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Obstetrics and Gynecology International
Volume 2010, Article ID 749579, 11 pages
http://dx.doi.org/10.1155/2010/749579
Review Article

Endometrial Cancer: What Is New in Adjuvant and Molecularly Targeted Therapy?

1Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, University of Athens, Athens, Greece
2Oncology Centre, Castle Hill Hospital, Hull and East Yorkshire NHS Trust, Cottingham, UK

Received 27 September 2009; Accepted 8 December 2009

Academic Editor: Paul J. Hoskins

Copyright © 2010 Flora Zagouri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Endometrial cancer is the most common gynaecological cancer in western countries. Radiotherapy remains the mainstay of postoperative management, but accumulating data show that adjuvant chemotherapy may display promising results after staging surgery. The prognosis of patients with metastatic disease remains disappointing with only one-year survival. Progestins represent an effective option, especially for those patients with low-grade estrogen and/or progesterone receptor positive disease. Chemotherapy using the combination of paclitaxel, doxorubicin, and cisplatin is beneficial for patients with advanced or metastatic disease after staging surgery and potentially for patients with early-stage disease and high-risk factors. Toxicity is a point in question; however, the combination of paclitaxel with carboplatin may diminish these concerns. In women with multiple medical comorbidities, single-agent chemotherapy may be better tolerated with acceptable results. Our increased knowledge of the molecular aspects of endometrial cancer biology has paved the way for clinical research to develop novel targeted antineoplastic agents (everolimus, temsirolimus, gefitinib, erlotinib, cetuximab, trastuzumab, bevacizumab, sorafenib) as more effective and less toxic options. Continued investigation into the molecular pathways of endometrial cancer development and progression will increase our knowledge of this disease leading to the discovery of novel, superior agents.