MCW Researchers Help Inform Clinical Guidelines for Treatment of Endometrial Cancer

Patient and DoctorSince the American Society for Radiation Oncology (ASTRO) first published its endometrial cancer guideline in 2014, several clinical trials across risk groups and stages of endometrial cancer have reported on the impacts of post-operative therapies. MCW researchers led a task force that synthesized findings from these trials into a new clinical guideline that provides recommendations on using adjuvant radiation therapy and systemic therapy to treat patients with endometrial cancer.

“The new guideline also considers how surgical staging, which now includes sentinel lymph node mapping with pathologic ultra-staging, impacts adjuvant treatment recommendations, as well as the use of molecular profiling techniques to fine-tune whether a patient should receive post-operative therapy,” said Beth Erickson, MD, FACR, FASTRO, FABR, professor of radiation oncology and chair of the ASTRO guideline task force.

Endometrial cancer is the most common cancer of the female reproductive organs and is projected to affect more than 1,400 women in Wisconsin this year. Dr. Erickson explained that standard treatment often involves surgical removal of the patient’s uterus, cervix, fallopian tubes, and ovaries, as well as selective lymph node sampling with additional adjuvant therapy given to reduce the risk of recurrence and improve overall survival.

“The guideline offers treatment algorithms for stage I-II endometrial cancers, stage I-II cancers with high-risk histologies, and stage III-IVA cancers. It continues to endorse the use of patient-specific factors like age and uterine and extra-uterine pathologic risk factors, which have guided adjuvant therapy for many years,” she added.

ASTRO’s guideline task force brings together a multidisciplinary group of gynecologic and radiation oncologists. Partnerships among these top cancer experts have been key to outlining best practices for patient-centered care. “The Froedtert & the Medical College of Wisconsin team has been collaborating for decades at multidisciplinary tumor boards that bring together radiation oncologists, gynecologic oncologists, radiologists, and pathologists. It has been progressive in incorporating sentinel lymph node mapping and pathologic ultra-staging into their routine practice and is now also obtaining and using molecular profiling to guide these important decisions,” said Dr. Erickson.

The task force anticipates adjuvant therapy for endometrial cancer will continue to evolve in the coming years. Dr. Erickson explained that future directions in adjuvant management will be driven by further discoveries and thoughtfully designed clinical trials.

“Equity-focused clinical research, including diverse study teams, inclusive enrollment practices, pragmatic study designs, and targeted dissemination of results, will ensure more equitable cancer treatment for all patients with endometrial cancer,” said Dr. Erickson.

“These new guidelines based on the latest clinical trial results help advance treatment options across the country. Having Dr. Erickson at MCW—a national clinical leader in endometrial cancers—is a huge asset for the Cancer Center and especially for patients locally and nationally,” said Cancer Center Director Gustavo Leone, PhD.
Review the full clinical guidelines in Practical Radiation Oncology.