Systemic therapy for advanced or recurrent endometrial carcinoma.

The prognosis for metastatic or recurrent endometrial cancer remains poor. Patients with local recurrences can sometimes be salvaged with radiation, and these salvage rates might improve with the addition of concomitant chemotherapy. Hormone therapy benefits a small group of patients, and routine immunohistochemical determination of tumor receptor status may help select patients most likely to benefit from such therapy. Anthracyclines, platinum compounds, and paclitaxel consistently produce response rates of over 20%. Combination chemotherapy produces higher response rates, but it is toxic and appears to have minimal effect on survival. New drugs and combinations continue to be tested. A subset of endometrial cancers overexpress the HER2/neu oncogene, and a trial of anti-HER2/neu monoclonal antibody for this group is planned through the Gynecologic Oncology Group.