Endometrial cancer cells often have horomonal receptors and when they do, responsiveness to hormonal blockade may exist. Hormone receptor positivity in metastatic endometrial cancer is predictive of response to hormonal therapy, which supports the place of hormones in treating metastatic disease. Prospective trials demonstrated overall response rates between 11% and 16% in women treated with Megace, with progression-free intervals of several months. The best studied hormonal drugs are progesterone, tamoxifen and the combination of the two, as well as GHRH antagonists, but a study of GNRH concluded that the evidence is insufficient to warrant further study of GnRH agonists in the treatment of metastatic endometrial cancer.
The results of two phase II studies of aromatase inhibitors, such as letrozole have been published. TTher esposne rates have been low.
NCCN does recommend progestational agents: Megestrol acetate, tamoxifen and aromatase inhibitors on p. ENDO-B, although it combines this recommendations with the suggestion that when available, clinical trials should be pursued.