BACKGROUND: Approximately 20% of women with endometrial cancer have advanced-stage disease or suffer from a recurrence. For these women, prognosis is poor, and palliative treatment options include hormonal therapy and chemotherapy. Lack of predictive biomarkers and suboptimal use of existing markers for response to hormonal therapy have resulted in overall limited efficacy. OBJECTIVE: This study aimed to improve the efficacy of hormonal therapy by relating immunohistochemical expression of estrogen and progesterone receptors and estrogen receptor pathway activity scores to response to hormonal therapy. STUDY DESIGN: Patients with advanced or recurrent endometrial cancer and available biopsies taken before the start of hormonal therapy were identified in 16 centers within the European Network for Individualized Treatment in Endometrial Cancer and the Dutch Gynecologic Oncology Group. Tumor tissue was analyzed for estrogen and progesterone receptor expressions and estrogen receptor pathway activity using a quantitative polymerase chain reaction-based messenger RNA model to measure the activity of estrogen receptor-related target genes in tumor RNA. The primary endpoint was response rate defined as complete and partial response using the Response Evaluation Criteria in Solid Tumors. The secondary endpoints were clinical benefit rate and progression-free survival. RESULTS: Pretreatment biopsies with sufficient endometrial cancer tissue and complete response evaluation were available in 81 of 105 eligible cases. Here, 22 of 81 patients (27.2%) with a response had estrogen and progesterone receptor expressions of >50%, resulting in a response rate of 32.3% (95% confidence interval, 20.9-43.7) for an estrogen receptor expression of >50% and 50.0% (95% confidence interval, 35.2-64.8) for a progesterone receptor expression of >50%. Clinical benefit rate was 56.9% for an estrogen receptor expression of >50% (95% confidence interval, 44.9-68.9) and 75.0% (95% confidence interval, 62.2-87.8) for a progesterone receptor expression of >50%. The application of the estrogen receptor pathway test to cases with a progesterone receptor expression of >50% resulted in a response rate of 57.6% (95% confidence interval, 42.1-73.1). After 2 years of follow-up, 34.3% of cases (95% confidence interval, 20-48) with a progesterone receptor expression of >50% and 35.8% of cases (95% confidence interval, 20-52) with an estrogen receptor pathway activity score of >15 had not progressed. CONCLUSION: The prediction of response to hormonal treatment in endometrial cancer improves substantially with a 50% cutoff level for progesterone receptor immunohistochemical expression and by applying a sequential test algorithm using progesterone receptor immunohistochemical expression and estrogen receptor pathway activity scores. However, results need to be validated in the prospective Prediction of Response to Hormonal Therapy in Advanced and Recurrent Endometrial Cancer (PROMOTE) study.

• Klíčová slova
• aromatase inhibitors, estrogen receptor pathway activity, progesterone receptor, progestin therapy,
• MeSH
• alfa receptor estrogenů metabolismus   MeSH
• antagonisté estrogenu terapeutické užití   MeSH
• doba přežití bez progrese choroby MeSH
• endometroidní karcinom farmakoterapie   genetika   metabolismus   patologie   MeSH
• hormonální protinádorové látky terapeutické užití   MeSH
• imunohistochemie MeSH
• inhibitory aromatasy terapeutické užití   MeSH
• kritéria léčebné odpovědi MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru farmakoterapie   genetika   metabolismus   patologie   MeSH
• messenger RNA metabolismus   MeSH
• nádorové biomarkery metabolismus   MeSH
• nádory endometria farmakoterapie   genetika   metabolismus   patologie   MeSH
• progestiny terapeutické užití   MeSH
• receptory progesteronu metabolismus   MeSH
• regulace genové exprese u nádorů genetika   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tamoxifen terapeutické užití   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• alfa receptor estrogenů MeSH
• antagonisté estrogenu MeSH
• hormonální protinádorové látky MeSH
• inhibitory aromatasy MeSH
• messenger RNA MeSH
• nádorové biomarkery MeSH
• progestiny MeSH
• receptory progesteronu MeSH
• tamoxifen MeSH

Retroperitoneal fibrosis (RPF) is a rare inflammatory disease which is characterized by the development of a fibrous process that surrounds the major vessels and organs located within the retroperitoneum. About two thirds of all cases of RPF are idiopathic and are thought to be immunological in origin. Diagnosis of RPF should be considered in patients with unexplained abdominal and low back pain and retroperitoneal lesions. We present a case report of a 59-year-old white male with idiopathic RPF with history of low back pain and weight loss as only symptoms and treated by tamoxifen, corticosteroids, and insertion of JJ endoureteric catheters due to the obstruction of the upper urinary tract.

• MeSH
• antagonisté estrogenu terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lumbalgie etiologie   MeSH
• magnetická rezonanční tomografie MeSH
• retroperitoneální fibróza komplikace   farmakoterapie   MeSH
• tamoxifen terapeutické užití   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• antagonisté estrogenu MeSH
• tamoxifen MeSH

• MeSH
• antagonisté estrogenu terapeutické užití   MeSH
• hormon uvolňující gonadotropiny analogy a deriváty   terapeutické užití   MeSH
• lidé MeSH
• nádory dělohy farmakoterapie   MeSH
• progestiny terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antagonisté estrogenu MeSH
• hormon uvolňující gonadotropiny MeSH
• progestiny MeSH

• MeSH
• antagonisté estrogenu farmakologie   terapeutické užití   MeSH
• gynekologická onemocnění farmakoterapie   MeSH
• infertilita farmakoterapie   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antagonisté estrogenu MeSH

• MeSH
• antagonisté estrogenu terapeutické užití   MeSH
• glukokortikoidy terapeutické užití   MeSH
• lidé MeSH
• nádory farmakoterapie   MeSH
• pohlavní steroidní hormony terapeutické užití   MeSH
• progestiny terapeutické užití   MeSH
• prolaktin antagonisté a inhibitory   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• antagonisté estrogenu MeSH
• glukokortikoidy MeSH
• pohlavní steroidní hormony MeSH
• progestiny MeSH
• prolaktin MeSH