Despite the fact that the results of randomized trials have varied, there is level-1 evidence for the utilization of adjuvant chemotherapy in stage IIIC endometrial cancer (positive lymph nodes). While there is a lack of prospective trial data to authenticate this practice, chemotherapy is regularly suggested for high-risk subgroups of stage 1 diseases like serous carcinomas.
In light of the extrapolation of information from the metastatic setting, carboplatin plus paclitaxel is the present standard regime. Adjuvant pelvic radiotherapy has been compared by numerous clinical trials to a mixture of chemotherapy and radiotherapy with mixed results. Postoperative Radiation Therapy in Endometrial Carcinoma 3 (PORTEC-3) is one of the biggest of these trials and has finished accrual; it now awaits information development. Metastatic disease is incurable. Endocrine therapy with a progestin-based regime is suitable for tumors of low-grade endometrioid histology with a lengthy time for repetition. In most other cases, chemotherapy will be utilized, and the standard first-line regime would be paclitaxel and carboplatin.
Not many chemotherapy agents have been displayed to produce significant response rates in the second-line setting. Researchers have looked into molecularly targeted therapies like mTOR inhibitors and antiangiogenic agents including bevacizumab but their part in armamentarium remains unclear.