Biomarkers can predict treatment response in women with endometriosis

Biomarkers can predict whether women will respond to the first-line treatment for endometriosis, an extremely painful condition in which the tissue usually found inside the uterus grows in places it shouldn't, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Endometriosis is a debilitating gynecologic disease that causes pelvic pain and, in some cases, infertility. It is estimated to affect one in 10 reproductive-aged women, and 50 percent to 60 percent of women and adolescents with pelvic pain and/or unexplained infertility. Progestin-based therapies such as oral contraceptives are the first-line treatment for managing endometriosis-associated pain. However, response to progestins is unpredictable and varies among women.

"Receptor status in endometriosis could be used in a similar way to how estrogen receptor and progesterone receptor status is used in breast cancer for personalizing treatment options," said study author Valerie A. Flores, M.D., of the Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, Yale University, in New Haven, Conn. "Such an approach to endometriosis management could better determine which medication each individual patient responds to and minimize delays in providing the optimal medical therapy."

In the retrospective cohort study, researchers studied 52 subjects with endometriosis and found that progesterone receptor levels were an important predictor of progesterone responsiveness in endometriosis. Hormonal therapy and surgery are the two cornerstones of endometriosis management, and recurrence rates are high. Having a method to determine a patient's response to progestin-based therapy could help determine the best treatment options and ideally reduce the risk of the disease recurring.

"Examining progesterone receptor status in endometriotic lesions may allow for a novel, targeted approach to treating endometriosis," Flores said.

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