Uterine Sarcoma: Targeted Therapy

Targeted therapy is a type of cancer treatment. It uses medicines made to focus on parts of cancer cells that make them different from normal, healthy cells. For instance, they might affect certain genes or proteins that help the cancer cells grow, live longer, and spread. Because of this targeting, these medicines attack cancer cells but may cause less damage to normal cells.

Uterine sarcomas are a rare and diverse group of cancers. Targeted therapy may be used to treat uterine sarcoma that doesn’t respond to chemotherapy, returns after chemotherapy, or has spread outside the pelvis (metastasized). It may also be used if your cancer cells have certain gene or protein changes.

Specific therapies for uterine sarcomas include:

• Kinase inhibitors. Think of kinases as little messengers. They’re proteins that send signals to a cell. Sometimes those signals tell the cell to grow. By blocking these kinases, targeted therapy can stop or slow growth in some cancer cells.
• TRK inhibitors. In some uterine sarcomas, an NTRK gene might change. This can cause cells to produce too many abnormal TRK proteins. That can lead to abnormal cell growth and cancer. TRK inhibitors step in and help keep cancer cells from growing.
• PARP inhibitors. Some uterine sarcomas may have an altered BRCA gene. PARP inhibitors make it hard for tumors with an abnormal BRCA gene to fix cell problems. This can help kill cancer cells.

Your healthcare provider will decide which option works best for you.

Some targeted therapy medicines are given through an IV (intravenous) line that goes into a vein. You may need to go to an outpatient facility or your healthcare provider’s office for treatment. Most targeted therapies for uterine sarcomas are taken by mouth as pills or capsules. A missed or late dose can make the therapy less effective. If you go with this option, make sure you ask your provider for instructions. Bring up questions like:

• When should I take this medicine?
• What is the dose?
• What should I do if I forget to take it?

Anti-cancer medicines are vital to treatment of uterine sarcomas. But they can be expensive. Before you become overwhelmed with concerns about how to pay for each medicine, reach out to your health insurance. Talk with your healthcare provider, too. Both may have insights or suggestions about ways to pay for them.

Also, there are other resources available to help. Visit the American Cancer Society (ACS) for information on financial assistance programs. The ACS also offers tips and resources on managing the costs of cancer treatment.

Targeted therapy may cause some side effects. But how you will feel from the treatment depends on many things, such as:

• The types of medicines you get
• The dose of those medicines
• Your overall health before treatment

The most common side effects from targeted therapy include:

• Fever
• High blood pressure
• Diarrhea
• Constipation
• Nausea
• Vomiting
• Headache
• Cough
• Muscle and joint pain
• Skin changes
• Severe tiredness (fatigue)
• Liver, kidney, or thyroid problems
• Dizziness
• Decrease in blood count levels
• Slow wound healing

Rarely, serious side effects can include:

• Bleeding in the lung
• Hole in the intestine (bowel)
• Heart damage (especially if used with chemo medicines)
• Autoimmune reactions

If you do have any of these, talk with your provider right away. There are ways to prevent and treat side effects. Most of them go away after treatment ends.

It's important to know which medicines you're taking. Write down the names of all your medicines. Ask your healthcare team how they work and what side effects they might cause.

Talk with your healthcare providers about what changes and side effects you should look for and when to call them. Make sure you know what number to call with questions or problems. You may need to call a different number for evenings, weekends, and holidays.

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team in managing your side effects.