GYNECOLOGIC ONCOLOGY

What happens after menopause? (WHAM): Impact of risk-reducing salpingo-oophorectomy on depressive and anxiety symptoms at 24 months
Hickey M, Nguyen TL, Krejany EO, Domchek SM, Brand A, Hopper JL and Joffe H
For women with pathogenic variants in BRCA1 and BRCA2, risk-reducing salpingo-oophorectomy (RRSO) at the recommended age causes surgical menopause. We previously reported elevated depressive symptoms at 6 and 12 months and elevated anxiety symptoms at 6 months after RRSO. We now report these outcomes at 24 months, their baseline and 12-month predictors and the effect of Menopausal Hormone Therapy (MHT).
Hormonal biomarkers remain prognostically relevant within the molecular subgroups in endometrial cancer
Vrede SW, Van Weelden WJ, Bulten J, Gilks CB, Teerenstra S, Huvila J, Matias-Guiu X, Gil-Moreno A, Asberger J, Sweegers S, van der Putten LJM, Küsters-Vandevelde HVN, Reijnen C, Colas E, Hausnerová J, Weinberger V, Snijders MPLM, Vinklerova P, Ravaggi A, Odicino F, Bignotti E, McAlpine JN, Kruitwagen R and Pijnenborg JMA
The prognostic relevance of hormonal biomarkers in endometrial cancer (EC) has been well-established. A refined three-tiered risk model for estrogen receptor (ER)/progesterone receptor (PR) expression was shown to improve prognostication. This has not been evaluated in relation to the molecular subgroups. This study aimed to evaluate the ER/PR expression within the molecular subgroups in EC.
Evolutionary pathways in early-stage, non-myoinvasive endometrioid endometrial cancers of no specific molecular profile
Moufarrij S, Lakhman Y, Aghajanian C, Abu-Rustum NR, Ellenson LH, Weigelt B and Momeni-Boroujeni A
To characterize the genomic landscape of FIGO 2009 stage IA, non-myometrial invasive endometrioid endometrial cancers (ECs) of no specific molecular profile (NSMP) and define the earliest driver genetic alterations and subsequent tumor evolution.
Hormonal maintenance therapy for advance low grade serous ovarian carcinoma appears to be of benefit - That's a relief!
Brown J
Prognostic and therapeutic implication of molecular classification including L1CAM expression in high-risk endometrial cancer
Kleppe A, Lindemann K, Kildal W, Tobin KAR, Pradhan M, Vlatkovic L, Isaksen MX, Danielsen HE, Askautrud HA and Kristensen GB
The role of molecular classification and L1CAM in high-risk endometrial cancer is uncertain. We aimed to determine the association of molecular profiling and L1CAM with patterns of relapse and survival.
Efficacy and safety of dostarlimab in combination with chemotherapy in patients with dMMR/MSI-H primary advanced or recurrent endometrial cancer in a phase 3, randomized, placebo-controlled trial (ENGOT-EN6-NSGO/GOG-3031/RUBY)
Powell MA, Cibula D, O'Malley DM, Boere I, Shahin MS, Savarese A, Chase DM, Gilbert L, Black D, Herrstedt J, Sharma S, Kommoss S, Gold MA, Thijs AM, Ring K, Bolling MF, Buscema J, Gill SE, Nowicki P, Nevadunsky N, Callahan M, Willmott L, McCourt C, Billingsley C, Ghamande SA, He Z, Balas MM, Stevens S, Fleming E and Mirza MR
Part 1 of the RUBY trial (NCT03981796) demonstrated improved survival in patients with primary advanced or recurrent endometrial cancer (EC) treated with dostarlimab plus carboplatin-paclitaxel versus placebo plus carboplatin-paclitaxel. Here, we examine additional efficacy and safety data from patients with mismatch repair deficient/microsatellite instability-high (dMMR/MSI-H) EC in the RUBY trial.
Cost-effectiveness of dostarlimab plus carboplatin-paclitaxel for primary advanced or recurrent endometrial cancer from a US payer perspective
Coleman RL, Lubinga SJ, Shen Q, Walder L, Burton M and Mathews C
Dostarlimab in combination with carboplatin-paclitaxel (CP) improves progression-free survival in patients with primary advanced or recurrent endometrial cancer (pA/rEC), including in patients whose cancer is mismatch repair-deficient (dMMR) or microsatellite instability-high (MSI-H). This study examined the cost-effectiveness of dostarlimab plus CP as a first-line treatment in the dMMR/MSI-H and overall populations.
Insurance coverage and access to gynecologic oncology: Where are we are now
Mulugeta-Gordon L and Smith AJB
In the United Sates, over 115,000 individuals are diagnosed with a gynecologic cancer annually with access to a gynecologic oncologist and evidence-based treatment remaining a persistent challenge. Coverage decisions by private and public insurance, including Medicaid and Medicare, play key roles in access to care, impacting oncologic outcomes. The expansion of Medicaid insurance under the Affordable Care Act improved early diagnosis, treatment, and survival in gynecologic cancers, but disparities remain for individuals in non-Medicaid expansion states. For individuals with Medicare or private insurance, coverage gaps and high out-of-pocket costs are barriers to cancer care, particularly for novel therapeutic treatments. Efforts to streamline care access, expand clinical trial participation, and reduce administrative burdens continue. Addressing these disparities require improving insurance literacy in patients and clinicians, coordination, and community partnerships to support equitable and comprehensive gynecologic cancer care.
Adverse events in the placebo arm of SOLO2/ENGOT-Ov21 maintenance trial of olaparib in recurrent ovarian cancer
Francis KE, Simon S, Gebski V, Joly F, Ledermann JA, Penson RT, Oza AM, Korach J, Lainez N, Cecere SC, Tasca G, Gropp-Meier M, Fujiwara K, Lowe ES, Friedlander M, Pujade-Lauraine E and Lee CK
In women with platinum sensitive recurrent ovarian cancer (PSROC) undergoing maintenance treatment, adverse events (AEs) not attributable to the current treatment are not well understood. We used data from SOLO2/ENGOT-Ov21 to evaluate AEs reported in the placebo arm and to explore their longitudinal trajectories.
Clinical trial enrollment during first course of gynecologic cancer treatment and survival
Khadraoui W, Sinnott JA, Meade CE, Plascak J, Carey A, Backes FJ, Dood RL, Trabert B and Felix AS
Among gynecologic cancer patients, it is unclear whether participation in clinical trials impacts survival outcomes. In addition, given the known racial and ethnic disparities in gynecologic cancer trial enrollment, it is important to assess whether clinical trial enrollment is similarly related to overall survival among racial and ethnic minorities. Therefore, we examined associations between clinical trial enrollment and overall survival and potential effect modification by race/ethnicity and cancer site among gynecologic cancer patients.
Repair Assisted Damage Detection (RADD) as a predictive biomarker for immunotherapy response in ovarian cancer
Sonavane M, Hedlich-Dwyer J, Dal Zotto VL, Tang M, Nemunaitis J, Stanbery L, Walter A, Bognar E, Rocconi RP and Gassman NR
Genomic instability has been proposed as a predictive biomarker for immunotherapy in ovarian cancer. We tested a method for measuring DNA damage, a direct measure of genomic instability, in ovarian tumors and its ability to predict immunotherapy response to Vigil (gemogenovatucel-T).
A randomized controlled trial of an online support group addressing psychosexual distress among women treated for gynecologic cancer
Classen CC, Chivers ML, Brotto LA, Barbera L, Carter J, Koval J, Robinson JW and Ferguson SE
To assess whether a 12-week, professionally facilitated, asynchronous online support group would reduce sexual distress (primary outcome) and improve sexual function, body image, depression symptoms, relationship satisfaction, and social support (secondary outcomes) in women treated for gynecologic cancer.
KRAS mutations in endometrial cancers: Possible prognostic and treatment implications
Kilowski KA, Dietrich MF, Xiu J, Baca Y, Hinton A, Ahmad S, Herzog TJ, Thaker P and Holloway RW
Patients with recurrent or metastatic endometrial cancer (EC) have poor prognoses with limited therapeutic options following immunotherapy or immunochemotherapy treatments. Inhibitors of KRAS mutations (KRAS-mut) have shown efficacy in early solid tumor studies, but data in EC are lacking. This study describes the frequency of KRAS-mut relative to other oncogenic alterations in EC to identify genomic characteristics of KRAS-mut tumors that could lead to novel therapeutic options.
Associations of the gut microbiome with outcomes in cervical and endometrial cancer patients treated with pembrolizumab: Insights from the phase II PRIMMO trial
De Jaeghere EA, Hamerlinck H, Tuyaerts S, Lippens L, Van Nuffel AMT, Baiden-Amissah R, Vuylsteke P, Henry S, Trinh XB, van Dam PA, Aspeslagh S, De Caluwé A, Naert E, Lambrechts D, Hendrix A, De Wever O, Van de Vijver KK, Amant F, Vandecasteele K, Verhasselt B and Denys HG
The phase II PRIMMO trial investigated a pembrolizumab-based regimen in patients with recurrent and/or metastatic cervical (CC) or endometrial (EC) carcinoma who had at least one prior line of systemic therapy. Here, exploratory studies of the gut microbiome (GM) are presented.
Oncologic and fertility outcomes in patients with juvenile granulosa cell tumor - a retrospective single centre analysis
Marino G, Marchetta L, Negri S, Testa F, Lugotti D, Cavallo G, Grassi T, Jaconi M, De Ponti E, Bonazzi MC, Landoni F and Fruscio R
Granulosa cell tumors (GCTs) are rare neoplasia that account for less than 5 % of all the ovarian tumors. Juvenile GCT histotype is generally observed in adolescent and young women, representing a very rare disease, so only a paucity of data are present in literature. The aim of this study is to analyse the oncologic and fertility outcome in our case series of juvenile GCTs.
Too much of a good thing? Projecting the need for gynecologic oncologists over the next 20 years
Boitano TKL, Blank SV, Havrilesky LJ, Huh WK and Myers ER
To estimate the effect of growth in gynecologic oncology fellowships in the United States on surgical volume for trainees and practicing gynecologic oncologists over the next 20 years.
Disparities in ovarian cancer survival among ethnic Asian American populations, 2006-2020
Lee AW, Poynor V and Siddiqui S
Asian Americans have the highest ovarian cancer survival across the major racial groups although it is unclear whether this survival advantage is observed when each Asian ethnic subgroup is examined separately. Disaggregated survival analyses of this heterogeneous population is needed to ensure ethnic-specific disparities are not overlooked.
Safety and tolerability of mirvetuximab soravtansine monotherapy for folate receptor alpha-expressing recurrent ovarian cancer: An integrated safety summary
Moore KN, Lorusso D, Oaknin A, Oza A, Colombo N, Van Gorp T, O'Malley DM, Banerjee S, Murphy CG, Harter P, Konecny GE, Pautier P, Method M, Wang Y, Coleman RL, Birrer M and Matulonis UA
Mirvetuximab soravtansine-gynx (MIRV) is a novel antibody-drug conjugate targeting folate receptor alpha (FRα), which is overexpressed in epithelial ovarian cancer (EOC), with limited expression on normal tissues. This integrated safety summary sought to characterize the safety profile of MIRV monotherapy in participants with FRα-expressing recurrent EOC.
Standard of care treatment for stage IVB cervical cancer: A systematic review and meta-analysis
Hunsberger KS, Tewari KS, Monk BJ and Chase DM
Our aim was to perform a systematic review and meta-analysis evaluating the efficacy of standard treatment for stage IVB cervical cancer.
Biobehavioral predictors of mood, pain, fatigue, and insomnia in endometrial cancer survivors
Ver Hoeve ES, Rumble ME, Gorzelitz JS, Rose SL, Nelson AM, Morris KE and Costanzo ES
Endometrial cancer survivors experience persistent health-related quality of life concerns, including pain, fatigue, and disrupted emotional and social functioning. The purpose of this longitudinal study was to evaluate associations between biobehavioral factors, including daytime physical activity, nighttime sleep, and 24-h circadian rest-activity rhythms, with psychological and physical symptoms following endometrial cancer surgery.
Impact of postoperative residual disease on survival in epithelial ovarian cancer with consideration of recent frontline treatment advances: A systematic review and meta-analysis
Kim JH, Kim SI, Park EY, Ha HI, Kim JW, Coleman RL, Bristow RE, Park SY, Fotopoulou C and Lim MC
Current treatment strategies for primary epithelial ovarian cancer (EOC) have significantly evolved, and the value of complete cytoreduction has not yet been reassessed. The study aimed to investigate the impact of residual disease after cytoreductive surgery for EOC on survival outcomes within the recent paradigm of frontline ovarian cancer treatment.