Uterine cancer, primarily endometrial cancer, ranks as the fourth leading cause of global gynecological malignancy-related deaths. Risk factors include extended estrogen exposure, early menarche, late menopause, nulliparity, obesity, hypertension, diabetes, estrogen-only HRT, and genetic syndromes like Lynch and Cowden. This FAQ explores the developments in endometrial cancer treatment, focusing on innovative drugs, ongoing clinical trials, and their potential impact on patient outcomes.

1. What is the global prevalence of endometrial cancer and how does it vary across different regions?

Endometrial cancer poses a significant health burden with nearly 420,370 new cases and 97,720 deaths reported in 2022, globally. Asia recorded the highest incidence, followed by Europe, North America, and rest of the world regions. The country-wise incidence rates showed variations, with the United States, Canada, Russia, Ukraine, and Poland having the highest rates among others. These diverse trends reflect the complex epidemiological landscape of endometrial cancer across the world.  

2. What are the recent trends in clinical trials for endometrial cancer, particularly in terms of geographical distribution and patient recruitment?

Recent trends observed in endometrial cancer clinical trials globally include a surge in trials initiated since 2018, with over 1200 trials being initiated by the biotech and biopharma industry. North America and Asia-Pacific are leading in the number of trials conducted, followed by the European region, while the rest of the world contributes moderately. Prominent countries in North America include the United States, whereas Mainland China dominates in Asia-Pacific. Significant research efforts are also observed in countries like Spain in Europe and Israel in the rest of the world.  With respect to patient recruitment trends, Asia-Pacific showed shorter recruitment durations and faster patient recruitment rates in comparison to the United States and Europe.

3. What are the recently approved FDA drugs for endometrial cancer?

The recently approved FDA drugs for endometrial cancer include dostarlimab-gxly (Jemperli, GlaxoSmithKline) and pembrolizumab (Keytruda) in combination with lenvatinib (Lenvima). Dostarlimab-gxly received FDA approval on July 31, 2023, for primary advanced or recurrent endometrial cancer, specifically for patients with mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H) status, confirmed by an FDA-approved test. It can be used alone or combined with carboplatin and paclitaxel. Pembrolizumab, approved on July 21, 2021, in combination with lenvatinib, is indicated for patients with advanced endometrial carcinoma without MSI-H or dMMR status. These approvals represent significant advancements in endometrial cancer treatment options.

4. How does precision medicine differ from traditional approaches to endometrial cancer treatment?

Precision medicine in endometrial cancer treatment differs from traditional approaches by focusing on individualized patient care based on the tumor's molecular characteristics. Unlike traditional one-size-fits-all approaches, precision medicine categorizes tumors into unique subtypes based on molecular subtyping, enabling tailored treatment plans for each subtype. An example is the FDA-approved dostarlimab-gxly for primary advanced or recurrent endometrial cancer in patients with dMMR or MSI-H status, as confirmed by an FDA-approved test. This approach uses advanced techniques like next-generation sequencing to analyze genetic and protein markers. It enables personalized treatment tailored to the tumor's molecular makeup. Additionally, it explores new therapies such as immunotherapy and targeted therapy. These therapies promise improved patient outcomes by targeting specific molecular pathways involved in cancer progression.

5. How are public funding initiatives impacting endometrial cancer treatment accessibility?

Public funding initiatives are significantly reshaping the landscape of endometrial cancer treatment accessibility, particularly in countries like Australia and the United States. These investments aim to expand access to innovative therapies and improve the quality of care for individuals affected by endometrial cancer. By alleviating financial burdens and demonstrating a commitment to enhancing patient outcomes, these initiatives play a crucial role in addressing unmet medical needs in the fight against endometrial cancer.