What's New in Endometrial Cancer Research?

Endometrial cancer is usually found early, when it's small and treatment is more likely to be successful.     Advanced endometrial, on the other hand, is less common and has been hard to study well. Most experts agree that treatment in a clinical trial should be considered for any type or stage of endometrial cancer. This way a person can get the best treatment available now and might get treatments that are thought to be even better. Many of the new and promising treatments discussed here are only available in clinical trials.

Research on gene changes in endometrial cancer cells

For years we have known that damaged or defective DNA (DNA mutations) can change key genes that control cell growth. If these genes are damaged, out-of-control growth may result in cancer. Scientists are learning more about how certain genes called oncogenes and tumor suppressor genes control cell growth and how changes in these genes cause normal endometrial cells to become cancer.

Sometimes, endometrial cancer and colon cancer may seem to “run in a family.” We now know that some of these families have a higher risk for these cancers because they have an inherited defect in certain genes that normally help repair damage to DNA. If these repair enzymes aren't working properly, damage to DNA is more likely to cause cancer. Tests for DNA changes may someday be used to help predict how fast the cancer might grow and spread. This will help doctors choose the best treatments for this disease.

Research on the early detection of endometrial cancer

At the present, there is no screening test for endometrial cancer.  Studies are looking for ways to find endometrial cancer early -- before  symptoms begin. Researchers are looking for DNA changes in endometrial cancer cells or biomarkers, that may suggest presence of cancer cells. Tests for these changes may someday help find endometrial cancers early.

Research into prevention of endometrial cancer

As doctors have learned more about the risk factors for endometrial cancer, they've begun looking for ways to help prevent it. For instance, being overweight is known to put you at higher risk for uterine cancer. Studies are being done to find out if these there is a benefit from prevention therapies. One study is looking at whether routine screening with endometrial biopsies might be useful in finding cell changes so they can be treated before they become cancer.  Other studies are looking at how specific diets can lower the risk of endometrial cancer for certain people.      

Research on new drug treatments for endometrial cancer

New drugs, new combinations of drugs, chemotherapy drugs, immunotherapies, and targeted therapies are being researched for treatment of advanced endometrial cancer. The use of chemotherapy, with or without radiation after surgery is also being studied.

Targeted therapy

Researchers have developed drugs that target the gene and protein changes found in cancer cells. As a result, targeted therapy can slow or block the growth of cancer cells with minimal harm to the healthy normal cells.  Studies are looking at how targeted drugs, such as ridaforolimus and temsirolimus can be used either alone or combined with chemotherapy, to improve treatment outcomes for patients with advanced endometrial cancer.

Immunotherapy

An exciting  area of research is the use of immunotherapy to treat endometrial cancer. This treatment uses the body’s own immune system to fight cancer.

The immune system uses certain proteins to see and attack foreign cells while leaving normal cells alone. Studies have found that some endometrial cancer cells use these proteins to keep from being attacked by the immune system. Drugs called checkpoint inhibitors help the immune system find and attack these cancer cells better. Checkpoint inhibitors, such as pembrolizumab, dostarlimab, and durvalumab are already used treat endometrial cancer. Researchers are studying how combining this type of immunotherapy with other forms of therapy, such as chemotherapy or radiation therapy, can improve treatment outcomes for different stages of endometrial cancer.   

Research into radiation therapy for endometrial cancer

MRI-guided radiation therapy combines MRI with a linear accelerator to deliver the radiation therapy with more accuracy and precision. This helps reduce the amount of healthy tissue exposed to radiation and focuses the treatment on the tumor and affected organs as much as possible. Systems to deliver this treatment are being studied.

Research on surgery for endometrial cancer

Surgery for endometrial cancer usually means removing the uterus, cervix, ovaries, and fallopian tubes. Studies are comparing different ways to do this surgery, for instance, open vs. laparoscopic surgery and laparoscopic vs. robot-assisted surgery, to see if any method is better than others.

Studies are also looking at outcomes when the ovaries are left in place. This keeps you from going into menopause and having the problems that come with it. It's most important in younger patients with endometrial cancer.