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Gynecologic Cancers

Expert Point of View: Ernst Lengyel, MD, PhD

Invited discussant Ernst Lengyel, MD, PhD, of University of Chicago Medicine, found the results of ATHENA-MONO promising. “I think it is encouraging that in the BRCA-mutation subgroup of patients, we see such a clear increase in progression-free survival compared to the intention-to-treat...

Gynecologic Cancers

Rucaparib Maintenance Improves Progression-Free Survival in Patients With Newly Diagnosed Advanced Ovarian Cancer Who Responded to Platinum-Based Therapy

Maintenance therapy with the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib led to a significant improvement in progression-free survival compared with placebo in patients with newly diagnosed advanced ovarian cancer who responded to first-line platinum-based chemotherapy. The...

Gynecologic Cancers

ARIEL4 Confirms Rucaparib’s Efficacy in Recurrent, BRCA-Mutated Ovarian Cancer: Does It Tell Us Anything New?

In March 2022, Kristeleit et al reported the results of the ARIEL4 trial1 of rucaparib in relapsed BRCA-mutant ovarian cancer in The Lancet Oncology (summarized in this issue of The ASCO Post) and are to be congratulated on this accomplishment. This report, along with the almost simultaneous...

Gynecologic Cancers

ARIEL4 Trial: Rucaparib Improves Progression-Free Survival vs Chemotherapy in Relapsed Ovarian Cancer With BRCA1/2 Mutations

As reported in The Lancet Oncology by Rebecca Kristeleit, MD, of Guy’s and St. Thomas’ NHS Foundation Trust, and colleagues, the phase III ARIEL4 trial has shown a statistically significant improvement in progression-free survival with rucaparib vs chemotherapy in relapsed ovarian cancer with...

Gynecologic Cancers
Genomics/Genetics

Factors That May Predict Response to the Addition of Bevacizumab to Front-Line Chemotherapy in Patients With Endometrial Cancer

In an analysis from an NRG Oncology/Gynecologic Oncology Group phase II study (GOG-86P) reported in the Journal of Clinical Oncology, Thiel et al looked at outcomes in patients with advanced endometrial cancer treated with bevacizumab added to front-line chemotherapy. The investigators found that...

Gynecologic Cancers

Ovarian Cancer: First-Line Every-3-Week Carboplatin/Paclitaxel vs Weekly Dose-Dense Regimens

As reported in The Lancet Oncology by Andrew R. Clamp, PhD, and colleagues, no significant differences in overall survival or updated progression-free survival were found with first-line treatment with weekly dose-dense regimens of carboplatin/paclitaxel vs every-3-week carboplatin/paclitaxel in...

gynecologic cancers

Ursula A. Matulonis, MD, and Domenica Lorusso, MD, PhD, on Gynecologic Cancers: New Findings on Trabectedin vs Clinician’s Choice Chemotherapy

Ursula A. Matulonis, MD, of Dana-Farber Cancer Institute, and Domenica Lorusso, MD, PhD, of Italy’s Gemelli University Hospital, discuss phase III data from the MITO23 trial on single-agent trabectedin vs clinician’s choice of chemotherapy in patients with recurrent ovarian, primary peritoneal, or fallopian tube cancers of BRCA-mutated or BRCAness phenotype. Although trabectedin has demonstrated antitumor activity in relapsed platinum-sensitive disease, it does not appear to improve survival outcomes when compared with standard chemotherapy in the BRCA-mutated population (Abstract LBA5504).

Gynecologic Cancers
Immunotherapy

Cemiplimab-rwlc Improves Overall Survival vs Chemotherapy in Recurrent Cervical Cancer After First-Line Platinum-Based Chemotherapy

As reported in The New England Journal of Medicine by Krishnansu S. Tewari, MD, of the Division of Gynecologic Oncology, University of California, Irvine, and colleagues, the phase III ­EMPOWER-Cervical1/GOG-3016/ENGOT-cx9 trial has shown improved overall survival with cemiplimab-rwlc vs...

gynecologic cancers
immunotherapy

Ursula A. Matulonis, MD, and Ignace Vergote, MD, PhD, on Cervical Cancer: Interim Results on Tisotumab Vedotin-tftv Plus Pembrolizumab

Ursula A. Matulonis, MD, of Dana-Farber Cancer Institute, and Ignace Vergote, MD, PhD, of Belgium’s University Hospitals Leuven, discuss interim safety and efficacy results from a third dose-expansion cohort evaluating first-line tisotumab vedotin-tftv plus pembrolizumab in patients with recurrent or metastatic cervical cancer. Data on the combination showed durable antitumor activity with a manageable safety profile (Abstract 5507).

Gynecologic Cancers

ATHENA-MONO Trial: Rucaparib Maintenance in Newly Diagnosed Patients With Advanced Ovarian Cancer

As presented at the 2022 ASCO Annual Meeting (Abstract LBA5500) and simultaneously reported in the Journal of Clinical Oncology by Bradley J. Monk, MD, and colleagues, the phase III ATHENA-MONO trial found that maintenance rucaparib significantly improved progression-free survival vs placebo among...

gynecologic cancers

Ursula A. Matulonis, MD, and Nicoletta Colombo, MD, on Ovarian Cancer: Overall Survival Data on Relacorilant Plus Nab-Paclitaxel

Ursula A. Matulonis, MD, of Dana-Farber Cancer Institute, and Nicoletta Colombo, MD, of the University of Milan and the European Institute of Oncology, discuss phase II results on the overall survival benefit of intermittent relacorilant, a selective glucocorticoid receptor modulator, combined with nab-paclitaxel, compared with nab-paclitaxel alone in patients with recurrent platinum-resistant ovarian cancer. A phase III trial comparing intermittent relacorilant plus nab-paclitaxel with investigator’s choice of chemotherapy in primary platinum-refractory disease is ongoing (Abstract LBA5503).

gynecologic cancers

Benoit You, MD, PhD, on Ovarian Cancer: Who Benefits From Bevacizumab in the First-Line Setting

Benoit You, MD, PhD, of Lyon University hospital (HCL, France) and GINECO group (France), discusses findings from the GOG-0218 trial of patients with ovarian cancer, which appears to confirm earlier data on the link between poor tumor chemosensitivity and benefit from concurrent plus maintenance bevacizumab. In Dr. You’s validation study, patients who derived the most progression-free and overall survival benefit from bevacizumab were those with high-risk disease (stage IV or incompletely resected stage III) associated with an unfavorable KELIM score (CA-125 kinetic elimination rate constant, calculable online) (Abstract 5553).

Gynecologic Cancers

Combination Therapy of Olaparib, Cyclophosphamide, and Metformin Under Study in Advanced Endometrial Cancer

A triplet regimen consisting of the PARP (poly [ADP-ribose] polymerase) inhibitor olaparib, metronomic (the chronic administration of low, equally spaced doses of) cyclophosphamide, and metformin demonstrated activity in elderly, heavily pretreated patients with recurrent, advanced endometrial...

Gynecologic Cancers

Addition of Vistusertib to Anastrozole for Hormone Receptor–Positive Recurrent or Metastatic Endometrial Cancer

In a French phase I/II trial (VICTORIA) reported in JAMA Oncology, Heudel et al found that the addition of the mTOR inhibitor vistusertib to anastrozole improved outcomes in women with hormone receptor–positive recurrent or metastatic endometrial cancer. As stated by the investigators, “Endometrial ...

gynecologic cancers

Pedro T. Ramirez, MD, on Hysterectomy for Early Cervical Cancer: New Findings on Open vs Minimally Invasive Surgery

Pedro T. Ramirez, MD, of The University of Texas MD Anderson Cancer Center, discusses the final analysis of the LACC trial (Laparoscopic Approach to Cervical Cancer), which showed that women with early cervical cancer who need a radical hysterectomy may have worse outcomes with minimally invasive surgery compared with open surgery. All treatment guidelines support open surgery, which yields similar outcomes in terms of complications and quality of life (Abstract LBA10).

gynecologic cancers

Ursula A. Matulonis, MD, on Ovarian Cancer: New Data on Mirvetuximab Soravtansine

Ursula A. Matulonis, MD, of Dana-Farber Cancer Institute, discusses findings from the SORAYA study on the efficacy and safety of mirvetuximab soravtansine in patients who have platinum-resistant ovarian cancer with high folate receptor–alpha expression. Based on the results, Dr. Matulonis believes this agent might become a practice-changing, biomarker-driven standard-of-care treatment option (Abstract LBA4).

Gynecologic Cancers

Trends in Hysterectomy-Corrected Uterine Cancer Mortality and Racial/Ethnic Differences

In a study reported in JAMA Oncology, Clarke et al found that hysterectomy-corrected rates of mortality from uterine corpus cancer overall and from nonendometrioid carcinomas have increased in recent years, with mortality rates being highest in Black women. The study involved data from the U.S....

Gynecologic Cancers

PRIME Trial: Niraparib Maintenance Therapy Improves Progression-Free Survival in Advanced Ovarian Cancer

A larger population of patients with newly diagnosed advanced ovarian cancer may be able to benefit from niraparib maintenance therapy, with an improved safety profile, according to phase III data presented at the 2022 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer.1 Results ...

Gynecologic Cancers

Absence of FAM19A4/miR124-2 DNA Methylation and Clinical Regression of High-Grade Cervical Intraepithelial Neoplasia

In the Dutch CONCERVE study reported in the Journal of Clinical Oncology, Kremer et al found that the absence of FAM19A4/miR124-2 DNA methylation was associated with a high rate of clinical regression of high-grade cervical intraepithelial neoplasia over 24 months among women treated with a...

Gynecologic Cancers

Deborah K. Armstrong, MD, on the Rationale for Intraperitoneal Treatment of Ovarian Cancer

Abstract discussant Deborah K. Armstrong, MD, of Johns Hopkins Kimmel Cancer Center Baltimore, elucidated the rationale for intraperitoneal (IP) treatment, which is the peritoneal pharmacokinetic advantage for many drugs used in ovarian cancer, including carboplatin, as used in the iPocc trial.1 In ...

Gynecologic Cancers

Intraperitoneal Carboplatin Plus Paclitaxel vs Intravenous Chemotherapy in Ovarian Cancer

When compared with intravenous (IV) chemotherapy, the use of intraperitoneal (IP) carboplatin with dose-dense weekly paclitaxel improved progression-free survival in patients with ovarian, fallopian tube, or primary peritoneal carcinoma, according to data presented at the 2022 Society of...

Gynecologic Cancers

Topical Imiquimod vs Surgery for Vulvar High-Grade Squamous Intraepithelial Neoplasia

In an Austrian phase III trial reported in The Lancet, Trutnovsky et al found that topical imiquimod was noninferior to surgery as measured by complete clinical response in patients with vulvar high-grade squamous intraepithelial lesions. Study Details In the multicenter trial, 107 evaluable...

Gynecologic Cancers

Cemiplimab-rwlc Improves Overall Survival vs Chemotherapy in Recurrent Cervical Cancer After First-Line Platinum-Based Chemotherapy

As reported in The New England Journal of Medicine by Krishnansu S. Tewari, MD, of the Division of Gynecologic Oncology, University of California, Irvine, and colleagues, the phase III EMPOWER-Cervical1/GOG-3016/ENGOT-cx9 trial has shown improved overall survival with cemiplimab-rwlc vs...

Gynecologic Cancers

Research Suggests Over Half of Eligible Women Would Prefer Self-Sampling for Cervical Screening

According to the results of a new study published by Drysdale et al in the Journal of Medical Screening, 51.4% of women preferred self-sampling for human papillomavirus (HPV)-based cervical cancer screening, compared to 36.5% who preferred being tested by a clinician. The findings came from a...

Gynecologic Cancers

Patient-Reported Outcomes and Toxicity With Adjuvant Stereotactic Pelvic Radiation Therapy in Uterine Cancers

In the Canadian phase I/II SPARTACUS study reported in JAMA Oncology, Leung et al found very low rates of severe genitourinary and gastrointestinal toxicity and worsening in only one patient-reported outcome domain among women receiving adjuvant stereotactic hypofractionated pelvic radiation...

Gynecologic Cancers

SORAYA Trial: Mirvetuximab Soravtansine Improves Response Rate in Drug-Resistant Ovarian Cancer

The novel antibody-drug conjugate mirvetuximab soravtansine could become the new standard of care for patients with folate receptor alpha–positive, platinum-resistant ovarian cancer, according to data presented at the Society of Gynecologic Oncology (SGO) 2022 Annual Meeting on Women’s Cancer.1...

gynecologic cancers
breast cancer
pancreatic cancer
prostate cancer
genomics/genetics

Timothy A. Yap, MBBS, PhD, on Ovarian, Breast, Pancreatic, and Prostate Cancers With Genetic Mutations: A First-in-Human Trial of AZD5305

Timothy A. Yap, MBBS, PhD, of The University of Texas MD Anderson Cancer Center, discusses results from the PETRA study, a first-in-class, first-in-human trial of the next-generation PARP1-selective inhibitor AZD5305 in patients with BRCA1/2, PALB2, or RAD51C/D mutations in advanced or metastatic ovarian cancer, HER2-negative breast cancer, pancreatic, or prostate cancer. Target engagement was demonstrated across all dose levels, and antitumor activity was observed in selected tumor and molecular subtypes.

Gynecologic Cancers

Navicixizumab Plus Paclitaxel in Platinum-Resistant Ovarian Cancer

In a phase Ib study reported in the Journal of Clinical Oncology, Fu et al found that the combination of navicixizumab (a bispecific antiangiogenic antibody to VEGF and delta-like ligand 4) and paclitaxel showed activity in patients with platinum-resistant ovarian cancer. Delta-like ligand 4 is a...

Gynecologic Cancers

Fuzuloparib Maintenance Therapy in Patients With Platinum-Sensitive Recurrent Ovarian Carcinoma

In an interim analysis of a Chinese phase III trial (FZOCUS-2) reported in the Journal of Clinical Oncology, Li et al found that maintenance treatment with the poly (ADP-ribose) polymerase (PARP) inhibitor fuzuloparib significantly prolonged progression-free survival vs placebo in patients with...

Gynecologic Cancers

MEK Inhibition Is Now a Standard of Care in Recurrent Low-Grade Serous Ovarian Cancer: What Next?

As summarized in this issue of The ASCO Post, the highly anticipated results of the GOG 281/LOGS study, which randomly assigned patients with recurrent low-grade serous ovarian cancer to the MEK inhibitor trametinib vs standard-of-care chemotherapy or endocrine therapy, have now been reported by...

Gynecologic Cancers

Trametinib Improves Progression-Free Survival vs Standard-of-Care Treatment in Recurrent Low-Grade Serous Ovarian Carcinoma

As reported in The Lancet by David M. Gershenson, MD, of the Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, and colleagues, the phase II/III GOG 281/LOGS trial showed that trametinib improved progression-free survival vs standard-of-care treatment...

Gynecologic Cancers

Why Are Many Women Overdue for Cervical Cancer Screening?

Cervical cancer screening has reduced new cases and deaths from the disease over the past 50 years. However, the percentage of women in the United States who are overdue for cervical cancer screening has been growing, and the reasons have not been clear. To better understand the decline in cervical ...

Gynecologic Cancers

Selinexor Improves Progression-Free Survival in Endometrial Cancer

In the treatment of advanced endometrial cancer, maintenance therapy with oral selinexor after response to first-line chemotherapy may result in a significantly reduced risk of disease progression, according to the results of the global phase III ENGOT-EN5/GOG-3055/SIENDO trial, presented at the...

gynecologic cancers

Benoit You, MD, PhD, on Endometrial Cancer: New Data on Combining Olaparib, Cyclophosphamide, and Metformin

Benoit You, MD, PhD, of the Lyon University Hospital (France), discusses phase I/II safety and efficacy results from the ENDOLA trial that combined olaparib with metronomic cyclophosphamide and metformin in patients with advanced pretreated endometrial cancer. At 10 weeks, the non–disease progression rate was 61.5%, reaching the primary endpoint of the study. Median progression-free survival was 5.1 months. Research on biomarkers of efficacy is ongoing (Abstract CT005).

Gynecologic Cancers

Hyperthermic Intraperitoneal Chemotherapy With Primary or Interval Cytoreductive Surgery for Advanced Ovarian Cancer

In a Korean study reported in JAMA Surgery, Lim et al found that hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery did not improve progression-free survival vs no HIPEC in women with newly diagnosed stage III or IV epithelial ovarian cancer. A benefit of HIPEC was...

Gynecologic Cancers

Association of Serous Tubal Intraepithelial Carcinoma at Risk-Reducing Salpingo-Oophorectomy With Risk of Subsequent Peritoneal Carcinomatosis

Findings from a meta-analysis of individual patient data were reported in the Journal of Clinical Oncology. Steenbeek et al found that among women with BRCA1/2 pathogenic variants who underwent risk-reducing salpingo-oophorectomy for prevention of epithelial ovarian cancer, those with serous tubal...

Gynecologic Cancers
Genomics/Genetics

ARIEL4 Trial: Rucaparib vs Chemotherapy in Patients With Relapsed Ovarian Cancer and Deleterious BRCA1 or BRCA2 Mutations

As reported in The Lancet Oncology by Rebecca Kristeleit, MD, and colleagues, the phase III ARIEL4 trial has shown a statistically significant improvement in progression-free survival with rucaparib vs chemotherapy in patients with relapsed ovarian cancer and deleterious BRCA1/2 mutations. Study...

Gynecologic Cancers

Olaparib With or Without Cediranib vs Platinum-Based Chemotherapy in Recurrent Platinum-Sensitive Ovarian Cancer

As reported in the Journal of Clinical Oncology by Joyce F. Liu, MD, and colleagues, the phase III NRG-GY004 trial has shown no significant improvement in progression-free survival with olaparib/cediranib vs platinum-based chemotherapy in patients with recurrent platinum-sensitive ovarian cancer....

Gynecologic Cancers
Genomics/Genetics

HRR Mutational Status May Be Prognostic of Survival Outcomes for Women With Recurrent Platinum-Sensitive Ovarian Cancer

Results of a biomarker analysis of the NRG Oncology NRG-GY004 trial were presented during the Society for Gynecologic Oncology’s (SGO) Annual Meeting on Women’s Cancer. The analysis, which occurred as part of a preplanned translational endpoint for the study, concluded that homologous recombination ...

Gynecologic Cancers
Immunotherapy

Atezolizumab Plus Chemoradiation Is Safe, Demonstrates Signs of Immune Activation in Patients With Cervical Cancer

A phase I/Ib trial conducted by the National Cancer Institute’s National Clinical Trials Network group NRG Oncology, NRG-GY017, concluded that the addition of the immunotherapy atezolizumab prior to and concurrently given with chemoradiation was safe for women with node-positive, locally advanced...

Gynecologic Cancers
Immunotherapy

SORAYA Trial: Antibody-Drug Conjugate Produces Remissions in One-Third of Patients With Drug-Resistant Ovarian Cancer

In a clinical trial involving patients with ovarian cancer previously treated with platinum-based chemotherapy, a novel antibody-drug conjugate therapy produced a substantially better response than standard treatments, investigators from Dana-Farber Cancer Institute reported at the Society of...

Gynecologic Cancers

Abemaciclib/Letrozole in Patients With Recurrent ER-Positive Endometrial Cancer

A combination therapy caused tumors to shrink or stabilize in 75% of patients with recurrent or persistent estrogen receptor (ER)-positive endometrial cancer, results from a recent clinical trial show. Trial leaders from Dana-Farber Cancer Institute presented the findings at the Society of...

Gynecologic Cancers
Immunotherapy

FDA Approves Pembrolizumab for Advanced Endometrial Carcinoma

On March 21, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) as a single agent for patients with advanced endometrial carcinoma that is microsatellite instability–high or mismatch repair–deficient (as determined by an FDA-approved test). Eligible patients have disease...

Gynecologic Cancers
Genomics/Genetics

Genetic Testing of Samples From Deceased Patients With Tubo-ovarian Cancer to Inform Families of Identification of Pathogenic Variants

As reported in the Journal of Clinical Oncology by Delahunty et al, an Australian pilot study of a genetic testing program (TRACEBACK) for deceased patients with tubo-ovarian cancer was successful in identifying pathogenic variants in samples from the patients, informing family, and engaging family ...

Gynecologic Cancers
Immunotherapy

Time for a Radical Change in the Treatment of Endometrial Cancer: KEYNOTE-775 and Beyond

I had the privilege of sitting in a meeting on the treatment of endometrial cancer as a junior investigator in January 2015 where a representative from the U.S. Food and Drug Administration was present. The topic of the meeting was on how to design the next endometrial cancer trials. I remember...

Gynecologic Cancers
Immunotherapy

Lenvatinib/Pembrolizumab Improves Progression-Free and Overall Survival vs Chemotherapy in Previously Treated Advanced Endometrial Cancer

As reported in The New England Journal of Medicine by Vicky Makker, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the phase III Study 309/KEYNOTE-775 trial has shown prolonged progression-free and overall survival with lenvatinib plus pembrolizumab vs physician’s choice of...

Gynecologic Cancers

Robust and Durable Responses to Pembrolizumab in Patients With Previously Treated MSI-H/dMMR Endometrial Cancer

“Robust and clinically meaningfulantitumor activity,” with durable responses and “encouraging survival outcomes,” were reported among patients with previously treated microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) endometrial tumors who received pembrolizumab in the...

Gynecologic Cancers

Effect of Secondary Cytoreductive Surgery on Survival in Patients With Platinum-Sensitive Recurrent Ovarian Cancer

In a meta-analysis reported in the Journal of Clinical Oncology, Baek et al found that increased rates of complete and optimal cytoreduction with secondary cytoreductive surgery were associated with improved overall survival in patients with platinum-sensitive recurrent ovarian cancer. Study...

Gynecologic Cancers

GOG 281/LOGS: Trametinib vs Standard of Care in Recurrent Low-Grade Serous Ovarian Carcinoma

In a phase II/III trial reported in The Lancet, David M. Gershenson, MD, and colleagues found that trametinib improved progression-free survival vs standard of care treatment in women with low-grade serous ovarian carcinoma. As stated by the investigators, “Low-grade serous carcinoma of the ovary...

Gynecologic Cancers
Symptom Management

Web-Based Intervention to Manage Symptoms and Quality of Life in Women With Recurrent Ovarian Cancer

In an NRG Oncology/GOG study (GOG-0259) reported in the Journal of Clinical Oncology, Donovan et al found that both nurse-led (Nurse-WRITE) and self-directed (SD-WRITE) Web-based symptom self-management interventions (WRITE Symptoms) improved symptom control vs enhanced usual care alone in women...

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