Non-invasive therapeutic evaluation and treatment resistance mechanism of fertility-preserving progestin therapy for endometrial cancer

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K16763
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56040:Obstetrics and gynecology-related
• Research Institution: University of Fukui
• Principal Investigator: Yamada Shizuka 福井大学, 学術研究院医学系部門(附属病院部), 特命助教 (40792643)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 子宮体癌 / FES-PET / 妊孕性温存 / 黄体ホルモン療法

Outline of Final Research Achievements

16α-[18F]-fluoro-17β-estradiol (FES) is a radiopharmaceutical that binds to the estrogen receptor (ER) and is commonly used to prove the presence of ER-positive metastases. The aim of this study was to determine if FES positron emission tomography (PET) can predict the treatment response of fertility-sparing treatment with progestin in patients with atypical endometrial hyperplasia (AEH) and low-grade endometrial cancer (LGEC). The mean standardized uptake value (SUVmean) decreased greatly in patients with pathologically complete response (44.2%, 46.2%), while there was only a small change (22.5%) in the patient with pathologically stable disease. FES PET can be a non-invasive method to evaluate response to fertility-sparing progestin treatment.

Free Research Field

婦人科腫瘍

Academic Significance and Societal Importance of the Research Achievements

プロゲステロン製剤を用いたホルモン療法は、増加傾向にある若年子宮体癌患者に対する唯一の妊孕性温存療法だが、その約4割が増悪・再発すること、治療効果判定として行う侵襲的な子宮内膜操作により自然妊娠率が低いことが問題になっている。本研究を通して腫瘍のFES集積変化がホルモン療法の治療効果と相関する傾向にあることがわかり、FES-PET検査により、ホルモン療法が有効となる症例を適切に選択し、さらに侵襲的な内膜操作を減らすことで治療後の妊娠率の改善にもつながる可能性が示唆された。