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Endometrial cancer

Nature Reviews Disease Primers volume 7, Article number: 88 (2021) Cite this article

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Abstract

Although endometrial cancer management remains challenging, a deeper understanding of the genetic diversity as well as the drivers of the various pathogenic states of this disease has led to development of divergent management approaches in an effort to improve therapeutic precision in this complex malignancy. This comprehensive review provides an update on the epidemiology, pathophysiology, diagnosis and molecular classification, recent advancements in disease management, as well as important patient quality-of-life considerations and emerging developments in the rapidly evolving therapeutic landscape of endometrial cancers.

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Fig. 1: Uterine anatomy.
Fig. 2: Incidence and mortality of cancers of the corpus uteri.
Fig. 3: Molecular subgroup of EC.
Fig. 4: Crosstalk between endometrial cancer cells, TAMs and microenvironment.
Fig. 5: Staging of endometrial cancer.
Fig. 6: Histological features of endometrial cancer.
Fig. 7: Progression-free survival of endometrial cancer.
Fig. 8: PORTEC-4a trial schema.

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Acknowledgements

V.M. is supported in part through the NIH/NCI Cancer Center Support Grant P30 CA008748. S.N.W. is supported in part through the NIH/NCI Cancer Center Support Grant (NIH CA016672) and the NIH SPORE in Uterine Cancer (NIH 5P50CA098258-13).

Author information

Authors and Affiliations

  1. Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Vicky Makker

  2. Department of Medicine, Weill Cornell Medical College, New York, NY, USA

    Vicky Makker

  3. University of Toronto, Division of Medical Oncology & Hematology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada

    Helen MacKay

  4. Department of Medical Oncology, Centre Leon Berard, Laboratoire Reshape University Claude Bernard Lyon, Lyon, France

    Isabelle Ray-Coquard

  5. Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA

    Douglas A. Levine

  6. Merck Research Labs, Rahway, NJ, USA

    Douglas A. Levine

  7. Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Shannon N. Westin

  8. Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan

    Daisuke Aoki

  9. Gynaecologic Cancer Programme, Vall d’Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain

    Ana Oaknin

Authors
  1. Vicky Makker
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  2. Helen MacKay
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  3. Isabelle Ray-Coquard
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  4. Douglas A. Levine
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  5. Shannon N. Westin
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  6. Daisuke Aoki
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  7. Ana Oaknin
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Contributions

Introduction (V.M.); Epidemiology (V.M.); Mechanisms/pathophysiology (I.R.-C. and D.A.L.); Diagnosis, screening and prevention (A.O.); Management (H.M.); Quality of life (D.A.); Outlook (S.N.W.); Overview of Primer (V.M.).

Corresponding author

Correspondence to Vicky Makker.

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Competing interests

Outside the submitted work, V.M. reports research (all funding to institution)/consultant/advisory board member support from Merck, Eisai, Karyopharm, AstraZeneca, Clovis, Moreo, Takeda, Zymeworks, Genentech, GSK, Dicephera and Faeth. D.A.L. has held consulting/advisory role for Tesaro/GSK, Merck, receives research funding to his institution from Merck, Tesaro, Clovis Oncology, Regeneron, Agenus, Takeda, Immunogen, VBL Therapeutics, Genentech, Celsion, Ambry and Splash Pharmaceuticals. D.A.L. is a founder of Nirova BioSense, Inc. D.A.L. is currently a full-time employee of Merck. I.R.-C. reports honoraria (self) from AbbVie, Agenus, Advaxis, BMS, PharmaMar, Genmab, Pfizer, AstraZeneca, Roche, GSK, MSD, Deciphera, Mersena, Merck Sereno, Novartis, Amgen, Tesaro and Clovis; honoraria (institution) from GSK, MSD, Roche and BMS; advisory/consulting fees from AbbVie, Agenus, Advaxis, BMS, PharmaMar, Genmab, Pfizer, AstraZeneca, Roche/Genentech, GSK, MSD, Deciphera, Mersena, Merck Sereno, Novartis, Amgen, Tesaro and Clovis; research grant/funding (self) from MSD, Roche and BMS; research grant/funding (institution) from MSD, Roche, BMS, Novartis, AstraZeneca and Merck Sereno; and travel support from Roche, AstraZeneca and GSK. A.O. has served on advisory boards for Roche, AstraZeneca, PharmaMar, Clovis Oncology, Tesaro, Inmunogen, Genmab, Mersana Therapeutic, GSK and Deciphera Pharmaceutical and has received support for travel or accommodation from Roche, AstraZeneca and PharmaMar. H.M. has served on the advisory boards of Merck, Essai, GSK and AstraZeneca. D.A. has research grant support from Aska Pharmaceutical, Takeda and Tsumura; has served as consultant for AstraZeneca, Takeda, MSD, Myriad Genetics, AbbVie, Chugai and Ono; and has received honoraria from AbbVie, MSD, Aska Pharmaceutical, AstraZeneca, Takeda, Chugai, Ono, Taiho and Bayer. S.N.W. reports research support from ArQule, AstraZeneca, Bayer, Bio-Path, Clovis Oncology, Cotinga Pharmaceuticals, GSK/Tesaro, Mereo, Novartis, Roche/Genentech and Zentalis; and has served as consultant for Agenus, AstraZeneca, Circulogene, Clovis Oncology, Eisai, EQRX, GSK/Tesaro, Lilly, Merck, Novartis, Pfizer, Roche/Genentech and Zentalis.

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Nature Reviews Disease Primers thanks Amanda Fader, Kimberly Leslie, George Maxwell, Jone Trovik and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Makker, V., MacKay, H., Ray-Coquard, I. et al. Endometrial cancer. Nat Rev Dis Primers 7, 88 (2021). https://doi.org/10.1038/s41572-021-00324-8

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