Targeted treatment for uterine carcinoma

Helping patients with metastatic disease

The two main uterine cancer subtypes, endometrial and cervical carcinoma, represent a major worldwide female health problem. Although prognosis is generally good with low stage uterine carcinoma, survival is poor and treatment options few for patients with advanced and recurrent disease. Efforts in enhancing treatment schedules for these patients are lagging behind and precise prognostic and predictive biomarkers are vital to optimize treatment effects. Emerging next-generation sequencing (NGS) studies using available patient cohorts are currently unraveling molecular subtypes with potential clinical implications, however the clinical utility of such studies is dependent on patient cohorts that truly reflect clinical settings.

The HER2 protein as biomarker

Halle has investigated biomarkers that can predict which patients who will experience relapse and who will need additional treatment. She has further examined whether specific biomarkers can identify patients who may benefit from new and targeted treatment. The study shows that many patients have high expression of the HER2 protein. HER2 has proved to be an effective biomarker for response to the drug Herceptin in breast cancer treatment. Halle’s study also highlights possible resistance mechanisms for HER2-directed treatment in endometrial cancer and that the level of HER2 may change from the primary tumor to the metastatic lesions.

Hunt for promising biomarkers in the metastases

For patients with uterine or cervical cancer who cannot be treated effectively by surgery, chemotherapy or radiation, very few approved targeted treatments exist. Such treatments are directed towards cancer cells that have spread beyond the pelvis. Metastasizing cells are constantly changing, and to successfully target these cells, we need to know more about the expression patterns of promising biomarkers also within the metastatic lesions. Identification of robust biomarkers can contribute to more tailored treatment strategies, avoiding over-treatment of patients with low risk of relapse, and more effective treatments for patients with metastatic disease.

Bio

Mari Kyllesø Halle (born 1982) is born and raised in Sandnes and has a molecular biologist degree from the Norwegian University of Life Sciences in 2006. She started as a PhD fellow in 2012 at the University of Bergen. The work was performed at the Department of Clinical Science and CCBIO at the University of Bergen, and the Department of Gynecology and Obstetrics, Haukeland University Hospital. Main supervisors were Professor Camilla Krakstad and Professor Helga Salvesen. Co-supervisor was Professor Jone Trovik.