Clinical outcome of advanced or recurrent endometrial carcinoma treated with chemotherapy: a French observational retrospective cohort: the ENDOVIE study

Abstract

Objective: Advanced or recurrent endometrial carcinoma (EC) represents a significant clinical challenge. This study aimed to evaluate patient (age and comorbidities) and disease (histological subtypes and stages) characteristics, treatment patterns and survival outcomes in a real-world French healthcare setting.

Methods and analysis: In this national, multi-centre, retrospective observational cohort study, 200 patients with advanced or recurrent EC receiving first- or second-line chemotherapy during the year 2019 were analysed. Data collected included baseline characteristics, treatment regimens, real-world progression-free survival (rwPFS) and overall survival (OS).

Results: 127 and 73 were included in the first and second lines, respectively. Endometrioid carcinoma was the most represented histological subtype (62.0%). Patients in the first line, of whom 31.5% had FIGO (Fédération Internationale de Gynécologie Obstétrique) IVB disease, mainly received a combination of carboplatin and paclitaxel (78.0%), while 131 patients receiving second-line therapy were mainly administered anthracycline (54.2%). Median rwPFS and OS were, respectively, 8.5 and 13.2 months for patients receiving first-line therapy and 4.0 and 9.4 months for patients receiving second-line therapy. In Cox analyses, a diagnosis of carcinosarcoma, the presence of liver metastases and stage IVB disease were associated with worse survival outcomes for patients recieving first-line chemotherapy. Non-platinum chemotherapy and liver metastases were associated with poorer survival in patients receiving second-line chemotherapy.

Conclusions: This study highlights the landscape of metastatic EC treatment in a real-world French setting before the availability of PD1 inhibitors, emphasising the discrepancy between clinical trial data and real-world outcomes. It underscores the necessity for further real-world studies to complement clinical trials for a comprehensive understanding of metastatic EC management.

Keywords: CHEMOTHERAPY; Gynaecological oncology; Observational Study.

Figure 1. Kaplan–Meier curves for 1-year rwPFS and OS in patients receiving first-line chemotherapy (cohort 1). Three patients (1 in cohort 1 and 2 in cohort 2) were excluded from the OS analyses as they lacked both date of death and date of last follow-up. rwPFS: real-world progression-free survival; OS: overall survival.

Figure 2. Kaplan–Meier curves for 1-year rwPFS and OS in patients receiving a second-line chemotherapy during the study period (cohort 2+ part of cohort 1). Three patients (1 in cohort 1 and 2 in cohort 2) were excluded from the OS analyses as they lacked both date of death and date of last follow-up. rwPFS: real-world progression-free survival; OS: overall survival.