Adjuvant chemotherapy for stage III and IVA cancer

Adriamycin + Cisplatin
Doxorubicin (Adriamycin) 60 mg/m2 iv q3w x 7 cycles
Cisplatin (CDDP) 50 mg/m2 iv q3w x 8 cycles

Randall, ME et al. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 2006; 24:36 (link to the article).
 

Adjuvant chemotherapy for carcinosarcoma

CIM
Cisplatin (CDDP) 20 mg/m2/d iv d1-4
Ifosfamide 1.5 g/m2/d iv d1-4
Mesna 120 mg/m2 iv loading dose followed by 1.5 g/m2/d iv d1-4
Q3w x 3 cycles

Wolfson AH et al. A gynecologic oncology group randomized trial of whole abdominal irradiation (WAI) vs cisplatin-ifosfamide-mesna (CIM) in optimally debulked stage I-IV carcinosarcoma (CS) of the uterus. 2006 ASCO annual meeting. Abstract 5001.  (link to the article).
 

Hormonal therapy for stage IVB (metastatic) cancer (back to top)

Megestrol acetate
Megestrol acetate (megace) 200 mg po qd

Thigpen, JT et al. Oral medroxyprogesterone acetate in the rreatment of advanced or recurrent endometrial carcinoma: A dose-response study by the Gynecologic Oncology Group. J Clin Oncol 1999; 17:1736 (link to the article).

Tamoxifen
Tamoxifen 20 mg po bid

Carlson, JA Jr et al. Tamoxifen and endometrial carcinoma: alterations in estrogen and progesterone receptors in untreated patients and combination hormonal therapy in advanced neoplasia. Am J Obstet Gynecol 1984; 149:149 (link to the article).
 

Chemotherapy for stage IVB (metastatic) cancer (back to top)

Carboplatin
Carboplatin (Paraplatin) 400 mg/m2 iv
Q4w

van Wijk, FH et al. Phase II study of carboplatin in patients with advanced or recurrent endometrial carcinoma. A trial of the EORTC Gynaecological Cancer Group. Eur J Cancer 2003; 39:78 (link to the article).

Paclitaxel
Paclitaxel (Taxol) 110-200 mg/m2 iv
Q3w

Ball, HG et al. A phase II trial of paclitaxel in patients with advanced or recurrent adenocarcinoma of the endometrium: a Gynecologic Oncology Group study. Gynecol Oncol 1996; 62:278 (link to the article).

Lissoni, A et al. Phase II study of paclitaxel as salvage treatment in advanced endometrial cancer. Ann Oncol 1996; 7:861 (link to the article).

Lincoln, S et al. Activity of paclitaxel as second-line chemotherapy in endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2003; 88:277 (link to the article).

Topotecan
Topotecan (Hycamtin) 1.2-1.5 mg/m2/d iv d1-5
Q3w

Wadler, S et al. Topotecan is an active agent in the first-line treatment of metastatic or recurrent endometrial carcinoma: Eastern Cooperative Oncology Study E3E93. J Clin Oncol 2003; 21:2110 (link to the article)

Dactinomycin
Dactinomycin (Cosmegen) 2 mg/m2 iv
Q4w

Moore, DH et al. Dactinomycin in the treatment of recurrent or persistent endometrial carcinoma: A Phase II study of the Gynecologic Oncology Group. Gynecol Oncol 1999; 75:473 (link to the article).

Carboplatin + Paclitaxel
Carboplatin (Paraplatin) AUC 5-7 iv d1
Paclitaxel (Taxol) 175 mg/m2 iv d1
Q4w

Hoskins, PJ et al. Paclitaxel and carboplatin, alone or with irradiation, in advanced or recurrent endometrial cancer: a phase II study. J Clin Oncol 2001; 19:4048 (link to the article).

Cisplatin + Paclitaxel
Cisplatin (CDDP) 75 mg/m2 iv d1
Paclitaxel (Taxol) 175 mg/m2 iv d1
Q3w

Dimopoulos, MA et al. Paclitaxel and cisplatin in advanced or recurrent carcinoma of the endometrium: long-term results of a phase II multicenter study. Gynecol Oncol 2000; 78:52 (link to the article).

Adriamycin + Cisplatin + Paclitaxel
Doxorubicin (Adriamycin) 45 mg/m2 iv d1
Cisplatin (CDDP) 50 mg/m2 iv d1
Palictaxel (Taxol) 160 mg/m2 iv d2
Filgrastim (Neupogen) support
Q3w

Fleming, GF et al. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol 2004; 22:2159 (link to the article).

Ifosfamide + Paclitaxel (for carcinosarcoma)
Ifosfamide 1.6 g/m2/d (1.2 g/m2/d if patients received prior radiation) iv d1-3
Paclitaxel (Taxol) 135 mg/m2 iv over 3 hrs d1
Mesna 2 g iv over 12 hrs beginning 15 min before ifosfamide
Filgrastim (Neupogen) 5 mcg/kg sc d4 till ANC > 2000
Q3w x 8 cycles

Homesley HD et al. Phase III trial of ifosfamide with or without paclitaxel in advanced uterine carcinosarcoma: a Gynecologic Oncology Group study. J Clin Oncol 2007; 25:526 (link to the article).