Cancer Treatment Today

Cytotoxic chemotherapy has a limited place in the management of advanced or recurrent endometrial cancer. Commonly used agents include cisplatin and doxorubicin, but the side-effect profile may be unacceptable for many patients. More intense combination chemotherapy significantly improves the disease-free survival and the data indicate a modest improvement in OS. The addition of anthracyclines (e.g. doxorubicin) or the taxanes [e.g. paclitaxel (Taxol)] to cisplatin increases the response rate. While no one drug or regimen offers a clear benefit for women with advanced endometrial cancer, platinum drugs, anthracyclines and paclitaxel seem the most promising agents. More intensive regimens are associated with the gain in survival. However, grade 3 and 4 myelosuppression and gastrointestinal toxicity are also increased. Weekly Taxol may preserve effectiveness while limiting toxicity.  There is not much information on weekly Taxol in recurrent endometrial cancer. A 3 cases series concluded that: “The weekly administration of paclitaxel is a rational management approach in women with metastatic or recurrent endometrial cancer who have previously received treatment with both a platinum agent and paclitaxel.” A 4 case series concluded: “Outpatient treatment with weekly paclitaxel was well-tolerated and feasible for patients with CAP-resistant recurrent or advanced endometrial carcinoma. Further trials to confirm the efficacy and toxicity of weekly paclitaxel are warranted.” There are occasional other scattered reports in the literature.