TY - CHAP M1 - Book, Section TI - Tumors of the Uterine Corpus A1 - Onstad, Michaela A. A1 - Westin, Shannon N. A1 - Lu, Karen H. A2 - Kantarjian, Hagop M. A2 - Wolff, Robert A. A2 - Rieber, Alyssa G. PY - 2022 T2 - The MD Anderson Manual of Medical Oncology, 4e AB - KEY CONCEPTSFor women with early-stage, intermediate-risk endometrial cancer, there is no evidence that adjuvant therapy improves overall survival. For women with low-intermediate-risk disease, observation is favored. For women with high-intermediate-risk disease, vaginal cuff brachytherapy is favored.Women with high-risk disease have either serous or clear cell adenocarcinoma (any stage) or have pathologic stage III disease with extrauterine involvement. Adjuvant treatment may involve radiation, chemotherapy, or a combination of the two modalities, based on histology, stage, and other factorsRecurrent or metastatic endometrial cancer is associated with a poor prognosis. Clinical trial GOG 209 supports the use of carboplatin and paclitaxel in this setting.Immunotherapy may be considered as second-line treatment for recurrent/metastatic endometrial cancer. Pembrolizumab has a response rate (RR) of 53% for women with mismatch repair–deficient tumors. The combination of pembrolizumab with the tyrosine kinase inhibitor lenvatinib has a RR of 38% among women with microsatellite stable tumors.Targeted therapies with demonstrated efficacy in second-line treatment include single-agent bevacizumab (GOG229E), and the combination of the mTOR inhibitor everolimus with letrozole.Endocrine therapy may also be used to treat metastatic/recurrent endometrial cancer. It tends to be well tolerated with relatively minor side effects, and has modest RRs, ranging from 11% to 24%. Characteristics that improve the likelihood that a patient will have a favorable response to hormone therapy include having a low tumor grade (1 or 2), endometrioid histology, the presence of estrogen and progesterone receptors, having a longer disease-free interval, and being asymptomatic or minimally symptomatic. SN - PB - McGraw Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1190837099 ER -