Diagnosis and management of uterine serous carcinoma: current strategies and clinical challenges

Omar Najjar, Britt K. Erickson, Amanda N. Nickles-Fader

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Uterine serous carcinoma (USC) is a subtype of endometrial cancer accounting for a disproportionate number of uterine cancer-related deaths. Recent studies have enhanced the understanding of the pathogenesis of USC, advanced treatment guidelines, and have driven the investigation of targeted therapies. A search of the PubMed database was performed for research articles published between 1/1/2005 and 1/1/2020 in which the studied population included women with USC. Areas covered: Complete surgical staging, including comprehensive lymphadenectomy and omentectomy, is recommended in all patients. Genomic studies have helped guide treatment recommendations and have driven the development of agents targeting the HER2/neu, PIK3/AKT, and CCNE1/FBXW7 pathways. Platinum/taxane chemotherapy ± radiotherapy is associated with the best survival compared to other treatments for all stages. For those with HER2-positive advanced/recurrent disease, the addition of trastuzumab to carboplatin/paclitaxel improves survival.  Expert opinion: The rarity of USC limits the feasibility of randomized studies. Systemic chemotherapy is recommended for all stages of USC, particularly in light of the high rates of multi-site or distant recurrence. Pathological testing of tumor samples for molecular targets is expected to play a larger role in guiding clinical management. Clinical trials are needed to establish the clinical efficacy and safety of novel targeted therapies.

Original languageEnglish (US)
Pages (from-to)1-13
Number of pages13
JournalExpert Opinion on Orphan Drugs
DOIs
StatePublished - 2020

Keywords

  • adjuvant chemotherapy
  • endometrial cancer
  • genomics
  • surgery
  • targeted therapy
  • Uterine serous carcinoma

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy
  • Pharmacology (medical)

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