Hormone therapy

Progesterone and estrogen hormone receptors are commonly found in endometrial carcinoma tissues. Response to hormone therapy is correlated with the presence and level of hormone receptors and the degree of tumor differentiation.[19] Patients with tumors that are positive for estrogen and progesterone receptors respond best to progestin therapy.

When distant metastases, especially pulmonary metastases, are present, hormonal therapy is indicated. Patients who are not candidates for either surgery or radiation therapy may be treated with progestational agents, the most common hormonal treatment. Progestational agents produce good antitumor responses in 15% to 30% of patients. These responses are associated with significant improvement in survival.[19]

Standard progestational agents include:[19]

Evidence (progestin therapy):

A receptor-poor status may predict a poor response to progestins and a better response to cytotoxic chemotherapy.[21]

Other hormonal agents have shown benefit in treating endometrial cancer. Tamoxifen (20 mg bid) yields a 20% response rate in patients who do not respond to standard progesterone therapy.[22]

Aromatase inhibitors have also been evaluated for the treatment of advanced and recurrent endometrial cancer, although they yield lower response rates than progestational agents.[23]