Endometrial cancer: reviving progesterone therapy in the molecular age. 2011

Shujie Yang, and Kristina W Thiel, and Koenraad De Geest, and Kimberly K Leslie
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa 52242, USA.

Endometrial cancer is the most common gynecologic malignancy and represents a major health concern because overall five-year survival rates have not improved in the last three decades. A great deal of research demonstrates that the endometrium is extremely sensitive to hormones, and a shift in the estrogen:progesterone balance is the major cause for the development of endometrial cancer. Progestin-based therapy has proven effective in a subset of patients, particularly in situations where expression of progesterone receptor (PR) is maintained. However, this approach is not routinely used in the clinic in the U.S. for several reasons. For example, many endometrial tumors have lost PR expression, which limits the clinical application of progestin-based therapy. While the idea that restoring PR expression will resensitize tumors to progestin was proposed over 20 years ago, we only now have the molecular tools to accomplish this goal. Basic science research has revealed several pathways that govern the expression of PR at the DNA, RNA, and protein levels. In this article, we describe one current approach to restore expression of PR at the epigenetic level in endometrial cancer. While still in the preclinical stage, we believe this strategy to re-establish PR expression will result in resensitization of endometrial tumors to progestin therapy.

UI MeSH Term Description Entries
D011374 Progesterone The major progestational steroid that is secreted primarily by the CORPUS LUTEUM and the PLACENTA. Progesterone acts on the UTERUS, the MAMMARY GLANDS and the BRAIN. It is required in EMBRYO IMPLANTATION; PREGNANCY maintenance, and the development of mammary tissue for MILK production. Progesterone, converted from PREGNENOLONE, also serves as an intermediate in the biosynthesis of GONADAL STEROID HORMONES and adrenal CORTICOSTEROIDS. Pregnenedione,Progesterone, (13 alpha,17 alpha)-(+-)-Isomer,Progesterone, (17 alpha)-Isomer,Progesterone, (9 beta,10 alpha)-Isomer
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016889 Endometrial Neoplasms Tumors or cancer of ENDOMETRIUM, the mucous lining of the UTERUS. These neoplasms can be benign or malignant. Their classification and grading are based on the various cell types and the percent of undifferentiated cells. Cancer of Endometrium,Endometrial Cancer,Endometrial Carcinoma,Cancer of the Endometrium,Carcinoma of Endometrium,Endometrium Cancer,Neoplasms, Endometrial,Cancer, Endometrial,Cancer, Endometrium,Cancers, Endometrial,Cancers, Endometrium,Carcinoma, Endometrial,Carcinomas, Endometrial,Endometrial Cancers,Endometrial Carcinomas,Endometrial Neoplasm,Endometrium Cancers,Endometrium Carcinoma,Endometrium Carcinomas,Neoplasm, Endometrial
D058990 Molecular Targeted Therapy Treatments with drugs which interact with or block synthesis of specific cellular components characteristic of the individual's disease in order to stop or interrupt the specific biochemical dysfunction involved in progression of the disease. Targeted Molecular Therapy,Molecular Targeted Therapies,Molecular Therapy, Targeted,Targeted Molecular Therapies,Targeted Therapy, Molecular,Therapy, Molecular Targeted,Therapy, Targeted Molecular
D020249 Hormone Replacement Therapy Therapeutic use of hormones to alleviate the effects of hormone deficiency. Replacement Therapy, Hormone,Therapy, Hormone Replacement,Hormone Replacement Therapies,Replacement Therapies, Hormone,Therapies, Hormone Replacement

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