ASCO Conference Coverage

Adjuvant Cisplatin/Etoposide Therapy Improves Outcomes in Aggressive Endometrial Neuroendocrine Tumors, Study Finds

Kate Young

Key Highlights:

  • Endometrial neuroendocrine tumors are aggressive and predominantly diagnosed at an advanced stage.
  • Median event-free survival was 0.8 years and median overall survival was 1.6 years.
  • Adjuvant treatment with cisplatin/etoposide significantly reduced recurrence and mortality risk.
  • Stage III/IV disease was associated with a threefold increase in mortality risk.

Endometrial neuroendocrine tumors (ENETs), though rare, are highly aggressive and associated with poor survival outcomes. In a retrospective analysis of 97 patients from a single tertiary cancer center, researchers observed that treatment with cisplatin/etoposide or carboplatin/paclitaxel significantly decreased the risk of disease recurrence and improved overall survival. Among patients with early-stage disease, cisplatin/etoposide demonstrated superior effectiveness over carboplatin/paclitaxel in reducing recurrence risk.

Due to the rarity and severity of ENETs, there is a lack of standardized treatment protocols. This study aimed to address the gap by evaluating clinicopathological characteristics and treatment outcomes in a substantial patient cohort, thereby informing future therapeutic strategies.

Researchers conducted an IRB-approved retrospective cohort study of women with histologically confirmed ENETs treated at MD Anderson Cancer Center from 1994 to 2024. Event-free survival (EFS) and overall survival (OS) were calculated from the initiation of treatment using Kaplan-Meier methods. Cox regression was used to identify prognostic factors.

The cohort had a median age of 60 years, with most patients presenting at advanced FIGO stages III/IV (62%). Most underwent primary surgery (84%), with adjuvant chemotherapy and/or radiotherapy in the majority. The median EFS was 0.8 years (95% CI: 0.6–1.3), and OS was 1.6 years (95% CI: 1.2–3.0). Multivariate analysis showed that treatment with cisplatin/etoposide was associated with a hazard ratio (HR) of 0.35 for recurrence and death, significantly lower than those receiving no or alternative chemotherapy. Stage III/IV patients had nearly a threefold increased mortality risk.

“This study highlights the aggressive nature of ENETs, often diagnosed at advanced stage,” the study authors concluded. “Adjuvant therapy with cisplatin/etoposide was associated with reduced the risk of death compared to other treatments. Despite chemotherapy, median EFS was short, highlighting the need for improved treatment strategies.”

Reference:
Bou Zerdan M, How JA, Meyer LA, Munsell M, Soliman PT. Clinicopathological features and survival outcomes in women with endometrial neuroendocrine tumors. Presented at: 2025 American Society of Clinical Oncology Annual Meeting; 2025 May 30–June 3; Chicago, IL.