Tag Archive for: endometrial cancer treatment

Navigating Advanced Endometrial Cancer: Treatment, Prognosis, and Lifestyle Strategies

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Navigating Advanced Endometrial Cancer: Treatment, Prognosis, and Lifestyle Strategies from Patient Empowerment Network on Vimeo.

How does the treatment of advanced endometrial cancer prognosis differ from other gynecological cancers? Expert Dr. Charlotte Gamble from MedStar Health shares common challenges that she’s seen with her patients and patient advice to help optimize their care. 

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“…I always encourage patients, and when I meet with them for the first time, I ask them, who is your main support person? And if they’re not here right now, let’s actually get them on the phone. They need to be involved from the start to understand this hurdle that you’re going to be going through over the next several months.”

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See More from [ACT]IVATED Endometrial Cancer

Related Resources:

Addressing Disparities in Gynecologic Oncology | Key Challenges and Solutions

Addressing Disparities in Gynecologic Oncology | Key Challenges and Solutions

 How Is Gynecological Cancer Care Impacted by Social Determinants of Health?

How Is Gynecological Cancer Care Impacted by Social Determinants of Health?

 How Can Gynecologic Oncology Racial Disparities Be Addressed

How Can Gynecologic Oncology Racial Disparities Be Addressed

Transcript:

Lisa Hatfield:

Dr. Gamble, how does advanced endometrial cancer differ from other gynecological cancers in terms of treatment of prognosis, and what lifestyle changes can help improve outcomes for patients with advanced endometrial cancer?

This is such a heavy question, so necessary. I think that, classically what we’re taught is that endometrial cancer is very curable, very treatable.  

All you need is a hysterectomy and surgery, and then you’ll be done. But what we see, and specifically in my work, and I take care of mostly Black or African American patients, is that, there are certain types of cancers specifically that are a little bit more prevalent in the, African American community within endometrial cancers that are more aggressive, that need not only surgery, but need chemotherapy and might, because they’re more aggressive, patients come and are already at like stage III or sometimes stage IV, when they’re actually being diagnosed, not due to any sort of delay and recognizing their symptoms or delay in diagnosis, but literally when their symptoms occurred, they were already stage IV. And this is a really, really, really challenging space to be in.

And historically also very challenging because again, as I mentioned, endometrial cancer is one of the least, if not the least funded cancers of the National Cancer Institute in terms of clinical trials. And so there have not been, historically a lot of options for patients who have advanced stage endometrial cancer,  aside from our classic chemotherapy drugs with carboplatin (Paraplatin) and paclitaxel (Abraxane) take six cycles. You see how things go and maybe these patients get radiation. And so it’s been a very challenging space to be in over the past couple of years. 

As I mentioned, these new immunotherapy drugs are really, giving us a lot of hope and very exciting space, now to see how these novel immunotherapy drugs help to maybe change some of those prognostic factors for patients. But it’s a tougher diagnosis. The survival is not as good as someone who has early stage non-aggressive endometrial cancer.

And so, not only do patients get their surgery, but they’re also getting the chemotherapy. And now, oftentimes getting immunotherapy onto this, and immunotherapy continues after the chemotherapy for oftentimes up to three years. And so patients are on treatment for a lot longer. I think that, you know, in terms of lifestyle changes, again, there’s not a lot of research in this area.

Traditionally, we think of, endometrial cancer as a cancer that is, that can occur more frequently in patients who are overweight, or have elevated BMIs. And so, their cardiovascular health is actually very important. And so lifestyle changes to address their cardiovascular health is going to be much more beneficial than anything else, that occurs. But what I unfortunately see in my practice is that you, might, your heart might be just fine, but if you’ve got cancer that’s in your lungs or in your upper abdomen or in your bones, when you’re diagnosed, that kind of takes over everything, and it’s very difficult to treat.

 I think what is important when I personally think about lifestyle factors and, advanced stage of endometrial cancer, is trying to maintain a healthy enough lifestyle and adequate strength to get through the necessary treatments, that are really tough with chemotherapy and immunotherapy. And so the healthier a patient is when they’re diagnosed, the stronger they are through their treatments, the better able that they’re able to maintain their nutrition and as, moderate amount of exercise during their treatments, the better they are able to get through their treatments in a timely fashion.

And a lot of this can be also tied to the amount of support that patients have in their lives. If someone is isolated and has very little, family or friends that are able to be there for them, it’s a much harder mental barrier to get through all of this aggressive treatment than someone who might, have patient or patient advocates with them or friends or family members that are always around.

So I always encourage patients, and when I meet with them for the first time, I ask them, who is your main support person? And if they’re not here right now, let’s actually get them on the phone. They need to be involved from the start to understand this hurdle that you’re going to be going through over the next several months.

So I always tell folks that, you know, I’ll take care of all the medical stuff, I’ll do the surgery, and I’ll run the chemotherapy, and me and my nurse navigator will be able to handle all the medical things. And so you don’t need to worry about that. But the psychological burden this takes, the mental and emotional burden this takes is going to be something that is really going to be much more in the patient’s control and much more in your control as you get through this.

And so finding your support structures and making them, making sure they’re involved from the very start is very, very critical. One of the trials that we have open here, at my health system is looking at the role for increasing social support for patients who are Black, who have advanced stage endometrial cancer and seeing what forms of social support, if that’s group therapy or if that’s one-to-one, peer survivor support or just additional information, if that actually can, which one of those might be the best and help patients get through their therapies. And that’s a trial that’s run by Dr. Doll out of University of Washington.

Advanced endometrial cancer is a tough diagnosis to have, and the survival outcomes, although changing rapidly with the introduction of immunotherapy drugs, are, still a challenge. The lifestyle changes, it really comes to, you know, what patients can do to get through their treatment in a timely fashion. But I think the role of social support and having people that can carry patients through and get them through this tough time is central to this question.

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Endometrial Cancer Care Disparities: The Impact of Rural Residence

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Endometrial Cancer Care Disparities: The Impact of Rural Residence from Patient Empowerment Network on Vimeo.

What kind of care disparities do endometrial cancer patients from rural areas face? Expert Dr. Emily Hinchcliff from Northwestern Medicine shares her perspective on obstacles for patient care in rural areas and patient advice to help ensure optimal care.

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See More from [ACT]IVATED Endometrial Cancer

Related Resources:

Which Endometrial Cancer Clinical Trials Are Showing Promise

Which Endometrial Cancer Clinical Trials Are Showing Promise?

 Understanding Endometrial Cancer Risk: Factors Influencing Incidence and Mortality

Understanding Endometrial Cancer Risk: Factors Influencing Incidence and Mortality

 Overcoming Geographical Barriers in Endometrial Cancer Care

Overcoming Geographical Barriers in Endometrial Cancer Care

Transcript:

Lisa:

Dr. Hinchcliff, can you speak to barriers faced by rural endometrial cancer patients, those living in rural areas, and are there specific challenges that these women in rural areas face in accessing timely and quality healthcare services for endometrial cancer screening and treatment?

Dr. Emily Hinchcliff: 

Absolutely. So, when I think of barriers, I think that barriers can be broken into some really key steps along the kind of diagnosis continuum. So certainly, a patient needs to understand that the symptom that they’re having is a problem. Then they need to see that problem and seek care. Then once they have established care they need to obtain a diagnosis. And then once you have a diagnosis, you need to get treated. And so I would suspect that those living remote from major hospital centers or from subspecialty care probably experience delays at each single one of those time points.

First, I think a knowledge gap probably exists about what bleeding should be, especially for postmenopausal women. Postmenopausal bleeding is not normal. And so even a small episode of spotting should warrant a visit to your physician. And then I think for those who see their physician, who have a less kind of either geographic or less access for whatever reason, there’s probably a greater prolongation of the series of visits that are required before they get the necessary endometrial sampling and a transvaginal ultrasound, which are really core tests when it comes to diagnosis.

Once the diagnosis is obtained, I think that the further referral and potential delay to someone like myself, like a GYN oncologist, is also a key barrier for those who are rural. There’s actually a really good study in gynecologic specifically in the Midwest that showed that rural women were significantly less likely to receive care from a subspecialist like myself.  I think that particular study was in endometrial, sorry in ovarian cancer, but it showed that those who receive care by a specialist are more likely to get optimal surgery and to get guideline-inherent care. So getting yourself to that subspecialist, I think is really key, but can be difficult for women who live remote from subspecialty care.

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Endometrial Cancer Treatment Decisions | Factors That Impact Your Options

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Endometrial Cancer Treatment Decisions | Factors That Impact Your Options from Patient Empowerment Network on Vimeo.

Endometrial cancer expert Dr. Emily Ko explains health considerations and other key factors that may impact options when determining an optimal treatment approach for each patient. 

Dr. Emily Ko is a gynecologic oncologist and Associate Professor of Obstetrics and Gynecology at the University of Pennsylvania. Learn more about Dr. Ko.
See More from Evolve Endometrial Cancer

 

Related Programs:

How Is Endometrial Cancer Staged?

How Is Endometrial Cancer Staged?

 What Are Treatment Options for Endometrial Cancer?

What Are Treatment Options for Endometrial Cancer?

Transcript:

Katherine:

Dr. Ko, what goes into determining a treatment approach for an individual patient? Is there key testing that helps guide a patient’s prognosis and treatment options? 

Dr. Ko:

Absolutely. So, I think the key pieces of information come from several sources. First, we do take the whole patient into account, like baseline health, baseline function, meaning every day, how active are you? Are there limitations to your daily activities? Looking at baseline health conditions, what we call comorbidities. Are there other health conditions, like diabetes, heart conditions, lung condition, kidney conditions, that could really impact a patient’s overall health and well-being? That is always part of it, number one. 

Then, we look specific to the cancer details. So, from all the pathology information, biopsies, followed by a surgical staging procedure, what exact stage, what exact substage, and we might even look at other unique features. Was there cells that got into the lymph vessels, the lymph nodes? Are there other just features from a pathology standpoint that are important, like the – I talked about microsatellite status, microsatellite instable versus microsatellite stable. 

Those are all information we can gather from the tumor tissue itself. That then kind of tailors our therapy. And then, like I was saying, now we’re going into this molecular era where we can actually take that tumor tissue and even do more expanded testing on it. 

So, I think it’s worthwhile to talk to your provider and say, “Hey, would it be worthwhile to send my tumor out for expanded testing, whether it’s done at your institution, at a specialized lab, or whether it’s sent out to a company that does expanded testing?” Because then, they might be able to test for 500 different genetic signatures, a much more broad panel, but that might open the door for opportunities to say, “Hey, you actually do have a very unique signature, and maybe it is worth tailoring your therapy even further.” 

So, I think these are very important questions to have with your provider, and these pieces of information can help guide the prognosis. I think we’re always asking what does this mean long-term, and I think when we have all these individual pieces of information, we can then give guidance on that.   

Katherine:

I wanted to get your point of view on why is it important for patients to engage in their care and their treatment decisions?  

Dr. Ko:

Right. I think that it is so important. Medical treatments, I think, do work the best for the patient when the patient is truly an active participant, and what I mean by that is I think we can really understand the patient if there’s a conversation, there’s a mutual discussion, and I think every patient has unique circumstances, has unique goals, has…whether it’s just the daily whatever responsibilities, or just either health or non-health concerns that they have, we want to be able to find a treatment that fits the patient, and we realize that one treatment doesn’t fit all. 

And so, the more, I think, that there is this mutual discussion, mutual understanding, then there’s a mutual decision treatment plan that is made, and there’s the more ability to modify that plan when – if you realize, oh, maybe we can tailor it, maybe we try one thing, and maybe we realize we got to change a little bit. 

And, I think that with a cancer condition, it is a journey. It is not just a one-time thing. It really is a journey, and I think that the more a patient can participate throughout that journey, I think the better the outcomes for the patient, and honestly, the better the treatment course will be for everyone participating.  

Katherine:

Why should a patient consider finding an endometrial cancer specialist? What are the benefits? 

Dr. Ko:

So, I think naturally, an endometrial cancer specialist is a provider who spends more time thinking about the disease, reading about it, looking at what’s the newest research studies that are coming out, what are the available clinical trials here, locally, regionally, or nationally, what are other support services available for the patient in the space. 

And, of course, probably the folks that do the most surgeries gear towards endometrial cancer patients, and so, I think just working in that space naturally then brings more resources and more opportunity for the patient to kind of really know what’s out there, what is the newest, and I think that really benefits the patient. 

What Are Treatment Options for Endometrial Cancer?

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What Are Treatment Options for Endometrial Cancer? from Patient Empowerment Network on Vimeo. 

What endometrial cancer treatment options are currently available? Endometrial cancer expert Dr. Emily Ko shares an overview of options, including chemotherapy, surgery, radiation, targeted therapies, combination therapies, hormonal therapies, and discusses considerations for patients who are trying to preserve their fertility.

Dr. Emily Ko is a gynecologic oncologist and Associate Professor of Obstetrics and Gynecology at the University of Pennsylvania. Learn more about Dr. Ko.
See More from Evolve Endometrial Cancer

 

Related Programs:

How Is Endometrial Cancer Staged?

How Is Endometrial Cancer Staged?

 Monitoring for an Endometrial Cancer Recurrence

Monitoring for an Endometrial Cancer Recurrence

Transcript:

Katherine:

I’d like to talk about the treatments that are currently available. You mentioned chemotherapy, but what else is available for people? 

Dr. Ko:

Absolutely. So, treatment for endometrial cancer is usually some combination of surgery, and then it may be followed by possibly chemotherapy, as well as radiation, and sometimes, it may be a combination of all three treatments, or sometimes, it’s a combination of one or two of those, depending on the exact stage, depending on the exact cell type, and some of the other factors. 

Katherine:

Are hormonal therapies used as well, and targeted therapies? 

Dr. Ko:

Yes. 

Katherine:

I know they are in other cancers. 

Dr. Ko:

Yes. And so, I think the question is where do those come into play? So, I would say the usual algorithm most commonly would be that surgery is done first, as the most common first step, and then, based on the information obtained from surgery and the pathology report that comes from that, then there’s usually some type of a recommendation about should there be a second stepped treatment, and that frequently can be chemotherapy/radiation.  

Now, the areas where targeted therapy – for example, immunotherapy – where does that come in? So, that now has come into the – I would call it the second stage. We’re combining it with the classic chemotherapy drugs – Taxol-carboplatin, for example. That’s one example where it could come into play. Another example could come into play where a patient had gone through classic Taxol/paclitaxel and carboplatin, then had cancer come back, and so, that could be another instance where that pembrolizumab or pembro with lenvatinib (Lenvima) combination can be used in the setting of recurrence. 

Now, we could also say, hey, if your cancer type has those hormonal receptors present or is some type of what we call endometrioid histology, and we think that hormonal therapy may be more effective in that case, then that could also be used in a setting where the cancer has kind of grown again, the cancer has grown back, or actually, there are certain situations where patients, for example, may not undergo a hysterectomy. 

And, there are unique cases and those situations where patients are still trying to preserve their fertility, and therefore not wanting to undergo a hysterectomy, or they’re unable to undergo surgery safely. And so, in some unique situations, we may also use hormonal therapy as the mechanism to treat their cancer, and whether that is by way of a pill, whether that is by way of a progesterone intrauterine device, IUD, that is placed into the uterus, we also have situations where we tailor the therapy to the condition of the patient. 

Katherine:

When treating more advanced endometrial cancer disease in general, are the treatment options different than if you were treating somebody who had stage I or stage II, for instance? 

Dr. Ko:

Sure, great question. So, for some patients with, say, stage I, surgery alone is enough. 

For some other patients, subcategories of stage I, where we call them more high/intermediate-risk patients, they’re stage I, but there are a few features about their pathology that might make them slightly higher risk for recurrence – in those cases, we might consider a little bit of radiation after surgery, what we call adjuvant radiation or what we call radiation vaginal brachytherapy. Just three short treatments of a little bit of radiation to the top of the vagina has been shown to possibly decrease chance of recurrence in that area with very minimal side effects. 

So, that would be more commonly in line with stage I. There are some subtypes that can still be what we call high-risk, even in stage I/stage II uterine serous carcinoma, uterine carcinosarcoma. In those cases, we might also recommend chemotherapy along with some vaginal brachytherapy following their hysterectomy, so that’s the early stage. 

And then, with the advanced stage, yes. So, frequently, it’d be surgery first to secure the diagnosis, followed by some type of – it might be primarily chemotherapy, or it could be combination chemotherapy with radiation. And over time, I would say our paradigm for what we use for chemotherapy and radiation has changed a little bit.  

If you go back a couple decades, I think radiation was used a lot – whole pelvic radiation, even just without any chemotherapy. And then, we then had more data from research clinical trials, GOG-258 or PORTEC-3, that then had given us evidence that perhaps doing chemotherapy with some combination of radiation is going to be beneficial, or even moving towards primarily radiation could be a very good option in terms of long-term benefit/long-term survival. 

And, of course, that brings us to the present day, those two trials that I mentioned from ASCO, the GY018 and the RUBY, now bringing in the immunotherapy component to the chemotherapy, so there has definitely been an evolution to managing advanced stage. 

What Should Endometrial Cancer Patients Know About Clinical Trials?

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What Should Endometrial Cancer Patients Know About Clinical Trials? from Patient Empowerment Network on Vimeo.

Should endometrial cancer patients consider a clinical trial as a treatment option? Expert Dr. Emily Ko reviews the potential benefits of participating in a clinical trial.

Dr. Emily Ko is a gynecologic oncologist and Associate Professor of Obstetrics and Gynecology at the University of Pennsylvania. Learn more about Dr. Ko.
See More from Evolve Endometrial Cancer

Related Programs:

How Is Endometrial Cancer Staged?

How Is Endometrial Cancer Staged?

 What Are Treatment Options for Endometrial Cancer?

What Are Treatment Options for Endometrial Cancer?

Transcript:

Katherine:

Well, you just mentioned clinical trials, and I think it’s a good topic to cover a little bit. Why is it important for patients to actually consider enrolling? What are the benefits for them? 

Dr. Ko:

Sure. So, while we certainly have a good armamentarium of standard-of-care therapies already, and I should mention that does include our classic chemotherapy drugs like paclitaxel (Abraxane), carboplatin (Paraplatin), and even doxorubicin (Adriamycin), if you will, or doxorubicin Hcl (Doxil), there are the immunotherapy drugs now that have become standard of care as well, like pembrolizumab (Keytruda), but sometimes, despite using those best available drugs, the cancer unfortunately either continues to grow or you had a good response, but somehow it shows up again – the cancer shows up again – and so, then, we’re looking for additional opportunities, additional therapies. 

And so, some of the best opportunities are actually to consider these clinical trials. The way that clinical trials are designed is that they always are going  to provide you at least a backbone of a standard available therapy, so you’re never going to get less than what would be considered standard of care. 

But, what they’re doing is they’re usually partnering another drug – a more novel therapy – or they’re basically testing a more novel therapy that could be more targeted, that could potentially have better efficacy than what’s already available standardly. And so, the value of that is that you could have an opportunity to have a therapy that could work even better. 

When you’ve tried something already, unfortunately, the cancer has grown, there is still opportunity, and while you’re on a clinical trial, I think one of the huge benefits is it’s very regulated. You are monitored so closely because at the base of all of this is safety. There is never going to be a drug or therapy that’s going to be administered to a patient without ensuring that there’s absolute safety for that patient, and so, that’s a way that you really have opportunity to get more treatment that could really help your cancer condition and do it in a very, very safe, formal fashion. 

Katherine:

And ultimately help others as well, in the future. 

Dr. Ko:

Exactly, absolutely, because as you’re participating in this process – and, of course, it’s a voluntary process to participate on a clinical trial, so we so appreciate all the patients who, in the past, have participated and are willing to participate in the future, but allows us also to really gather a lot of information to really inform cancer treatment for all the patients coming down the road, and those could be anyone. They could be our neighbors, our friends, our own family members, and that could really be so helpful to everyone that’s going through this type of thing. 

Katherine:

Absolutely, yeah. I’d like to back up a bit and talk about what endometrial cancer is. It’s often referred to as uterine cancer. So, are they the same thing? Are these terms interchangeable? 

Dr. Ko:

Sure, it’s a great question. So, endometrial cancer refers to cancer that starts in what I call the lining of the uterine cavity. So, inside the uterus, there’s a uterine cavity, and there’s a tissue that coats that cavity, and that’s called the endometrium. So, endometrial cancer is basically when cancer cells start growing from that tissue. And, of course, since that exists in the uterus, of course, it’s considered uterine cancer, and we’re just being a little bit more specific when we say endometrial cancer. But, of course, endometrial cancer is the most common form of uterine cancer by far, so in some ways, it’s almost – it’s synonymous. 

Endometrial Cancer Treatment and Research Updates

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Endometrial Cancer Treatment and Research Updates from Patient Empowerment Network on Vimeo. 

Are there advances in endometrial cancer research that patients should know about? Expert Dr. Emily Ko shares updates about ongoing clinical trials, including immunotherapy and combination approaches, and discusses how endometrial cancer subtypes affect treatment options. 
 
Dr. Emily Ko is a gynecologic oncologist and Associate Professor of Obstetrics and Gynecology at the University of Pennsylvania. Learn more about Dr. Ko.
See More from Evolve Endometrial Cancer

Related Programs:

What Should Endometrial Cancer Patients Know About Clinical Trials?

 How Is Endometrial Cancer Staged?

How Is Endometrial Cancer Staged?

 What Are Treatment Options for Endometrial Cancer?

What Are Treatment Options for Endometrial Cancer?

Transcript:

Katherine:

Well, let’s start by learning about the latest research news. Just this June, endometrial cancer researchers from around the world met to discuss their findings at the annual American Society of Clinical Oncology meeting, or ASCO, in Chicago. Can you walk us through the highlights that patients should know about? 

Dr. Ko:

Sure. So, the ASCO meeting is a very big meeting that happens once a year in June, and really, it is a national – actually, international – meeting where the biggest breakthroughs in cancer therapy are really presented and discussed. 

So, within the field of gynecologic cancer and specifically endometrial cancer, we really saw a couple breakthrough clinical trial results, if you will. The two specific trials that have hit the spotlight – and, it was presented at ASCO; they were also previously presented at the Society of Gynecologic Oncology annual meeting in March of 2023. These two trials – one of them is called GY018, and the other one is called RUBY, and these two trials specifically were geared at patients with endometrial cancer of either advanced stage, meaning stage III or IV at diagnosis, or patients who have recurrent endometrial cancer.  

And, these both trials were very large, multisite, international trials enrolling a huge number of patients. They were randomized controlled trials, meaning that they were specifically testing what we call a standard therapy, Taxol-carboplatin, versus a standard therapy plus a newer agent, and that newer agent falls in the realm of an immunotherapy drug. 

So, with this kind of novel approach, where we’re combining standardly used chemotherapy plus a newer immunotherapy drug, the question was if you did this combination, would patients have a better outcome? And, in fact, the groundbreaking news was that yes, patients did have a better outcome with this new combination of therapy, and this was shown in various forms of results. 

One of the primary outcomes is always something called survival, and with the GY018, they looked at progression-free survival as a primary outcome, and it did show that patients on this new combination did better with progression-free survival. And the difference was about median of about three months. Now, that may not sound like a whole lot. However, in the realm of cancer therapy, when you take a very large group of patients, that was a meaningful difference that was statistically significant. 

And furthermore, as we’re moving forward with our therapy drugs, we are moving into this era of targeted therapy, precision medicine, where we’re really trying to hone into more the specifics of the biology of each person’s cancer, and not treating everyone the same. 

What’s interesting with these two trials is when they looked at different subpopulations of patients with advanced or recurrent endometrial cancer, whether they had a type of endometrial cancer that was considered MSI-high, or a microsatellite instable type of cancer, which basically refers to a certain biology of these endometrial cancers, it has to deal with how the cells – the cancer cells – behave, how they’re able to not follow the rules and be able to replicate themselves.  

The patients who are MSI-high particularly had a really great response with this chemotherapy, so it was even beyond just a three-month difference. With that being said, even in patients who are what we call microsatellite-stable, who didn’t have this unique signature, they still saw a benefit with this novel combination, and to add to that, the nice thing about it is the toxicities were not bad. Even this new combination was very well-tolerated. 

It was not a high rate of severe toxicities or side effects, if you will, and that actually, the great majority of patients were able to stay on this therapy and really get through – complete the therapy course.  

So, there are some sort of nuanced differences between the two trials I mentioned, GY018 versus the RUBY. And some of those details are with regards to the even specific subtype of endometrial cancer, which we haven’t talked about yet, for example, uterine carcinosarcoma versus uterine serous carcinoma, uterine clear cell, uterine endometrioid – these are all specific subtypes of endometrial cancer. So there are some nuances where the RUBY trial was able to include patients with uterine carcinosarcoma, whereas the GY018 did not. 

But suffice it to say, now we have enough data that virtually all endometrial cancer patients with advanced stage, regardless of what histology, there is essentially a trial that can apply to you where it demonstrated this added benefit to doing this novel combination, and that was found with microsatellite-stable patients as well as microsatellite-instable in both randomized controlled trials that I mentioned. 

Katherine:

Dr. Ko, are there other research or treatment advances that patients should know about? 

Dr. Ko:

Certainly. Like I mentioned, we’re really moving towards the realm of treating with a targeted therapy approach, and within endometrial cancer, the prior paradigm was much simpler, but really not in the space of target therapy. So, for example, what does that mean? 

So, as we’re realizing that there are very unique biologic signatures to different patients’ endometrial cancer – there could be, for example, some cancers that are particularly receptive to hormonal therapy, meaning their specific cancer, when we send it for detailed – we call it genomic or somatic testing, we can discover, oh, they have estrogen-receptor-positive, progesterone-receptor-positive, and so, those type of cancers may be very responsive to hormonal-based therapy, and in that space, we have a standard available drugs, but we also have clinical trials that are trying newer drugs. 

If, for example, the standard aromatase inhibitor or the standard progesterone agent may be helpful, but there are even more in that space that this point – CDK inhibitors that you can combine with these aromatase inhibitors or hormonal agents that have been around for longer that have shown a lot of promise, a lot of data in breast cancer. But now we’re realizing, wow, there could be some efficacy in endometrial cancer as well, so that’s just one example.  

And there’s other unique biologic gene signatures, again, kind of a good list now out there, that are being studied in various clinical trials, whether they’re PARP inhibitors, whether they’re drugs that target CCNE1, whether they’re drugs that target ARID1A, so there are actually many more that are available. So, they’re really expanding the opportunity for treatment for endometrial cancer patients. 

Endometrial Cancer Treatment Options for Patients to Consider

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Endometrial Cancer Treatment Options for Patients to Consider from Patient Empowerment Network on Vimeo.

What do endometrial cancer patients need to consider for treatment options? Expert Dr. Ebony Hoskins explains key factors that play into treatment decisions and recommended questions for patients to ask their doctor.

Dr. Ebony Hoskins is a board-certified gynecologic oncologist at MedStar Washington Hospital Center and assistant professor of Clinical Obstetrics and Gynecology at Georgetown University Medical Center.

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“…asking the right questions in terms of “How effective is this treatment that you’re recommending? Do you think it’s worth the side effects? Is my quality of life going to be affected? Can I still travel?”

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See More from [ACT]IVATED Endometrial Cancer

Related Resources:

Emerging Endometrial Cancer Treatments _ Promising Data and Challenges

Emerging Endometrial Cancer Treatments | Promising Data and Challenges

 What Endometrial Cancer Patients Should Know About Clinical Trials

What Endometrial Cancer Patients Should Know About Clinical Trials

 What is the Role of Immunotherapy in Endometrial Cancer

What is the Role of Immunotherapy in Endometrial Cancer?

Transcript:

Mikki:

Dr. Hoskins, how do you work with your patients to make treatment decisions and what increase in treatment options, what should endometrial cancer patients consider when deciding on treatment?

Dr. Ebony Hoskins:

So I think this is a good question. In terms of patients up front, I think we follow kind of certain guidelines, if you will and providing standard of care and the first frontline therapy is pretty standard, right? In terms of advanced treatment, when patients recur and we have to look at alternate treatment therapies, I always look at the patient, I always look at what their medical problems are or any side effects. And, of course, the data to see how well are they going to do what side effects and quality of life?

There are numerous factors that are not just something looking in a book and say, “Okay, I’ll take A,” right? Like I think we have to look at all of that and make a decision with our patients over undergoing the side effects, the efficacy, all of these things that are in mind when we talk to patients. So my activation tip for patients would be being involved in the decision-making, asking the right questions in terms of “How effective is this treatment that you’re recommending? Do you think it’s worth the side effects? Is my quality of life going to be affected? Can I still travel?” Those are questions like, we want to live, right? And I don’t think anybody wants to be stuck every three weeks getting treatment or…so those are questions to ask in terms of like, quality of life. And so those are questions that I would recommend you ask your doctor when you’re deciding what treatments. 

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Emerging Endometrial Cancer Treatments | Promising Data and Challenges

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Emerging Endometrial Cancer Treatments | Promising Data and Challenges from Patient Empowerment Network on Vimeo.

What is the latest in endometrial cancer treatment updates? Expert Dr. Ebony Hoskins shares updates from the RUBY study and one NRG study and provides advice for patients.

Dr. Ebony Hoskins is a board-certified gynecologic oncologist at MedStar Washington Hospital Center and assistant professor of Clinical Obstetrics and Gynecology at Georgetown University Medical Center.

[ACT]IVATION TIP

“…if someone’s diagnosed with endometrial cancer, ‘Am I a candidate for a clinical trial to be a part of this new frontier, if you will, for endometrial cancer?’”

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See More from [ACT]IVATED Endometrial Cancer

Related Resources:

Endometrial Cancer Treatment Options for Patients to Consider

Endometrial Cancer Treatment Options for Patients to Consider

 What Endometrial Cancer Patients Should Know About Clinical Trials

What Endometrial Cancer Patients Should Know About Clinical Trials

 What is the Role of Immunotherapy in Endometrial Cancer

What is the Role of Immunotherapy in Endometrial Cancer?

Transcript:

Mikki:

Dr. Hoskins, what endometrial cancer data and studies coming out of major medical conferences are you most excited about? And can you speak to those kinks and challenges or promises of emerging treatments?

Dr. Ebony Hoskins:

Well, Mikki, I’m very excited. The SGO 2023 in Tampa, Florida, we had new data that came out from one of the NRG studies as well as another study called the RUBY Study. And both were looking at up-front carboplatin (Paraplatin) and paclitaxel (Abraxane) with the addition of immunotherapy. And we saw improved progression-free survival. So that means when the disease is no longer there, how long are patients living without it recurring, and that has increased. So this is a big deal.

And then one of the studies showed again, the data is still maturing so it’s not completely out there yet. So we still have to wait on it, but there may be improved overall survival. And that’s kind of one of the study goals that we always want to do is improve overall survival. So I’m excited about that. There was also some new data looking at whether up-front patients with advanced endometrial cancer, whether they are treated with systemic chemotherapy versus systemic chemotherapy and radiation.

And this is a long ongoing survival data that said, patients basically did equally well with just chemotherapy alone without the addition of radiation. So that I think is very interesting, because we use radiation and chemotherapy in patients with advanced endometrial cancer. That certainly doesn’t mean that it’s not an option, just means that it may need to be more tailored and discussed and discussed with our radiation oncology colleagues.

In terms of what the challenges are, I think immunotherapy is a game changer. But it’s also what I use in terms of second-line treatment. So now I’m using it up front. What happens if a patient recurs while on it? What am I going to do now? That’s my question. What am I going to do next? And I’m not too worried because there are new treatment options that are out. Again, they are not necessarily standard now, but they’re ongoing in clinical trials. So I’m not too worried. But definitely some questions that cross my mind. My activation tip for this for patients is if someone’s diagnosed with endometrial cancer, “Am I a candidate for a clinical trial to be a part of this new frontier, if you will, for endometrial cancer?” 

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What Treatment Options Are Available for Advanced Endometrial Cancer?

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What Treatment Options Are Available for Advanced Endometrial Cancer? from Patient Empowerment Network on Vimeo.

What are the latest advanced endometrial cancer treatment options? Expert Dr. Ebony Hoskins shares updates about research advances and advice for newly diagnosed patients to be proactive in their care.

Dr. Ebony Hoskins is a board-certified gynecologic oncologist at MedStar Washington Hospital Center and assistant professor of Clinical Obstetrics and Gynecology at Georgetown University Medical Center.

[ACT]IVATION TIP

“…if a patient is newly diagnosed with endometrial cancer, is going in, knowing that we have more molecular markers, ‘Hey, are you going to send my tumor for next-generation sequencing, or are you going to be looking at the tumor for more information about targets that we could use for treatment?’

Download Guide  |  Descargar Guía en Español

See More from [ACT]IVATED Endometrial Cancer

Related Resources:

What Treatment Options and Factors Should Be Considered for Endometrial Cancer

What Treatment Options and Factors Should Be Considered for Endometrial Cancer?

 Are Endometrial Cancer Outcomes Worse for Minority Patients

Are Endometrial Cancer Outcomes Worse for Underrepresented Patients?

 How Can Endometrial Cancer Patients Advocate for Better Care

How Can Endometrial Cancer Patients Advocate for Better Care?

Transcript:

Mikki:

Okay. Dr. Hoskins, fortunately, the endometrial cancer arsenal keeps expanding. What promising treatments are available to patients facing advanced endometrial cancer diagnosis?

Dr. Ebony Hoskins:

So, in recent years, we’ve had more research dollars into endometrial cancer that wasn’t there, say even five to 10 years ago. Some of the promising treatments that are coming about, are treatments that look at the molecular markers, meaning when we look at the tumor, and determining what proteins that are upregulated or down, now we have treatments that can more target, if you will, the specific cancer. So I think, these are definitely promising.

Other promising things that are occurring is that we are having more clinical trials that are offered for patients with advanced endometrial cancer that I know in my earlier years in practice or even in training, that just were not there. So I think this is a good time in the advancement in terms of endometrial cancer.

So my activation tip for this would be if a patient is newly diagnosed with endometrial cancer, is going in, knowing that we have more molecular markers, “Hey, are you going to send my tumor for next-generation sequencing, or are you going to be looking at the tumor for more information about targets that we could use for treatment?”

So those are questions that as a patient you can ask, because now these treatments are covered, and the testing is covered. And so we’re in a different realm than we were say, even five to 10 years ago. 

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What Treatment Options and Factors Should Be Considered for Endometrial Cancer?

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What Treatment Options and Factors Should Be Considered for Endometrial Cancer? from Patient Empowerment Network on Vimeo.

Endometrial cancer treatment options take different factors into account, but what are they? Expert Dr. Ebony Hoskins explains key factors that play into treatment decisions and shares advice to be proactive in your care. 

Dr. Ebony Hoskins is a board-certified gynecologic oncologist at MedStar Washington Hospital Center and assistant professor of Clinical Obstetrics and Gynecology at Georgetown University Medical Center.

[ACT]IVATION TIP

“…asking your doctor based off the stage and grade, ‘What is the standard of care?’”

Download Guide  |  Descargar Guía en Español

See More from [ACT]IVATED Endometrial Cancer

Related Resources:

Are Endometrial Cancer Outcomes Worse for Minority Patients

Are Endometrial Cancer Outcomes Worse for Underrepresented Patients?

 How Can Endometrial Cancer Patients Advocate for Better Care

How Can Endometrial Cancer Patients Advocate for Better Care?

 What Treatment Options Are Available for Advanced Endometrial Cancer

What Treatment Options Are Available for Advanced Endometrial Cancer?

Transcript:

Mikki:

Dr. Hoskins, please walk us through a treatment option for endometrial cancer by stage, and what other factors should be considered when making treatment, the decisions?

Dr. Ebony Hoskins:

So this question used to be so easy where I would say, okay, if you had stage I, if someone is diagnosed with stage I, they don’t need any further treatment. If they have stage two, they may need radiation. Stage III and IV, typically chemotherapy and radiation. And I think what makes the difference in this question now is that it all depends not just in stage, but the type of cancer or the grade. So it’s one is the extent of disease. And the second question is the type of cancer. So some there could be a higher risk endometrial cancer, that’s early stage where we may need to give chemotherapy.

So I think my activation tip for this question would be asking your doctor based off the stage and grade, “What is the standard of care?” We always want standard of care, because that’s a golden standard in terms of treatment. And looking at all the options are into that care. Usually standard of care is either usually one, maybe two options. And I think looking at the whole scenario in terms of the patient, any other side effects that they may have, medications or diagnosis.

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