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Int J Mol Sci. 2017 May 20;18(5). pii: E1100. doi: 10.3390/ijms18051100.

Target Therapies for Uterine Carcinosarcomas: Current Evidence and Future Perspectives.

Author information

1
Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 98125 Messina, Italy. vitalesalvatore@hotmail.com.
2
Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 98125 Messina, Italy. antlagana@unime.it.
3
Department of Obstetrics and Gynecology, Campus Bio Medico University of Rome, 00128 Rome, Italy. s.capriglione@unicampus.it.
4
Department of Obstetrics and Gynecology, Campus Bio Medico University of Rome, 00128 Rome, Italy. angie_cest@hotmail.com.
5
Unit of Psychodiagnostics and Clinical Psychology, University of Catania, 95124 Catania, Italy. psicolarosa@gmail.com.
6
Department of Obstetrics and Gynecology, Campus Bio Medico University of Rome, 00128 Rome, Italy. s.lopez@unicampus.it.
7
Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy. valentigaetano@gmail.com.
8
Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy. fabrizio.sapia@libero.it.
9
Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy. sarpietrogiuseppe@gmail.com.
10
Department of Human Pathology, Unit of Urology, University of Messina, 98124 Messina, Italy. salvobu@gmail.com.
11
Radiation Oncology Department, AO "Bianchi-Melacrino-Morelli", 89124 Reggio Calabria, Italy. carmelotuscano@hotmail.it.
12
Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, 90127 Palermo, Italy. fandan@libero.it.
13
Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy. alessandrotropea@aol.com.
14
Unit of Gynecology and Obstetrics, Desenzano del Garda Hospital, Section of Gavardo, 25085 Gavardo, Brescia, Italy. docrossetti@gmail.com.

Abstract

Carcinosarcomas (CS) in gynecology are very infrequent and represent only 2-5% of uterine cancers. Despite surgical cytoreduction and subsequent chemotherapy being the primary treatment for uterine CS, the overall five-year survival rate is 30 ± 9% and recurrence is extremely common (50-80%). Due to the poor prognosis of CS, new strategies have been developed in the last few decades, targeting known dysfunctional molecular pathways for immunotherapy. In this paper, we aimed to gather the available evidence on the latest therapies for the treatment of CS. We performed a systematic review using the terms "uterine carcinosarcoma", "uterine Malignant Mixed Müllerian Tumors", "target therapies", "angiogenesis therapy", "cancer stem cell therapy", "prognostic biomarker", and "novel antibody-drug". Based on our results, the differential expression and accessibility of epithelial cell adhesion molecule-1 on metastatic/chemotherapy-resistant CS cells in comparison to normal tissues and Human Epidermal Growth Factor Receptor 2 (HER2) open up new possibilities in the field of target therapy. Nevertheless, future investigations are needed to clarify the impact of these new therapies on survival rate and medium-/long-term outcomes.

KEYWORDS:

carcinosarcomas; epigenetics; genetics; immunotherapy; uterine cancer

PMID:
28531111
PMCID:
PMC5455008
DOI:
10.3390/ijms18051100
[Indexed for MEDLINE]
Free PMC Article

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