Dr. Marcia Hernandez
(Mercy Women's Oncology)
Shares About The Latest in Uterine Cancer
June 2023 was designated by the International Gynecologic Cancer Advocacy Network (IGCAN) as uterine cancer awareness month to raise awareness on the sixth most common cause of cancer in women, globally. In the United States, uterine cancer affects over 67,000 women annually. Uterine cancer manifests as two primary types: sarcomas; which originate in the muscle wall of the uterus, and carcinomas; which arise in the endometrium, the inner lining of the womb. Sarcomas are less common but highly aggressive, whereas carcinomas, the most prevalent type, are often curable. There are additional subtypes within both uterine sarcomas and carcinomas.
The incidence of uterine cancers is on the rise, contrasting with decreasing rates in other cancer types. This trend is partly attributed to increasing risk factors such as obesity, hypertension, and diabetes. Fortunately, more than 80% of women diagnosed with uterine cancer survive beyond five years. Common signs and symptoms of all uterine cancer include abnormal uterine bleeding, postmenopausal bleeding, abnormal vaginal discharge, and abdominal and pelvic pain. Less common symptoms include, an enlarging uterus, abdominal distention, changes in bowel and bladder function, and nausea and vomiting.
Surgical intervention is the primary treatment for uterine cancers, offering a cure for approximately 70% of women. Additional treatment modalities include systemic therapy, (chemotherapy, immunotherapy, and targeted agents) and radiation therapy, which can be administered alone or in conjunction with systemic therapy.
Clinical trials have been critical in advancing treatments for uterine cancer, contributing to enhanced overall survival rates. Patient participation provides the data necessary to identify and seek pathways to cures. Over the past decade, breakthroughs in cancer treatment have revolutionized the management of uterine cancer and significantly impacted survival outcomes. This surge in new medical treatments in attributed to several factors that includes, the completion of the Human Genome Project, fostering collaboration in the scientific community, the development of novel therapeutic agents, the establishment of clinical trials, and notably, the participation of patients in these trials, leading to the approval of innovative treatments.
Clinical trials enhancing uterine cancer treatments span all modalities. Surgical trials have implemented changes in techniques, reducing surgical morbidity through minimally invasive approaches and sentinel lymph node mapping and resections. Trials such as the Ruby trial and Keynote 868 demonstrated the efficacy of moving immunotherapeutic agents, like dostarlimab and pembrolizumab, respectively, into frontline treatment in advanced endometrial cancer, impacting progression-free survival. Additionally, the Destiny 2 trial resulted in the FDA approval for targeted therapy, trastuzumab deruxtecan (T-DXd) in the treatment of recurrent Her2-nu positive, endometrial cancer, significantly affecting patients’ disease-free intervals and survival.
Uterine cancer is the most common gynecologic cancer, and its proportionate frequency is increasing. Treatment options for uterine cancers have significantly improved in the last decade. But treatment starts with awareness and a thorough evaluation for any of the symptoms described above. The best outcomes for uterine cancer patients are when their management is in conjunction with a gynecologic oncologist, someone who has received specialized training in the treatment of all gynecologic malignancies.
Sources:
International Gynecologic Cancer. (n.d.). Uterine Cancer Awareness Month. Retrieved from https://igcs.org/ucam/
National Cancer Institute. (n.d.). Uterine Cancer. Retrieved from https://www.cancer.gov/types/uterine
Eskander RN, Sill MW, Beffa L, Moore RG, Hope JM, Musa FB, Mannel R, Shahin MS, Cantuaria GH, Girda E, Mathews C, Kavecansky J, Leath CA 3rd, Gien LT, Hinchcliff EM, Lele SB, Landrum LM, Backes F, O'Cearbhaill RE, Al Baghdadi T, Hill EK, Thaker PH, John VS, Welch S, Fader AN, Powell MA, Aghajanian C. Pembrolizumab plus Chemotherapy in Advanced Endometrial Cancer. N Engl J Med. 2023 Jun 8;388(23):2159-2170. doi: 10.1056/NEJMoa2302312. Epub 2023 Mar 27. PMID: 36972022; PMCID: PMC10351614.
Mirza MR, Chase DM, Slomovitz BM, dePont Christensen R, Novák Z, Black D, Gilbert L, Sharma S, Valabrega G, Landrum LM, Hanker LC, Stuckey A, Boere I, Gold MA, Auranen A, Pothuri B, Cibula D, McCourt C, Raspagliesi F, Shahin MS, Gill SE, Monk BJ, Buscema J, Herzog TJ, Copeland LJ, Tian M, He Z, Stevens S, Zografos E, Coleman RL, Powell MA; RUBY Investigators. Dostarlimab for Primary Advanced or Recurrent Endometrial Cancer. N Engl J Med. 2023 Jun 8;388(23):2145-2158. doi: 10.1056/NEJMoa2216334. Epub 2023 Mar 27. PMID: 36972026.
Meric-Bernstam F, Makker V, Oaknin A, Oh DY, Banerjee S, González-Martín A, Jung KH, Ługowska I, Manso L, Manzano A, Melichar B, Siena S, Stroyakovskiy D, Fielding A, Ma Y, Puvvada S, Shire N, Lee JY. Efficacy and Safety of Trastuzumab Deruxtecan in Patients With HER2-Expressing Solid Tumors: Primary Results From the DESTINY-PanTumor02 Phase II Trial. J Clin Oncol. 2024 Jan 1;42(1):47-58. doi: 10.1200/JCO.23.02005. Epub 2023 Oct 23. PMID: 37870536; PMCID: PMC10730032.
The incidence of uterine cancers is on the rise, contrasting with decreasing rates in other cancer types. This trend is partly attributed to increasing risk factors such as obesity, hypertension, and diabetes. Fortunately, more than 80% of women diagnosed with uterine cancer survive beyond five years. Common signs and symptoms of all uterine cancer include abnormal uterine bleeding, postmenopausal bleeding, abnormal vaginal discharge, and abdominal and pelvic pain. Less common symptoms include, an enlarging uterus, abdominal distention, changes in bowel and bladder function, and nausea and vomiting.
Surgical intervention is the primary treatment for uterine cancers, offering a cure for approximately 70% of women. Additional treatment modalities include systemic therapy, (chemotherapy, immunotherapy, and targeted agents) and radiation therapy, which can be administered alone or in conjunction with systemic therapy.
Clinical trials have been critical in advancing treatments for uterine cancer, contributing to enhanced overall survival rates. Patient participation provides the data necessary to identify and seek pathways to cures. Over the past decade, breakthroughs in cancer treatment have revolutionized the management of uterine cancer and significantly impacted survival outcomes. This surge in new medical treatments in attributed to several factors that includes, the completion of the Human Genome Project, fostering collaboration in the scientific community, the development of novel therapeutic agents, the establishment of clinical trials, and notably, the participation of patients in these trials, leading to the approval of innovative treatments.
Clinical trials enhancing uterine cancer treatments span all modalities. Surgical trials have implemented changes in techniques, reducing surgical morbidity through minimally invasive approaches and sentinel lymph node mapping and resections. Trials such as the Ruby trial and Keynote 868 demonstrated the efficacy of moving immunotherapeutic agents, like dostarlimab and pembrolizumab, respectively, into frontline treatment in advanced endometrial cancer, impacting progression-free survival. Additionally, the Destiny 2 trial resulted in the FDA approval for targeted therapy, trastuzumab deruxtecan (T-DXd) in the treatment of recurrent Her2-nu positive, endometrial cancer, significantly affecting patients’ disease-free intervals and survival.
Uterine cancer is the most common gynecologic cancer, and its proportionate frequency is increasing. Treatment options for uterine cancers have significantly improved in the last decade. But treatment starts with awareness and a thorough evaluation for any of the symptoms described above. The best outcomes for uterine cancer patients are when their management is in conjunction with a gynecologic oncologist, someone who has received specialized training in the treatment of all gynecologic malignancies.
Sources:
International Gynecologic Cancer. (n.d.). Uterine Cancer Awareness Month. Retrieved from https://igcs.org/ucam/
National Cancer Institute. (n.d.). Uterine Cancer. Retrieved from https://www.cancer.gov/types/uterine
Eskander RN, Sill MW, Beffa L, Moore RG, Hope JM, Musa FB, Mannel R, Shahin MS, Cantuaria GH, Girda E, Mathews C, Kavecansky J, Leath CA 3rd, Gien LT, Hinchcliff EM, Lele SB, Landrum LM, Backes F, O'Cearbhaill RE, Al Baghdadi T, Hill EK, Thaker PH, John VS, Welch S, Fader AN, Powell MA, Aghajanian C. Pembrolizumab plus Chemotherapy in Advanced Endometrial Cancer. N Engl J Med. 2023 Jun 8;388(23):2159-2170. doi: 10.1056/NEJMoa2302312. Epub 2023 Mar 27. PMID: 36972022; PMCID: PMC10351614.
Mirza MR, Chase DM, Slomovitz BM, dePont Christensen R, Novák Z, Black D, Gilbert L, Sharma S, Valabrega G, Landrum LM, Hanker LC, Stuckey A, Boere I, Gold MA, Auranen A, Pothuri B, Cibula D, McCourt C, Raspagliesi F, Shahin MS, Gill SE, Monk BJ, Buscema J, Herzog TJ, Copeland LJ, Tian M, He Z, Stevens S, Zografos E, Coleman RL, Powell MA; RUBY Investigators. Dostarlimab for Primary Advanced or Recurrent Endometrial Cancer. N Engl J Med. 2023 Jun 8;388(23):2145-2158. doi: 10.1056/NEJMoa2216334. Epub 2023 Mar 27. PMID: 36972026.
Meric-Bernstam F, Makker V, Oaknin A, Oh DY, Banerjee S, González-Martín A, Jung KH, Ługowska I, Manso L, Manzano A, Melichar B, Siena S, Stroyakovskiy D, Fielding A, Ma Y, Puvvada S, Shire N, Lee JY. Efficacy and Safety of Trastuzumab Deruxtecan in Patients With HER2-Expressing Solid Tumors: Primary Results From the DESTINY-PanTumor02 Phase II Trial. J Clin Oncol. 2024 Jan 1;42(1):47-58. doi: 10.1200/JCO.23.02005. Epub 2023 Oct 23. PMID: 37870536; PMCID: PMC10730032.