Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins
Abstract Purpose The objective of this study is to determine primary survival endpoints in women with recurrent and metastatic endometrial carcinoma (RMEC) treated with progestins. Methods A retrospective chart review was conducted at The Ottawa Hospital using electronic medical records. Inclusion c...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-08-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.6276 |
| _version_ | 1827386751349424128 |
|---|---|
| author | A. Kulkarni N. M. Andrews Wright A. N. Forget T. Ramsay R. Mallick J. I. Weberpals |
| author_facet | A. Kulkarni N. M. Andrews Wright A. N. Forget T. Ramsay R. Mallick J. I. Weberpals |
| author_sort | A. Kulkarni |
| collection | DOAJ |
| description | Abstract Purpose The objective of this study is to determine primary survival endpoints in women with recurrent and metastatic endometrial carcinoma (RMEC) treated with progestins. Methods A retrospective chart review was conducted at The Ottawa Hospital using electronic medical records. Inclusion criteria were a diagnosis of RMEC between 2000 and 2019, endometrioid histology, and ≥one line of progestin treatment. Progression‐free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Results Of 2342 cases reviewed, 74 met inclusion criteria. Sixty‐six (88.0%) patients received megestrol acetate and 9 (12.0%) received a progestin alternative. The distribution of tumors by grade was: 1: 25 (33.3%), 2: 30 (40.0%), and 3: 20 (26.7%). The PFS and OS for the entire study sample was 14.3 months (95% CI 6.2–17.9) and 23.3 months (14.8–36.8), respectively. The PFS for patients with Grade 1–2 RMEC was 15.7 months (8.0, 19.5), compared to 5.0 months (3.0, 23.0) with Grade 3 disease. The OS for patients with Grade 1–2 versus Grade 3, was 25.9 months (15.3, 40.3) versus 12.5 months (5.7, 35.9), respectively. Thirty‐four (45.9%) and 40 (54.1%) patients were treated with 0 and ≥1 line of chemotherapy. The PFS for chemotherapy‐naïve patients was 17.9 months (14.3, 27.0), versus 6.2 months (3.9, 14.8) following ≥1 line of treatment. The OS was 29.1 months (17.9, 61.1) for chemotherapy‐naïve patients versus 23.0 months (10.5, 37.6) for patients previously exposed. Conclusions This real‐world data on RMEC suggests there is a role for progestins in select subgroups of women. The PFS for chemotherapy‐naïve patients was 17.9 months (14.3, 27.0), versus 6.2 months (3.9, 14.8) following ≥1 line of treatment. The OS was 29.1 months (17.9, 61.1) for chemotherapy‐OS was 29.1 months (17.9, 61.1) for chemotherapy‐naïve patients versus 23.0 months (10.5, 37.6) for patients previously exposed. |
| first_indexed | 2024-03-08T15:51:07Z |
| format | Article |
| id | doaj.art-c2fc397b9ad94141a8bd77d28ffd1217 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-08T15:51:07Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-c2fc397b9ad94141a8bd77d28ffd12172024-01-09T05:41:08ZengWileyCancer Medicine2045-76342023-08-011215161731618010.1002/cam4.6276Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestinsA. Kulkarni0N. M. Andrews Wright1A. N. Forget2T. Ramsay3R. Mallick4J. I. Weberpals5Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine University of Ottawa Ottawa Ontario CanadaOttawa Hospital Research Institute Ottawa Ontario CanadaOttawa Hospital Research Institute Ottawa Ontario CanadaOttawa Hospital Research Institute Ottawa Ontario CanadaOttawa Hospital Research Institute Ottawa Ontario CanadaDepartment of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine University of Ottawa Ottawa Ontario CanadaAbstract Purpose The objective of this study is to determine primary survival endpoints in women with recurrent and metastatic endometrial carcinoma (RMEC) treated with progestins. Methods A retrospective chart review was conducted at The Ottawa Hospital using electronic medical records. Inclusion criteria were a diagnosis of RMEC between 2000 and 2019, endometrioid histology, and ≥one line of progestin treatment. Progression‐free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Results Of 2342 cases reviewed, 74 met inclusion criteria. Sixty‐six (88.0%) patients received megestrol acetate and 9 (12.0%) received a progestin alternative. The distribution of tumors by grade was: 1: 25 (33.3%), 2: 30 (40.0%), and 3: 20 (26.7%). The PFS and OS for the entire study sample was 14.3 months (95% CI 6.2–17.9) and 23.3 months (14.8–36.8), respectively. The PFS for patients with Grade 1–2 RMEC was 15.7 months (8.0, 19.5), compared to 5.0 months (3.0, 23.0) with Grade 3 disease. The OS for patients with Grade 1–2 versus Grade 3, was 25.9 months (15.3, 40.3) versus 12.5 months (5.7, 35.9), respectively. Thirty‐four (45.9%) and 40 (54.1%) patients were treated with 0 and ≥1 line of chemotherapy. The PFS for chemotherapy‐naïve patients was 17.9 months (14.3, 27.0), versus 6.2 months (3.9, 14.8) following ≥1 line of treatment. The OS was 29.1 months (17.9, 61.1) for chemotherapy‐naïve patients versus 23.0 months (10.5, 37.6) for patients previously exposed. Conclusions This real‐world data on RMEC suggests there is a role for progestins in select subgroups of women. The PFS for chemotherapy‐naïve patients was 17.9 months (14.3, 27.0), versus 6.2 months (3.9, 14.8) following ≥1 line of treatment. The OS was 29.1 months (17.9, 61.1) for chemotherapy‐OS was 29.1 months (17.9, 61.1) for chemotherapy‐naïve patients versus 23.0 months (10.5, 37.6) for patients previously exposed.https://doi.org/10.1002/cam4.6276deathmetastasisrecurrenceskin neoplasms |
| spellingShingle | A. Kulkarni N. M. Andrews Wright A. N. Forget T. Ramsay R. Mallick J. I. Weberpals Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins Cancer Medicine death metastasis recurrence skin neoplasms |
| title | Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins |
| title_full | Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins |
| title_fullStr | Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins |
| title_full_unstemmed | Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins |
| title_short | Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins |
| title_sort | should we abandon hormonal therapy in endometrial cancer outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins |
| topic | death metastasis recurrence skin neoplasms |
| url | https://doi.org/10.1002/cam4.6276 |
| work_keys_str_mv | AT akulkarni shouldweabandonhormonaltherapyinendometrialcanceroutcomesofrecurrentandmetastaticendometrialcancertreatedwithsystemicprogestins AT nmandrewswright shouldweabandonhormonaltherapyinendometrialcanceroutcomesofrecurrentandmetastaticendometrialcancertreatedwithsystemicprogestins AT anforget shouldweabandonhormonaltherapyinendometrialcanceroutcomesofrecurrentandmetastaticendometrialcancertreatedwithsystemicprogestins AT tramsay shouldweabandonhormonaltherapyinendometrialcanceroutcomesofrecurrentandmetastaticendometrialcancertreatedwithsystemicprogestins AT rmallick shouldweabandonhormonaltherapyinendometrialcanceroutcomesofrecurrentandmetastaticendometrialcancertreatedwithsystemicprogestins AT jiweberpals shouldweabandonhormonaltherapyinendometrialcanceroutcomesofrecurrentandmetastaticendometrialcancertreatedwithsystemicprogestins |