Wei Qin,1,* Yazhou Qi,2,* Qianwen Li,2,* Bei Wang,2,* Jingmiao Wang,3 Xueke Ge,3 Yanhong Li,4 Xinyue Zhang,4 Kuan Liu4 

1Internal Medicine of Integrated Chinese and Western Medicine, Affiliated Hospital of Hebei University, Baoding, People’s Republic of China; 2Department of Gynecology, Affiliated Hospital of Hebei University, Baoding, People’s Republic of China; 3Department of Radiotherapy, Baoding First Central Hospital, Baoding, People’s Republic of China; 4Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Kuan Liu, Affiliated Hospital of Hebei University, No. 212 East Yuhua Road, Lianchi District, Baoding, Hebei, 071000, People’s Republic of China, Email liukuanhdfs@sina.com Xinyue Zhang, Affiliated Hospital of Hebei University, No. 212 East Yuhua Road, Lianchi District, Baoding, Hebei, 071000, People’s Republic of China, Email 993687160@qq.com

Abstract: Endometrial cancer, a common malignancy of the female reproductive system, has a rising incidence and complex clinical management due to its diverse molecular subtypes. This review examines the molecular mechanisms underlying EC, particularly the roles of the Bcl-2 family in apoptosis regulation and estrogen receptor signaling in tumor progression. We explore pharmacological interventions targeting these pathways, including BH3 mimetics and selective estrogen receptor modulators, which show promise but face challenges such as resistance and adverse effects. Additionally, we highlight the potential of natural compounds like curcumin, paclitaxel, and Ganoderma lucidum polysaccharides as adjunctive therapies, demonstrating efficacy in preclinical studies and early-phase clinical trials. This review aims to provide insights into the development of personalized therapeutic strategies for EC and to identify opportunities for optimizing clinical outcomes in future treatments.

Keywords: endometrial cancer, Bcl-2 family, estrogen receptors, natural polysaccharides, therapeutic interventions