K.V. Menshikov1,2, A.V. Sultanbaev1, Sh.I. Musin1, I.A. Menshikova2, D.O. Lipatov2, N.I. Sultanbaeva1, R.B. Valiakhmedov1
1Republican Clinical Oncology Dispensary, Ufa
2Bashkir State Medical University, Ufa
Menshikov Konstantin V. ― Cand. of Sci. (Med.), Associate Professor of the Department of Oncology with courses on oncology and pathological anatomy of IAPE of the Bashkir State Medical University; oncologist of the Department of Chemotherapy of the Republican Clinical Oncology Dispensary, ORCID ID: 0000-0003-3734-2779
73/1, Oktyabrya Ave., Ufa, 450054, Russian Federation, e-mail: firstname.lastname@example.org
Abstract. Endometrial cancer (ER) is a fairly urgent problem at the present time. Endometrial carcinoma (or endometrial cancer) is the most common type of cancer of the uterus. In the structure of oncogynecological pathology, RE takes the first place; this situation is possibly associated with the so-called «global epidemic» of obesity. In the Russian Federation in 2019, a total of 552 166 patients were registered with newly diagnosed malignant neoplasms. Systemic chemotherapy for advanced ER is currently represented by several drug combinations. The most commonly used regimen is paclitaxel, carboplatin. Unlike the first line of chemotherapy for advanced ER, the second line shows poorer results. The overall response rate to second-line chemotherapy is much lower than first-line chemotherapy. According to research, the best result was obtained in the mono paclitaxel group, where the overall response rate was 26,7% and 20,09%, respectively. For drugs such as cyclophosphamide, etoposide, ifosfomide, the overall response rate was 0. In EC, the most studied drugs at the moment are mTOR inhibitors. In general, they show moderate efficacy in patients with progression on systemic chemotherapy. Microsatellite instability is of particular importance for the treatment of advanced ER. The combination of lenvatinib and pembrolizumab is currently being studied in two ongoing phase III trials. Lenvatinib with pembrolizumab versus doxorubicin or weekly paclitaxel for advanced second-line EC after platinum-containing chemotherapy regimens. There are many unresolved issues for the second line of ER therapy. Overall, monotherapy with checkpoint inhibitors resulted in moderate improvements in overall response rates and median progression-free survival in advanced ER.
Key words: advanced endometrial cancer, endometrial carcinoma, chemotherapy, targeted therapy, immunotherapy, checkpoint inhibitors, tyrosine kinase inhibitors.