NEW YORK (Reuters Health) – When the cell adhesion molecule L1CAM is expressed in early-stage endometrial tumors, there is a 50% chance of recurrence, a multicenter study has shown.

Furthermore, “This adhesion molecule might serve as a treatment target for the fully humanized anti-L1CAM antibody currently under development for clinical use,” the researchers say.

Writing in the Journal of the National Cancer Institute online June 18, they explain that type I tumors make up 80% of endometrial cancers, and in the early stage have an excellent prognosis with risk-adapted treatment. However, despite optimal treatment, recurrence and death occur in a “substantial” number of cases.

Based on prior evidence that L1CAM (also termed CD171) may be associated with aggressive tumors, the authors conducted a retrospective analysis of L1CAM expression in 1021 stage I, type I endometrial cancer specimens in relation to clinical outcomes.

Dr. Alain G. Zeimet, at Innsbruck Medical University, Austria, and colleagues found that 17.7% of the specimens were positive for L1CAM. During a median follow-up of 5.3 years, recurrence rates were 51.4% among the L1CAM-positive cases compared to just 2.9% when cancers were negative for L1CAM. Median overall survival was 8.9 years in patients with L1CAM-positve tumors, whereas median survival has not been reached in the L1CAM-negative patients.

On multivariate analysis, these figures translated to hazard ratios of 16.33 for recurrence and 15.01 for death with L1CAM-positve cancers, according to the report.

Dr. Zeimet and colleagues conclude that L1CAM is the best prognostic factor in stage I, type I endometrial cancer so far published. However, given the retrospective nature of this study, they say, “A prospective randomized trial will be the highest priority next step in validating the real clinical usefulness of that biomarker.”

Regarding treatment of L1CAM-positive endometrial cancer, the authors speculate that adjuvant chemotherapy may be the most “valid” option. Meanwhile, they add, “A fully humanized anti-L1CAM antibody has been successfully synthesized and tested, and members of our research group are developing this antibody for clinical use.”

SOURCE: L1CAM in Early-Stage Type I Endometrial Cancer: Results of a Large Multicenter Evaluation
J Natl Cancer Inst 2013.