Topotecan-induced Long-term Remission of an Advanced Endometrial Cancer After Treatment with Cisplatinum, an Anthracycline and Paclitaxel

Background: The optimal palliative chemotherapy in endometrial cancer is unknown. Case Report: A patient was diagnosed to have primary endometrioid endometrial cancer metastatic to the pelvic, paraaortic and right inguinal lymph nodes (FIGO IVb). After radical surgery, she received 6 adjuvant cycles of cisplatin and epirubicin. Twelve months later, she developed a pelvic recurrence and received second-line paclitaxel chemotherapy. Three months thereafter, computed tomography showed diffuse peritoneal carcinomatosis with lesions up to 2 cm in diameter. She received eighteen weekly cycles of topotecan which led to a complete clinical response confirmed by CT. Forty-three months after the start of third-line chemotherapy with topotecan, the patient is alive with no evidence of disease. Conclusion: Long-term survival with NED may be achievable by topotecan in selected patients with an initial diagnosis of extensive endometrial cancer despite repeated relapses and previous exposure to cisplatinum, an anthracycline and a taxane.