EFFICACY OF EVEROLIMUS IN COMBINATION WITH LETROZOLE, MEGESTROL ACETATE, AND PACLITAXEL FOR RECURRENT ENDOMETRIAL CANCER

Abstract

Everolimus, an mTOR inhibitor, has already demonstrated efficacy in endometrial cancer, but experience with its use in Uzbekistan is limited. Resistance to standard therapy often develops in recurrent/metastatic endometrial carcinoma, underscoring the need for novel treatment regimens. Objective. To assess the efficacy and safety of everolimus-based combination therapies in this patient population. Materials and methods. This retrospective, single-center study (May 2022 – June 2024) enrolled 44 patients who had previously received platinum and paclitaxel. In Group 1 (n = 14), patients received everolimus 10 mg daily in combination with letrozole, megestrol acetate, or paclitaxel; Group 2 (control, n = 30) received the same regimens without everolimus. Tumor response was evaluated every eight weeks using RECIST v1.1, and toxicity was graded according to CTCAE v5.0. Results. The objective response rate was 28.6% in the everolimus group versus 13.3% in controls (p = 0.18), while the disease control rate was 78.6% versus 50.0% (p = 0.047). Median time to progression (TTP) increased to 6.2 months (HR 0.46; p = 0.011), and median overall survival (OS) to 28.0 months (HR 0.55; p = 0.032). Grade 3–4 stomatitis and hyperglycemia each occurred in 14% of patients; only one patient discontinued therapy due to toxicity. Conclusion. The addition of everolimus significantly improved disease control and prolonged TTP and OS with acceptable safety, supporting its use in this setting and corroborating existing phase II data.