Future directions, including nomograms, multi-modality approaches, and more individualized patient care based on genomic profiles, may help to tailor each endometrial cancer patient’s therapy to her individual risk.
In this review, the results and limitations of studies concerning adjuvant radiation therapy and chemotherapy for endometrial cancer will be discussed, focusing on evidence that can help to guide treatment decisions.
Using easy-to-obtain risk factors for breast, ovarian, and endometrial cancers, researchers have come up with models that can predict an individual woman’s absolute risk for developing each type of cancer.
The data on HE4 as a prognosticator in both ovarian and endometrial cancer constitute, at most, an interesting observation, but most likely they are simply a reflection of total tumor burden. There are certainly not enough data to justify making major treatment decisions in ovarian or endometrial cancer on the basis of absolute marker levels. Proteomics and genomics seem more likely to make a difference in this area.
While a prominent role for HE4 in these areas remains to be determined, this thorough review of HE4 demonstrates that the biomarker is complementary to, and occasionally more useful than, the widely used CA 125 in the management of gynecologic malignancies.
Don Dizon, MD, Brown University, discusses the paradigm shift in the treatment of endometrial cancer with the use of medical therapy, including chemotherapy with biologics, mTOR inhibitors combined with chemotherapy, and targeted therapies.