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A new treatment for endometrial cancer with gonadotrophin releasing-hormone analogue
C J Gallagher1, R T Oliver, D H Oram
1Department of Medical Oncology, Royal London Hospital.
Objective:
To test the antitumour effect of gonadotrophin releasing-hormone (GnRH) analogues in women with recurrent endometrial cancer.
Design:
An open phase II observational trial of GnRH analogues. Serial measurements of gonadotrophins, sex hormones and tumour dimensions were made together with repeat biopsy when possible to assess the response to treatment.
Setting:
The outpatient clinics of the Department of Medical Oncology at The Royal London, Royal Marsden and St Bartholomew's hospitals.
Subjects:
17 patients with endometrial cancer which had recurred after surgery, radiotherapy and progesterone treatment and was symptomatic, progressive and assessable for response.
Intervention:
Monthly subcutaneous injection of GnRH analogue.
Main Outcome Measures:
Reduction in serum gonadotrophins and reduction in tumour dimensions.
Results:
Six out of 17 patients (35%, 95% CI 12.6-58%) achieved a complete or partial remission which continues for a median of 20 months with no adverse effects.
Conclusion:
GnRH analogues have a significant antitumour effect in recurrent endometrial cancer which warrants further examination in comparison with progestogens.
Insights
Gonadotrophin-releasing hormone (GnRH) analogues show a significant antitumour effect in women with recurrent endometrial cancer. This finding suggests GnRH analogues warrant further investigation against progestogens for this condition.
Area of Science:
- Gynecologic Oncology
- Endocrinology
- Medical Oncology
Background:
- Recurrent endometrial cancer poses a significant clinical challenge.
- Limited treatment options exist for symptomatic, progressive disease after standard therapies.
- Hormonal therapies are a recognized approach in endometrial cancer management.
Purpose of the Study:
- To evaluate the antitumour efficacy of gonadotrophin-releasing hormone (GnRH) analogues.
- To assess the impact of GnRH analogues on tumor dimensions and hormone levels in recurrent endometrial cancer.
- To determine the safety and duration of response to GnRH analogue treatment.
Main Methods:
- An open-label, phase II observational trial was conducted.
- 17 patients with recurrent, symptomatic endometrial cancer received monthly subcutaneous GnRH analogue injections.
- Serial measurements of hormones, tumor dimensions, and repeat biopsies were performed to assess treatment response.
Main Results:
- Six out of 17 patients (35%) achieved complete or partial remission.
- Remissions were sustained for a median of 20 months.
- No adverse effects were reported during the study period.
Conclusions:
- GnRH analogues demonstrate a significant antitumour effect in recurrent endometrial cancer.
- The observed efficacy suggests GnRH analogues are a promising treatment modality.
- Further comparative studies with progestogens are warranted to establish optimal treatment strategies.
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