The 4 Most Popular Medications That Treat Endometrial Cancer

Endometrial cancer — also called uterine cancer — is the most common cancer that starts in the uterus. If you or a loved one have endometrial cancer, you may be curious about your treatment options. 

Thankfully, there are now many ways to treat endometrial cancer. When possible, most people are treated with surgery. But there are other treatments to choose from. These include options like radiation therapy and/or medications. Your cancer specialist may decide that one or more of these options is best for your situation. 

Here, we’ll discuss the various medications used to treat endometrial cancer.

What types of medications are used to treat endometrial cancer?

Many kinds of medications can treat endometrial cancer. They fall into four main groups:

1. Chemotherapy: This is the most common type of medication for endometrial cancer. Chemotherapy stops and kills cancer cells before they can grow and spread. Chemotherapy is usually given into the vein, but some can be taken by mouth.

2. Immunotherapy: Sometimes, cancer cells can outsmart your immune system and hide from it. Immunotherapy works by boosting your immune system to better fight cancer cells.

3. Targeted therapy: Targeted therapy works by seeking out specific targets on cancer cells that play a role in cancer growth. These medications usually block one or more of these targets. They can help slow or stop cancer growth.

4. Endocrine therapy: Endocrine therapy is also called hormone therapy. Hormones like estrogen can fuel some endometrial cancer cells to grow. Endocrine therapy works by regulating these hormones in the body.

Chemotherapy for endometrial cancer

Chemotherapy is a backbone of treatment for endometrial cancer. It's sometimes used before surgery to shrink cancer. And after surgery it’s used to lower the chances of cancer coming back. Chemotherapy regimens for endometrial cancer are usually a combination of two or more medications. 

Chemotherapy is usually recommended to treat advanced or recurrent endometrial cancer. This means it's used for cancer that has spread outside of the uterus or cancer that has come back after other treatments didn’t work.

Chemotherapy for endometrial cancer includes medications like:

• Carboplatin

• Cisplatin

• Paclitaxel (Taxol)

• Docetaxel (Taxotere)

• Doxorubicin (Adriamycin)

• Liposomal doxorubicin (Doxil)

Some common chemotherapy combinations include: 

• Carboplatin plus paclitaxel

• Carboplatin plus docetaxel 

• Cisplatin plus doxorubicin

Chemotherapy can affect many cells in the body, including healthy cells. This can cause side effects like nausea and vomiting, hair loss, and low blood cell counts. Specific side effects vary by medication.

Immunotherapy for endometrial cancer

Immunotherapy is a newer option for endometrial cancer. Immunotherapy is recommended to treat advanced endometrial cancer when other treatments haven't worked.

Example immunotherapy medications for endometrial cancer include:

• Pembrolizumab (Keytruda): Pembrolizumab is given by itself for advanced endometrial cancer that is mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H). It can also be used for advanced endometrial cancer with a targeted therapy called lenvatinib (Lenvima).

• Dostarlimab (Jemperli): Dostarlimab was recently approved for the treatment of endometrial cancer. It can treat advanced or recurrent dMMR endometrial cancer that has gotten worse after receiving carboplatin or cisplatin.

• Nivolumab (Opdivo): Nivolumab may be used by itself to treat advanced or recurrent endometrial cancer that is dMMR/MSI-H. It’s usually saved for specific situations.

Understandably, these uses can be confusing to interpret. dMMR/MSI-H is a type of biomarker. A biomarker is a protein or gene that can provide different information about your cancer. If you have mutations like dMMR/MSI-H, it means your cancer may respond to these immunotherapies.

Immunotherapy medications can also cause side effects. Although specific side effects vary by medication, common side effects of immunotherapies include:

• Skin rash or itching

• Muscle or joint pain

• Feeling tired

• Cough

• Shortness of breath

• Diarrhea

• Infusion reactions

Targeted therapy for endometrial cancer

Targeted therapy medications target specific proteins and/or gene changes on cancer cells. Targeted therapy medications are usually given with chemotherapy or immunotherapy to treat advanced endometrial cancer.

Some common targeted therapy options for endometrial cancer are:

• Lenvatinib: Lenvatinib may be given with pembrolizumab for treating advanced or recurrent endometrial cancer. It targets proteins on cancer cells to prevent the creation of new blood vessels that can fuel cancer cells.

• Bevacizumab (Avastin) and its biosimilars: Bevacizumab is a monoclonal antibody medication that is given by itself or with chemotherapy to treat endometrial cancer that has come back after other treatments haven’t worked. Like lenvatinib, it also works by preventing new blood vessels from forming.

• Trastuzumab (Herceptin) and its biosimilars: Trastuzumab is a monoclonal antibody medication that targets a protein on some cancer cells called HER2. If your endometrial cancer has large amounts of HER2, you may benefit from trastuzumab. It’s usually used in advanced cases of a high-risk endometrial cancer called uterine serous carcinoma. 

• mTOR Inhibitors: mTOR inhibitors include medications like everolimus (Afinitor) and temsirolimus (Torisel). They block the mTOR protein on cancer cells, which plays a key role in cancer cell growth. They can be given by themselves or with other types of treatment. They’re usually used after other treatments haven’t worked.

Endocrine therapy for endometrial cancer

Endometrial cancer cells can rely on hormones like estrogen. They can use them as a source of fuel to grow. Endocrine therapy cuts off this food supply, so it helps stop cancer cells from growing.

Endocrine therapy is usually recommended for people with advanced endometrial cancer or early stage endometrial cancer who can’t have or don’t want surgery. It’s also considered for certain people with endometrial cancer who wish to have a child in the future — a type of treatment called fertility-sparing therapy. Endocrine therapy can also be used with other treatments.

There are many types of medications that are used for endocrine therapy:

Side effects of endocrine therapy can include:

• Menopause symptoms, like hot flashes, mood changes, and vaginal dryness

• Vaginal discharge

• Weight gain

• Swelling in hands and feet

• Tiredness

• Less interest in sex

• Blood clots

• Bone thinning

• Joint and muscle pain

Do endometrial cancer medication treatments vary by stage?

Yes, treatments for endometrial cancer vary by stage. 

When possible, surgery is the first step for almost all endometrial cancers. Surgery may include removing the uterus, ovaries, or fallopian tubes. If caught early, surgery may be all that is needed to treat endometrial cancer.

Advanced endometrial cancers usually need more treatment after surgery. Chemotherapy and hormone therapy are used when endometrial cancer has spread out of the uterus to other parts of the body. Chemotherapy is also used for cancer that has come back after other treatments haven’t worked.

Immunotherapy and targeted therapy are also options for treating advanced endometrial cancer.

What other factors determine which treatments are available to you?

There are many factors that may determine the best treatment for you. For example, results from tumor biomarker testing. These are lab tests your cancer specialist may use to help choose the best treatment option(s) for you.

Endometrial cancer can be tested for biomarkers, like dMMR/MSI-H and tumor mutational burden-high (TMB-H) mutations. If your cancer has any of these features, you could be a candidate for immunotherapy and/or targeted therapy.

Other biomarkers that may be tested can include hormone receptor testing, like estrogen receptors (chemical binding sites). If estrogen and/or progesterone receptors are present, you may benefit from endocrine therapy. 

If your cancer does not have certain biomarkers, targeted therapy and/or immunotherapy may not be the best options for you.

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Written by:

Sonja Jacobsen, PharmD, BCPS, BCOP

Sonja Jacobsen, PharmD, BCPS, BCOP,  is a clinical oncology pharmacy specialist currently practicing in Seattle. She has been practicing as a pharmacist since 2015 and is licensed to practice in Washington state and North Carolina.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Rachel Feaster, PharmD, BCOP, BCPS

Rachel Feaster has over 10 years of professional experience in ambulatory, inpatient, pharmacogenomics, and oncology care. She is board certified in oncology and pharmacotherapy.

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