Uterine cancer is the most common gynecologic cancer in the western world. Cancer of the uterus most frequently involves the endometrium. Endometrial cancer is the most common gynecologic malignancy and the fourth most commonly diagnosed cancer in women in the United States. The most crucial factor is chronic unopposed estrogen stimulation with a lack of progesterone. Other risk factors include nulliparity, non-insulin-dependent diabetes, hypertension, the birth control pill, as well as the use of tamoxifen.
The most common presentation for endometrial cancer is postmenopausal vaginal bleeding occurring in approximately 80-90% of patients. The uterus has a rich and complex lymphatic network. Tumor cells may gain access to the peritoneal cavity at times leading to distant metastasis like ovarian cancer. Sites of distant spread include lung, liver, and bone. Treatment of early-stage I and II diseases is through surgery and radiation. Adjuvant chemotherapy is not routinely recommended for patients at this stage, although recurrences do occur.
With stage IV cancers, distant recurrence chemotherapy is the first-line of treatment. Unfortunately, current combination chemotherapy regimens only yield response rates of 50-60%. For this reason, personalized genomic evaluation is essential at any stage. Targeted therapies unique to each patient are crucial. Combination therapy is most beneficial.
New predictive “biomarkers” allow us to evaluate the molecular characteristic of your tumor, and by blocking this pathway, we can slow the growth of the tumor. Recent research has shown that the use of molecularly targeted agents has increased survival in patients. New antiangiogenic agents have shown activity in endometrial cancer. A combination of these with an mTOR inhibitor agent in addition to hormonal therapy and chemotherapy is now possible through new genomic testing. Epidermal growth factor receptor HER 1 and 2 is found in about 20-30% of some uterine cancers. Other targets found in uterine cancer include fibroblast growth factor receptor 2, and the PI 3K pathway. All these and many more are evaluated on your study and are blocked.
Testing is performed for chemosensitivity to find out which is the most effective chemotherapy to take in your cancer. In addition natural testing will show which natural substances can synergistically increase your response rate.
Low dose personalized metronomic chemotherapy has shown to induce less chemotherapy resistance and less immune suppression of the patient. When compared to traditional maximum tolerated dose chemotherapy, it is much less toxic with minimal side effects. Natural substances used to provide synergistic efficacy. The numerous “biomarker” cancer pathways targeted and blocked. Various agents used to inhibit new blood vessel growths around cancer and to inhibit cell proliferation and decreased tumor growth.
New research has shown that evaluation of microsatellite instability and tumor mutational burden is now a biomarker for the use of immune checkpoint inhibitors in endometrial cancer. This evaluation was reported in the Onco Target journal 2018. New scientific studies have now shown the effectiveness and clinical utility of Keytruda in tumors that have high microsatellite instability. These are tumors that respond to checkpoint inhibitors.
As reported by the American Society of clinical oncology (ASCO), in some trials, the patient’s monotherapy with checkpoint inhibitors resulted in an overall response rate of 53-72%. Combining monotherapy with antiangiogenic therapy and immunotherapy, the patients can achieve the best results.
Personalized cancer vaccines made for your endometrial cancer. They are taken from the patient’s cancer cells in the blood and made in the laboratory. These personalized vaccines are then injected back in your bloodstream several times a year to attack cancer. Optimization of your immune function Critical for the effectiveness and is performed throughout your treatment plan. Optimization performed during the entire treatment plan.
Through new personalized genomic testing, we can formulate a new, truly personalized cancer care. By evaluating your “biomarkers,” we can see which cancer pathways are causing your cancer to be more aggressive and to spread. These pathways are manipulated and blocked. Through chemosensitivity testing, we can find which chemotherapy is most effective. Low dose metronomic chemotherapy is used, which does not have the toxic side effects. Natural substances are synergistic and nontoxic. Immunotherapy with checkpoint inhibitors, combined with autologous whole cancer vaccines, dendritic cell vaccine, and supportive oligonucleotide (SOT), creates synergistic. Your underlying immune function is evaluated and optimized.
If you have stage IV endometrial carcinoma, please call us at 480-860-2030.