Gynecologic Cancers

In this slide show we highlight some of the top news on gynecologic cancers in 2017, including studies on surgery for cervical and ovarian cancer, the FDA approval of niraparib, and more.

The majority of surveyed ovarian cancer patients required a 5-year survival benefit of 6% or less to justify an additional 50 miles of travel for cancer care.

The immune checkpoint inhibitor pembrolizumab demonstrated antitumor activity in a small trial of patients with advanced cervical cancer. The agent had a similar toxicity profile to that seen in other malignancies.

Comprehensive geriatric assessments will play an increasingly important role in identifying patient frailty and personalizing geriatric oncology treatment, according to recently published reviews.

A large cohort study found no concerning safety issues associated with the use of human papillomavirus (HPV) vaccine in adult women. There was an increased rate of celiac disease, but this may be related to general underdiagnosis of the condition and its unmasking at vaccination visits.

Extending the platinum-free interval following disease progression in ovarian cancer with a non-platinum agent does not improve outcomes over the standard practice of using a platinum-based chemotherapy, according to a prospective trial.

The USPSTF issued a new draft recommendation for cervical cancer screening, recommending screening with cervical cytology every 3 years for women aged 21 to 29, and offering a choice between cytology every 3 years and high-risk human papillomavirus testing every 5 years for those aged 30 to 65 years.

A large database study found that most patients with stage I endometrioid epithelial ovarian cancer or ovarian clear cell cancer do not have better survival outcomes when treated with adjuvant chemotherapy.

This video reviews results of a phase III trial that compared pelvic radiation therapy vs vaginal cuff brachytherapy plus chemotherapy in patients with early-stage, high-risk endometrial cancer.

Weekly dose-dense chemotherapy can be delivered successfully and with lower toxicity than standard 3-weekly regimens, but it does not improve progression-free survival among patients with epithelial ovarian cancer, according to a large new study presented at the ESMO.

Two studies on Lynch syndrome highlight cancer screening and surveillance opportunities.

Women with increased levels of cadmium, which mimics estrogen in the body, had a higher risk of endometrial cancer, according to a recently published observational study.

Olaparib tablet maintenance therapy provided a significant improvement in progression-free survival over placebo in patients with relapsed, platinum-sensitive ovarian cancer with a BRCA1/2 mutation.

Women who undergo HPV testing following a test showing abnormal cytology have earlier detection of high-grade cervical intraepithelial neoplasia, compared to those who do not undergo HPV testing.

Niraparib is the most effective but most costly of the currently FDA-approved PARP inhibitors for the treatment of recurrent ovarian cancer.

Almost one quarter of long-term cervical cancer survivors reported experiencing chronic fatigue, according to a study conducted in Norway.

According to a study recently presented at the 2017 American Society of Clinical Oncology Annual Meeting, held June 2–6 in Chicago, women diagnosed with endometrial cancer are oftentimes not provided with genetic counseling referrals.

In a Significant Percentage of Patients, Neoadjuvant Therapy Yields Equivalent Survival, With Better Quality of Life and Lower Costs

Cytoreductive Surgery Is the Best Way to Affect Survival Outcomes

Despite previously reported progression-free survival improvements with cediranib, results from the ICON6 trial failed to show a statistically significant improvement in overall survival.

Systematic lymphadenectomy in patients with advanced ovarian cancer and complete resection does not improve progression-free or overall survival, and should be omitted, according to results of a new study.

Platinum-sensitive ovarian cancer patients with a positive predictive AGO score who undergo a secondary debulking surgery after relapse on platinum chemotherapy experience longer progression-free survival.

Despite toxicity, olaparib maintenance therapy is associated with improved patient-reported symptoms outcomes and improved quality-adjusted progression-free survival among patients with germline BRCA mutation-positive, platinum-sensitive relapsed serious ovarian cancer.

Women infected with the human immunodeficiency virus (HIV) are more likely to have human papillomavirus (HPV) infection that progresses to pre-cancerous cervical lesions.

The number of women who undergo regular screening for cervical cancer drops as they get older, and while this is acceptable if women have been followed regularly until the age of 65 years, women who are not up to date with screening should be screened when they are older.

The diagnostic benefits of SLN evaluation include an ability to identify the extent of tumor dissemination and the utility of SLN mapping in guiding targeted adjuvant treatment in high-risk patients.

The question that should be posed to those who advocate for lymphadenectomy as a tool to guide the adjuvant therapy of endometrial cancer is: At what cost to the patient is lymphadenectomy performed?

A phase I study combining the PD-L1 inhibitor durvalumab with either olaparib or cediranib found that the combinations are reasonably well tolerated and active in recurrent women’s cancers.

Women undergoing robotic surgery procedures for gynecologic cancers and nonmalignant conditions report more patient education needs than those undergoing traditional laparotomy.

Patients with ovarian cancer who express the NY-ESO-1 testis antigen have significantly shorter overall survival than those who do not, according to a new study. These patients may benefit from immunotherapy agents.