Gynecologic oncology最新文献

{"title":"Implementation of enhanced recovery protocol did not increase rates of acute kidney injury in open gynecologic oncology surgery: A single-institution experience.","authors":"Brandon P Maddy, Kristin M Tischer, Michaela E McGree, Angela J Fought, Sean C Dowdy, Gretchen E Glaser","doi":"10.1016/j.ygyno.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.12.005","url":null,"abstract":"<p><strong>Objective: </strong>To compare the incidence of acute kidney injury (AKI) among patients undergoing gynecologic surgery before and after implementing an Enhanced Recovery After Surgery (ERAS) pathway.</p><p><strong>Methods: </strong>We conducted a retrospective review of medical records from Mayo Clinic during three time periods when ERAS was used, focusing on patients who underwent open gynecologic surgery. AKI was defined using Kidney Disease Improving Global Outcomes (KDIGO) criteria. We used inverse-probability of treatment weighting (IPTW) to adjust for baseline covariates between pre-ERAS (135 patients) and post-ERAS (486 patients) cohorts. Statistical comparisons were made using t-test, Wilcoxon rank-sum, chi-square or Fisher's exact test, and univariate logistic regression with odds ratio (OR) and 95 % confidence interval (CI).</p><p><strong>Results: </strong>Pre-IPTW, the AKI incidence was similar between cohorts (10.4 % vs 8.4 %, p = 0.48), and the odds of AKI for post-ERAS patients compared to pre-ERAS was not significant (OR 0.80, 95 % CI 0.42-1.51). After IPTW-adjustment, the AKI incidence remained comparable (10.3 % vs 8.1 %, p = 0.41), with the odds ratio unchanged (OR 0.76, 95 % CI 0.40-1.45). AKI patients were older (mean 67.0 vs 62.4 years, p < 0.01), had higher ASA scores (61.8 % vs 45.2 %, p = 0.02), lower preoperative hemoglobin (median 10.8 vs 12.5 g/dL, p < 0.01), longer surgeries (median 331 vs 222 min, p < 0.01), greater intraoperative blood loss (median 800 vs 500 mL, p < 0.01), more transfusions (56.4 % vs 29.3 %, p < 0.01), and higher fluid volumes (median 5750 vs 4165 mL, p < 0.01).</p><p><strong>Conclusion: </strong>The ERAS pathway did not significantly impact AKI incidence in gynecologic surgery patients. AKI remains associated with increased postoperative complications, highlighting the need for improved risk prediction and preventive strategies.</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"181-188"},"PeriodicalIF":4.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational trophoblastic neoplasm: Patient outcomes and clinical pearls from a multidisciplinary referral center.","authors":"Ying L Liu, Aaron M Praiss, Sarah Chiang, Kelly Devereaux, James Huang, Gabrielle Rizzuto, Duaa Al-Rawi, Britta Weigelt, Elizabeth Jewell, Nadeem R Abu-Rustum, Carol Aghajanian","doi":"10.1016/j.ygyno.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.12.009","url":null,"abstract":"<p><strong>Objectives: </strong>To describe clinical outcomes and pearls for patients with gestational trophoblastic neoplasm (GTN).</p><p><strong>Methods: </strong>Patients with GTN treated at a referral center from 1/2006 to 12/2022 were included. Clinical characteristics, World Health Organization risk score (low-risk 0-6, high-risk ≥7), and treatments/outcomes were evaluated using summary statistics, stratified by initial treatment at a referral center versus locally. Histologies included complete hydatidiform mole (CHM), partial hydatidiform mole (PHM), choriocarcinoma (CCA), placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT).</p><p><strong>Results: </strong>Of 189 patients with GTN, 125 were treated initially at a referral center and 64 locally. Median age at diagnosis was 34 years (range, 17-70). Most patients were White (n = 132, 70 %); 80 patients had CHM, 26 PHM, 52 CCA, 11 PSTT, 19 ETT, and 1 ETT/CCA. For low-risk GTN, first-line treatment was primarily methotrexate, although some were cured with repeat dilation and curettage. For high-risk disease, first-line therapy consisted of multiagent chemotherapy regimens at a referral center (n = 18/18) compared to 7 of 15 patients with high-risk GTN treated with methotrexate at local institutions. Patients with low-risk and high-risk disease who received initial care at a tertiary referral institution had cure rates of 100 % (n = 87/87) and 89 % (n = 16/18), respectively, while patients with initial care locally had cure rates of 87 % (n = 33/37) and 47 % (n = 7/15), respectively.</p><p><strong>Conclusion: </strong>GTN is a rare gynecologic malignancy with high cure rates, particularly in low-risk disease. Treatment consolidation at a tertiary referral institution is critical for improved outcomes, particularly in those with high-risk disease or PSTT/ETT.</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"171-177"},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Less is more: The benefits of reduced follow-up in gynecologic cancers.","authors":"Julien A M Vos, M Caroline Vos, Luc R C W van Lonkhuijzen, Lonneke V van de Poll-Franse, Nicole P M Ezendam","doi":"10.1016/j.ygyno.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.12.008","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"178-180"},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of exercise therapy on chemotherapy-induced peripheral neuropathy in patients with ovarian cancer: A scoping review.","authors":"Masanori Konuma, Tomohiro Ikeda, Tomohiro Mitoma, Shinsuke Shirakawa, Jota Maki, Yoshimi Katayama, Masanori Hamada, Shoji Nagao, Toshifumi Ozaki","doi":"10.1016/j.ygyno.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.12.007","url":null,"abstract":"<p><strong>Background & aims: </strong>Exercise therapy is a potentially beneficial treatment option for chemotherapy-induced peripheral neuropathy (CIPN). However, there is a lack of consensus on the management of CIPN in patients with ovarian cancer. The purpose of this scoping review was to evaluate the evidence on the effectiveness of exercise therapy in patients with ovarian cancer and explore key physical fitness parameters.</p><p><strong>Methods: </strong>A systematic electronic search was conducted using the MEDLINE, CINAHL, Web of Science, PEDro, and ClinicalTrials.gov databases. Two independent reviewers summarized the features and data from the literature regarding the effectiveness of exercise therapy for CIPN and the association between CIPN and physical fitness parameters.</p><p><strong>Results: </strong>Ten articles involving 3402 participants were reviewed. The study design included one randomized controlled trial, one single-arm trial, one prospective cohort study, five retrospective cohort studies, and two cross-sectional studies. The mean patient age was >60 years in three studies and 50-60 years in six studies. The mean body mass index was >25.0 kg/m² in six studies and not stated in four studies. In six references, patients received platinum and taxane-based chemotherapy. The effectiveness of an exercise therapy program for CIPN was reported in a randomized controlled trial. Two cross-sectional studies highlighted the association between daily physical inactivity and CIPN; two retrospective cohort studies showed an association between low skeletal muscle density and CIPN; one article demonstrated an association between physical dysfunction and CIPN.</p><p><strong>Conclusion: </strong>This scoping review indicates that although evidence is lacking, exercise intervention programs for CIPN in patients with ovarian cancer have potential benefits, especially when focused on daily physical activity, skeletal muscle density, and physical function.</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"155-162"},"PeriodicalIF":4.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and impact of vulvar lesions diagnosed prior to vulvar squamous cell carcinoma: A population-based cohort study.","authors":"Féline O Voss, Guus Fons, Annette H Bruggink, Hans H B Wenzel, Johannes Berkhof, Marc van Beurden, Maaike C G Bleeker","doi":"10.1016/j.ygyno.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.12.002","url":null,"abstract":"<p><strong>Objective: </strong>To systematically explore vulvar pathology diagnosed prior to vulvar squamous cell carcinoma (VSCC), as well as the association with tumor characteristics, stage and survival outcome, with the aim of improving vulvar cancer prevention strategies.</p><p><strong>Methods: </strong>VSCC diagnosed between 2005 and 2019 were identified from a population-based cohort provided by the Dutch Nationwide Pathology Databank. Pathology reports were reviewed to identify vulvar pathology diagnosed before primary VSCC. Data on treatment, tumor stage and survival were collected from the Netherlands Cancer Registry. Prior vulvar pathology was correlated to tumor characteristics and stage. Cox's proportional hazards model was used to assess the impact of clinicopathological variables on survival.</p><p><strong>Results: </strong>A total of 1036 VSCC patients were identified, of whom most (73 %) had no prior biopsy-confirmed vulvar pathology. High-grade squamous intraepithelial lesion (HSIL) and differentiated vulvar intraepithelial neoplasia (dVIN) were diagnosed prior to VSCC in only 8 % and 2 % of cancer patients, respectively, while adjacent HSIL and adjacent dVIN were reported in 35 % and 22 % of surgical VSCC resection specimens, respectively. The remaining 17 % had a benign vulvar pathology diagnosis prior to cancer. Patients showed advanced staged tumors in 15 % and 9 % of patients with prior HSIL and dVIN, respectively, as compared to 32 % in patients without prior vulvar pathology (p < 0.001). There was no independent association between prior vulvar pathology and survival outcomes.</p><p><strong>Conclusion: </strong>The vast majority of VSCC patients were not preceded by a pre-malignant lesion or other benign vulvar pathology, although such lesions were frequently identified adjacent to VSCC in resection specimens. Patients without prior vulvar pathology showed more advanced-stage tumors, which may contribute to less favorable outcomes.</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"163-170"},"PeriodicalIF":4.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of circulating tumor DNA at diagnosis and its early decrease after one cycle of neoadjuvant chemotherapy for patients with advanced epithelial ovarian cancer. An ancillary analysis of the CHIVA phase II GINECO trial.","authors":"Henri Azaïs, Camille Brochard, Valérie Taly, Louise Benoit, Gwenaël Ferron, Isabelle Ray-Coquard, Benoit You, Sophie Abadie-Lacourtoisie, Coriolan Lebreton, Laurence Venat, Christophe Louvet, Laure Favier, Cyriac Blonz, Nadine Dohollou, Emmanuelle Malaurie, Coraline Dubot, Jean-Emmanuel Kurtz, Eric Pujade-Lauraine, Etienne Rouleau, Alexandra Leary, Anne-Sophie Bats, Hélène Blons, Pierre Laurent-Puig","doi":"10.1016/j.ygyno.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.12.004","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prognostic impact of circulating tumor DNA (ctDNA) detection at diagnosis (T0) and its early decrease after one cycle (T1) of neoadjuvant chemotherapy (NACT) in patients with advanced epithelial ovarian cancer (EOC) included in the CHIVA trial (NCT01583322).</p><p><strong>Methods: </strong>Blood samples were collected at T0 and before each administration of NACT. Circulating tumor DNA detection was performed by next-generation sequencing. Multivariate analysis was performed. A p-value of 0.05 was considered significant. Progression-free survival (PFS) and overall survival (OS) were compared between groups defined by ctDNA kinetic profile. Cox survival model was used to search variables associated with PFS and OS. Kaplan-Mayer curve was used to graphically express the differences in PFS and OS. A log-rank test compared the two curves.</p><p><strong>Results: </strong>188 patients were included. Blood samples were available for 168 patients at T0 and for 160 patients at T0 and T1 to assess ctDNA ratio kinetics. At T0, 107 patients (63.7 %) had detectable ctDNA. At T1, 137 (85.6 %) patients had negative ctDNA or a decrease of more than 80 %. There was a significant benefit in either PFS (p = 0.0017) or OS (p = 0.0036) in favor of early decrease of ctDNA ratio. A favorable decrease was associated with a greater likelihood of being able to perform CRS (OR: 3.94 (CI95 % 1.45-10.70), p = 0.0074).</p><p><strong>Conclusions: </strong>Early decrease of ctDNA ratio can provide prognostic information early in the management of patients, allowing a more accurate information to patients and an early preparation for CRS (prehabilitation).</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"145-154"},"PeriodicalIF":4.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living in a food desert in Louisiana and its effects on gynecologic cancer outcomes.","authors":"Tina Nguyen, Yong Yi, Shawna Morron, Devin Brittain, Ryan Yates, Tara Castellano, Amelia Jernigan, Xiao-Cheng Wu, Navya Nair","doi":"10.1016/j.ygyno.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.12.001","url":null,"abstract":"<p><strong>Objective: </strong>Food insecurity is becoming recognized as an important measure of public health. Louisiana has a poorer health index and a higher food insecurity rate than the national average. This study aims to investigate how living in a food desert affects the stage at diagnosis and 5-year overall survival in patients with gynecologic cancers.</p><p><strong>Methods: </strong>Data on genital cancers diagnosed between 2015 and 2019 among Louisiana women aged 20 years and older were from the Louisiana Tumor Registry. The food desert data was based on the USDA Food Access Research Atlas (FARA). The covariates included in this study were race, age, insurance status, BMI, tobacco use, and Charlson Comorbidity Index. Univariate, multivariable logistic regression and Cox proportional hazard regression models were employed.</p><p><strong>Results: </strong>Food insecurity is independently associated with diagnoses at an advanced stage in patients with cervical and uterine cancer (OR = 1.41 [1.01, 1.96] and 1.28 [1.04, 1.58], respectively) after adjusting for covariates. This association was not observed in patients with ovarian cancer (OR = 0.94 [0.64, 1.39]). In evaluating overall survival at 5 years after initial diagnosis, patients living in a food desert have higher mortality rates across cervical, uterine, and ovarian cancers in the univariate analysis (OR = 1.27 [1.01, 1.60], 1.27 [1.07, 1.49], and 1.34 [1.10, 1.65], respectively); however, this significance is diminished in the multivariate analyses.</p><p><strong>Conclusions: </strong>Food insecurity affects gynecologic cancer morbidity and can offer an important point of intervention to increase cancer prevention initiatives and improve resources for underserved populations.</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"137-144"},"PeriodicalIF":4.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palbociclib plus letrozole in estrogen receptor-positive advanced/recurrent endometrial cancer: Double-blind placebo-controlled randomized phase II ENGOT-EN3/PALEO trial.","authors":"Mansoor R Mirza, Line Bjørge, Frederik Marmé, René DePont Christensen, Marta Gil-Martin, Annika Auranen, Beyhan Ataseven, Maria Jesús Rubio, Vanda Salutari, Adam A Luczak, Ingo B Runnebaum, Andrés Redondo, Kristina Lindemann, Fabian Trillsch, M Pilar Barretina Ginesta, Henrik Roed, Jean-Emmanuel Kurtz, Karen S Petersson, Gitte-Bettina Nyvang, Jalid Sehouli","doi":"10.1016/j.ygyno.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.12.003","url":null,"abstract":"<p><strong>Purpose: </strong>The CDK4/6 inhibitor palbociclib inhibits cyclin A, which is overexpressed in endometrial cancer. Combining palbociclib with endocrine therapy improves efficacy in hormone receptor-positive breast cancer. We investigated palbociclib combined with endocrine therapy for estrogen receptor-positive advanced/recurrent endometrial cancer.</p><p><strong>Patients and methods: </strong>This placebo-controlled double-blind, randomized phase II screening trial (NCT02730429) enrolled women with measurable/evaluable estrogen receptor-positive endometrioid endometrial cancer that was primary metastatic or had relapsed after ≥1 prior systemic therapy. Patients were randomized in a 1:1 ratio, stratified by number of prior chemotherapy lines, measurable versus evaluable non-measurable disease, and prior medroxyprogesterone/megestrol acetate treatment, to receive oral letrozole 2.5 mg on days 1-28 plus either oral palbociclib 125 mg or placebo on days 1-21, repeated every 28 days until disease progression or unacceptable toxicity. The primary end point was investigator-assessed progression-free survival (PFS).</p><p><strong>Results: </strong>Among 77 patients randomized between February 16, 2017, and December 21, 2018, 73 were treated (36 with palbociclib-letrozole, 37 with placebo-letrozole). Median follow-up was 21.9 (95 % CI, 16.7 to 22.3) months. Median PFS was 8.3 (95 % CI, 4.6 to 11.2) versus 3.1 (95 % CI, 2.7 to 6.8) months, respectively. In a landmark analysis at 12 months the PFS hazard ratio was 0.57 (95 % CI, 0.32 to 0.99; P = .044). Grade ≥ 3 adverse events were more common with palbociclib-letrozole (67 %) than placebo-letrozole (30 %), most commonly neutropenia (44 % v 0 %, respectively).</p><p><strong>Conclusion: </strong>These results support a potential role of the palbociclib-letrozole combination as treatment for hormone receptor-positive advanced/recurrent endometrial cancer. Based on these encouraging results, phase III evaluation of letrozole combined with a CDK4/6 inhibitor is planned.</p><p><strong>Clinical trial information: </strong>NCT02730429.</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"128-136"},"PeriodicalIF":4.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between genomic instability score and progression-free/overall survival in patients with newly diagnosed non-BRCA1/2 ovarian cancer.","authors":"Stephen Graves, Mackenzie W Sullivan, Anusha Adkoli, Qin Zhou, Alexia Iasonos, Pier Selenica, Carol Aghajanian, Ying L Liu, William Tew, Yukio Sonoda, Lora H Ellenson, Dennis Chi, Roisin E O'Cearbhaill, Britta Weigelt, Rachel N Grisham","doi":"10.1016/j.ygyno.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.11.011","url":null,"abstract":"<p><strong>Objective: </strong>We sought to describe the association between genomic instability score (GIS) and progression-free survival (PFS) and overall survival (OS) in patients with newly diagnosed, non-BRCA1/2 ovarian cancer.</p><p><strong>Methods: </strong>Homologous recombinant deficiency (HRD) status was based on a cutoff of ≥42 GIS; patients <42 were categorized with homologous recombination proficiency (HRP). We collected type and duration of maintenance therapy, among other variables, and built a multivariate model with landmark analysis at 6 months from baseline and applied it for time-dependent variables.</p><p><strong>Results: </strong>Increasing GIS as a continuous variable was associated with improved PFS and OS in our cohort. Overall, median PFS was significantly longer in patients with HRD ovarian cancer (35.4 months, 25.4-NE) than in those with HRP disease (14.9 months, 13.1-16.2; p < 0.001). Median OS was 36.2 months (32.4-NE) for HRP and not reached for HRD (p = 0.002). Notably, in patients with HRP ovarian cancer, we observed a shorter median PFS in those who received a poly (adenosine diphosphate-ribose) polymerase inhibitor (PARPi) than in those who did not (12.7 months for HRP with PARPi vs 15.2 months for HRP without PARPi).</p><p><strong>Conclusions: </strong>Our results demonstrate that in newly diagnosed advanced non-BRCA1/2 ovarian cancer, GIS as a continuous variable is associated with longer PFS and OS. In patients with HRP ovarian cancer, PARPi treatment may be associated with shorter PFS, which warrants further evaluation.</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"120-127"},"PeriodicalIF":4.5,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical trial screening in gynecologic oncology: Defining the need and identifying best practices.","authors":"T Castellano, O D Lara, C McCormick, D Chase, V BaeJump, A L Jackson, J T Peppin, S Ghamande, K N Moore, B Pothuri, T J Herzog, T Myers","doi":"10.1016/j.ygyno.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.11.009","url":null,"abstract":"<p><strong>Background: </strong>Evidence is limited in gynecologic cancers on best practices for clinical trial screening, but the risk of ineffective screening processes and subsequent under-enrollment introduces significant cost to patient, healthcare systems, and scientific advancement. Absence of a defined screening process makes determination of who and when to screen potential patients inconsistent allowing inefficiency and potential introduction of biases. This is especially germane as generative artificial intelligence (AI), and electronic health record (EHR) integration is applied to trial screening. Though often a requirement of cooperative groups such as the Cancer therapy Evaluation Program (CTEP), and/or the Commission on Cancer (CoC), there are no standard practice guidelines on best practices regarding screening and how best to track screening data.</p><p><strong>Development of manuscript: </strong>The authors provided a review of current clinical trial screening practices and the effect on enrollment and trial activation across a variety of disease and practice sites. Established clinical trial screening practices and evidence supporting emerging strategies were reviewed and reported. Due to lack of published literature in gynecologic oncology, authors sought to survey the members of current rostered GOG sites to provide perspectives on clinical trial screening practices. Survey results showed a variety of screening practices. Most respondents participate in some type of manual screening process, where approximately 13 % also report incorporating AI or EHR integration. Over half (60 %) of sites track screening data to use for feasibility when opening new trials. The rapid increase in generative AI, EHR integration, and site agnostic screening initiatives could provide a significant opportunity to improve screening efficiency, translating to improved enrollment, but limitations and barriers remain.</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"192 ","pages":"111-119"},"PeriodicalIF":4.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}