What is endometrial cancer?
What are the signs and symptoms of endometrial cancer?
Abnormal vaginal bleeding
~90% of women with endometrial cancer will experience abnormal vaginal bleeding such as a change in periods, bleeding between periods, or bleeding after menopause.
Non-bloody vaginal discharge
Feeling a mass
Weight loss without trying
What is the unmet need in endometrial cancer?
The majority of women who have endometrial cancer are diagnosed early and are cured with surgery.
Endometrial cancer has the highest rate of mismatch repair deficiency (dMMR) among tumor types,11,12 at approximately 25%,12 and increased rates of recurrence have been reported for some women with dMMR endometrial cancer13 resulting in an unmet need for expanded treatment options for these women.
In normal cells, Mismatch Repair (MMR) corrects errors that are introduced during DNA replication via enzymes. Under normal conditions, the enzymes as part of the MMR system restore DNA integrity by detecting and fixing the erroneous strands.14
A dMMR system may result in the accumulation of these errors and may lead to cancer.15
How is endometrial cancer diagnosed?
- Endometrial cancer is usually diagnosed after a women visits her doctor due to a variety of abnormal symptoms. Pelvic examination, ultrasounds, CT scans, MRIs and endometrial tissue sampling may all be used to diagnose endometrial cancer.16
Who is at increased risk for endometrial cancer?
- Certain risk factors can increase the likelihood that a woman will develop endometrial cancer, such as obesity, things that affect hormone levels, age, diet and exercise, type 2 diabetes, family history, past history of breast or ovarian cancer, treatment with radiation therapy to the pelvis17 and past history of endometrial hyperplasia.18
2 Cancer Facts & Figures 2021. American Cancer Society. Accessed March 30, 2021. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2021/cancer-facts-and-figures-2021.pdf
3 Bagaria M, Shields E, Bakkum-Gamez JN. Novel approaches to early detection of endometrial cancer. Curr Opin Obstet Gynecol. 2017;29(1):40-46.
4 Burton ER, Sorosky JI. Recognition and Therapeutic Options for Malignancy of the Cervix and Uterus. Obstet Gynecol Clin North Am. 2017;44(2):195-206.
5 Matteson KA, Robison K, Jacoby VL. Opportunities for Early Detection of Endometrial Cancer in Women With Postmenopausal Bleeding. JAMA Intern Med. 2018;178(9):1222-1223.
6 Burke WM, Orr J, Leitao M, et al. Endometrial Cancer: a review and current management strategies: part II. Gynecol Oncol. 2014;134(2):393-402.
7 Brooks RA, Flemming GF, Lastra RR, et al. Current recommendations and recent progress in endometrial cancer. CA Cancer J Clin. 2019;69(4):258-279.
8 Oaknin A, Tinker AV, Gilbert L, et al. Clinical activity and safety of the anti–programmed death 1 monoclonal antibody dostarlimab for patients with recurrent or advanced mismatch repair–deficient endometrial cancer: a nonrandomized phase 1 clinical trial. JAMA Oncol. 2020;6(11):1766-1772.
10 NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Uterine Neoplasms V1.2020. © National Comprehensive Cancer Network, Inc. 2020. All rights reserved. Accessed April 17, 2020.SGO Clinical Practice Endometrial Cancer Working Group.
11 Le DT, Durham JN Smith KN, et al. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science 2017;357(6349):409-413.
12 Lorenzi M, Amonkar M, Zhang J, et al. Epidemiology of microsatellite instability high (MSI-H) and deficient mismatch repair (dMMR) in solid tumor: a structured literature review. Journal of Oncology 2020; Article ID 1807929
13 Backes FJ, Haag J, Cosgrove CS, et al. Mismatch repair deficiency identifies patients with high-intermediate risk (HIR) endometrioid endometrial cancer at the highest risk of recurrence: a prognostic biomarker. Cancer 2019;125(3):398-405.
14 Microsatellite Instability - Defective DNA Mismatch Repair: ESMO Biomarker Factsheet. Retrieved March 30, 2021, from https://oncologypro.esmo.org/education-library/factsheets-on-biomarkers/microsatellite-instability-defective-dna-mismatch-repair (ESMO p1 [DNA mismatch repair] lines 1-2).
15 Mismatch Repair Deficiency – NCI Dictionaries. Retrieved March 30, 2021, from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/mismatch-repair-deficiency
16 American Society of Clinical Oncology. Uterine Cancer: Diagnosis. 6/2017. Accessed March 30, 2021. www.cancer.net/cancer-types/uterine-cancer/diagnosis
17 American Society of Clinical Oncology. Uterine Cancer: Risk Factors and Prevention. 6/2017. Accessed March 30, 2021. www.cancer.net/cancer-types/uterine-cancer/risk-factors-and-prevention
18 Endometrial Cancer Risk Factors. American Cancer Society. (n.d.). Accessed April 28, 2021. https://www.cancer.org/cancer/endometrial-cancer/causes-risks-prevention/risk-factors.html.