Share This Article:

Short-term Femara (letrozole) treatment and suppression of Ki67 expression in postmenopausal endometrial carcinoma

Abstract Full-Text HTML Download Download as PDF (Size:122KB) PP. 347-351
DOI: 10.4236/ojog.2013.33064    3,307 Downloads   4,812 Views   Citations

ABSTRACT

Objective: To determine if short-term treatment with Femara (letrozole) induces measurable reduction in tumor Ki67 expression in postmenopausal women with FIGO grade 1 and 2 endometrial carcinoma. Methods: In this non-randomized prospective study, 12 patients were given Femara (letrozole) 2.5 mg daily for approximately 3 weeks prior to planned hysterectomy for FIGO grade 1 or 2 endometrial carcinoma. A group of 12 demographically similar patients were enrolled as no-treatment controls. Ki67 expression in tumor cells was quantitated by immunohistochemistry with mechanical scanning within the initial endometrial biopsy and compared to that in the hysterectomy specimen for each patient in the treatment and control groups. Results: The treatment and control groups were similar in age, tumor grade and FIGO stage. When “aromatase inhibitor responsiveness” was defined as proportionate decline in Ki67% stained tumor cells of at least 70% between the pre-treatment endometrial biopsy and post-treatment hysterectomy specimens, 5 of 12 patients were found to be “responsive” in the treatment group with none of the controls fulfilling these criteria. Conclusion: Femara (letrozole) 2.5 mg daily for approximately 3 weeks induced a significant reduction in tumor cell Ki67 expression among 5 of 12 (41%) postmenopausal women with FIGO grade 1 or 2 endometrial carcinoma. We postulate that Ki67 may be a useful marker during aromatase inhibitor medical treatment of patients with endometrial cancer who are not candidates for surgical treatment.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Smith, L. , Leiserowitz, G. , Xing, G. and Bishop, J. (2013) Short-term Femara (letrozole) treatment and suppression of Ki67 expression in postmenopausal endometrial carcinoma. Open Journal of Obstetrics and Gynecology, 3, 347-351. doi: 10.4236/ojog.2013.33064.

References

[1] Siegel, R., Naishadham, D. and Jemal, A. (2012) Cancer statistics: 2012. CA: A Cancer Journal for Clinicians, 62, 10-29. doi:10.3322/caac.20138
[2] Yanick, R. (2005) Population aging and cancer: A crossnational concern. Cancer Journal, 11, 437-441. doi:10.1097/00130404-200511000-00002
[3] Wright, J.D., Lewin, S.N., Barrena Medel, N.I., et al. (2011) Morbidity and mortality of surgery for endometrial cancer in the oldest old. American Journal of Obstetrics and Gynecology, 205, 66.e1-66.e8.
[4] Kondalsamy-Chennakesavan, S., Bouman, C., DeJong, S., et al. (2009) Clinical audit in gynecological cancer surgery: Development of a risk scoring system to predict adverse events. Gynecologic Oncology, 115, 329-333. doi:10.1016/j.ygyno.2009.08.004
[5] Erekson, E., Yip, S., Ciarleglio, M., et al. (2011) Postoperative complications after gynecologic surgery. Obstetrics & Gynecology, 118, 785-793. doi:10.1097/AOG.0b013e31822dac5d
[6] Berstein, L., Maximov, S., Gershfeld, E., et al. (2002) Neoadjuvant therapy of endometrial cancer with the aromatase inhibitor letrozole: Endocrine and clinical effects. European Journal of Obstetrics & Gynecology and Reproductive Biology, 105, 161-165. doi:10.1016/S0301-2115(02)00147-1
[7] Baker, L., Brand, I. and Crawford, S. (2009) Sustained effect of the aromatase inhibitors anastrozole and letrozole on endometrial thickness in patients with endometrial hyperplasia and endometrial carcinoma. Current Medical Research and Opinion, 25, 1105-1109. doi:10.1185/03007990902860549
[8] Altman, A., Thompson, J., Nelson, G., et al. (2012) Use of aromatase inhibitors as firstand second-line medical therapy in patients with endometrial adenocarcinoma: A retrospective study. Journal of Obstetrics and Gynaecology Canada, 34, 664-672.
[9] Rose, P., Brunetto, V.L., VanLe, L., et al. (2000) A phase II trial of anastrozole in advanced recurrent or persistent endometrial carcinoma: A Gynecologic Oncology Group study. Gynecologic Oncology, 78, 212-216. doi:10.1006/gyno.2000.5865
[10] Miller, W.R., White, S., Dixon, J.M., et al. (2006) Proliferation, steroid receptors and clinical/pathological response in breast cancer treated with letrozole. British Journal of Cancer, 94, 1051-1056. doi:10.1038/sj.bjc.6603001
[11] Sabattini, E., Bisgaard, K., Ascani, S., et al. (1998) The EnVision++ system: A new immunohistochemical method for diagnostics and research. Critical comparison with the APAAP, ChemMate, CSA, LABC, and SABC techniques. Journal of Clinical Pathology, 51, 506-511. doi:10.1136/jcp.51.7.506
[12] Baker, J., Obermair, A., Gebski, V., et al. (2012) Efficacy of oral or intrauterine device-delivered progestin in patients with complex endometrial hyperplasia with atypia or early endometrial adenocarcinoma: A meta-analysis and systemic review of the literature. Gynecologic Oncology, 125, 263-270. doi:10.1016/j.ygyno.2011.11.043
[13] Marshall, L (2003) Megestrol acetate therapy in geriatric patients: Case reviews and associated deep vein thrombosis. The Consultant Pharmacist, 18, 764-773.
[14] Stewart, C., Crook, M. and Doherty, D. (2010) Microanatomical variation in cellular proliferation in endometrial adenocarcinoma, and inverse correlation between Ki67 and cytokeratin 7 expression. Histopathology, 57, 46-54. doi:10.1111/j.1365-2559.2010.03588.x
[15] Horree, N., Van Diest, P.J., Sie-Go, D., et al. (2007) The invasive front in endometrial carcinoma: Higher proliferation and associated derailment of cell cycle regulators. Human Pathology, 38, 1232-1238. doi:10.1016/j.humpath.2007.01.008

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.