First-line treatments for advanced or recurrent endometrial cancer: systematic literature review of clinical evidence.

Mansoor Raza Mirza, Domenica Lorusso, Qin Shen, Odette Allonby, Mahmoud Slim, Katarzyna Borkowska, Marissa Betts, Robert L Coleman
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Abstract

Novel therapies are driving meaningful changes to the management of endometrial cancer (EC). Herein, a systematic literature review was conducted to evaluate the efficacy and safety of first-line treatments for advanced/recurrent EC. Searches were conducted using multiple databases through October 26, 2023. In total, 108 records of 57 unique trials (48 of first-line therapies) met the inclusion criteria. Baseline characteristics varied by study, and sample sizes ranged from 28 to 1328. Median progression-free survival was reported in 28 trials (range, 1.9-18.8 months), median overall survival in 26 trials with mature data (range, 6.9-41 months), and safety in 21 trials evaluating first-line systemic therapy ± maintenance. The potentially high risk of adverse events may outweigh the suboptimal efficacy benefits reported for conventional chemotherapy or hormonal therapies. The safety and efficacy of immunotherapies identified within are expected to contribute to a paradigm shift in the management of primary advanced/recurrent EC.

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晚期或复发性子宫内膜癌的一线治疗:临床证据系统文献综述。
新型疗法正在推动子宫内膜癌(EC)的治疗发生有意义的变化。在此,我们进行了一项系统性文献综述,以评估晚期/复发性子宫内膜癌一线治疗的有效性和安全性。我们使用多个数据库进行了检索,检索时间截止到 2023 年 10 月 26 日。共有57项独特试验(48项一线疗法)的108条记录符合纳入标准。不同研究的基线特征各不相同,样本量从28个到1328个不等。28项试验报告了中位无进展生存期(范围为1.9-18.8个月),26项有成熟数据的试验报告了中位总生存期(范围为6.9-41个月),21项评估一线系统疗法±维持治疗的试验报告了安全性。不良事件的潜在高风险可能超过传统化疗或激素疗法的次优疗效。免疫疗法的安全性和疗效有望推动原发性晚期/复发性乳腺癌治疗模式的转变。
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