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gynecologic cancers
immunotherapy

Mansoor Raza Mirza, MD, and Don S. Dizon, MD, on Recurrent Platinum-Sensitive Ovarian Cancer: Niraparib Plus Bevacizumab

Don S. Dizon, MD, of the Lifespan Cancer Institute, and Mansoor Raza Mirza, MD, of Copenhagen University Hospital, discuss study findings that showed, compared with niraparib alone, niraparib plus bevacizumab improved progression-free survival in women with recurrent platinum-sensitive ovarian cancer (Abstract 5505).

gynecologic cancers

Matthew A. Powell, MD, and Don S. Dizon, MD, on Uterine or Ovarian Cancer: Paclitaxel Plus Carboplatin vs Ifosfamide in Chemotherapy-Naive Patients

Don S. Dizon, MD, of the Lifespan Cancer Institute, and Matthew A. Powell, MD, of Washington University School of Medicine, discuss phase III findings on paclitaxel plus carboplatin vs paclitaxel plus ifosfamide in chemotherapy-naive patients with stages I to IV, persistent or recurrent carcinosarcoma of the uterus or ovaries (Abstract 5500).  

Hepatobiliary Cancer
Gynecologic Cancers

Aspirin Use and Cancer Prevention: Long-Term Data Needed on Benefits and Risks

In addition to its well-known cardioprotective benefits, aspirin has a substantial body of observational, preclinical, and clinical evidence supporting its efficacy in preventing cancer, most strongly for colorectal cancer.1 The strength of this evidence led the U.S. Preventive Services Task...

Gynecologic Cancers
Hepatobiliary Cancer

Regular Aspirin Use and Risk of Hepatocellular Carcinoma and Epithelial Ovarian Cancer

Data from two large U.S. prospective cohort studies indicate the benefits of regular aspirin use in preventing hepatocellular carcinoma and epithelial ovarian cancer. As reported by Tracey G. Simon, MD, MPH, of Massachusetts General Hospital, Harvard Medical School, and colleagues, in JAMA...

gynecologic cancers

Panagiotis A. Konstantinopoulos, MD, PhD, on Endometrial Cancer: Avelumab in Microsatellite-Stable and -Instable Disease

Panagiotis A. Konstantinopoulos, MD, PhD, of Dana-Farber Cancer Institute, discusses his phase II study on the response to avelumab in microsatellite-stable and -instable recurrent or persistent endometrial cancer with a polymerase epsilon mutation (Abstract 5502).

gynecologic cancers

Richard T. Penson, MD, and Don S. Dizon, MD, on Ovarian Cancer: SOLO3 Trial on Olaparib vs Chemotherapy in Relapsed Disease

Don S. Dizon, MD, of the Lifespan Cancer Institute, and Richard T. Penson, MD, of Massachusetts General Hospital Cancer Center, discuss phase III study findings on the PARP inhibitor olaparib, which showed a significantly higher objective response rate vs nonplatinum chemotherapy for patients with ovarian cancer who relapsed, are platinum-sensitive, and have BRCA-mutant disease (Abstract 5506).  

gynecologic cancers
immunotherapy

Yoland C. Antill, MD, on Endometrial Cancer: PHAEDRA Trial on Durvalumab and Mismatch Repair Status

Yoland C. Antill, MD, of Cabrini Health, discusses phase II data on the effect of durvalumab, a PD-L1 inhibitor, as a single agent in the setting of recurrent or advanced endometrial cancer. Her research compares the response in mismatch repair–deficient and –proficient tumors (Abstract 5501).

gynecologic cancers
immunotherapy

Kamran A. Ahmed, MD, on Cervical Cancer: Stereotactic Body Radiation Therapy Plus Atezolizumab

Kamran A. Ahmed, MD, of the H. Lee Moffitt Cancer Center and Research Institute, reports on a trial in progress that is investigating whether treatment with atezolizumab plus hypofractionated radiation therapy will improve the objective response rate compared with atezolizumab alone in patients with recurrent, persistent, or metastatic cervical cancer (Abstract TPS5596).

Issues in Oncology
Gynecologic Cancers
Global Cancer Care

Barriers to Cervical Cancer Screening Among HIV-Infected Women in Tanzania

Population screening programs and the advent of human papillomavirus (HPV) vaccination have made cervical cancer largely a preventable disease. Despite these advances, ­cervical cancer remains a leading cause of cancer death for ­women in low- and middle-income countries. A recent study identified...

Gynecologic Cancers

Modeling Projections of Global Cervical Cancer Control

In a modeling study reported in The Lancet Oncology, Karen Canfell, DPhil, and colleagues detailed the preventive effects on cervical cancer that could be achieved by scaled-up human papillomavirus (HPV) vaccination and cervical screening efforts with the aim of disease elimination. The major...

Gynecologic Cancers

Effect of Lymphadenectomy on Progression-Free and Overall Survival in Advanced Ovarian Cancer

In the international phase III LION study reported in The New England Journal of Medicine, Philipp Harter, MD, and colleagues found that lymphadenectomy did not improve progression-free or overall survival vs no lymphadenectomy in women with advanced ovarian cancer. Study Details The trial...

Gynecologic Cancers

Conservatively Managing Ovarian Tumors

In an interim analysis of a prospective cohort study (IOTA5) reported in The Lancet Oncology, Wouter Froyman, MD, and colleagues found that the risk of malignancy and acute complications is low when adnexal masses with benign ultrasound findings are managed conservatively. In the study, patients...

Gynecologic Cancers

Welcome Questions About Cervical Cancer Treatment Options

TWO STUDIES reported in The New England Journal of Medicine1,2 showed that patients with early-stage cervical cancer had reduced disease-free and overall survival when treated with minimally invasive radical hysterectomy vs open or radical hysterectomy. The findings of these studies have been...

Gynecologic Cancers

Comparing Survival Outcomes With Minimally Invasive and Open Surgical Approaches to Early-Stage Cervical Cancer

MINIMALLY INVASIVE radical hysterectomy for women with early-stage cervical cancer has been associated with reduced rates of disease-free and overall survival in the phase III LACC randomized noninferiority trial comparing minimally invasive and open abdominal radical hysterectomy. The results...

Gynecologic Cancers

Minimally Invasive vs Open Abdominal Radical Hysterectomy in Early-Stage Cervical Cancer

TWO STUDIES recently reported in The New England Journal of Medicine indicate that minimally invasive radical hysterectomy is associated with poorer survival outcomes than open abdominal radical hysterectomy in women with early-stage cervical cancer. As reported by Pedro T. Ramirez, MD, of The...

Gynecologic Cancers

Study Identifies Suitable Partner for Bevacizumab in Recurrent Ovarian Cancer

For patients with recurrent ovarian cancer who receive platinum-based retreatment, the more suitable partner for bevacizumab (Avastin) may be carboplatin plus pegylated liposomal doxorubicin, rather than carboplatin and gemcitabine, according to the results of a phase III ENGOT/GCIG Intergroup...

Gynecologic Cancers

Expert Point of View: Jonathan Ledermann, MD, and Clara MacKay

“A KEY AIM of treatment is the need to focus on preventing recurrence, which happens in 70% of patients. Over the past 20 years, we have made few inroads in preventing recurrence. This study brings a poly (ADP-ribose) polymerase (PARP) inhibitor olaparib (Lynparza) to the first-line setting,...

Gynecologic Cancers

Results Reported for Olaparib Maintenance in Ovarian Cancer

TWO-YEAR MAINTENANCE therapy with olaparib (Lynparza), a poly (ADP-ribose) polymerase inhibitor, achieved a significant improvement in progression-free survival in patients with newly diagnosed advanced ovarian cancer and a BRCA1 or BRCA2 mutation, according to results of the phase III SOLO-1...

Gynecologic Cancers

Niraparib Maintenance Therapy in Recurrent Ovarian Cancer

In a study reported in The Lancet Oncology, Amit M. Oza, MD, of the Princess Margaret Cancer Centre, University Health Network, Toronto, and colleagues found that quality of life based on patient-reported outcomes was not worsened with niraparib (Zejula) maintenance vs placebo in the phase III...

Gynecologic Cancers

Analgesics and Ovarian Cancer Survival

In a prospective cohort study reported in The Lancet Oncology, Melissa A. Merritt, PhD, of the University of Hawaii Cancer Center’s Epidemiology Program, and colleagues found evidence that recent use of aspirin or nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) after diagnosis appears to...

Gynecologic Cancers

Rucaparib for Maintenance Treatment of Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

IN APRIL 2018, the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib (Rubraca) was granted approval for maintenance treatment of patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2...

Gynecologic Cancers

Actively Recruiting Clinical Trials Focused on Gynecologic Cancers

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on gynecologic cancers—cervical, vaginal, uterine, ovarian, and vulvar cancers. These trials are studying chemoradiotherapy combination treatments, cancer vaccines, intraperitoneal ...

Gynecologic Cancers
Immunotherapy

Pembrolizumab for Advanced Cervical Cancer Progressing During or After Chemotherapy

In June 2018, pembrolizumab (Keytruda) was approved for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express programmed cell death ligand 1 (PD-L1; combined positive score [CPS] ≥ 1), as determined by a U.S....

Gynecologic Cancers

NCCN Publishes Guidelines for Gestational Trophoblastic Neoplasia to Optimize Therapy, Preserve Fertility in Pregnant Women With Rare Cancer

THE NATIONAL Comprehensive Cancer Network® (NCCN®) has released new treatment guidelines for a group of rare cancers that impact women during pregnancy. Gestational trophoblastic neoplasia, also known as gestational trophoblastic disease, can occur when tumors develop in the cells that would...

Gynecologic Cancers

Inaugural Award Recipient Studies Potential of HE4 Blockade as a Novel Immune Therapy in Ovarian Cancer

In 2018, Bristol-Myers Squibb (BMS) provided funds for Conquer Cancer to establish a Young Investigator Award (YIA) supporting female researchers and underscore the importance of gender diversity in oncology practice and research.  “We provided this grant as part of our commitment to empowering...

Gynecologic Cancers

FDA Approves HPV Test for First-Line Cervical Cancer Screening

ON JULY 30, 2018, Roche announced approval by the U.S. Food and Drug Administration (FDA) of its cobas HPV Test in first-line screening for cervical cancer in women 25 years and older using cervical specimens collected in SurePath preservative fluid. The FDA first approved the cobas HPV test...

Gynecologic Cancers

Long-Term Follow-up of Women With DES-Related Vaginal and Cervical Clear Cell Adenocarcinoma

In a letter to the editor of The New England Journal of Medicine, Dezheng Huo, MD, of the University of Chicago, Chicago, and colleagues described the long-term outcomes of women with vaginal and cervical clear cell adenocarcinoma associated with prenatal exposure to the synthetic nonsteroidal...

Gynecologic Cancers
Immunotherapy

Bevacizumab Plus Chemotherapy in Advanced Ovarian Cancer

ON JUNE 13, 2018, bevacizumab (Avastin) was granted approval for treatment of epithelial ovarian, fallopian tube, or primary peritoneal cancer in combination with carboplatin and paclitaxel, followed by single-agent bevacizumab, for stage III or IV disease after initial surgical resection1,2. The...

Gynecologic Cancers

FDA Approves Bevacizumab in Combination With Chemotherapy for Ovarian Cancer

ON JUNE 13, 2018, the U.S. Food and Drug Administration (FDA) approved bevacizumab (Avastin) for the treatment of patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer in combination with carboplatin and paclitaxel, followed by single-agent bevacizumab, for stage III or IV...

Gynecologic Cancers
Lymphoma

Pembrolizumab Receives FDA Approval for Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma, Advanced Cervical Cancer

THE U.S. FOOD and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma or who have relapsed after two or more prior lines of therapy on June 13, 2018. The newest ...

Gynecologic Cancers
Pain Management

Study Evaluates Effect of Restrictive Opioid Protocol After Gynecologic Surgery

THE NUMBER of opioids prescribed after surgery for gynecologic cancer decreased significantly after implementation of an ultra-restrictive opioid prescription protocol, with no apparent negative effect on patient satisfaction or pain, according to research presented by Jaron Mark, MD, and...

Gynecologic Cancers

Expert Point of View: Shitanshu Uppal, MD

COMMENTING ON the study, invited discussant Shitanshu Uppal, MD, of the University of Michigan in Ann Arbor, called the data “provocative” but said he had progressed through the “five stages of grief” in reaction to the results. “I’ve gone through denial, I’ve gone through anger, I couldn’t...

Gynecologic Cancers

Poorer Outcomes Reported With Minimally Invasive Surgery Than Open Approach in Early Cervical Cancer

PATIENTS UNDERGOING minimally invasive radical hysterectomy for early cervical cancer had higher rates of disease recurrence and worse disease-free, progression-free, and overall survival than did women who had the open approach, according to results from the phase III LACC trial, presented by...

Gynecologic Cancers

Expert Point of View: Oliver Dorigo, MD, PhD

COMMENTING ON the study, invited discussant Oliver Dorigo, MD, PhD, of Stanford University, said that tumor size and disease site are useful clinical parameters for predicting nonresponse to immunotherapy and should be considered when selecting and “unselecting” patients for immunotherapy...

Gynecologic Cancers

Clinical Findings Predict Early Treatment Discontinuation in Patients Receiving Immunotherapy for Ovarian Cancer

PRETREATMENT CLINICAL findings may predict early treatment discontinuation in patients with ovarian cancer receiving checkpoint blockade immunotherapy agents. Data presented by MD candidate Julia L. Boland at the 2018 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer revealed that...

Solid Tumors
Gynecologic Cancers

Addition of Pazopanib to Paclitaxel in Persistent or Recurrent Ovarian Cancer

In a phase II trial reported in JAMA Oncology by Debra L. Richardson, MD, of Stephenson Cancer Center, Oklahoma University Health Science Center, and colleagues, the addition of pazopanib (Votrient) to paclitaxel did not improve progression-free survival among women with persistent or recurrent...

Solid Tumors
Gynecologic Cancers

HPV Vaccine Could Have Prevented My Cancer

In the fall of 2015, I was feeling great. At age 37, I had just completed running my fourth half-marathon and regularly hiked trails near my home in Arlington, Texas, to stay fit in-between races. The only symptom that foretold what was in my future was some light watery discharge I was...

gynecologic cancers
cost of care
immunotherapy

Juliet Elizabeth Wolford, MD, on Ovarian Cancer: The Cost of Care

Juliet Elizabeth Wolford, MD, of the University of California, Irvine, discusses the cost-effectiveness of various types of maintenance therapy in advanced ovarian cancer: paclitaxel, bevacizumab, niraparib, rucaparib, olaparib, and pembrolizumab (Abstract 5508).

gynecologic cancers
immunotherapy

Robert L. Coleman, MD, on Ovarian Cancer: Results From an NRG Oncology/Gynecologic Oncology Group Trial

Robert L. Coleman, MD, of The University of Texas MD Anderson Cancer Center, discusses phase III study findings on secondary surgical cytoreduction followed by platinum-based combination chemotherapy, with or without bevacizumab, in platinum-sensitive, recurrent ovarian cancer (Abstract 5501).

gynecologic cancers

Martee L. Hensley, MD, on Leiomyosarcoma: Results From a GOG Treatment Trial

Martee L. Hensley, MD, of Memorial Sloan Kettering Cancer Center, discusses phase III study findings on adjuvant gemcitabine plus docetaxel followed by doxorubicin vs observation for uterus-limited, high-grade leiomyosarcoma (Abstract 5505).

gynecologic cancers

Ursula A. Matulonis, MD, and Daniel J. Margul, MD, PhD, on Cervical Cancer and Minimally Invasive Surgery

Ursula A. Matulonis, MD, of Dana-Farber Cancer Institute, and Daniel J. Margul, MD, PhD, of Northwestern University, discuss the outcomes and costs of open, robotic, and laparoscopic radical hysterectomy for stage IB1 cervical cancer (Abstract 5502).

gynecologic cancers
immunotherapy

Ursula A. Matulonis, MD, and Stéphanie Gaillard, MD, PhD, on Ovarian Cancer: Results From an NRG Oncology/COG Trial

Ursula A. Matulonis, MD, of Dana-Farber Cancer Institute, and Stéphanie Gaillard, MD, PhD, of Duke Cancer Institute, discuss an evaluation of bevacizumab in the primary treatment of advanced ovarian cancer (Abstract 5517).

gynecologic cancers
immunotherapy

David M. O’Malley, MD, on Ovarian Cancer: Early Results From the FORWARD II Study

David M. O’Malley, MD, of The Ohio State University College of Medicine, discusses phase Ib study findings on mirvetuximab soravtansine, a folate receptor alpha-targeting antibody-drug conjugate, in combination with bevacizumab in patients with platinum-resistant ovarian cancer (Abstract 5549).

gynecologic cancers

Kathleen N. Moore, MD, on Ovarian Cancer: Results From the QUADRA Study

Kathleen N. Moore, MD, of the University of Oklahoma Health Sciences Center, discusses phase II study findings on niraparib in patients with relapsed ovarian cancer who have received three or more prior chemotherapy regimens (Abstract 5514).

gynecologic cancers

Martee L. Hensley, MD, on Leiomyosarcoma: Results From a GOG Treatment Trial

Martee L. Hensley, MD, of Memorial Sloan Kettering Cancer Center, discusses phase III study findings on adjuvant gemcitabine plus docetaxel followed by doxorubicin vs observation for uterus-limited, high-grade leiomyosarcoma (Abstract 5005).

Gynecologic Cancers

How a Recent Study Heats up the Debate Over Intraperitoneal Chemotherapy in Newly Diagnosed Advanced Ovarian Cancer

Based on pharmacokinetic and preclinical data, there appears to be a biologic advantage to the use of intraperitoneal chemotherapy in treating some malignancies confined to the abdomen. Since most ovarian, fallopian tube, and peritoneal cancers present and recur in the peritoneal cavity, this...

Gynecologic Cancers

Adding Hyperthermic Intraperitoneal Chemotherapy to Cytoreductive Surgery Improves Outcomes in Advanced Ovarian Cancer

In a Dutch/Belgian phase III trial reported in The New England Journal of Medicine by Willemien J. van Driel, MD, PhD, of the Netherlands Cancer Institute, and colleagues, the addition of hyperthermic intraperitoneal chemotherapy (aka HIPEC) to interval cytoreductive surgery following neoadjuvant...

Issues in Oncology
Gynecologic Cancers

Patient Attitude May Play a Part in Fears About Gynecologic Cancer Recurrence

CONCERNS ABOUT how recurrence of gynecologic cancer can affect a person’s life, and not simply fear of recurrence alone, play an important role in patient distress and functional impairment, according to a presentation at the 2018 American Psychosocial Oncology Society (APOS) Annual Conference in...

Gynecologic Cancers

Follow-up Too Short in Ovarian Cancer, Too Long in Other Gynecologic Malignancies

A STANDARDIZED 5-year period of surveillance by a gynecologic oncologist was found to be inadequate for some gynecologic cancers and excessive for others, according to research presented by Robert Dood, MD, of The University of Texas MD Anderson Cancer Center, Houston, at the 2018 Society of...

Gynecologic Cancers

Expert Point of View: Oliver Dorigo, MD, PhD

COMMENTING ON THE study by Cybulska et al, invited discussant Oliver Dorigo, MD, PhD, of Stanford University, said several important questions still need answers. “Tumor immune scores differ between metastatic sites, but how do these immune scores predict response to immunotherapy? And how does...

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