Neoadjuvant chemotherapy in patients with advanced endometrial cancer

Olivia R. Khouri, Melissa K. Frey, Fernanda Musa, Franco Muggia, Jessica Lee, Leslie Boyd, John P. Curtin, Bhavana Pothuri

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)281-285
Number of pages5
JournalCancer Chemotherapy and Pharmacology
Volume84
Issue number2
DOIs
StatePublished - Aug 1 2019
Externally publishedYes

Fingerprint

Chemotherapy
Endometrial Neoplasms
Surgery
Drug Therapy
Disease Progression
Survival
Ovarian Neoplasms
Carcinosarcoma
Lost to Follow-Up

Keywords

  • Endometrial cancer
  • Interval debulking
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Toxicology
  • Pharmacology
  • Cancer Research
  • Pharmacology (medical)

Cite this

Khouri, O. R., Frey, M. K., Musa, F., Muggia, F., Lee, J., Boyd, L., ... Pothuri, B. (2019). Neoadjuvant chemotherapy in patients with advanced endometrial cancer. Cancer Chemotherapy and Pharmacology, 84(2), 281-285. https://doi.org/10.1007/s00280-019-03838-x

Neoadjuvant chemotherapy in patients with advanced endometrial cancer. / Khouri, Olivia R.; Frey, Melissa K.; Musa, Fernanda; Muggia, Franco; Lee, Jessica; Boyd, Leslie; Curtin, John P.; Pothuri, Bhavana.

In: Cancer Chemotherapy and Pharmacology, Vol. 84, No. 2, 01.08.2019, p. 281-285.

Research output: Contribution to journalArticle

Khouri, OR, Frey, MK, Musa, F, Muggia, F, Lee, J, Boyd, L, Curtin, JP & Pothuri, B 2019, 'Neoadjuvant chemotherapy in patients with advanced endometrial cancer', Cancer Chemotherapy and Pharmacology, vol. 84, no. 2, pp. 281-285. https://doi.org/10.1007/s00280-019-03838-x
Khouri, Olivia R. ; Frey, Melissa K. ; Musa, Fernanda ; Muggia, Franco ; Lee, Jessica ; Boyd, Leslie ; Curtin, John P. ; Pothuri, Bhavana. / Neoadjuvant chemotherapy in patients with advanced endometrial cancer. In: Cancer Chemotherapy and Pharmacology. 2019 ; Vol. 84, No. 2. pp. 281-285.
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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.",
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