Platinum rechallenge in second-line treatment for endometrial carcinoma

Objectives: Metastatic endometrial carcinoma (EC) has a poor prognosis. Systemic treatment (hormone therapy or chemotherapy) has been used in first line, however, the best therapy as second-line therapy is not known. The aim of this study is to evaluate the role of platinum-based chemotherapy rechallenge in second-line treatment for EC. Materials and Methods: Retrospective review of patients with recurrent EC who were treated with second-line systemic therapy from April 2007 to April 2015 at two cancer centers. Clinical data included: age, histology, tumor grade, tumor stage at diagnosis, site of disease progression, ECOG performance status, adjuvant chemotherapy, first- and second-line chemotherapy for recurrent disease and comorbidities. Results: A total of 84 patients were evaluated. Median age was 66.2 years; most patients had endometrioid histology (67.9%) and grade 2 tumors (45.8%). Twenty-nine patients (34.5%) were treated with platinum rechallenge at second line. Median overall survival (OS) was 9.7 months (7.1-12.3 months; 95%CI). Longer OS was observed in platinum rechallenge group compared to non-re-exposed (13.8 months vs. 7.9 months, p = 0.005). Only platinum rechallenge was significantly associated to a better OS on multivariate analysis (HR 0.43 [95%CI 0.21-0.87, p = 0.019]). Platinum rechallenge was also associated with a higher progression-free survival (PFS) (4.9 months vs. 3.4 months, p = 0.008). Con-clusions: The present findings suggest a longer OS and PFS for patients treated with platinum rechallenge at second-line treatment for EC and add more evidence for adoption of this strategy in a scenario where there is little evidence of effective treatments.

Endometrial carcinoma; Second-line therapy.

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