Weekly ixabepilone with or without concurrent bevacizumab in the treatment of recurrent endometrial cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15526-e15526 ◽  
Author(s):  
Dana Marie Roque ◽  
Elena Ratner ◽  
Dan-Arin Silasi ◽  
Masoud Azodi ◽  
Peter E. Schwartz ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Ca 125 ◽  
Platinum Resistant ◽  
Phase Ii Studies ◽  
Disease Stabilization ◽  
Long Term Follow Up ◽  
Institutional Experience ◽  
Recurrent Endometrial Cancer ◽  
First Recurrence ◽  
Dosing Strategy

e15526 Background: Ixabepilone for endometrial cancer has only been evaluated in phase II studies administered at 30-40 mg/m2 q21 days (GOG 129P, GOG 86P). The objective of this study is to describe the institutional experience using a weekly dosing strategy of ixabepilone ± bevacizumab in the treatment of paclitaxel/platinum-resistant recurrent endometrial cancer. Methods: Patients who received weekly ixabepilone (16-20 mg/m2 on days 1, 8, 15 of a 28-day cycle) ± bevacizumab (10 mg/kg on days 1, 15 of a 28-day cycle) off-protocol were identified retrospectively. Results: Thirteen patients were included. Demographic/disease characteristics are provided in Table 1. Median time to first recurrence was 15.9 months (IQR: 9.5-21.66). Patients received a mean of 4.8 ± 1.9 cycles of ixabepilone; treatment is ongoing in 4 patients. A total of 46% of patients demonstrated either a partial response (PR, 8%) or disease stabilization (SD, 38%). PR/SD was associated with a mean decline in CA-125 of 56%. Approximately 50% of patients received concurrent bevacizumab. Of patients who did not receive concurrent bevacizumab, 83% experienced progression and 17% demonstrated SD. Median survival after ixabepilone initiation was 12.7 and 6.9 months in patients treated with and without concurrent bevacizumab, respectively (HR 0.42 [0.09-1.98]). Grade 1/2 hematologic (thrombocytopenia, 15.4%) and gastrointestinal toxicities (emesis/constipation, 7.7%) were observed infrequently. Median overall survival of this cohort was 2.88 years. Conclusions: Ixabepilone shows encouraging activity and promising durability in patients with heavily pre-treated paclitaxel/platinum-resistant recurrent endometrial cancer. Weekly dosing at 16-20mg/m2 on days 1, 8, and 15 ± bevacizumab is well-tolerated. Additional investigation of this regimen and long-term follow-up is warranted. [Table: see text]

Temsirolimus in women with platinum-resistant ovarian cancer or advanced/recurrent endometrial cancer: A multicenter phase II trial of the AGO Study Group (AGO-GYN 8).

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 5565-5565 ◽  
Author(s):  
Guenter Emons ◽  
Christian Kurzeder ◽  
Barbara Schmalfeldt ◽  
Alexander Reuss ◽  
Nikolaus de Gregorio ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Endometrial Cancer ◽  
Phase Ii ◽  
Phase Ii Trial ◽  
Study Group ◽  
Multicenter Phase ◽  
Platinum Resistant ◽  
Recurrent Endometrial Cancer

scholarly journals A Proposal for a Classification for Recurrent Endometrial Cancer: Analysis of a French Multicenter Database From the FRANCOGYN Study Group

2018 ◽  
Vol 28 (7) ◽  
pp. 1278-1284 ◽  
Author(s):  
Alexandre Bricou ◽  
Sofiane Bendifallah ◽  
Mathilde Daix-Moreux ◽  
Lobna Ouldamer ◽  
Vincent Lavoue ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Risk Groups ◽  
Recurrence Risk ◽  
Nodal Metastasis ◽  
Primary Surgery ◽  
Multiple Pathway ◽  
Distant Organ ◽  
Recurrent Endometrial Cancer ◽  
First Recurrence ◽  
Multiple Recurrences

ObjectiveEndometrial cancer (EC) recurrences are relatively common with no standardized way of describing them. We propose a new classification for them called locoregional, nodal, metastasis, carcinomatosis recurrences (rLMNC).Patients and MethodsThe data of 1230 women with EC who were initially treated by primary surgery were included in this French multicenter retrospective study. Recurrences were classified based on dissemination pathways: (1) locoregional recurrence (rL); (2) nodal recurrence (rN) for lymphatic pathway; (3) distant organ recurrence (rM) for hematogenous pathway; and (4) carcinomatosis recurrence (rC) for peritoneal pathway. These pathways were further divided into subgroups. We compared recurrence free survival and overall survival (OS) between the 4 groups (rL/rN/rM/rC).ResultsThe median follow-up was 35.6 months (range, 1.70–167.60). One hundred ninety-eight women (18.2%) experienced a recurrence: 150 (75.8%) experienced a single-pathway recurrence and 48 (24.2%) a multiple-pathway recurrence. The 5-year OS was 34.1% (95% confidence interval [CI], 27.02%–43.1%), and the median time to first recurrence was 18.9 months (range, 0–152 months). The median survival after recurrence was 14.8 months (95% CI, 11.7–18.8). Among women with single pathway of recurrence, a difference in 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) was found between the 4 rLNMC groups. The carcinomatosis group had the worst prognosis compared with other single recurrence pathways. Women with multiple recurrences had poorer 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) than those with single metastasis recurrence, other than women with peritoneal carcinomatosis.ConclusionsThis easy-to-use and intuitive classification may be helpful to define EC recurrence risk groups and develop guidelines for the management of recurrence. Its prognosis value could also be a tool to select homogenous populations for further trials.

Long-Term Follow-up of Gonadotrophin-Releasing Hormone Analog Treatment for Recurrent Endometrial Cancer

1996 ◽  
Vol 63 (1) ◽  
pp. 47-52 ◽  
Author(s):  
A.R. Jeyarajah ◽  
C.J. Gallagher ◽  
P.R. Blake ◽  
D.H. Oram ◽  
M. Dowsett ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Releasing Hormone ◽  
Hormone Analog ◽  
Long Term Follow Up ◽  
Recurrent Endometrial Cancer ◽  
Gonadotrophin Releasing Hormone

Management of Recurrent Endometrioid Endometrial Carcinoma: An Overview

2009 ◽  
Vol 19 (3) ◽  
pp. 314-320 ◽  
Author(s):  
F.H. van Wijk ◽  
M.E.L. van der Burg ◽  
Curt W. Burger ◽  
Ignace Vergote ◽  
Helena C. van Doorn
Keyword(s):  
Endometrial Cancer ◽  
Combination Therapy ◽  
Performance Status ◽  
Treatment Modalities ◽  
Low Grade ◽  
Line Treatment ◽  
Short Treatment ◽  
Free Interval ◽  
Phase Ii Studies ◽  
Recurrent Endometrial Cancer

In this paper, an overview of the literature on the management of recurrent endometrial cancer is presented, focusing on patients with histopathologic endometrioid type of tumors. The different treatment modalities are described, and a management recommendation scheme is presented. Indications for surgical treatment depend on resectability, site and size of the tumor, and performance status of the patient. Indications for radiotherapy depend on the site of the recurrence and also on the initial therapy received. When considering systemic treatment for patients with recurrent endometrial cancer, it is important to take into account the general health status and condition of the patient as well as which prior therapy the patient has received. The treatments of choice for patients with hormone-sensitive tumors (positive receptor levels, low-grade tumors, and long disease-free interval) are progestagens as first-line treatment and tamoxifen as second-line treatment. Patients with high-grade tumors, negative hormone receptor levels, and short treatment-free interval are best treated with chemotherapy. Paclitaxel, doxorubicin, and cisplatin are the most active combination therapy for these patients but with significant toxicity. In phase II studies, the combination therapy with paclitaxel and carboplatin seems to be as effective but less toxic and can be administered in outpatient clinic. The literature on the management of patients with recurrent endometrial cancer is discussed in detail. The different sites of recurrent disease (ie, local, regional, and/or distant) are evaluated separately; management recommendations are proposed, and alternative approaches are given.

Phase II study of MKC-1 in patients with metastatic or resistant epithelial ovarian cancer or advanced endometrial cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5577-5577 ◽  
Author(s):  
C. Elser ◽  
H. Hirte ◽  
L. Kaizer ◽  
H. Mackay ◽  
S. Bindra ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Endometrial Cancer ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Single Agent ◽  
Gastrointestinal Disorder ◽  
Ca 125 ◽  
Platinum Resistant ◽  
Parallel Group ◽  
Grade 3

5577 Background: MKC-1 is a novel oral cell cycle inhibitor with preclinical activity in xenograft models of human ovarian and endometrial cancers. MKC-1 also reduces pAKT, an attractive target in endometrial cancer due to frequent PTEN mutations. Methods: The objective of this phase II study is to assess the efficacy of MKC-1 in 2 patient (pt) populations: metastatic or recurrent platinum-resistant ovarian cancer (EOC) and advanced endometrial cancer (EC). Three prior lines of treatment were allowed in both groups. A two arm, parallel group multicenter 2-stage design was used. The primary endpoint was tumor response by RECIST or CA-125. MKC-1 125 mg/m2 was administered orally twice daily for 14 days in 28-day cycles. Results: Accrual to stage one is complete with 21 pts in each arm. 19 pts with EOC (median age 56 yrs, range 31–71) and 9 patients with EC (median 63 range 50–74) were available for efficacy. A total of 66 cycles (EOC/EC: 39/27cycles) median 2 per patient (range 1–8) were delivered. 11/4 pts had prior adjuvant CT, 14/10 had prior systemic CT for advanced disease, and 2/6 received prior radiation. In pts with EOC, 7 pts have stable disease (SD), 12 progressive disease (PD), 2 remain on study. Median time to progression is 1.8 months. In pts with EC 4 pts had SD, 5 PD, 6 remain on study. Toxicity data are available in 28 pts (17/11). Most common adverse events (AE) possibly related to MKC-1 were fatigue, nausea, elevated ALT or AST, urine discoloration, anemia, anorexia, elevated AP and gastrointestinal disorder in 55%, 39%, 36%, 24%, 23%, 21%, 21%, and 21 % of cycles respectively. The only possibly related grade 3+ AEs were neutropenia, leucopenia and hyponatremia in 9 %, 3 %, and 2% of cycles. Conclusions: MKC-1 was well tolerated in both patient populations. Single agent MKC-1 has insufficient activity in platinum resistant EOC to warrant further investigation. Updated clinical data for both patient groups will be presented at the meeting. [Table: see text]

Salvage Cytoreductive Surgery for Recurrent Endometrial Cancer

2015 ◽  
Vol 25 (9) ◽  
pp. 1623-1632 ◽  
Author(s):  
Taner Turan ◽  
Tolga Tasci ◽  
Alper Karalok ◽  
Isin Ureyen ◽  
Ozgur Kocak ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Cytoreductive Surgery ◽  
Surgical Procedure ◽  
Ca 125 ◽  
Optimal Cytoreduction ◽  
Entire Cohort ◽  
Initial Surgery ◽  
Laparotomy Group ◽  
Recurrent Endometrial Cancer

ObjectiveThe aim of this study was to determine the effect of salvage cytoreductive surgery (SCS) on overall survival (OS) among patients with recurrent endometrial cancer and if there is any predictor for residual tumor status.MethodsBetween January 1993 and May 2013, data of 34 patients who had SCS for recurrent endometrial cancer were retrospectively analyzed. Overall survival was determined from SCS to last follow-up.ResultsThe surgical procedure was local excision without laparotomy in 12 patients, and optimal cytoreduction (no visible disease) was achieved in 24 of 34 patients. There were no perioperative deaths. None of the factors was associated with achievement of optimal cytoreduction. Five-year OS rates were 37% and 27% for the entire cohort and for the laparotomy group, respectively. For the entire cohort, disease-free interval (from initial surgery to recurrence), adjuvant therapy after initial surgery, CA-125 level at recurrence, multiplicity of recurrence, surgical procedure, and optimal cytoreduction and for the laparotomy group adjuvant treatment and optimal cytoreduction were associated with OS. In the laparotomy group, OS rates were 53 and 9 months in the patients who did and did not have optimal SCS, respectively.ConclusionsSignificant survival benefit can be achieved with optimal resection. Prospective studies should be designed to define optimal cytoreduction and to determine the predictors of optimal cytoreduction achievement.

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