Neoadjuvant chemotherapy in patients with advanced endometrial cancer
Objectives Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is a treatment strategy for ovarian cancer patients with unresectable disease or poor performance status (PS). This strategy has been used in the treatment of advanced endometrial cancer and a survival benefit ha...
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| Veröffentlicht in: | Cancer chemotherapy and pharmacology 2019-08, Vol.84 (2), p.281-285 |
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| creator | Khouri, Olivia R. Frey, Melissa K. Musa, Fernanda Muggia, Franco Lee, Jessica Boyd, Leslie Curtin, John P. Pothuri, Bhavana |
| description | Objectives
Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is a treatment strategy for ovarian cancer patients with unresectable disease or poor performance status (PS). This strategy has been used in the treatment of advanced endometrial cancer and a survival benefit has been shown in patients who are subsequently able to undergo interval cytoreduction. This study sought to review our single institution experience with NACT for advanced endometrial cancer.
Methods
We conducted a retrospective review of all patients who received NACT for advanced endometrial cancer at two institutions in New York City between 2002 and 2016.
Results
We identified 39 patients (median age 61, range 35–89). The histologic subtype distribution was: serous (44%), endometrioid (28%), carcinosarcoma (10%), clear cell (8%), mixed (8%), neuroendocrine (3%). Contraindications to primary surgery included: unresectable disease (72%), poor PS (15%), unresectable disease and poor PS (13%). Twenty-three patients (59%) did not undergo IDS due to: progression of disease (70%), medical ineligibility (4%), unresectable disease (17%), lost to follow-up (4%), death (4%). Sixteen patients (41%) underwent IDS, 81% had an optimal cytoreduction. Disease status at NACT completion was: partial response (56%), stable disease (3%) and progression of disease (41%). There were no complete responses. Patients who responded to NACT had a significantly longer overall survival than those who did not (15 vs. 5 months.
P
= 0.015). IDS was also associated with an improvement in overall survival versus no surgery (16 vs. 6 months,
P
= 0.04).
Conclusions
Unlike ovarian cancer, less than half of the patients undergoing NACT for endometrial cancer underwent IDS, none had a complete response, and 41% had disease progression during NACT. However, endometrial cancer patients who underwent IDS had a high rate of optimal cytoreduction. Both response to NACT and IDS were associated with improved survival. |
| doi_str_mv | 10.1007/s00280-019-03838-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2209610916</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2208516091</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-478ffce705428df9ba531f3f7f8e924753774cb73ad2b65a2ed13681f969a6033</originalsourceid><addsrcrecordid>eNp9kE1PwzAMhiMEYuPjD3BAlbhwKThx2qRHhMaHhOAC5yhrHdZpbUfSAvv3ZIwPiQMnS_bj19bD2BGHMw6gzgOA0JACL1JAjTp932JjLlGkoCVuszGglGmmQI7YXghzAJAccZeNEAoNHMWYTe6ps9V8eLVtn5Qzarp-Rt4uV0ndJkvb19T2IXmr-1liqwiVVCXUVl1Dva_tIinXLX_AdpxdBDr8qvvs6WryeHmT3j1c315e3KUlqqxPpdLOlaQgk0JXrpjaDLlDp5ymQkiVoVKynCq0lZjmmRVUccw1d0Ve2BwQ99npJnfpu5eBQm-aOpS0WNiWuiEYIaDIORQ8j-jJH3TeDb6N360pnfE8YpESG6r0XQienFn6urF-ZTiYtWSzkWyiZPMp2bzHpeOv6GHaUPWz8m01ArgBQhy1z-R_b_8T-wEcfIcc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2208516091</pqid></control><display><type>article</type><title>Neoadjuvant chemotherapy in patients with advanced endometrial cancer</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Khouri, Olivia R. ; Frey, Melissa K. ; Musa, Fernanda ; Muggia, Franco ; Lee, Jessica ; Boyd, Leslie ; Curtin, John P. ; Pothuri, Bhavana</creator><creatorcontrib>Khouri, Olivia R. ; Frey, Melissa K. ; Musa, Fernanda ; Muggia, Franco ; Lee, Jessica ; Boyd, Leslie ; Curtin, John P. ; Pothuri, Bhavana</creatorcontrib><description>Objectives
Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is a treatment strategy for ovarian cancer patients with unresectable disease or poor performance status (PS). This strategy has been used in the treatment of advanced endometrial cancer and a survival benefit has been shown in patients who are subsequently able to undergo interval cytoreduction. This study sought to review our single institution experience with NACT for advanced endometrial cancer.
Methods
We conducted a retrospective review of all patients who received NACT for advanced endometrial cancer at two institutions in New York City between 2002 and 2016.
Results
We identified 39 patients (median age 61, range 35–89). The histologic subtype distribution was: serous (44%), endometrioid (28%), carcinosarcoma (10%), clear cell (8%), mixed (8%), neuroendocrine (3%). Contraindications to primary surgery included: unresectable disease (72%), poor PS (15%), unresectable disease and poor PS (13%). Twenty-three patients (59%) did not undergo IDS due to: progression of disease (70%), medical ineligibility (4%), unresectable disease (17%), lost to follow-up (4%), death (4%). Sixteen patients (41%) underwent IDS, 81% had an optimal cytoreduction. Disease status at NACT completion was: partial response (56%), stable disease (3%) and progression of disease (41%). There were no complete responses. Patients who responded to NACT had a significantly longer overall survival than those who did not (15 vs. 5 months.
P
= 0.015). IDS was also associated with an improvement in overall survival versus no surgery (16 vs. 6 months,
P
= 0.04).
Conclusions
Unlike ovarian cancer, less than half of the patients undergoing NACT for endometrial cancer underwent IDS, none had a complete response, and 41% had disease progression during NACT. However, endometrial cancer patients who underwent IDS had a high rate of optimal cytoreduction. Both response to NACT and IDS were associated with improved survival.</description><identifier>ISSN: 0344-5704</identifier><identifier>EISSN: 1432-0843</identifier><identifier>DOI: 10.1007/s00280-019-03838-x</identifier><identifier>PMID: 30980132</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cancer ; Cancer Research ; Chemotherapy ; Endometrial cancer ; Endometrial Neoplasms - drug therapy ; Endometrial Neoplasms - pathology ; Endometrium ; Female ; Humans ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoadjuvant Therapy - methods ; Oncology ; Original Article ; Ovarian cancer ; Patients ; Pharmacology/Toxicology ; Surgery ; Survival</subject><ispartof>Cancer chemotherapy and pharmacology, 2019-08, Vol.84 (2), p.281-285</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Cancer Chemotherapy and Pharmacology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-478ffce705428df9ba531f3f7f8e924753774cb73ad2b65a2ed13681f969a6033</citedby><cites>FETCH-LOGICAL-c375t-478ffce705428df9ba531f3f7f8e924753774cb73ad2b65a2ed13681f969a6033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00280-019-03838-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00280-019-03838-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30980132$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khouri, Olivia R.</creatorcontrib><creatorcontrib>Frey, Melissa K.</creatorcontrib><creatorcontrib>Musa, Fernanda</creatorcontrib><creatorcontrib>Muggia, Franco</creatorcontrib><creatorcontrib>Lee, Jessica</creatorcontrib><creatorcontrib>Boyd, Leslie</creatorcontrib><creatorcontrib>Curtin, John P.</creatorcontrib><creatorcontrib>Pothuri, Bhavana</creatorcontrib><title>Neoadjuvant chemotherapy in patients with advanced endometrial cancer</title><title>Cancer chemotherapy and pharmacology</title><addtitle>Cancer Chemother Pharmacol</addtitle><addtitle>Cancer Chemother Pharmacol</addtitle><description>Objectives
Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is a treatment strategy for ovarian cancer patients with unresectable disease or poor performance status (PS). This strategy has been used in the treatment of advanced endometrial cancer and a survival benefit has been shown in patients who are subsequently able to undergo interval cytoreduction. This study sought to review our single institution experience with NACT for advanced endometrial cancer.
Methods
We conducted a retrospective review of all patients who received NACT for advanced endometrial cancer at two institutions in New York City between 2002 and 2016.
Results
We identified 39 patients (median age 61, range 35–89). The histologic subtype distribution was: serous (44%), endometrioid (28%), carcinosarcoma (10%), clear cell (8%), mixed (8%), neuroendocrine (3%). Contraindications to primary surgery included: unresectable disease (72%), poor PS (15%), unresectable disease and poor PS (13%). Twenty-three patients (59%) did not undergo IDS due to: progression of disease (70%), medical ineligibility (4%), unresectable disease (17%), lost to follow-up (4%), death (4%). Sixteen patients (41%) underwent IDS, 81% had an optimal cytoreduction. Disease status at NACT completion was: partial response (56%), stable disease (3%) and progression of disease (41%). There were no complete responses. Patients who responded to NACT had a significantly longer overall survival than those who did not (15 vs. 5 months.
P
= 0.015). IDS was also associated with an improvement in overall survival versus no surgery (16 vs. 6 months,
P
= 0.04).
Conclusions
Unlike ovarian cancer, less than half of the patients undergoing NACT for endometrial cancer underwent IDS, none had a complete response, and 41% had disease progression during NACT. However, endometrial cancer patients who underwent IDS had a high rate of optimal cytoreduction. Both response to NACT and IDS were associated with improved survival.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer</subject><subject>Cancer Research</subject><subject>Chemotherapy</subject><subject>Endometrial cancer</subject><subject>Endometrial Neoplasms - drug therapy</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Endometrium</subject><subject>Female</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy - methods</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Ovarian cancer</subject><subject>Patients</subject><subject>Pharmacology/Toxicology</subject><subject>Surgery</subject><subject>Survival</subject><issn>0344-5704</issn><issn>1432-0843</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kE1PwzAMhiMEYuPjD3BAlbhwKThx2qRHhMaHhOAC5yhrHdZpbUfSAvv3ZIwPiQMnS_bj19bD2BGHMw6gzgOA0JACL1JAjTp932JjLlGkoCVuszGglGmmQI7YXghzAJAccZeNEAoNHMWYTe6ps9V8eLVtn5Qzarp-Rt4uV0ndJkvb19T2IXmr-1liqwiVVCXUVl1Dva_tIinXLX_AdpxdBDr8qvvs6WryeHmT3j1c315e3KUlqqxPpdLOlaQgk0JXrpjaDLlDp5ymQkiVoVKynCq0lZjmmRVUccw1d0Ve2BwQ99npJnfpu5eBQm-aOpS0WNiWuiEYIaDIORQ8j-jJH3TeDb6N360pnfE8YpESG6r0XQienFn6urF-ZTiYtWSzkWyiZPMp2bzHpeOv6GHaUPWz8m01ArgBQhy1z-R_b_8T-wEcfIcc</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Khouri, Olivia R.</creator><creator>Frey, Melissa K.</creator><creator>Musa, Fernanda</creator><creator>Muggia, Franco</creator><creator>Lee, Jessica</creator><creator>Boyd, Leslie</creator><creator>Curtin, John P.</creator><creator>Pothuri, Bhavana</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20190801</creationdate><title>Neoadjuvant chemotherapy in patients with advanced endometrial cancer</title><author>Khouri, Olivia R. ; Frey, Melissa K. ; Musa, Fernanda ; Muggia, Franco ; Lee, Jessica ; Boyd, Leslie ; Curtin, John P. ; Pothuri, Bhavana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-478ffce705428df9ba531f3f7f8e924753774cb73ad2b65a2ed13681f969a6033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer</topic><topic>Cancer Research</topic><topic>Chemotherapy</topic><topic>Endometrial cancer</topic><topic>Endometrial Neoplasms - drug therapy</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Endometrium</topic><topic>Female</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy - methods</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Ovarian cancer</topic><topic>Patients</topic><topic>Pharmacology/Toxicology</topic><topic>Surgery</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khouri, Olivia R.</creatorcontrib><creatorcontrib>Frey, Melissa K.</creatorcontrib><creatorcontrib>Musa, Fernanda</creatorcontrib><creatorcontrib>Muggia, Franco</creatorcontrib><creatorcontrib>Lee, Jessica</creatorcontrib><creatorcontrib>Boyd, Leslie</creatorcontrib><creatorcontrib>Curtin, John P.</creatorcontrib><creatorcontrib>Pothuri, Bhavana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer chemotherapy and pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khouri, Olivia R.</au><au>Frey, Melissa K.</au><au>Musa, Fernanda</au><au>Muggia, Franco</au><au>Lee, Jessica</au><au>Boyd, Leslie</au><au>Curtin, John P.</au><au>Pothuri, Bhavana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neoadjuvant chemotherapy in patients with advanced endometrial cancer</atitle><jtitle>Cancer chemotherapy and pharmacology</jtitle><stitle>Cancer Chemother Pharmacol</stitle><addtitle>Cancer Chemother Pharmacol</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>84</volume><issue>2</issue><spage>281</spage><epage>285</epage><pages>281-285</pages><issn>0344-5704</issn><eissn>1432-0843</eissn><abstract>Objectives
Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is a treatment strategy for ovarian cancer patients with unresectable disease or poor performance status (PS). This strategy has been used in the treatment of advanced endometrial cancer and a survival benefit has been shown in patients who are subsequently able to undergo interval cytoreduction. This study sought to review our single institution experience with NACT for advanced endometrial cancer.
Methods
We conducted a retrospective review of all patients who received NACT for advanced endometrial cancer at two institutions in New York City between 2002 and 2016.
Results
We identified 39 patients (median age 61, range 35–89). The histologic subtype distribution was: serous (44%), endometrioid (28%), carcinosarcoma (10%), clear cell (8%), mixed (8%), neuroendocrine (3%). Contraindications to primary surgery included: unresectable disease (72%), poor PS (15%), unresectable disease and poor PS (13%). Twenty-three patients (59%) did not undergo IDS due to: progression of disease (70%), medical ineligibility (4%), unresectable disease (17%), lost to follow-up (4%), death (4%). Sixteen patients (41%) underwent IDS, 81% had an optimal cytoreduction. Disease status at NACT completion was: partial response (56%), stable disease (3%) and progression of disease (41%). There were no complete responses. Patients who responded to NACT had a significantly longer overall survival than those who did not (15 vs. 5 months.
P
= 0.015). IDS was also associated with an improvement in overall survival versus no surgery (16 vs. 6 months,
P
= 0.04).
Conclusions
Unlike ovarian cancer, less than half of the patients undergoing NACT for endometrial cancer underwent IDS, none had a complete response, and 41% had disease progression during NACT. However, endometrial cancer patients who underwent IDS had a high rate of optimal cytoreduction. Both response to NACT and IDS were associated with improved survival.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30980132</pmid><doi>10.1007/s00280-019-03838-x</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Aged, 80 and over Cancer Cancer Research Chemotherapy Endometrial cancer Endometrial Neoplasms - drug therapy Endometrial Neoplasms - pathology Endometrium Female Humans Medicine Medicine & Public Health Middle Aged Neoadjuvant Therapy - methods Oncology Original Article Ovarian cancer Patients Pharmacology/Toxicology Surgery Survival |
| title | Neoadjuvant chemotherapy in patients with advanced endometrial cancer |
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