Recent advances in systemic therapy for advanced endometrial cancer

Endometrial cancer is the most common gynaecologic cancer in the western world. Systemic treatments for advanced disease have traditionally included hormonal therapy and chemotherapy. Responses to treatment are short-lived and advanced-stage disease remains incurable. Recent research has focused on optimizing chemotherapy regimens, the development of alternative hormonal therapy strategies and the introduction of targeted therapies. The most recent developments in these areas will be reviewed here.

Phase III trials continue to focus on the optimization of combination chemotherapy regimens. The elucidation of a hormonal pathway central to the control of oestrogen-stimulated cancer growth has led to the development of a new class of hormonal agents currently undergoing evaluation in the clinical trial setting. Increasing understanding of the molecular basis for malignant transformation continues to provide rationale for the development of many targeted therapies. Mammalian target of rapamycin inhibition, in particular, offers further encouraging results in this context.

The development of new hormone treatments and effective targeted therapies will provide new opportunities to improve therapy for women with advanced endometrial cancer. Optimization of therapy will require an approach to personalized therapy in order to guide choice and sequence of therapy and improve survival and quality of life.