PT  - JOURNAL ARTICLE
AU  - Rachel Nicole Grisham
AU  - Christina Adaniel
AU  - David M. Hyman
AU  - Weining Ma
AU  - Alexia Iasonos
AU  - Carol Aghajanian
AU  - Jason Konner
TI  - Gemcitabine for Advanced Endometrial Cancer: A Retrospective Study of the Memorial Sloan-Kettering Cancer Center Experience
AID  - 10.1097/IGC.0b013e31824a33a2
DP  - 2012 Jun 01
TA  - International Journal of Gynecologic Cancer
PG  - 807--811
VI  - 22
IP  - 5
4099  - http://ijgc.bmj.com/content/22/5/807.short
4100  - http://ijgc.bmj.com/content/22/5/807.full
SO  - Int J Gynecol Cancer2012 Jun 01; 22
AB  - Background Gemcitabine is active in several gynecologic malignancies including ovarian cancer, cervical cancer, and uterine leiomyosarcoma. It has been used in an off-label setting for the treatment of advanced endometrial cancer, despite lack of published data showing efficacy. We performed a retrospective study to determine the progression-free survival and response rate of endometrial cancer patients treated with gemcitabine at Memorial Sloan-Kettering Cancer Center.Methods Eligible patients had histologically confirmed advanced (stage IV or recurrent) endometrial cancer that was treated with single-agent gemcitabine at Memorial Sloan-Kettering Cancer Center between 1999 and 2009. Response to therapy was determined by review of computed tomography imaging by Response Evaluation Criteria in Solid Tumors 1.1 criteria.Results Forty-six patients were included in the analysis. Median age was 66 years (range, 52–87 years). All patients were previously treated with chemotherapy. The median number of prior lines of chemotherapy was 2 (range, 1–8). Median dose of gemcitabine administered was 800 mg/m2 infused on days 1 and 8 of a 21-day cycle. Predominant histology was endometrioid (48%, n = 22) followed by serous (35%, n = 16), clear cell (15%, n = 7), and undifferentiated (2%, n = 1). Overall response rate was 10.9% (95% confidence interval, 1.9%–19.9%); 5 patients (11%) achieved a partial response. Thirteen patients (28%) displayed stable disease lasting at least 3 months. Of note, 5 (71%) of the 7 patients with clear cell histology displayed stable disease or partial response (n = 5). The median progression-free survival was 3.0 months (95% confidence interval, 2.1–3.3 months). Nonhematologic grades 3 and 4 toxicities were rare. Ten patients (22%) were treated with granulocyte colony-stimulating factor during treatment. Grade 3 thrombocytopenia was seen in 4 patients (9%). There were no cases of grade 4 thrombocytopenia.Conclusions In a mixed population of patients with previously treated advanced endometrial cancer, gemcitabine was well tolerated and showed modest activity. Patients with clear cell histology appeared to have greater likelihood of benefit.