How endometrial cancer is being treated using molecular profiling

This content is provided by MedStar Washington Hospital Center.

Endometrial cancer, also known as uterine cancer, accounts for seven percent of all cancers in women, according to the National Cancer Institute (NCI). Endometrial cancer is the most common gynecologic cancer in the U.S., and the NCI estimated there will be just under 70,000 new cases of endometrial cancer diagnosis this year, which will lead to over 13,000 deaths.

Endometrial cancer starts in the lining of the uterus, with the most common symptoms being vaginal bleeds or discharge unrelated to the menstrual cycle. Pelvis pain and abnormal findings on imaging are other possible indicators.

The sooner the cancer is identified, the better the chances of survival. When caught early, doctors can treat it with surgery. Most patients will treat the cancer by having the uterus, ovaries, and fallopian tube surgically removed. Often, radiation therapy or chemotherapy is needed to get rid of any remaining cancer cells in advanced stages of cancer or aggressive tumor types.

For individuals facing advanced endometrial cancer or those who see it return after treatment, new guidelines from the National Comprehensive Cancer Network (NCCN) highlight other treatment options, like immunotherapy and molecular profiling.

Dr. Ebony Hoskins, a board-certified gynecologic oncologist at MedStar Washington Hospital Center, said data showed combining immunotherapy with chemotherapy had improved progression-free survival.

“As of the spring, we’ve been incorporating immunotherapy with chemotherapy in patients with advanced endometrial cancer,” she said.

Immunotherapy uses the body’s own natural defenses to kill cancer cells.

All methods involve using the patient’s immune system to identify and fight the cancer, although there are many ways to approach it.

With molecular profiling, also known as biomarker testing, patients take part in genetic screening of the cancer and doctors look for biomarkers existing within the cells of the tumors to see if it is likely to respond to a specific, targeted treatment.

Biomarkers are abnormal proteins, cellular materials, or genes and chromosomes found in cancer cells and the surrounding tissues. Biomarkers of four types of endometrial cancer have been identified by researchers and each has a unique way of responding to treatment.

“So you’re looking for proteins that exist within the cells of those tumors to see if there’s something you can target with therapy.”

This kind of personalized treatment is recommended for all patients with endometrial cancer because it allows for targeted treatments to slow tumor growth.

Additionally, MedStar Washington Hospital Center is participating in two clinical trials to learn more about treatment options for patients with recurrent endometrial cancer. Dr. Hoskins also highlighted the importance of diversifying the demographics of patients participating in clinical trials geared towards endometrial cancer.

Cases of endometrial cancer have been increasing more rapidly among Black women than other ethnic groups in the country, according to the National Library of Medicine. Black women are also twice as likely as women of other groups to die from it. However, Black and Hispanic patients have been underrepresented in landmark clinical trials.

Dr. Hoskins said studies can help providers answer if there are other “cutting-edge” treatments they can offer patients to improve symptoms and survival rates.

“Collectively, we need to know this information – particularly in women of color – for trial enrollment because that patient population has been significantly less than what the actual general population is,” she said.

Dr. Hoskins said doctors are working to learn more through trials so they can offer standard care provided not just locally, but also nationally, with the hope of improving survival rates of patients.

“There’s so much cutting-edge data coming out from clinical trials, nationally and internationally, which is good for our patients,” Dr. Hoskins said.

Read more about endometrial cancer in a post by Dr. Ebony Hoskins on the MedStar Hospital Center website.

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