Complete Response of a Mutated BRCA2 Metastatic Clear Cell Endometrial Adenocarcinoma to the Poly (ADP ribose) Polymerase (PARP) Inhibitor Olaparib

2022 ◽  
Vol 2 (1) ◽  
pp. 84-86
Author(s):  
DIMITRI ANZELLINI ◽  
GIANLUCA ARCANGELI ◽  
SERGIO DEL BIANCO
Keyword(s):  
Endometrial Cancer ◽  
Case Report ◽  
Clear Cell ◽  
Early Stage ◽  
Parp Inhibitor ◽  
Endometrial Adenocarcinoma ◽  
Abnormal Uterine Bleeding ◽  
Complete Response ◽  
Developed Countries ◽  
Primary Therapy

Background: Cancer of the endometrium is the most common gynecologic malignancy in developed countries and the second most common in developing countries. Endometrioid tumors tend to have a favorable prognosis and typically present at an early stage with abnormal uterine bleeding. Clear cell carcinoma as well as serous endometrial carcinoma are associated with a poorer prognosis. Patients with metastatic endometrial cancer are treated with systemic therapy either following surgery or as primary therapy. As far as second-line chemotherapy is concerned, there are no general agreements on the chemotherapy to be used. Furthermore, to the best of knowledge, there are no studies on the use of poly (ADP ribose) polymerase (PARP) inhibitors in endometrial cancer even in BRCA mutated tumors. Case Report: We here present the case report of an 81-year-old woman with a mutated BRCA2 metastatic clear cell endometrial adenocarcinoma that showed an excellent clinical and radiological response to the PARP inhibitor olaparib. Conclusion: Olaparib could be successfully used in this patient setting.

scholarly journals Adjuvant brachytherapy for FIGO stage I serous or clear cell endometrial cancer

2021 ◽  
pp. ijgc-2020-002217
Author(s):  
Elizabeth B Jeans ◽  
William G Breen ◽  
Trey C Mullikin ◽  
Brittany A Looker ◽  
Andrea Mariani ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Clear Cell ◽  
Early Stage ◽  
Figo Stage ◽  
Stage I ◽  
High Dose ◽  
Vaginal Cuff ◽  
Locoregional Failure ◽  
Platinum Based Chemotherapy ◽  
Increased Risk

ObjectivesOptimal adjuvant treatment for early-stage clear cell and serous endometrial cancer remains unclear. We report outcomes for women with surgically staged International Federation of Gynecology and Obstetrics (FIGO) stage I clear cell, serous, and mixed endometrial cancers following adjuvant vaginal cuff brachytherapy with or without chemotherapy.MethodsFrom April 1998 to January 2020, women with FIGO stage IA–IB clear cell, serous, and mixed endometrial cancer underwent surgery and adjuvant vaginal cuff brachytherapy. Seventy-six patients received chemotherapy. High-dose rate vaginal cuff brachytherapy was planned to a total dose of 21 gray in three fractions using a multichannel vaginal cylinder. The primary objective was to determine the effectiveness of adjuvant vaginal cuff brachytherapy and to identify surgicopathological risk factors that could portend towards worse oncological outcomes.ResultsA total of 182 patients were included in the analysis. Median follow-up was 5.3 years (2.3–12.2). Ten-year survival was 73.3%. Five-year cumulative incidence (CI) of vaginal, pelvic, and para-aortic relapse was 1.4%, 2.1%, and 0.9%, respectively. Five-year locoregional failure, any recurrence, peritoneal relapse, and other distant recurrence was 4.4%, 11.6%, 5.3%, and 6.7%, respectively. On univariate analysis, locoregional failure was worse for larger tumors (per 1 cm) (HR 1.9, 95% CI 1.2 to 3.0, p≤0.01). Any recurrence was worse for tumors of at least 3.5 cm (HR 3.8, 95% CI 1.3 to 11.7, p=0.02) and patients with positive/suspicious cytology (HR 4.4, 95% CI 1.5 to 12.4, p≤0.01). Ten-year survival for tumors of at least 3.5 cm was 56.9% versus 86.6% for those with smaller tumors (HR 2.9, 95% CI 1.4 to 5.8, p≤0.01). Ten-year survival for positive/suspicious cytology was 50.9% versus 77.4% (HR 2.2, 95% CI 0.9 to 5.4, p=0.09). Multivariate modeling demonstrated worse locoregional failure, any recurrence, and survival with larger tumors, as well as any recurrence with positive/suspicious cytology. Subgroup analysis demonstrated improved outcomes with the use of adjuvant chemotherapy in patients with large tumors or positive/suspicious cytology.ConclusionAdjuvant vaginal cuff brachytherapy alone without chemotherapy is an appropriate treatment for women with negative peritoneal cytology and small, early-stage clear cell, serous, and mixed endometrial cancer. Larger tumors or positive/suspicious cytology are at increased risk for relapse and worse survival, and should be considered for additional upfront adjuvant treatments, such as platinum-based chemotherapy.

scholarly journals Systemic recurrence of endometrial cancer more than 10 years after hysterectomy: a report of two cases and a brief review of the literature

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Leonardo Muratori ◽  
Paola Sperone ◽  
Gabriella Gorzegno ◽  
Anna La Salvia ◽  
Giorgio Vittorio Scagliotti
Keyword(s):  
Endometrial Cancer ◽  
Case Report ◽  
Endometrial Carcinoma ◽  
Developed Countries ◽  
Disease Stage ◽  
Prior History ◽  
Disease Relapse ◽  
Review Of The Literature ◽  
Radical Treatment ◽  
Risk Of Disease

Abstract Background Endometrial carcinoma is one of the most common female cancers in developed countries. Disease stage is associated with the risk of disease relapse after radical treatment. Typically, the risk of disease relapse peaks at 3 years from local radical treatment and then diminishes over time, so that late relapses (i.e., from year 5 afterward) are extremely infrequent. Here, we report two cases of women with endometrial cancer who developed a disease relapse more than 15 years after radical treatment. A review of the literature revealed other seven reports of women with relapse from endometrial cancer occurring more than 10 years after radical treatment. Case presentation Case report 1 is a 56-year-old woman with an endometrioid cancer who underwent a hysterectomy with bilateral salpingo-oophorectomy in 1998. She relapsed in the lung in 2014, 16 years from radical surgery. Case report 2, a 75-year-old woman, with an endometrioid cancer, was treated by hysterectomy with bilateral salpingo-oophorectomy and adjuvant radiotherapy. The disease relapse in the lung was detected in 2019, 22 years from radical treatment. Conclusion Although guidelines do not support oncological follow-up beyond 5 years from surgery, oncologists should consider late recurrence of endometrial carcinoma in the differential diagnosis of women presenting with metastases of uncertain origin and prior history of this disease.

scholarly journals Cancer Endometrium: An Update

2012 ◽  
Vol 4 (2) ◽  
pp. 75-84 ◽  
Author(s):  
Piyush Kumar ◽  
Jai Kishan Goel
Keyword(s):  
Endometrial Cancer ◽  
Gynecological Cancer ◽  
Preoperative Staging ◽  
Abnormal Uterine Bleeding ◽  
Developed Countries ◽  
Endometrial Biopsy ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Estrogen Exposure ◽  
Cardinal Symptom

ABSTRACT Endometrial cancer is the most common gynecological cancer in developed countries and second most common in developing countries. Its incidence is increasing in postmenopausal women. Factors related to chronic estrogen exposure are associated with a higher incidence. Abnormal uterine bleeding is the cardinal symptom. All women with suspected endometrial cancer require transvaginal ultrasonography and most will undergo endometrial biopsy; more sophisticated radiological examinations are required for preoperative staging. The general approach for treatment of endometrial cancer is hysterectomy, bilateral salpingo-oophorectomy, abdominopelvic washings, lymph node evaluation and maximal surgical cytoreduction for those with advanced disease. Postoperative adjuvant therapy [vaginal brachytherapy, external beam radiation therapy (RT), chemotherapy] may be recommended depending on the estimated risk of recurrence. Individual patient characteristics and surgical as well as pathologic staging are the main factors that are used for postsurgical risk stratification, which in turn, directs the selection of adjuvant treatment. How to cite this article Goel JK, Kumar P. Cancer Endometrium: An Update. J South Asian Feder Obst Gynae 2012;4(2):75-84.

Predictors of Outcome in Early-Stage Papillary Serous and Clear Cell Endometrial Cancer

2013 ◽  
Vol 87 (2) ◽  
pp. S421-S422
Author(s):  
M.M. Dominello ◽  
P. Paximadis ◽  
I. Kaufman ◽  
S. Munns ◽  
G. Dyson ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Clear Cell ◽  
Early Stage ◽  
Predictors Of Outcome

Retrospective analysis of stage IC uterine cancer patients: A single center experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15573-e15573
Author(s):  
Nadire Kucukoztas ◽  
Selim Yalcin ◽  
Samed Rahatli ◽  
Ozlem Ozen ◽  
Nihan Haberal ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Uterine Cancer ◽  
Endometrial Adenocarcinoma ◽  
Cell Cancer ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Surgical Staging ◽  
Increased Risk

e15573 Background: Stage IC patients are at an increased risk of recurrence and overall worse prognosis compared with stage IA and IB patients. Adjuvant chemoherapy is utilized based on specific pathologic factors. The objective of this study is to evaluate treatment outcomes at a single institution in patients with 1988 FIGO stage IC endometrial adenocarcinoma. Methods: Records of the patients with FIGO stage IB (formerly IC) endometrial cancer were retrospectively evaluated. All patients were initially treated surgically with comprehensive staging lymphadenectomy. Results: A total of 85 patients were included. Patient and tumor characteristics are shown in the table. Median age of the patients was 60 (range 27-95). Fifty-nine patients had at least one co-morbid disease. Complete surgical staging including pelvic and paraaortic lymph node dissection was performed in all the patients. Sixteen patients (19%) received adjuvant chemotherapy, including 6 patients with serous cancer and one patient with small cell cancer. Paclitaxel/carboplatin was the preferred regimen in Median follow up was 30 months (range 10-61 months). Seven patients (8%) relapsed and 4 patients (5%) died on follow up. 5 year disease free survival was 89% and overall survival was 95%. One of the 16 patients (6.2%) who received chemotherapy and 6 of the 69 patients (8.7%) who did not receive relapsed/died on follow up. Survival analysis was not performed because of the low number of events in both groups. Conclusions: We found similar rates of recurrence and death with previous studies in stage IC endometrial cancer. Complete surgical staging is the mainstay of treatment. Marginally lower recurrence rate in chemotherapy treated patients delineate the need for prospective randomized data addressing the role of adjuvant systemic therapy in early-stage patients with endometrial adenocarcinoma. [Table: see text]

Practice patterns in post-treatment surveillance in patients with primary epithelial ovarian cancer

2020 ◽  
pp. ijgc-2020-001522
Author(s):  
Joseph DeMari ◽  
Monica Hagan Vetter ◽  
Shruthi Chandra ◽  
John L Hays ◽  
Ritu Salani
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Practice Patterns ◽  
Early Stage ◽  
Gynecologic Oncology ◽  
Complete Response ◽  
Response To Therapy ◽  
Primary Therapy ◽  
Advanced Stage

BackgroundThe Society of Gynecologic Oncology created guidelines to standardize cost-effective clinical surveillance for detection of recurrence of gynecologic cancers.ObjectiveTo determine practice patterns for surveillance of primary ovarian cancer after complete response to therapy and to identify the percentage of clinicians who follow the surveillance guidelines endorsed by the Society of Gynecologic Oncology.MethodsA single-institution retrospective cohort study was conducted including patients with epithelial ovarian cancer with a complete response to primary therapy between January 2012 and December 2016. Patients were excluded if they were participating in clinical trials that required routine imaging. Data on surveillance and recurrence were collected. Descriptive statistics as well as Fisher’s exact test and chi-square test were performed due to the exploratory nature of the study.ResultsA total of 184 patients met the inclusion criteria. Median follow-up for the cohort was 37 months (range 6–80). Surveillance was completed in compliance with Society of Gynecologic Oncology guidelines in 78% of patients. Of 39 visits that were non-compliant, 44% (17) were patient initiated (scheduling conflict, missed appointment), 15% (6) were due to the provider intentionally scheduling alternative follow-up, while 41% (16) were off schedule due to problem visits (patient complaint of symptoms). Patients with early-stage cancers were more likely than advanced-stage patients to be non-compliant (33% vs 15%, p=0.006). Patients with non-serous histologies had a higher frequency of non-compliance (31% vs 16%, p=0.035). When stratified by early versus advanced stage, there was no difference in progression-free survival or overall survival based on compliance.ConclusionsOverall, there was a relatively high rate of compliance with Society of Gynecologic Oncology surveillance guidelines for patients with epithelial ovarian cancer. Patients with non-serous histologies and patients with early-stage disease had a higher rate of non-compliance, and these patients may represent special groups that would benefit from additional survivorship education.

SIENDO/ENGOT-EN5/GOG-3055: A randomized phase 3 trial of maintenance selinexor versus placebo after combination platinum-based chemotherapy in advanced or recurrent endometrial cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. TPS5610-TPS5610
Author(s):  
Ignace Vergote ◽  
Jose Alejandro Perez-Fidalgo ◽  
Erika P. Hamilton ◽  
Toon Van Gorp ◽  
Giorgio Valabrega ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Maintenance Therapy ◽  
Nuclear Export ◽  
Early Stage ◽  
Stage Iv ◽  
Primary Therapy ◽  
Phase 3 ◽  
Primary Stage ◽  
Early Stage Disease ◽  
Platinum Based Chemotherapy

TPS5610 Background: Endometrial cancer (EC) is the most common gynecologic malignancy. Options for advanced or recurrent EC following platinum-based therapy and/or radiotherapy are limited and prognosis remains poor. Selinexor is a novel, oral selective inhibitor of nuclear export (SINE) which forces nuclear retention and activation of tumor suppressor proteins. Selinexor in combination with low dose dexamethasone is approved for relapsed/refractory multiple myeloma. In addition, selinexor monotherapy has demonstrated broad activity in other hematologic malignancies and solid tumors. In a phase 2 study, 50 mg/m2 (̃80 mg) selinexor administered twice weekly demonstrated a disease control rate ( SD ≥ 12 weeks or a PR) of 35% with 2 confirmed partial responses among 23 heavily pretreated EC patients); similar results were observed in 60 pts with platinum resistant or refractory ovarian cancer (median 5 prior regimens, ORR 8%, DCR 30%) (Vergote I et al. Gynecol Oncol 2020). In the absence of approved maintenance therapies, we conducted this study to evaluate the efficacy of selinexor compared with placebo as maintenance therapy in patients with advanced or recurrent EC following platinum-based chemotherapy. Methods: This is a multicenter, double-blind, placebo-controlled, randomized phase 3 study in patients in partial (PR) or complete remission (CR) after completing at least 12 weeks of taxane-platinum combination therapy for primary Stage IV disease and recurrent disease (i.e., relapse after primary therapy for early stage disease including surgery and/or adjuvant therapy). A total of 248 patients will be enrolled at 80 sites in Europe, North America, and Israel. Patients will be randomized in a 2:1 ratio to either maintenance therapy with 80 mg oral selinexor once weekly or placebo. Stratification factors include primary Stage IV versus first recurrence at the time of taxane-platinum therapy and disease status after chemotherapy (PR vs CR). Treatment will continue until disease progression. The primary endpoint is progression free survival (PFS) per RECIST v1.1. Secondary endpoints include disease-specific survival, overall survival, time to first subsequent therapy, time to second subsequent therapy, PFS on subsequent therapy and safety and tolerability. The study is currently open and enrolling patients. Clinical trial information: NCT03555422.

Annual Cervical Cancer Screening Revealed Early Stage Clear Cell Adenocarcinoma of the Uterine Cervix: A Case Report

2019 ◽  
Vol 8 (1) ◽  
pp. 21-24
Author(s):  
Mai Temukai ◽  
Yoshimi Tokugawa ◽  
Takeshi Hisamatsu ◽  
Yuri Kamino ◽  
Ayuko Otoshi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Case Report ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Uterine Cervix ◽  
Clear Cell ◽  
Early Stage ◽  
Clear Cell Adenocarcinoma
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