Endometrial Cancer Today: Defining the Persistent Unmet Needs in Advanced and Recurrent Disease

Advanced and recurrent endometrial cancer has long represented a major unmet clinical need because systemic treatment options remained unchanged for more than a decade. Carboplatin plus paclitaxel became the long standing standard after GOG209 showed non inferiority to TAP, but this did not translate into meaningful survival improvement. Progression free survival remained limited and over half of patients eventually died from their disease. Without new therapies, clinicians had few effective tools to alter the natural history of advanced or recurrent presentations, resulting in modest and short lived responses. These limitations persisted until the introduction of immune checkpoint inhibitors around 2018, which marked the first major therapeutic advance in many years. The long period of stagnation underscores why unmet needs remain significant and highlights the importance of continued innovation to improve long term outcomes.