What's New in Uterine Sarcoma Research?

Since uterine sarcomas are very rare, there's not been a lot of research done on them. Most experts agree that if available, treatment in a clinical trial should be considered for any type of uterine sarcoma. New ways to prevent and treat uterine sarcoma now are being researched.  Some of the promising new developments include the following.

Gene changes

Recent research has improved our understanding of how changes in certain genes can cause normal cells to become cancer. We know that if mutations (changes) in important genes that control cell growth are damaged, uncontrolled growth may lead to cancer.

Research on uterine sarcomas has found many changes in the genes that control cell growth. For example, changes in the RB1, TP53, and PTEN genes have been found in uterine leiomyosarcomas.  Doctors are looking at how these gene changes might be useful in discovering new imaging tests or new targeted drug therapies to help diagnose and treat uterine sarcomas. They are also studying how these changes might help improve the doctor’s ability to diagnose the specific type of uterine sarcoma, as well as predict a person’s outcome (prognosis).

Imaging tests

Imaging tests to more accurately diagnose uterine sarcomas is an active area of research. Treatment options for uterine tumors greatly depend on whether it is cancer or not, such as a leiomyoma (fibroid). Knowing this will help decide if surgery is needed, and, if so, would a cancer specialist be needed to remove the tumor. Efforts to improve imaging tests for these rare tumors have also led researchers to look at how these tests might be used to learn more about the tumor, such as whether chemo will be needed after surgery and the possible outcomes.

PET scans using different tracers are being studied, so are contrast-enhanced MRIs. And researchers are trying to find other factors that, used along with imaging tests, may help point to a uterine sarcoma, such as certain blood tests, tumor size, and the person's body weight.

Chemotherapy

New combinations of chemotherapy drugs, new drugs, and better ways to give chemo also are active areas of research. Surgery is the standard treatment for uterine sarcoma, but chemo with or without radiation treatments after surgery may help keep cancer from coming back. Studies are also being done to find out if giving certain chemo drugs after surgery can help some women with uterine sarcoma live longer.  

Hormone therapy

Hormone therapy may help treat and control some uterine sarcomas that have estrogen receptors and/or progesterone receptors. Researchers are trying to find out if drugs that control estrogen might help delay or even prevent these cancers from coming back after surgery. They are also looking at whether the ovaries need to be removed as part of treatment in all women with uterine sarcoma, or if it's safe to leave them, especially in young women with leiomyosarcoma or stage I cancers. 

Targeted drug therapy and immunotherapy

Doctors are also studying targeted drug therapies and immunotherapies as treatments for uterine sarcoma. These drugs don't work the same as chemotherapy drugs and may be used when chemo doesn't work or when uterine sarcoma comes back after treatment. Your doctor might test your cancer or blood for certain gene and protein changes that could help predict if your cancer could be treated with one of these targeted drugs or immunotherapy drugs. 

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Barral M, Placé V, Dautry R, et al. Magnetic resonance imaging features of uterine sarcoma and mimickers. Abdom Radiol (NY). 2017;42(6):1762-1772.

Benson C, Miah AB. Uterine sarcoma -- current perspectives. Int J Womens Health. 2017;9:597-606.

Cho HY, Kim K, Kim YB, No JH. Differential diagnosis between uterine sarcoma and leiomyoma using preoperative clinical characteristics. J Obstet Gynaecol Res. 2016;42(3):313-318. 

Davidson B, Hellesylt E, Holth A, et al. Neuron navigator-2 and cyclin D2 are new candidate prognostic markers in uterine sarcoma. Virchows Arch. 2017 Jun 22.

Gaillard S and Secord AA. Staging, treatment, and prognosis of endometrial stromal sarcoma and related tumors and uterine adenosarcoma. In: Chakrabarti A and Vora SR, eds. UpToDate. Waltham, Mass.: UpToDate, 2021. https://www.uptodate.com. Accessed June 22, 2022.

Hensley ML and Leitao MM. Treatment and prognosis of uterine leiomyosarcoma. In: Chakrabarti A and Vora SR, eds. UpToDate. Waltham, Mass.: UpToDate, 2021. https://www.uptodate.com. Accessed June 22, 2022.

Kusunoki S, Terao Y, Ujihira T, et al. Efficacy of PET/CT to exclude leiomyoma in patients with lesions suspicious for uterine sarcoma on MRI. Taiwan J Obstet Gynecol. 2017;56(4):508-513.

Kostov S, Kornovski Y, Ivanova V, et al. New Aspects of Sarcomas of Uterine Corpus-A Brief Narrative Review. Clin Pract. 2021;11(4):878-900. Published 2021 Nov 22. doi:10.3390/clinpract11040103.

Lin G, Yang LY, Huang YT, et al. Comparison of the diagnostic accuracy of contrast-enhanced MRI and diffusion-weighted MRI in the differentiation between uterine leiomyosarcoma / smooth muscle tumor with uncertain malignant potential and benign leiomyoma. J Magn Reson Imaging. 2016;43(2):333-342. 

Nasioudis D, Chapman-Davis E, Frey M, Holcomb K. Safety of ovarian preservation in premenopausal women with stage I uterine sarcoma. J Gynecol Oncol. 2017;28(4):e46. 

National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology. Uterine Neoplasms, Version 1.2022 – November 4, 2021. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/uterine.pdf on June 22, 2022.

Yamamoto M, Tsujikawa T, Yamada S, et al. 18F-FDG/18F-FES standardized uptake value ratio determined using PET predicts prognosis in uterine sarcoma. Oncotarget. 2017;8(14):22581-22589.

Last Revised: September 20, 2022

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