Targeted Therapy in Uterine Serous Carcinoma
Endometrial cancer (EC) is the most common female genital malignancy in the USA. Most carcinomas arising from the uterus are estrogen dependent and are associated with obesity and hypertension. They are designated type I ECs and typically, due to their early diagnosis secondary to postmenopausal bleeding, have a good prognosis. By contrast, type II ECs develop in older patients, are not hormone dependent and are responsible for most recurrences and deaths from EC. Uterine serous cancer constitutes up to 10% of all endometrial tumors, and represents the most biologically aggressive variant of type II EC. This article will describe the most salient molecular markers that have been identified in uterine serous cancer, thus far with emphasis on the use of erbB2 (HER2/neu) as the first of a series of therapeutic markers for the treatment of this highly-aggressive subset of ECs.
Endometrial cancer (EC) is the most common female genital tract malignancy in the USA, with an incidence of 40,000 cases and 7000 deaths annually. It is classified, based on the clinical picture and histopathological pattern, into type I and type II disease. Type I disease includes grade 1 and 2 endometrioid histology, is estrogen dependent and usually preceded by endometrial hyperplasia. This cancer typically occurs in obese patients and is associated with diabetes and hypertension. Most patients are typically diagnosed at an early stage, secondary to postmenopausal bleeding, and have a good prognosis. By contrast, type II EC, which includes uterine serous cancer (USC), clear cell cancer and grade 3 endometrioid carcinoma, typically occurs in older, thinner patients and is not hormone dependent. These tumors are generally more aggressive and have a worse prognosis than type I EC.
Abstract and Introduction
Abstract
Endometrial cancer (EC) is the most common female genital malignancy in the USA. Most carcinomas arising from the uterus are estrogen dependent and are associated with obesity and hypertension. They are designated type I ECs and typically, due to their early diagnosis secondary to postmenopausal bleeding, have a good prognosis. By contrast, type II ECs develop in older patients, are not hormone dependent and are responsible for most recurrences and deaths from EC. Uterine serous cancer constitutes up to 10% of all endometrial tumors, and represents the most biologically aggressive variant of type II EC. This article will describe the most salient molecular markers that have been identified in uterine serous cancer, thus far with emphasis on the use of erbB2 (HER2/neu) as the first of a series of therapeutic markers for the treatment of this highly-aggressive subset of ECs.
Introduction
Endometrial cancer (EC) is the most common female genital tract malignancy in the USA, with an incidence of 40,000 cases and 7000 deaths annually. It is classified, based on the clinical picture and histopathological pattern, into type I and type II disease. Type I disease includes grade 1 and 2 endometrioid histology, is estrogen dependent and usually preceded by endometrial hyperplasia. This cancer typically occurs in obese patients and is associated with diabetes and hypertension. Most patients are typically diagnosed at an early stage, secondary to postmenopausal bleeding, and have a good prognosis. By contrast, type II EC, which includes uterine serous cancer (USC), clear cell cancer and grade 3 endometrioid carcinoma, typically occurs in older, thinner patients and is not hormone dependent. These tumors are generally more aggressive and have a worse prognosis than type I EC.
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