Is there a specific drug for endometrial cancer?

Is there any specific medicine for endometrial cancer? The treatment principle of endometrial cancer should be determined based on comprehensive consideration of factors such as clinical stage, degree of differentiation of cancer cells, and the patient's general condition. Because most endometrial cancers are adenocarcinomas, which are not sensitive to radiotherapy, surgery is the main treatment, but drug therapy should also be used for comprehensive treatment.

1. Progestogen drug therapy is mostly used for cases of recurrence or metastasis after surgery or radiotherapy. It is also used for patients with well-differentiated, early-stage, young adenocarcinoma who need to retain fertility. Progestogen drugs are recommended as a component of comprehensive treatment. Progestogens can also reduce the rate of postoperative vaginal recurrence, so they can also be widely used as adjuvant therapy after surgery or radiotherapy. The mechanism of action of progestogens in the treatment of endometrial cancer is currently believed to be that it directly acts on tumor cells, causing them to transform from malignant to normal endometrium, inhibiting the synthesis of cancer cell DNA and RNA, reducing division, thereby inhibiting the reproduction of cancer cells, and finally the tumor is replaced by hyperplastic or atrophic endometrium. Commonly used drugs include: medroxyprogesterone acetate, megestrolacetate, 17-hydroxyprogesteronecaproate, and 18-methylnorgestrel. Medroxyprogesterone: also known as progesterone acetate. Short-acting can be taken orally; long-acting (depo-provera) is used for injection, 200-400 mg, intramuscular injection, twice a week, for 3-6 months, or after 12 weeks, change to a maintenance dose of 200 mg/d. Oral use is less common, usually for the first 5-6 weeks, at least 3 mg per week, then 400 mg/d, for long-term use. What is the best drug for endometrial cancer? Megestrol acetate: trade name Funing tablets, 40-160 mg/d, after 12 weeks of oral administration, change to a maintenance dose of 500 mg, twice a week. Progesterone acetate: 500 mg/d, intramuscular injection, once a day, after 12 weeks, change to 500 mg, twice a week, for a total of 6 months. The objective efficacy of progestogen drugs in the treatment of endometrial cancer is 30% to 35%, and sustained remission and even cure is about 90%. Progestogen drugs are non-cytotoxic drugs with high safety and little toxicity. Common side effects include mild sodium and water retention and digestive tract reactions, and other side effects include hypertension, acne, breast pain, etc. 0.6% may have allergic reactions, but no death has been caused. People with impaired heart, liver, and kidney function should use it with caution.

2. Anti-estrogen drug treatment Tamoxifen is a non-steroidal anti-estrogen drug that has a slight androgenic effect. It competes with estradiol for estrogen receptors (ER), occupies the receptors and acts as an anti-estrogen. After taking this drug, the PR in the tumor increases, which is beneficial to progesterone treatment. It is usually used in advanced cases, postoperative recurrence or metastasis. It can be used alone (progesterone treatment is ineffective) or with pregnancy hormones, or in combination with chemotherapy drugs. The dose is 20 mg/d, taken orally, and the effect is not obvious after several weeks, so it can be doubled. It has been reported that the loading dose for the first application is 80 mg/d. Side effects include nausea, vomiting, rash, hot flashes, bone marrow suppression, thrombocytopenia, vaginal bleeding, hypercalcemia, etc.

3. Chemotherapy is mostly used for patients with advanced or recurrent metastatic disease. For those who have the conditions to measure PR and ER in cancer tissue, progesterone therapy is preferred when the receptors are positive; chemotherapy is more often used when the receptors are negative. When there is no condition to measure the receptors, progesterone should be used if the cancer cells are well differentiated, and chemotherapy should be used if the differentiation is not good. 1. Single drug chemotherapy: 5-FU and CTX are more commonly used and have a more certain effect. 2. Combination drug chemotherapy Combination chemotherapy with multiple drugs instead of single chemotherapy is the trend of modern anti-cancer treatment. The combination chemotherapy regimens for endometrial cancer include: (1) ADR (37.5mg/m2) and CTX (500mg/m2) intravenous, with a treatment interval of 21 days, and an objective effective rate of 62%. (2) DDP (60mg/m2), ADR (50mg/m2) and CTX (600mg/m2), with a treatment interval of 28 days, and an objective effective rate of 57%. (3) VCR (vincristine 1.5mg), ADR (40mg/m2), CTX (500mg/m2) intravenously, plus 5-FU 500mg/m2 intravenously for 2 days, with an interval of 21 days between treatments, and an objective effective rate of 50%. What is the best drug for endometrial cancer? Combination chemotherapy is more likely to be used simultaneously with progesterone drugs.