IJGC Podcast

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss  KEYNOTE-A18 Overall Survival Results: Pembrolizumab and Chemoradiotherapy. Dr. Domenica Lorusso, MD, PhD, directs the Gynaecological Oncology Unit at Humanitas Hospital, Milan, and holds a Full Professorship in Obstetrics and Gynaecology at Humanitas University, Rozzano, Milan. She has led/participated in approximately 250 phase I-IV clinical trials. Currently overseeing more than 60 studies as Principal Investigator, Dr. Lorusso also chairs the Clinical Trials Committee of the MITO Group. She serves on the Board of Directors of the GCIG and is an active member of ENGOT, where she chairs the Gynecological Cancer Academy. Additionally, she sits on the Board of Directors of the ESGO. With around 300 international oncology publications and contributions to national and international treatment guidelines, her primary objectives are to ensure optimal patient care, foster clinical research, and advance international collaborations and education in the field. Highlights:  In a phase 3 trial (ENGOT-cx11/GOG-3047/KEYNOTE-A18), pembrolizumab added to chemoradiotherapy significantly improved progression-free survival and overall survival for patients with locally advanced, high-risk cervical cancer. Patient Group: 1060 patients with FIGO 2014 stage IB2–IVA cervical cancer from 30 countries were randomized to receive pembrolizumab with chemoradiotherapy or placebo with chemoradiotherapy. Overall Survival: At a median follow-up of 29.9 months, the 36-month overall survival rate was 82.6% in the pembrolizumab group versus 74.8% in the placebo group, with a hazard ratio for death of 0.67 (95% CI 0.50–0.90; p=0.0040). Safety Profile: Grade 3 or higher adverse events were reported in 78% of pembrolizumab-treated patients versus 70% in the placebo group, with higher rates of potentially immune-mediated adverse events in the pembrolizumab group (39% vs. 17%). Conclusion: These findings confirm pembrolizumab plus chemoradiotherapy as an effective and potentially new standard of care for locally advanced cervical cancer.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Alessandro Santin to discuss Sacituzumab Govitecan (TROPiCS—03) in Advanced Endometrial Cancer. Dr. Alessandro D. Santin, a native of Italy, graduated with honors from the University of Brescia, Italy and received his postgraduate training in Obstetrics & Gynecology at the same University. He served a fellowship in Gynecologic Oncology at the University of California, Irvine and an International Fellowship in the Division of Gynecologic Oncology at the University of Arkansas for Medical Sciences, Little Rock, Arkansas. Dr. Santin joined the faculty in the Section of Gynecologic Oncology in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale University as Professor as of July 2008. Dr. Santin has more than 400 original research and peer-reviewed publications including multiple review articles and book chapters and he has written extensively on various topics, including cancer of the ovary, endometrium and cervix as well as on tumor immunology and immunotherapy. Dr. Santin's clinical interests include the use of immunotherapy in ovarian, cervical and endometrial carcinoma patients with disease resistant/refractory to standard treatment, therapeutic vaccines against Human Papillomavirus (HPV) infected genital tumors, and the development of personalized treatment modalities including monoclonal antibodies and antibody-drug-conjugates (ADC) against chemotherapy resistant gynecologic tumors. Highlights: In the TROPiCS-03 trial Sacituzumab Govitecan demonstrated encouraging clinical activity in recurrent endometrial cancer patients in progression after chemotherapy and immune check point inhibitors Sacituzumab Govitecan toxicity profile was manageable with only 5% of patients discontinuing treatment due to TRAEs TROP-2 protein was expressed in over 90% of endometrial cancer patients enrolled in the TROPiCS-03 trial and showed limited correlation with efficacy to Sacituzumab Govitecan

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Drs. Anne Knisely and Nitecki Wilke to discuss Racial and Sociodemographic Disparities with Novel Therapeutics. Dr. Knisely is a 3rd year gynecologic oncology fellow at MD Anderson Cancer Center. She is originally from the New York City area and completed her residency training in Ob/Gyn at Columbia University in 2022 where Dr. Jason Wright served as her primary research mentor. Her current research focuses on early phase clinical trials, minimal residual disease in ovarian cancer, and sociodemographic factors that affect oncologic treatment and outcomes. She is a current SGO/GOG-F BRIDGES Research Scholar. In her free time, she mostly chases around her two toddlers, Zoe (3.5) and Isaiah (2). Dr. Nitecki Wilke is a gynecologic oncologist and assistant professor at the department of gynecologic oncology and reproductive medicine at the University of Texas MD Anderson Cancer Center.   Highlights: Of the 6242 patients who met inclusion criteria and were included in the final cohort, 4.4% received a PARP inhibitor, 34% received bevacizumab, and 6% received both.  On multivariable analysis, non-Hispanic Black patients were 23% less likely than non-Hispanic white patients to receive either targeted therapy Most patients in the study were treated in the recurrent setting; we suspect that the potential barriers to guideline-concordant prescription of these therapeutics would persist in the upfront treatment setting, but future studies are required to validate this. A key area of focus to reduce disparities in access to targeted therapies should be ensuring adequate reimbursement for genetic/ biomarker testing as well as brainstorming creative solutions to expand access to genetic counseling, including the use of mainstreaming. Use of the SEER-Medicare database specifically reduces external validity of this study, but the results are nonetheless hypothesis generating and should spark conversation regarding potential inequitable receipt of PARP inhibitors and bevacizumab in advanced ovarian cancer

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Rongyu Zang and Yulian Chen to discuss the SOC-1 trial. Dr. Rongyu Zang is the Director of the Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, & Institute for Ovarian Cancer, Fudan University and is the Principal investigator of the SOC-1 and SUNNY trials. Dr. Yulian Chen is an Attending Physician at the Department of Gynecologic Oncology, Fudan University Zhongshan Hospital.   Highlights: The SOC-1 trial concluded that in patients with platinum-sensitive, relapsed ovarian cancer, surgery did not increase overall survival in the intention-to-treat population, but resulted in a prolongation of survival after adjustment of crossover. Surgery may provide an obviously higher proportion of long-term relapse-free survivors than chemotherapy alone. An active preoperative evaluation for all patients with platinum-sensitive first relapsed ovarian cancer is suggested in specialized centers.