MRI is integral to the evaluation and treatment of endometrial cancer, and contemporary multiparametric MRI plays a key role in pretreatment planning, therapy selection, radiation therapy guidance,... Created with BioRender.com Endometrial cancer is the second most common gynecologic cancer worldwide and the most common gynecologic cancer in the United States, with an increasing incidence in high-income countries. Althoug...

Purpose: Treatment for patients with recurrent endometrioid endometrial cancer (EEC) are limited as paclitaxel is the only second-line chemotherapy with a response rate >13%. Targeting PIK3/mTOR in combination with hormonal therapy has shown promise. The addition of metformin may enhance this response. We conducted a phase II study evaluating everolimus, letrozole, and metformin in advanced/recurrent EEC. Patients and Methods: A Simon two-stage design was employed. Women with ≤2 prior chemotherapy regimens for recurrence were eligible. Pretreatment biopsy was required, followed by everolimus 10 mg orally, letrozole 2.5 mg orally, and metformin 500 mg orally twice a day on a 4-week cycle. The primary endpoint was clinical benefit (CB), defined as complete response (CR), partial response (PR), or stable disease (SD) confirmed at 16 weeks. Patients were treated until progression or toxicity. Results: Sixty-two patients were enrolled. Median age was 62 years (40–77) with 401 cycles completed, median of 6 cycles (1–31). Fifty-four patients were evaluable for response with a CB rate of 50% (27/54). Best overall response (OR) was PR 28% (15/54) and SD 22% (12/54). Thirteen patients received >12 cycles. Median follow-up was 17.9 months (2–47). Median progression-free survival was 5.7 [95% confidence interval (CI), 3.0–8.1] and OS was 19.6 months (95% CI, 14.2–26.3). Positive progesterone receptor expression was associated with CB (89.5% vs. 27.3%, P = 0.001). Conclusions: Everolimus, letrozole, and metformin resulted in 50% CB and 28% OR in women with recurrent EEC. Progesterone receptor–positive tumors may have better response; validation studies are needed. See related commentary by Madariaga et al., p. 523

To estimate if women in the general population are aware of the relationship between obesity and cancer risk, and to identify groups who may benefit from educational programs. A self-administered survey was distributed to women in the Houston community. The questions were taken from a bank of validated questions published by the Center for Disease Control, Behavioral Risk Factor Surveillance System, and the Harvard Forums on Health Survey. Demographic information and participant knowledge of obesity-related cancer risk was collected. Logistic regression and Cochran-Armitage tests for trend were use to assess the association between predictor variables and knowledge. One thousand five hundred forty-five women completed the survey; 28% were normal weight (body mass index [BMI] less than 25 kg/m(2)), 24% were overweight (BMI 25-30 kg/m(2)), and 45% were obese (BMI at least 30 kg/m(2)). Fifty-eight percent (95% confidence interval 56-61%) were not aware that obesity increased risk for endometrial cancer. There was no difference in knowledge of endometrial cancer risk associated with any of the demographic characteristics studied. Black women were the most likely to respond that they did not know about the relationship between obesity and cancer. There was no association between personal weight and knowledge of obesity-associated risk. There is limited knowledge of the relationship between obesity and cancer risk, particularly among black women. Patient education regarding these risks may increase awareness of the relationship between obesity and endometrial cancer among women.