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New Insights into Hormonal Therapies in Uterine Sarcomas

SIMPLE SUMMARY: Uterine sarcomas are rare mesenchymal malignant cancers, and surgery represents the mainstay of treatment for early-stage disease. In metastatic setting, uterine sarcomas’ treatment includes palliative surgery, a metastases resection, chemotherapy and targeted therapy. Hormonal thera...

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Autores principales: Maccaroni, Elena, Lunerti, Valentina, Agostinelli, Veronica, Giampieri, Riccardo, Zepponi, Laura, Pagliacci, Alessandra, Berardi, Rossana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870116/
https://www.ncbi.nlm.nih.gov/pubmed/35205669
http://dx.doi.org/10.3390/cancers14040921
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author Maccaroni, Elena
Lunerti, Valentina
Agostinelli, Veronica
Giampieri, Riccardo
Zepponi, Laura
Pagliacci, Alessandra
Berardi, Rossana
author_facet Maccaroni, Elena
Lunerti, Valentina
Agostinelli, Veronica
Giampieri, Riccardo
Zepponi, Laura
Pagliacci, Alessandra
Berardi, Rossana
author_sort Maccaroni, Elena
collection PubMed
description SIMPLE SUMMARY: Uterine sarcomas are rare mesenchymal malignant cancers, and surgery represents the mainstay of treatment for early-stage disease. In metastatic setting, uterine sarcomas’ treatment includes palliative surgery, a metastases resection, chemotherapy and targeted therapy. Hormonal therapies may also represent an effective option. Frequently, ER and PR are highly expressed in uterine sarcomas patients and they represent a favourable prognostic factor associated with improved overall survival. The scope of the present review is to report the existing evidence and future perspectives on hormonal therapy in uterine sarcomas, with a special focus on aromatase inhibitors, progestins and gonadotropin-releasing hormone analogues, in order to clarify their potential role in daily clinical practice. ABSTRACT: Uterine sarcoma (US) is a rare mesenchymal malignant cancer type, accounting for 3–7% of uterine malignancies. US prognosis is still poor due to high local and distant recurrence rates. As for molecular features, US may present variable oestrogen receptor (ER) and progesterone receptor (PR) expressions, mostly depending on histotype and grading. Surgery represents the mainstay of treatment for early-stage disease, while the role of adjuvant chemotherapy or local radiotherapy is still debated and defined on the basis of histotype, tumour grading and stage. In metastatic setting, uterine sarcomas’ treatment includes palliative surgery, a metastases resection, chemotherapy, hormonal therapy and targeted therapy. As for the chemotherapy regimen used, drugs that are considered most effective are doxorubicin (combined with ifosfamide or alone), gemcitabine combined with docetaxel and, more recently, trabectedin or pazopanib. Hormonal therapies, including aromatase inhibitors (AIs), progestins and gonadotropin-releasing hormone analogues (GnRH-a) may also represent an effective option, in particular for low-grade endometrial stromal sarcoma (LGESS), due to their favourable toxicity profile and patients’ compliance, while their role is still under investigation in uterine leiomyosarcoma (uLMS), high-grade endometrial stromal sarcoma (HGESS), undifferentiated uterine sarcoma (USS) and other rarer US. The present review aims to analyse the existing evidence and future perspectives on hormonal therapies in US, in order to clarify their potential role in daily clinical practice.
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spelling pubmed-88701162022-02-25 New Insights into Hormonal Therapies in Uterine Sarcomas Maccaroni, Elena Lunerti, Valentina Agostinelli, Veronica Giampieri, Riccardo Zepponi, Laura Pagliacci, Alessandra Berardi, Rossana Cancers (Basel) Review SIMPLE SUMMARY: Uterine sarcomas are rare mesenchymal malignant cancers, and surgery represents the mainstay of treatment for early-stage disease. In metastatic setting, uterine sarcomas’ treatment includes palliative surgery, a metastases resection, chemotherapy and targeted therapy. Hormonal therapies may also represent an effective option. Frequently, ER and PR are highly expressed in uterine sarcomas patients and they represent a favourable prognostic factor associated with improved overall survival. The scope of the present review is to report the existing evidence and future perspectives on hormonal therapy in uterine sarcomas, with a special focus on aromatase inhibitors, progestins and gonadotropin-releasing hormone analogues, in order to clarify their potential role in daily clinical practice. ABSTRACT: Uterine sarcoma (US) is a rare mesenchymal malignant cancer type, accounting for 3–7% of uterine malignancies. US prognosis is still poor due to high local and distant recurrence rates. As for molecular features, US may present variable oestrogen receptor (ER) and progesterone receptor (PR) expressions, mostly depending on histotype and grading. Surgery represents the mainstay of treatment for early-stage disease, while the role of adjuvant chemotherapy or local radiotherapy is still debated and defined on the basis of histotype, tumour grading and stage. In metastatic setting, uterine sarcomas’ treatment includes palliative surgery, a metastases resection, chemotherapy, hormonal therapy and targeted therapy. As for the chemotherapy regimen used, drugs that are considered most effective are doxorubicin (combined with ifosfamide or alone), gemcitabine combined with docetaxel and, more recently, trabectedin or pazopanib. Hormonal therapies, including aromatase inhibitors (AIs), progestins and gonadotropin-releasing hormone analogues (GnRH-a) may also represent an effective option, in particular for low-grade endometrial stromal sarcoma (LGESS), due to their favourable toxicity profile and patients’ compliance, while their role is still under investigation in uterine leiomyosarcoma (uLMS), high-grade endometrial stromal sarcoma (HGESS), undifferentiated uterine sarcoma (USS) and other rarer US. The present review aims to analyse the existing evidence and future perspectives on hormonal therapies in US, in order to clarify their potential role in daily clinical practice. MDPI 2022-02-12 /pmc/articles/PMC8870116/ /pubmed/35205669 http://dx.doi.org/10.3390/cancers14040921 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Maccaroni, Elena
Lunerti, Valentina
Agostinelli, Veronica
Giampieri, Riccardo
Zepponi, Laura
Pagliacci, Alessandra
Berardi, Rossana
New Insights into Hormonal Therapies in Uterine Sarcomas
title New Insights into Hormonal Therapies in Uterine Sarcomas
title_full New Insights into Hormonal Therapies in Uterine Sarcomas
title_fullStr New Insights into Hormonal Therapies in Uterine Sarcomas
title_full_unstemmed New Insights into Hormonal Therapies in Uterine Sarcomas
title_short New Insights into Hormonal Therapies in Uterine Sarcomas
title_sort new insights into hormonal therapies in uterine sarcomas
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870116/
https://www.ncbi.nlm.nih.gov/pubmed/35205669
http://dx.doi.org/10.3390/cancers14040921
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