peace and caring.

Progestin therapy
I am going to have to look into the progestin therapy for progesterone receptor positive endometrial cancer as I have never heard of this before. Progestins (synthetic progesterone) are used in women without cancer as a progesterone replacement. However, it looks like progestins are used to BLOCK the progesterone receptor in women with endometrial cancer. Really interesting.

This brings to mind the use of soy which is considered to be a "phytoestrogen" and it may actually block estrogen receptors in cancer cells. But who knows?

soromer

carolenk said:

Progestin therapy
I am going to have to look into the progestin therapy for progesterone receptor positive endometrial cancer as I have never heard of this before. Progestins (synthetic progesterone) are used in women without cancer as a progesterone replacement. However, it looks like progestins are used to BLOCK the progesterone receptor in women with endometrial cancer. Really interesting.

This brings to mind the use of soy which is considered to be a "phytoestrogen" and it may actually block estrogen receptors in cancer cells. But who knows?

Progestin info directly relevant to my earlier Q re Megace
which appears to be one of the two standard progestins now in clinical use. So, thanks, Linda, for posting this article.

I've found a fair amount about the subject of hormonal therapy in the past few days. Here's one other, slightly older, but comprehensive source focused on hormonal therapies:
http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=240
Kohorn, E, Hormonal therapy of endometrial carcinoma, Glob. libr. women's med.,(ISSN: 1756-2228) 2008; DOI 10.3843/GLOWM.10240

Regarding the soy question: the jury appears to be out on that whole issue of phytoestrogens, from what I can tell. Some think it's good to consume them, others don't. I myself am avoiding soy and other phytoestrogenic foods (e.g. cruciferous veggies), on the counsel of my osteopath.

paris11

soromer said:

Progestin info directly relevant to my earlier Q re Megace
which appears to be one of the two standard progestins now in clinical use. So, thanks, Linda, for posting this article.

I've found a fair amount about the subject of hormonal therapy in the past few days. Here's one other, slightly older, but comprehensive source focused on hormonal therapies:
http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=240
Kohorn, E, Hormonal therapy of endometrial carcinoma, Glob. libr. women's med.,(ISSN: 1756-2228) 2008; DOI 10.3843/GLOWM.10240

Regarding the soy question: the jury appears to be out on that whole issue of phytoestrogens, from what I can tell. Some think it's good to consume them, others don't. I myself am avoiding soy and other phytoestrogenic foods (e.g. cruciferous veggies), on the counsel of my osteopath.

Linda, Sweet Girl
Bravo! You are doin' it. I applaud your faith and courage.

Thanks for the STAT article.

We are out of the statistical pool - stats don't apply.

Love ya'

Connie

katsil

personal updates
new to this so bear with me please. tumors shrank more than 50%,after 1 year on temisrolimus (called it tiramisu easier to remember and gives everybody a laff!) now going on the trial at womens and infants with ixabpilone /taxol/ dioxirubin arms - hope spelling doesn't count. will keep you updated 6 wek intervals for cat scan info. dr says they've seen some good things 1 total remeission several partial remissions God bless all kat

Bluebird Bush

The New Article you told us about in Oncology STAT on Endometria
Linda, thank you for your offer to email this entire article to us who are interested in reading the whole thing. I would like very much to read it all and will appreciate it if you will email it to me. Thank you for sharing. As you said, it is rare to find anything on endometrial cancer that is current. Genie

kkstef

katsil said:

personal updates
new to this so bear with me please. tumors shrank more than 50%,after 1 year on temisrolimus (called it tiramisu easier to remember and gives everybody a laff!) now going on the trial at womens and infants with ixabpilone /taxol/ dioxirubin arms - hope spelling doesn't count. will keep you updated 6 wek intervals for cat scan info. dr says they've seen some good things 1 total remeission several partial remissions God bless all kat

Hi Kat
I am sorry to hear that of your need to access this website, but you have entered a great place....there are so many women here who are so willing to share information and encouragement.

Can you tell us a bit more more about yourself? When were you diagnosed? What type of endometrial cancer do you have? What grade and stage was it? We will be anxious to hear more about the trial you have entered.

Wishing you the very best...always!

Karen