Dr. Mutch on Frontline Treatment in Endometrial Cancer
David Mutch, MD
David Mutch, MD, Ira C. and Judith Gall professor, vice chair of obstetrics and gynecology, chief, Division of Gynecologic Oncology, Washington University School of Medicine in St. Louis, Siteman Cancer Center, discusses frontline treatment for patients with endometrial cancer.
In patients who have high-risk endometrial cancer, Mutch argues that based on GOG-209, which randomized patients to cisplatin, paclitaxel, and doxorubicin versus carboplatin and paclitaxel, the survival is the same in both arms. Toxicity is greater in the triplet therapy group; therefore, standard therapy for upfront treatment would be carboplatin and paclitaxel in the high-risk patients.
However, patients need to be monitored for a cuff recurrence. Cuff recurrences, if monitored carefully, have a cure rate of 100%. Then, radiation therapy is certainly indicated.