Endometrial Carcinoma Treatment Regimens

Endometrial Carcinoma Treatment Regimens

Clinical Trials: The NCCN recommends cancer patient participation in clinical trials as the gold standard for treatment.

Cancer therapy selection, dosing, administration, and the management of related adverse events can be a complex process that should be handled by an experienced healthcare team. Clinicians must choose and verify treatment options based on the individual patient; drug dose modifications and supportive care interventions should be administered accordingly. The cancer treatment regimens below may include both U.S. Food and Drug Administration-approved and unapproved indications/regimens. These regimens are only provided to supplement the latest treatment strategies.

These Guidelines are a work in progress that may be refined as often as new significant data becomes available. The National Comprehensive Cancer Network Guidelines® are a consensus statement of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN Guidelines® is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The NCCN makes no warranties of any kind whatsoever regarding their content, use, or application and disclaims any responsibility for their application or use in any way.

Note: All recommendations are category 2A unless otherwise indicated.

▶Systemic Therapy for Endometrial Carcinoma1

REGIMEN

DOSING

Adjuvant Therapy When Used for Uterine-Confined Disease

Chemotherapya

Preferred Regimens

Carboplatin + Paclitaxel2-4,b

Day 1: Paclitaxel 175mg/m2 IV over 3 hours, followed by:

Day 1: Carboplatin AUC 6-7.5 IV over 30 minutes.

Repeat cycle every 3 weeks for 6 cycles.

Adjuvant Therapy for High-Risk Disease or Primary Therapy for Initially Unresectable Disease

Chemotherapya

Preferred Regimens

Carboplatin + Paclitaxel2-4,b

Day 1: Paclitaxel 175mg/m2 IV over 3 hours, followed by:

Day 1: Carboplatin AUC 6-7.5 IV over 30 minutes.

Repeat cycle every 3 weeks for 6 cycles.

Other Recommended Regimens

Carboplatin5,b

Day 1: Carboplatin AUC 5-7 IV over 30 minutes.

Repeat cycle every 3 weeks for 6 cycles.

Carboplatin + Docetaxel6,7,b,d

Day 1: Docetaxel 75mg/m2 IV over 60 minutes, followed by:

Day 1: Carboplatin AUC 6 IV over 30 minutes.

Repeat cycle every 3 weeks for 6 cycles.

Cisplatin8,b,c

Day 1: Cisplatin 50mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks for 6 cycles.

Cisplatin + Doxorubicin9,10,b,c

Day 1: Doxorubicin 60mg/m2 IV push

Day 1: Cisplatin 50mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks for 6 cycles.

OR

Day 1: Doxorubicin 45mg/m2 (if prior pelvic radiation) IV push

Day 1: Cisplatin 50mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks for 6 cycles.

Cisplatin + Doxorubicin + Paclitaxel10,b,c,f

Day 1: Doxorubicin 45mg/m2 IV push

Day 1: Cisplatin 50mg/m2 IV over 60 minutes

Day 2: Paclitaxel 160mg/m2 IV over 3 hours.

Repeat cycle every 3 weeks for 6 cycles.

Cisplatin + Ifosfamide (for carcinosarcoma)11,b,c,e

Days 1-4: Ifosfamide 1,500mg/m2 IV over 3 hours

Days 1-4: Mesna 300mg/m2 IV over 15 minutes three times daily, one dose before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose

Days 1-4: Cisplatin 20mg/m2 IV over 60 minutes.

Repeat cycle every 3 weekfor 6 cycles.

OR

Days 1-4: Ifosfamide 1,200mg/m2 (if prior pelvic radiation) IV over 3 hours

Days 1-4: Mesna 240mg/m2 IV over 15 minutes three times daily, one dose before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose

Days 1-4: Cisplatin 20mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks for 6 cycles.

Docetaxel (Category 2B)12,b,d

Day 1: Docetaxel 70mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks for 6 cycles.

Ifosfamide (for carcinocarcinoma)13,e

Days 1-3: Ifosfamide 2,000mg/m2 IV over 3 hours

Days 1-3: Mesna 400mg/m2 IV three times daily, one dose before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose.

Repeat cycle every 3 weeks for 6 cycles.

OR

Days 1-3: Ifosfamide 1,200mg/m2 (if prior pelvic radiation) over 3 hours

Days 1-3: Mesna 240mg/m2 IV three times daily, one dose before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose.

Repeat cycle every 3 weeks for 6 cycles.

Ifosfamide + Paclitaxel (Category 1 for carcinocarinoma)13,b,e

Days 1-3: Ifosfamide 1,600mg/m2 IV over 3 hours

Days 1-3: Mesna 320mg/m2 IV over 15 minutes three times daily, one dose before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose.

Day 1: Paclitaxel 135mg/m2 IV over 3 hours.

Repeat cycle every 3 weeks for 6 cycles.

OR

Days 1-3: Ifosfamide 1,200mg/m2 (if prior pelvic radiation) IV over 3 hours

Days 1-3: Mesna 240mg/m2 IV over 15 minutes three times daily, one dose before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose.

Day 1: Paclitaxel 135mg/m2 IV over 3 hours.

Repeat cycle every 3 weeks for 6 cycles.

Paclitaxel14,15,b

Day 1: Paclitaxel 175mg/m2 IV over 3 hours.

Repeat cycle every 3 weeks for 6 cycles.

Adjuvant Therapy: Subsequent Treatment for High-Risk Disease

Targeted Therapy

Other Recommended Regimen

Bevacizumab16,17,g,h

Day 1: Bevacizumab 15mg/kg IV.

Repeat cycle every 3 weeks for 6 cycles.

Systemic Therapy for Recurrent or Metastatic Disease

Chemotherapya

Preferred Regimens

Carboplatin + Paclitaxel2-4,b

Day 1: Paclitaxel 175mg/m2 IV over 3 hours, followed by:

Day 1: Carboplatin AUC 6 IV over 30 minutes.

Repeat cycle every 3 weeks.

Carboplatin + Paclitaxel + Trastuzumab (for HER2-positive uterine serous carcinoma)18,19,b,i

Day 1: Paclitaxel 175mg/m2 IV over 3 hours, followed by:

Day 1: Carboplatin AUC 5 IV over 30 minutes

Day 1: Trastuzumab 8mg/kg IV over 90 minutes (cycle 1),

then 6mg/kg IV (starting with cycle 2).

Repeat every 3 weeks for 6 cycles, followed by:

Maintenance therapy with:

Day 1 (starting with cycle 7): Trastuzumab 6mg/kg IV.

Repeat cycle every 3 weeks.

Other Recommended Regimens

Albumin-Bound Paclitaxel20,21,j

Day 1: Albumin-Bound Paclitaxel 260mg/m2 IV over 30 minutes.

Repeat cycle every 3 weeks.

OR

Days 1,8,15: Albumin-Bound Paclitaxel 100-125mg/m2 IV over 30 minutes.

Repeat cycle every 4 weeks.

Bevacizumab16,17,g,h

Day 1: Bevacizumab 15mg/m2 IV.

Repeat cycle every 3 weeks

Carboplatin5,a

Day 1: Carboplatin AUC 5-7 IV over 30 minutes.

Repeat cycle every 3 weeks.

Carboplatin + Docetaxel6,7,b

Day 1: Docetaxel 60mg/m2 IV over 60 minutes, followed by:

Day 1: Carboplatin AUC 6 IV over 30 minutes.

Repeat cycle every 3 weeks.

OR

Day 1: Docetaxel 60mg/m2 IV over 60 minutes, followed by:

Day 1: Carboplatin AUC 6 IV over 30 minutes.

Repeat every 3 weeks.

Carboplatin + Paclitaxel + Bevacizumab17,22,23,b,g

Day 1: Paclitaxel 175mg/m2 IV over 3 hours, followed by:

Day 1: Carboplatin AUC 5 IV, followed by:

Day 1: Bevacizumab 15mg/kg IV.

Repeat cycle every 3 weeks for 6-8 cycles followed by:

Maintenance therapy with:

Day 1: Bevacizumab 15mg/kg IV.

Repeat cycle every 3 weeks.

Cisplatin8,a-c

Day 1: Cisplatin 50mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks.

Cisplatin + Doxorubicin9,10,b,c

Day 1: Doxorubicin 60mg/m2 IV push

Day 1: Cisplatin 50mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks until disease progression or unacceptable toxicity reaching a lifetime cumulative anthracycline dose.

OR

Day 1: Doxorubicin 45mg/m2 (if prior pelvic radiation) IV push

Day 1: Cisplatin 50mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks until disease progression or unacceptable toxicity reaching a lifetime cumulative anthracycline dose.

Cisplatin + Doxorubicin + Paclitaxel10,b,c,f

Day 1: Doxorubicin 45mg/m2 IV push

Day 1: Cisplatin 50mg/m2 IV over 60 minutes

Day 2: Paclitaxel 160mg/m2 IV over 3 hours.

Repeat cycle every 3 weeks until disease progression or unacceptable toxicity reaching a lifetime cumulative anthracycline dose.

Cisplatin + Ifosfamide (for carcinosarcoma)11,b,c,e

Days 1-4: Ifosfamide 1,500mg/m2 IV over 3 hours

Days 1-4: Mesna 300mg/m2 IV over 15 minutes before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose

Days 1-4: Cisplatin 20mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks.

OR

Days 1-4: Ifosfamide 1,200mg/m2 (if prior pelvic radiation) IV over 3 hours daily

Days 1-4: Mesna 240mg/m2 IV over 15 minutes before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose

Days 1-4: Cisplatin 20mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks.

Docetaxel (Category 2B)12,b,d

Day 1: Docetaxel 70mg/m2 IV over 60 minutes.

Repeat cycle every 3 weeks.

Doxorubicin24-26

Day 1: Doxorubicin 80mg/m2 IV push.

Repeat cycle every 3 weeks until disease progression or unacceptable toxicity including reaching a lifetime cumulative anthracycline dose.

Ifosfamide (for carcinosarcoma)13,e

Days 1-3: Ifosfamide 2,000mg/m2 IV over 3 hours daily

Days 1-3: Mesna 400mg/m2 IV over 15 minutes before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose.

Repeat cycle every 3 weeks.

OR

Days 1-3: Ifosfamide 1,200mg/m2 (if prior pelvic radiation) IV over 3 hours daily

Days 1-3: Mesna 240mg/m2 IV over 15 minutes before Ifosfamide, then at 4 and 8 hours from the start of each Ifosfamide dose.

Repeat cycle every 3 weeks.

Ifosfamide + Paclitaxel (Category 1 for carcinosarcoma)13,b,e

Days 1-3: Ifosfamide 1,600mg/m2 IV over 3 hours daily

Days 1-3: Mesna 320mg/m2 IV over 15 minutes before Ifosfamide, then at 4 and 8 hours from the start of Ifosfamide dose.

Day 1: Paclitaxel 135mg/m2 IV over 3 hours.

Repeat cycle every 3 weeks.

Liposomal Doxorubicin27,28,b

Day 1: Liposomal Doxorubicin 40-50mg/m2 IV

Repeat cycle every 4 weeks until disease progression or unacceptable toxicity including reaching a lifetime cumulative anthracycline dose.

Paclitaxel14,15,b

Day 1: Paclitaxel 175mg/m2 IV over 3 hours.

Repeat cycle every 3 weeks.

Temsirolimus29,30

Days 1,8,15,22: Temsiroliumus 25mg IV over 30 minutes.

Repeat cycle every 4 weeks.

Topotecan31

Days 1-5: Topotecan 1mg/m2 IV over 30 minutes.

Repeat cycle every 3 weeks.

OR

Days 1-5: Topotecan 0.8mg/m2 (if prior pelvic radiation) IV over 30 minutes.

Repeat cycle every 3 weeks.

Chemotherapy + Hormonal Therapy

Other Recommended Regimens

Everolimus + Letrozole (for endometrioid histology)32-34

Days 1-28: Everolimus 10mg orally daily

Days 1-28: Letrozole 2.5mg orally daily.

Repeat cycle every 4 weeks.

Targeted Therapy + Immunotherapy

Other Recommended Regimens

Lenvatinib + Pembrolizumab35-37,k

Days 1-21: Lenvatinib 20mg orally

Day 1: Pembrolizumab 200mg IV.

Repeat cycle every 3 weeks.

Subsequent Systemic Therapy for Recurrent Disease

Immunotherapy

Useful in Certain Circumstances

Pembrolizumab (for MSI-H/dMMR tumors)36,38,l

Day 1: Pembrolizumab 200mg IV over 30 minutes.

Repeat cycle every 3 weeks.

Systemic Therapy for Lower-Grade Endometrioid Histologies, Preferably in Patients With Small Tumor Volume or an Indolent Growth Pace

Hormone Therapym

Preferred Regimens

Anastrozole39

See NCCN Uterine Neoplasms Guidelines1

Exemestane40

Fulvestrant41

Letrozole

Levonorgestrel intrauterine device (IUD) (for select fertility-sparing cases)

Megestrol Acetate

Megestrol Acetate, Tamoxifen (alternating)

Medroxyprogesterone Acetate

Tamoxifen

 a.  Chemotherapy regimens can be used for all carcinoma histologies. Carcinosarcomas are now considered and treated as high-grade carcinomas. However, ifosfamide-based regimens were previously used for carcinosarcomas.

 b. Cisplatin, carboplatin, liposomal doxorubicin, paclitaxel, and docetaxel may cause drug reactions. (See NCCN Ovarian Cancer Guidelines – Management of Drug Reactions.)

 c. Hydration is required with supplemental electrolytes pre- and post-administration of Cisplatin.

 d. Docetaxel may be considered for patients in whom paclitaxel is contraindicated.

 e. Hydration is required pre- and postadministration of Ifosfamide.

  f. The cisplatin/doxorubicin/paclitaxel regimen is not widely used because of concerns about toxicity.

 g.  An FDA-approved biosimilar is an appropriate substitute for bevacizumab.

 h. Bevacizumab may be considered for use in patients who have progressed on prior cytotoxic chemotherapy.

  i. Only for advanced (stage III/IV) and recurrent uterine serous carcinomas that are HER2-positive.

  j.  Albumin-bound paclitaxel is a reasonable substitute for patients with a hypersensitivity to paclitaxel if the skin testing to paclitaxel is negative. If the patient has a positive skin test to paclitaxel then the patient required desensitization to paclitaxel. Albumin-bound paclitaxel is not a reasonable substitute for paclitaxel if the patient’s skin test is positive.

 k. For advanced and recurrent disease only.

  l. For recurrent endometrial cancer, NCCN recommends MSI-H or dMMR testing if not previously done. Pembrolizumab is indicated for patients with MSI-H or dMMR tumors that have progressed following prior cytotoxic chemotherapy.

m. Hormonal therapy is typically used for lower-grade endometrioid histologies, preferably in patients with small tumor volume or an indolent growth pace.

References

   1.  Referenced with permission from NCCN Clinical Practice Guidelines in Oncology™, Uterine Neoplasms. V5.2019. https://www.nccn.org/professionals/physician_gls/pdf/uterine.pdf. Accessed February 7, 2020.

   2.  Miller D, Filiaci V, Fleming G, et al. Randomized phase III noninferiority trial of first line chemotherapy for metastatic or recurrent endometrial carcinoma: A Gynecologic Oncology Group study [Abstract LBA1]. Gynecol Oncol. 2012;125(3):771.

   3.  Secord AA, Havrilesky LJ, O’Malley DM, et al. A multicenter evaluation of sequential multimodality therapy and clinical outcome for the treatment of advanced endometrial cancer. Gynecol Oncol. 2009;114:442-447.

   4.  Fields AL, Einstein MH, Novetsky AP, et al. Pilot phase II Trial of radiation “sandwiched” between combination paclitaxel/platinum chemotherapy in patients with uterine papillary serous carcinoma (UPSC). Gynecol Oncol. 2008;108:201-206.

   5.  Hoskins PJ, Swenerton KD, Pike JA, et al. Paclitaxel and carboplatin, alone or with irradiation, in advanced or recurrent endometrial cancer: A phase II study. J Clin Oncol. 2001;19:4048-4053.

   6.  Geller MA, Ivy JJ, Ghebre R, et al. A phase II trial of carboplatin and docetaxel followed by radiotherapy given in a “sandwich” method for stage III, IV, and recurrent endometrial cancer. Gynecol Oncol. 2011;121:112-117.

   7.  Glasgow M, Isaksson Vogel R, Burgart J, et al. Long term follow-up of a phase II trial of multimodal therapy given in a “sandwich” method for stage III, IV, and recurrent endometrial cancer. Gynecol Oncol Res Pract. 2016;3:6.

   8.  Thigpen JT, Blessing JA, Homesley H, et al. Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent endometrial carcinoma: A Gynecologic Oncology Group Study. Gynecol Oncol. 1989;33:68-70.

   9.  Fleming GF, Brunetto VL, Cella D, et al. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: A Gynecologic Oncology Group Study. Gynecol Oncol. 2004;22:2159-2166.

 10.  Homesley HD, Filiaci V, Gibbons SK, et al. A randomized phase III trial in advanced endometrial carcinoma of surgery and volume directed radiation followed by cisplatin and doxorubicin with or without paclitaxel: A Gynecologic Oncology Group Study. Gynecol Oncol. 2009;112:543-552.

 11.  Sutton G, Kauderer J, Carson LF, et al. Adjuvant ifosfamide and cisplatin in patients with completely resected stage I or II carcinosarcomas (mixed mesodermal tumors) of the uterus: A Gynecologic Oncology Group Study. Gynecol Oncol. 2005;96:630-634.

 12.  Katsumata N, Noda K, Nozawa S, et al. Phase II trial of docetaxel in advanced or metastatic endometrial cancer: A Japanese Cooperative Study. Br J Cancer. 2005;93:999-1004.

 13.  Homesley HD, Filiaci V, Markman M, et al. Phase III trial of ifosfamide with or without paclitaxel in advanced uterine carcinosarcoma: A Gynecologic Oncology Group Study. J Clin Oncol. 2007;25:526-531.

 14.  Dimopoulos MA, Papdimitriou CA, Georgoulias V, et al. Paclitaxel and cisplatin in advanced or recurrent carcinoma of the endometrium: Long-term results of a phase II multicenter study. Gynecol Oncol. 2000;78:52-57.

 15.  McMeekin S, Dizon D, Barter J, et al. Phase III randomized trial of second-line ixabepilone versus paclitaxel or doxorubicin in women with advanced endometrial cancer. Gynecol Oncol. 2015;138:18-23.

 16.  Aghajanian C, Sill MW, Darcy KM, et al. Phase II trial of bevacizumab in recurrent or persistent endometrial cancer: A Gynecologic Oncology Group Study. J Clin Oncol. 2011;29:2259-2265.

 17.  Bevacizumab (Avastin) [package insert]. South San Francisco, CA: Genentech, Inc.; 2019.

 18.  Fader AN, Roque DM, Siegel E, et al. Randomized phase II trial of carboplatin-paclitaxel versus carboplatin-paclitaxel-trastuzumab in uterine serous carcinomas that overexpress human epidermal growth factor receptor 2/neu. J Clin Oncol. 2018;36:2044-2051.

 19.  Trastuzumab (Herceptin) [package insert]. South San Francisco. CA: Genentech, Inc.; 2018.

 20.  Gradishar WJ, Tjulandin S, Davidson N, et al. Phase III trial of nanoparticle albumin-bound paclitaxel compared with polyethylated castor oil-based paclitaxel in women with breast cancer. Gynecol Oncol. 2005;23:7794-7803.

 21.  Alberts DS, Blessing JA, Landrum LM, et al. Phase II trial of nab-paclitaxel in the treatment of recurrent or persistent advanced cervix cancer: A Gynecologic Oncology Group Study. Gynecol Oncol. 2012;127:451-455.

 22.  Rose PG, Ali S, Moslemi-Kebria M, et al. Paclitaxel, carboplatin, and bevacizumab in advanced and recurrent endometrial carcinoma. Int J Gynecol Cancer. 2017;27:452-458.

 23.  Simpkins F, Drake R, Escobar PF, et al. A phase II trial of paclitaxel, carboplatin, and bevacizumab in advanced and recurrent endometrial carcinoma (EMCA). Gynecol Oncol. 2015;136:240-245.

 24.  Thigpen JT, Buchsbaum HJ, Mangan C, et al. Phase II trial of adriamycin in the treatment of advanced or recurrent endometrial carcinoma: A Gynecologic Oncology Group Study. Cancer Treat Rep. 1979;63:21-27.

 25.  Thigpen JT, Blessing JA, DiSaia PJ, et al. A randomized comparison of doxorubicin alone versus doxorubicin plus cyclophosphamide in the management of advanced or recurrent endometrial carcinoma: A Gynecologic Oncology Group Study. J Clin Oncol. 1994;12:1408-1414.

 26.  McMeekin S, Dizon D, Barter J, et al. Phase III randomized trial of second-line ixabepilone versus paclitaxel or doxorubicin in women with advanced endometrial cancer. Gynecol Oncol. 2015;138:18-23.

 27.  Muggia FM, Blessing JA, Sorosky J, et al. Phase II trial of the pegylated liposomal doxorubicin in previously treated metastatic endometrial cancer: A Gynecologic Oncology Group Study. Gynecol Oncol. 2002;20:2360-2364.

 28.  Homesley HD, Blessing JA, Sorosky J, et al. Phase II Trial of Liposomal Doxorubicin at 40 mg/m(2) Every 4 Weeks in Endometrial Carcinoma: A Gynecologic Oncology Group Study. Gynecol Oncol. 2005;98:294-298.

 29.  Temsirolimus (Torisel) [package insert]. New York, NY: Pfizer, Inc.; 2018.

 30.  Oza AM, Elit M, Tsao M-S, et al. Phase II study of temsirolimus in women with recurrent or metastatic endometrial cancer: A trial of the NCIC clinical trials group. J Clin Oncol. 2011;29:3278-3285.

 31.  Wadler S, Levy DE, Lincoln ST, et al. Topotecan is an active agent in the first-line treatment of metastatic or recurrent endometrial carcinoma: Eastern Cooperative Oncology Group Study E3E93. J Clin Oncol. 2003;21:2110-2114.

 32.  Slomovitz BM, Jiang Y, Yates MS, et al. Phase II study of everolimus and letrozole in patients with recurrent endometrial carcinoma. J Clin Oncol. 2015;33:930-936.

 33.  Everolimus (Affinitor) [package insert]. East Hanover, NJ: Novartis Pharmaceuticals Corp.; 2020.

 34.  Letrozole (Femara) [package insert]. East Hanover, NJ: Novartis Pharmaceuticals Corp.; 2018.

 35.  Levantinib (Lenvima) [package insert]. Woodcliff Lake, NJ: Eisai Inc.; 2019.

 36.  Pembrolizumab (Avastin) [package insert]. Whitehouse Station, NJ: Merck & Co., Inc.; 2020.

 37.  Makker V, Rasco D, Vogelzang NJ, et al. Lenvatinib plus pembrolizumab in patients with advanced endometrial cancer: an interim analysis of a multicenter, open-label, single-arm, phase 2 trial. Lancet Oncol. 2019;20:711-718.

 38.  Schellens JHM, Marabelle A, Zeigenfuss S, et al. Pembrolizumab for previously treated advanced cervical squamous cell cancer: Preliminary results from the phase 2 KEYNOTE-158 study [Abstract 5514]. J Clin Oncol. 2017;35(15_suppl):5514-5514.

 39.  Anastrozole (Arimidex_ [package insert]. Baudette, MN: ANI Pharmaceuticals, Inc.; 2018.

 40.  Exemestane (Aromasin) [package insert]. New York, NY: Pfizer, Inc.; 2019.

 41.  Fulvestrant (Faslodex) [package insert]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2019.

(Revised 2/2020; v5.2019 Uterine Neoplasms Guidelines) ©2020 Haymarket Media, Inc.