Efficient sequence of therapy for advanced and metastatic endometrial cancer

Historical standard of the first line endometrial cancer therapy was combination of paclitaxel and carboplatin. In more than a half of patients with advanced endometrial cancer receiving this combination, disease progression is observed after 2 years. Use of paclitaxel + carboplatin combination in a...

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Main Author: A. A. Rumyantsev
Format: Article
Language:Russian
Published: ABV-press 2022-09-01
Series:Опухоли женской репродуктивной системы
Subjects:
Online Access:https://ojrs.abvpress.ru/ojrs/article/view/978
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author A. A. Rumyantsev
author_facet A. A. Rumyantsev
author_sort A. A. Rumyantsev
collection DOAJ
description Historical standard of the first line endometrial cancer therapy was combination of paclitaxel and carboplatin. In more than a half of patients with advanced endometrial cancer receiving this combination, disease progression is observed after 2 years. Use of paclitaxel + carboplatin combination in adjuvant therapy requires search for effective regimens for progression after this systemic therapy. Chemotherapy effectiveness in progression after systemic therapy is low with a small exception: repeat administration of paclitaxel + carboplatin can be used after long platinum-free period. In a quarter of all patients with progression after systemic treatment, use of pembrolizumab monotherapy in case of microsatellite instability (or abnormalities in DNA reparation system) showed significant clinical benefit. Additionally, most tumors do not have abnormal DNA reparation system, and multitarget tyrosine kinase inhibitor and checkpoint inhibitor combination is considered pathogenetically justified. The first and only such regimen described in Russian clinical guidelines is lenvatinib and pembrolizumab combination which showed clinical benefit in the form of increased overall survival.
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spelling doaj.art-00149331dc4a428ba162c63a9c7851cd2023-03-13T08:44:38ZrusABV-pressОпухоли женской репродуктивной системы1994-40981999-86272022-09-0118211912610.17650/1994-4098-2022-18-2-119-126744Efficient sequence of therapy for advanced and metastatic endometrial cancerA. A. Rumyantsev0ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииHistorical standard of the first line endometrial cancer therapy was combination of paclitaxel and carboplatin. In more than a half of patients with advanced endometrial cancer receiving this combination, disease progression is observed after 2 years. Use of paclitaxel + carboplatin combination in adjuvant therapy requires search for effective regimens for progression after this systemic therapy. Chemotherapy effectiveness in progression after systemic therapy is low with a small exception: repeat administration of paclitaxel + carboplatin can be used after long platinum-free period. In a quarter of all patients with progression after systemic treatment, use of pembrolizumab monotherapy in case of microsatellite instability (or abnormalities in DNA reparation system) showed significant clinical benefit. Additionally, most tumors do not have abnormal DNA reparation system, and multitarget tyrosine kinase inhibitor and checkpoint inhibitor combination is considered pathogenetically justified. The first and only such regimen described in Russian clinical guidelines is lenvatinib and pembrolizumab combination which showed clinical benefit in the form of increased overall survival.https://ojrs.abvpress.ru/ojrs/article/view/978метастатический рак эндометриямикросателлитная нестабильностьиммунотаргетная терапияленватинибпембролизумаб
spellingShingle A. A. Rumyantsev
Efficient sequence of therapy for advanced and metastatic endometrial cancer
Опухоли женской репродуктивной системы
метастатический рак эндометрия
микросателлитная нестабильность
иммунотаргетная терапия
ленватиниб
пембролизумаб
title Efficient sequence of therapy for advanced and metastatic endometrial cancer
title_full Efficient sequence of therapy for advanced and metastatic endometrial cancer
title_fullStr Efficient sequence of therapy for advanced and metastatic endometrial cancer
title_full_unstemmed Efficient sequence of therapy for advanced and metastatic endometrial cancer
title_short Efficient sequence of therapy for advanced and metastatic endometrial cancer
title_sort efficient sequence of therapy for advanced and metastatic endometrial cancer
topic метастатический рак эндометрия
микросателлитная нестабильность
иммунотаргетная терапия
ленватиниб
пембролизумаб
url https://ojrs.abvpress.ru/ojrs/article/view/978
work_keys_str_mv AT aarumyantsev efficientsequenceoftherapyforadvancedandmetastaticendometrialcancer