Targeted Therapy for Endometrial Cancer

Targeted therapy is treatment with drugs that are made to target certain changes in the cancer cells. Targeted therapy drugs work differently from standard chemotherapy (chemo) drugs. They tend to have different (and sometimes less severe) side effects than chemo.

Targeted therapy is used to treat many types of cancer, but it's still fairly new in the treatment of endometrial cancer. Only a few of these drugs are in use at this time. Some of these are only given as part of a clinical trial, but many more are being studied. These drugs are mostly used to treat high-risk endometrial cancers and those that have spread (metastasized) or come back (recurred) after treatment.  

Lenvatinib

Lenvatinib (Lenvima) is a type of drug known as a kinase inhibitor. It helps block tumors from forming new blood vessels, as well as targeting some of the proteins in cancer cells that normally help them grow. 

It can be used along with the immunotherapy drug pembrolizumab (Keytruda) to treat some advanced endometrial cancers, typically after at least one other drug treatment has been tried. 

Lenvatinib is taken as capsules once a day.

Common side effects include diarrhea, fatigue, joint or muscle pain, loss of appetite, nausea and vomiting, mouth sores, weight loss, high blood pressure, and swelling in the arms or legs. Less common but more serious side effects can include serious bleeding, blood clots, very high blood pressure, severe diarrhea, holes forming in the intestines, and kidney, liver, or heart failure.

Bevacizumab

Bevacizumab (Avastin) belongs to a class of drugs called angiogenesis inhibitors. For cancers to grow and spread, they need to make new blood vessels to nourish themselves (a process called angiogenesis). This drug attaches to a protein called VEGF (which signals new blood vessels to form) and slows or stops cancer growth.

Bevacizumab is often given along with chemotherapy, but it can also be given alone, typically after other drug treatments have been tried.

This drug is given as an infusion into the vein (IV) every 2 to 3 weeks.

Common side effects include high blood pressure, tiredness, bleeding, low white blood cell counts, headaches, mouth sores, loss of appetite, and diarrhea. Rare, but possibly serious side effects include blood clots, severe bleeding, slow wound healing, holes forming in the colon (perforations), and the formation of abnormal connections between the bowel and the skin or bladder (fistulas). If a perforation or fistula forms, it can lead to severe infection and surgery may be needed.

mTOR inhibitors

These drugs block a cell protein known as mTOR, which normally helps cells grow and divide into new cells. These drugs might be given alone or added to chemo or hormone therapy to treat advanced (higher stage) endometrial cancers, or those that come back after treatment.

Everolimus (Afinitor) is taken as a pill once a day.

Common side effects include mouth sores, diarrhea, nausea, feeling weak or tired, shortness of breath, and cough. Everolimus can also cause low blood counts, increase blood lipids (cholesterol and triglycerides), and raise your blood sugar, so your doctor will check your blood work often while you are taking this drug. 

Temsirolimus (Torisel) is given as an intravenous (IV) infusion, typically once a week. It can be given alone.

The most common side effects of this drug are skin rash, weakness, mouth sores, diarrhea, nausea, loss of appetite, fluid build-up in the face or legs, and increases in blood sugar and cholesterol levels. Rarely, more serious side effects have been reported.