A 71-Year-Old Woman with Metastatic Endometrial Cancer - Episode 7

Racial Disparities and Unmet Needs in Endometrial Cancer

Robert Holloway, MD, highlights the issue of racial disparity in endometrial cancer, and the critical unmet needs for patients.

Case History

June 2021

A 71-year-old postmenopausal woman presented with intermittent uterine bleeding, increased urinary frequency, and cramping over the past 6 months.

  • She noted that she underwent menopause at 52 years of age
  • She is married and has 2 adult children
  • PMH: T1D since childhood, well-controlled
  • PE: Notable for uterine tenderness upon palpation
  • ECOG PS= 1
  • Chest/abdomen/pelvis CT revealed uterine and bladder masses
  • CA-125= 38.6 U/mL
  • Endometrial biopsy results:
  • Endometrioid adenocarcinoma
  • FIGO stage IVA
  • Grade 3 (poorly differentiated)
  • IHC testing revealed mismatch repair proficiency (pMMR) and estrogen receptor (ER) negativity

July 2021:

  • Patient started carboplatin/paclitaxel (6 cycles), which was well-tolerated
  • Patient was scheduled for follow-up visits every 3 months after completion

May 2022 (6 months post–chemotherapy completion):

  • CA-125 level increased to 42.1 U/mL
  • CT revealed that the previous bladder metastatic mass increased slightly in size
  • The patient discussed targeted systemic therapy options with her clinician, and she expressed the desire to spend as much time as possible with her grandchildren.
  • They jointly decided to trial lenvatinib/pembrolizumab, with instructions to continue follow-up visits every 3 months.