In a new study published by Merritt et al in Cancer Epidemiology, Biomarkers & Prevention, researchers demonstrated that sex hormones and insulin growth factors may be associated with recurrence risk in patients with endometrial cancer. The findings suggest endocrine-targeted therapies and an assessment of biomarkers in hormone and insulin signaling pathways may be useful in the prevention and treatment of recurrent endometrial cancer.
“These findings are very encouraging,” said Gloria Huang, MD, Associate Professor of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine, gynecologic oncologist at the Smilow Cancer Hospital Care Center, and co–senior author of the study. “Women who are diagnosed with more advanced stages of endometrial cancer have a substantially higher risk of recurrence and death.”
Study Findings
Researchers analyzed blood serum and endometrial tumor samples from several hundred women who participated in Gynecologic Oncology Group (GOG)-0210, a multi-institutional cooperative group study that prospectively followed women for up to 10 years following their initial surgical treatment for endometrial cancer. The focus was on women with the most common type of endometrial cancer, endometrioid adenocarcinoma, who were at risk for recurrence due to higher stage at presentation (stages II to IV).
Study results showed a recurrence in 280 patients (34%) during a median of 4.6 years of follow-up. Estrogen receptor positivity, insulin receptor positivity, and circulating insulin-like growth factor-I were inversely associated with recurrence risk. Circulating estradiol hormone and positivity for phosphorylated IGF1R/IR (pIGF1R/pIR), the activated form of cellular receptors for insulin-like growth factors and insulin, were associated with increased recurrence risk.
“Moving forward, we’ve begun a multicenter trial, which is currently open and enrolling patients at sites nationwide to evaluate the efficacy of a combination endocrine therapy for treating endometrial cancer recurrence,” said Dr. Huang. “The therapy combines two oral medications to simultaneously block the endocrine pathways identified in this study. We hope that this research serves as the gateway to more effective and less toxic treatment options for women with advanced stage or recurrent endometrial cancer.”
Disclosure: The study was funded by the National Cancer Institute at the National Institutes of Health. For full disclosures of the study authors, visit cebp.aacrjournals.org.
