Current Therapies for Endometriosis, Adenomyosis and Endometrial Cancer

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: 22 June 2024 | Viewed by 4272

Special Issue Editors

Research Associate in the Academic Unit of Obstetrics and Gynaecology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, Genova, Italy
Interests: endometrial cancer
Academic Unit of Obstetrics and Gynecology, Maternal and Child Health (DiNOGMI), IRCCS Ospedale Policlinico San Martino, Genova, Italy
Interests: gynecological ultrasound; endometriosis and pelvic pain; oncological gynecology
Clinic of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria San Martino di Genova, Genova, Italy
Interests: menopause; contraception; endometriosis; pelvic pain; gynecological endocrinology; biological rhytms; gynecological oncology

Special Issue Information

Dear Colleagues,

Endometriosis, adenomyosis, and endometrial cancer are three gynecological conditions with varying options for treatment. Endometriosis constitutes a complex disease whose etiology is not fully understood. Reflecting this, therapies to address this condition are mainly symptomatic, aimed at pain control and improving fertility through medical treatments, surgery, and medically assisted procreation. Adenomyosis is another estrogen-dependent condition that can cause pain, heavy bleeding, and infertility. While drug therapies can effectively relieve symptoms, the respite is temporary. Adenomyosis can also be associated with other conditions like endometriosis, and in rare cases, it can lead to adenocarcinomas, making diagnosis and treatment complicated. Conversely, there have been promising developments in identifying novel diagnostic markers and therapeutic targets of endometrial cancer. Potential therapeutic strategies for endometrial cancer include targeting specific pathways, such as mTOR or CDK4/6, and analyzing long non-coding RNA. Radiomics features and models have also been validated to differentiate endometrial cancer risk groups. However, a better understanding of these conditions' mechanisms is still needed to develop therapies with curative or preventive application. New developments for the treatment all three of the discussed pathologies include both hormonal and non-hormonal treatments. This Special Volume aims to discuss the merits of this area's current and future therapeutic lines.

Dr. Ambrogio Pietro Londero
Dr. Anjeza Xholli
Dr. Angelo Cagnacci
Guest Editors

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Keywords

  • endometriosis
  • adenomyosis
  • endometrial cancer
  • hormonal therapy
  • non-hormonal therapy
  • pain management
  • fertility preservation
  • complementary/alternative medicine
  • radiation therapy
  • chemotherapy
  • immunotherapy

Published Papers (3 papers)

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Review

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19 pages, 2189 KiB  
Review
Gut Microbiota and Endometriosis: Exploring the Relationship and Therapeutic Implications
by Anjeza Xholli, Francesca Cremonini, Isabella Perugi, Ambrogio Pietro Londero and Angelo Cagnacci
Pharmaceuticals 2023, 16(12), 1696; https://doi.org/10.3390/ph16121696 - 07 Dec 2023
Cited by 1 | Viewed by 1427
Abstract
Endometriosis is a common inflammatory disease affecting women of reproductive age, characterized by the growth of endometrial tissue beyond the uterus. In addition to gynecological manifestations, many endometriosis patients experience gastrointestinal symptoms, indicating a potential association between gut health and the disease. Recent [...] Read more.
Endometriosis is a common inflammatory disease affecting women of reproductive age, characterized by the growth of endometrial tissue beyond the uterus. In addition to gynecological manifestations, many endometriosis patients experience gastrointestinal symptoms, indicating a potential association between gut health and the disease. Recent studies have revealed alterations in the gut microbiota of individuals with endometriosis, including reduced diversity, microbial composition imbalances, and pathogenic bacteria. These changes can disrupt immune function, increase inflammation, and contribute to the chronic inflammatory state observed in endometriosis. Moreover, dysregulation of intestinal permeability may further exacerbate gastrointestinal symptoms in affected individuals. Understanding the role of the gut microbiota and intestinal permeability in endometriosis can provide valuable insights into disease pathogenesis, aid in non-invasive diagnostic approaches, and open new avenues for therapeutic interventions. Probiotics, in particular, have shown promise in improving endometriosis-associated pain symptoms and reducing endometriotic lesions in animal models. This review suggests that additional research and well-designed clinical trials are necessary to validate the potential diagnostic and therapeutic benefits of manipulating the gut microbiota in managing endometriosis and its gastrointestinal symptoms, thereby improving the quality of life for those affected. Full article
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20 pages, 1527 KiB  
Review
Clinical Efficacy, Pharmacokinetics, and Safety of the Available Medical Options in the Treatment of Endometriosis-Related Pelvic Pain: A Scoping Review
by Mislav Mikuš, Marina Šprem Goldštajn, Antonio Simone Laganà, Franka Vukorepa and Mario Ćorić
Pharmaceuticals 2023, 16(9), 1315; https://doi.org/10.3390/ph16091315 - 18 Sep 2023
Cited by 1 | Viewed by 1529
Abstract
Background: In this scoping review, we sought to identify published studies evaluating the drugs currently used in the treatment of endometriosis-related pelvic pain, with reflection on their chemical properties, pharmacokinetics, safety profile, and clinical efficacy. Methods: A literature search was conducted with the [...] Read more.
Background: In this scoping review, we sought to identify published studies evaluating the drugs currently used in the treatment of endometriosis-related pelvic pain, with reflection on their chemical properties, pharmacokinetics, safety profile, and clinical efficacy. Methods: A literature search was conducted with the use of the PubMed and EMBASE electronic databases, focusing on identifying articles published in English between January 1990 and 2023. Results: Based on the included studies, current therapy options for the treatment of endometriosis-related pain identified and reviewed in this article were: (1) non-steroidal anti-inflammatory drugs; (2) combined oral contraceptive (COCs); (3) progestins; (4) gonadotropin-releasing hormone agonists and antagonists; (5) aromatase inhibitors (AIs); (6) selective estrogen and progesterone receptor modulators; and (7) levonorgestrel-intrauterine device. Conclusions: Based on the published evidence, clinicians should consider NSAIDs, COCs, and progestins as the first-line medical therapies. Compared with second-line options, such as GnRH agonists/antagonists or AIs, the abovementioned first-line options are well tolerated, efficacious, and exhibit lower overall price. Future research priorities should be to identify novel target therapies and to evaluate the effects of available drugs through different routes of administration. Full article
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20 pages, 642 KiB  
Systematic Review
Shared Pathogenic and Therapeutic Characteristics of Endometriosis, Adenomyosis, and Endometrial Cancer: A Comprehensive Literature Review
by Melinda-Ildiko Mitranovici, Diana Maria Chiorean, Liviu Moraru, Raluca Moraru, Laura Caravia, Andreea Taisia Tiron, Titiana Cornelia Cotoi, Havva Serap Toru and Ovidiu Simion Cotoi
Pharmaceuticals 2024, 17(3), 311; https://doi.org/10.3390/ph17030311 - 28 Feb 2024
Viewed by 663
Abstract
Endometriosis and adenomyosis behave similarly to cancer. No current treatments represent a cure, even if there are several options, including hormonal and surgical therapy. In advanced or recurrent pathologies, however, personalized treatment is necessary. We have found that due to the multiple common [...] Read more.
Endometriosis and adenomyosis behave similarly to cancer. No current treatments represent a cure, even if there are several options, including hormonal and surgical therapy. In advanced or recurrent pathologies, however, personalized treatment is necessary. We have found that due to the multiple common features, various therapeutic options have been used or studied for all three pathologies, with varying results. The objective of this review is to extract from the relevant literature the compounds that are used for endometriosis and adenomyosis characterized by malignant behavior, with some of these drugs being studied first in the treatment of endometrial cancer. Special attention is needed in the pathogenesis of these pathologies. Despite the multiple drugs that have been tested, only a few of them have been introduced into clinical practice. An unmet need is the cure of these diseases. Long-time treatment is necessary because symptoms persist, and surgery is often followed by postoperative recurrence. We emphasize the need for new, effective, long-term treatments based on pathogeny while considering their adverse effects. Full article
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