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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...

Gynecologic Cancers
Immunotherapy

Microenvironment Heterogeneity May Contribute to Lack of Immunotherapy Success in High-Grade Serous Ovarian Cancer

INTER- AND INTRAPATIENT heterogeneity of the tumor microenvironment may explain the limited success of checkpoint blockade thus far observed in patients with advanced high-grade serous ovarian cancer, according to Paulina Cybulska, MD, MSc, of Memorial Sloan Kettering Cancer Center in New York....

Solid Tumors
Gynecologic Cancers

Leading Health Organizations Issue Challenge to Defeat Cervical Cancer

The Consortium of Universities for Global Health, Perlmutter Cancer Center, and the Department of Population Health at NYU Langone Health are issuing the “New York Challenge,” an ambitious campaign to end cervical cancer worldwide. They are challenging all nations to achieve a 70% human...

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

E. John Wherry, PhD, Awarded SU2C Funding to Lead Investigation of Gynecologic Cancer Therapies

E. John Wherry, PhD, a cancer and immunology researcher at the Perelman School of Medicine at the University of Pennsylvania and one of the most highly cited investigators in his field, has been awarded a “Convergence 2.0” research grant by Stand Up to Cancer (SU2C) to investigate immune system...

Gynecologic Cancers

USPSTF Recommends Against Screening for Ovarian Cancer in Asymptomatic Women

THE U.S. PREVENTIVE Services Task Force (USPSTF) recently published a final recommendation statement and evidence summary on screening for ovarian cancer. Based on its review of the evidence, the USPSTF recommends against screening for ovarian cancer in women who do not have any signs or symptoms...

Gynecologic Cancers

Kathleen M. Schmeler, MD: A Gynecologic Oncology Activist for Underserved Women

Kathleen M. Schmeler, MD, Associate Professor in the Department of Gynecologic Oncology at The University of Texas MD Anderson Cancer Center and the Lyndon B. Johnson Hospital, was given the “Heroes in Medicine” award from Physician’s Weekly in May 2016. Her primary work is in cervical cancer...

Solid Tumors
Gynecologic Cancers

Checkpoint Inhibition for Patients With Recurrent or Advanced Cervical Cancer: A Promising Strategy, but Which Patients Will Benefit the Most?

For nearly 20 years, chemoradiation using single-agent platinum therapy has been the standard of care for advanced or recurrent cervical cancer.1 More recently, the Gynecologic Oncology Group (GOG) 240 trial tested the addition of bevacizumab (Avastin) to platinum-based chemotherapy, which...

Solid Tumors
Gynecologic Cancers

Pembrolizumab in PD-L1–Positive Advanced Cervical Cancer

As reported in the Journal of Clinical Oncology by Jean-Sebastien Frenel, MD, of the Institut de Cancerologie de l’Ouest, Centre Rene Gauducheau, Saint-Herblain, France, and colleagues, pembrolizumab (Keytruda) treatment was found to be active in patients with programmed cell death ligand 1...

Gynecologic Cancers
Hepatobiliary Cancer
Gastroesophageal Cancer
Leukemia

Reports From the Journal of Clinical Oncology

Immunotherapy in PD-L1–Positive Advanced Cervical Cancer Pembrolizumab (Keytruda) treatment was active in patients with programmed cell death ligand 1 (PD-L1)–positive advanced cervical cancer enrolled in the phase Ib KEYNOTE-028 trial. The findings were reported by Jean-Sebastien Frenel, MD, of...

Solid Tumors
Gynecologic Cancers

Olaparib Tablets for Maintenance Treatment in Ovarian Cancer

On August 17, 2017, olaparib -(Lynparza) in tablet form was granted regular approval for maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2 Olaparib...

Gynecologic Cancers

Olaparib Tablets as Maintenance in BRCA1/2-Mutant Relapsed Ovarian Cancer

A phase III trial (SOLO2/ENGOT-Ov21) has shown improved progression-free survival with an olaparib tablet formulation vs placebo as maintenance therapy in patients with BRCA1/2-mutant platinum-sensitive relapsed ovarian cancer. These study results were reported by Eric Pujade-Lauraine, MD, of the...

Gynecologic Cancers

PARP Inhibitors in BRCA-Related Ovarian Cancer—and Beyond!

Poly (ADP ribose) polymerase (PARP) inhibitors are among the most exciting new classes of oncology drugs, and their development has coincided with the increasing recognition of the therapeutic vulnerability in targeting DNA damage response and DNA repair. The initial clinical testing of PARP...

Gynecologic Cancers

ARIEL3 Investigators Clarify the Effects of Rucaparib on the Liver

PRIMARY RESULTS from the randomized, placebo-controlled, phase III study ARIEL3—presented at the European Society for Medical Oncology (ESMO) 2017 Congress and published recently in The Lancet1—demonstrated that maintenance treatment with the poly(ADP-ribose) polymerase (PARP) inhibitor rucaparib ...

Gynecologic Cancers

EXPERT POINT OF VIEW: Geraldine M. Jacobson, MD, MPH, MBA

GERALDINE M. JACOBSON, MD, MPH, MBA, ASTRO Secretary/Treasurer, Professor and Chair of Radiation Oncology at the West Virginia University School of Medicine, Morgantown, went into more detail about the importance of this study. “The study directly compared brachytherapy/chemotherapy, which we use...

Gynecologic Cancers

Pelvic Radiation Therapy Preferred Over Brachytherapy Plus Chemotherapy in Treatment of High-Risk Endometrial Cancer

VAGINAL CUFF BRACHYTHERAPY plus chemotherapy failed to show superiority over pelvic radiation therapy for women with high-risk stage I–II endometrial cancer in a phase III trial.1 Furthermore, vaginal cuff brachytherapy plus chemotherapy led to more pelvic and para-aortic nodal recurrences and...

Breast Cancer
Gynecologic Cancers

More Data From ESMO 2017

In GEICAM 2006-10, the addition of fulvestrant at 250 mg/d to anastrozole did not improve 5-year disease-free survival over anastrozole alone (91.0% vs 90.8%).  “Immune induction” with chemotherapy or radiotherapy appeared to enhance response to nivolumab in women with metastatic triple-negative...

Breast Cancer
Gynecologic Cancers

International Trials Reveal New Findings in the Management of Breast and Ovarian Cancers

The European Society for Medical Oncology (ESMO) 2017 Congress, held in Madrid, featured important news including at least seven practice-changing or potentially practice-changing trials, which are covered in recent issues of The ASCO Post. Here we present additional highlights of studies in breast ...

Gynecologic Cancers

Expert Point of View: Markus Joerger, MD, PhD, and Domenica Lorusso, MD, PhD

PRESS CONFERENCE MODERATOR Markus Joerger, MD, PhD, of St. Gallen Cancer Center, Switzerland, indicated that prior to the current study, it was unclear whether chemotherapy followed by surgery would be superior to chemoradiotherapy. “I think we all agree that it has been confirmed as the standard...

Gynecologic Cancers

Standard of Care Upheld for Locally Advanced Cervical Cancer

THE FIRST FORMAL comparison of two acceptable approaches to locally advanced cervical cancer has concluded that standard chemoradiotherapy is preferable to neoadjuvant chemotherapy plus surgery. The findings confirm what most specialists have believed to be the optimal treatment.  The results came ...

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