Gynecologic oncology最新文献

{"title":"A phase 2 trial of pembrolizumab for recurrent Lynch-like versus sporadic endometrial cancers with microsatellite instability (NCT02899793): Updated survival and response analyses","authors":"Victoria M. Ettorre ,&nbsp;Stefania Bellone ,&nbsp;Michelle Greenman ,&nbsp;Blair McNamara ,&nbsp;Luca Palmieri ,&nbsp;Namrata Sethi ,&nbsp;Cem Demirkiran ,&nbsp;Katyayani Papatla ,&nbsp;Aparna Kailasam ,&nbsp;Eric R. Siegel ,&nbsp;Elena Ratner ,&nbsp;Alessandro D. Santin","doi":"10.1016/j.ygyno.2025.04.591","DOIUrl":"10.1016/j.ygyno.2025.04.591","url":null,"abstract":"<div><h3>Objective</h3><div>Microsatellite instability-high (MSI-H)/mismatch repair deficiency (dMMR) is a biomarker for response to immune checkpoint inhibitors. We report updated results including objective response rate, progression free survival, and overall survival data with 5-year follow-up in recurrent platinum-resistant, MSI-H, endometrial cancer (EC) patients fully sequenced using whole exome sequencing (WES) and treated within a prospective phase II study with pembrolizumab (<span><span>NCT02899793</span><svg><path></path></svg></span>).</div></div><div><h3>Methods</h3><div>Tumors from patients with measurable MSI-H/dMMR endometrial cancer confirmed by immunohistochemistry, polymerase chain reaction, and MLH-1 methylation assays were sequenced using whole exome sequencing and the FoundationOne platform for the identification of Lynch, Lynch-like, and MLH-1 methylated characteristics before receiving pembrolizumab 200 mg every 3 weeks for up to 24 months. The primary endpoint was objective response rate (ORR), and secondary endpoints were progression free survival (PFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>After almost 97 person-years of follow-up, the Lynch-like subgroup (<em>n</em> = 6) of MSI-H/dMMR patients continues to exhibit better ORR than the methylated (<em>n</em> = 18) subgroup (100 % versus 44 %, Fisher's exact <em>P</em> = 0.024), as well as improved PFS (unreached for Lynch-like versus 14.6 months, Log-Rank <em>P</em> = 0.005) and improved OS (unreached for Lynch-like versus 32.6 months, Log-Rank <em>P</em> = 0.058). Toxicity was manageable in both groups of MSI-H patients.</div></div><div><h3>Conclusion</h3><div>Mature follow-up results continue to suggest the prognostic significance of Lynch-like versus methylated MSI-H/dMMR features in endometrial cancer patients treated with pembrolizumab in terms of ORR, PFS, and OS. Stratification for these translational aspects may be warranted in future clinical trials with immune checkpoint inhibitors in MSI-H/dMMR endometrial cancer patients.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 110-115"},"PeriodicalIF":4.5,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906637","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":"Impact of mismatch repair (MMR) status on recurrence in high intermediate risk endometrial cancer","authors":"Kelsey Jean Keverline,&nbsp;Breana Hill,&nbsp;Marianne Hom-Tedla,&nbsp;Marni Jacobs,&nbsp;Ramez N. Eskander","doi":"10.1016/j.ygyno.2025.04.588","DOIUrl":"10.1016/j.ygyno.2025.04.588","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 25 % of endometrial cancers harbor deficiencies in mismatch repair (dMMR). The clinical impact of this molecular aberration remains undefined in patients with high intermediate risk (HIR) endometrial cancer.</div></div><div><h3>Methods</h3><div>We conducted a retrospective chart review of women diagnosed with Stage I high-intermediate risk endometrioid endometrial cancer in two hospital systems in Southern California between 2016 and 2018. We collected demographic information, mismatch repair status, pathology reports, and time to recurrence.</div></div><div><h3>Results</h3><div>244 patients met inclusion criteria, of which 86 (35 %) were found to be dMMR. The dMMR patient population had higher relative risks of lymphovascular space invasion (relative risk 1.63, 95 % confidence interval 1.26–2.10, <em>p</em>-value 0.0002) but were less likely to have deep myometrial invasion (relative risk 0.81, 95 % confidence interval 0.66–0.99, <em>p</em>-value 0.047) when compared to the pMMR EC cohort. No differences were found in the rate of recurrence or time to recurrence based on MMR status.</div></div><div><h3>Conclusions</h3><div>In this large, multi-institution, cohort study there were no significant differences identified between Stage I HIR dMMR and pMMR endometrioid endometrial cancer populations with regards to recurrence rates or alternate cancer-related outcomes.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 116-120"},"PeriodicalIF":4.5,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906638","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 of endometrial cancer epigenetic mismatch repair deficiency with clinicopathologic factors and survival in a large, diverse community-based cohort","authors":"Elizabeth Suh-Burgmann ,&nbsp;Yun-Yi Hung ,&nbsp;Holly Finertie ,&nbsp;Haoyuan Zhong ,&nbsp;Michael Bookman ,&nbsp;Claudia Nau ,&nbsp;Julie Schmittdiel","doi":"10.1016/j.ygyno.2025.04.584","DOIUrl":"10.1016/j.ygyno.2025.04.584","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate associations between epigenetic mismatch repair deficiency (MMRd), clinicopathologic factors and overall survival in a diverse endometrial cancer cohort.</div></div><div><h3>Methods</h3><div>Retrospective analysis of patients with endometrioid cancer whose tumor mismatch repair status was classified by a universal screening program. Associations between epigenetic MMRd, race, other patient characteristics, tumor grade, and stage were assessed using multivariate regression. The Kaplan-Meier method and Cox regression were used to evaluate the association between epigenetic MMRd and overall survival, stratified by receipt of adjuvant therapy.</div></div><div><h3>Results</h3><div>Among 6477 patients, 14.3 % were found to have MMRd tumors due to epigenetic promoter hypermethylation. Compared to MMR proficient (MMRp) tumors, epigenetic MMRd was associated with age ≥ 70 (<em>P</em> &lt; 0.001) and obesity (<em>P</em> = 0.03) but not smoking or comorbidity burden and were less common in Hispanic patients (<em>P</em> &lt; 0.01) and individuals of lower socioeconomic status (<em>P</em> &lt; 0.001). Epigenetic MMRd was associated with non-localized stage independent of tumor grade (aOR 1.28, 95 % CI 1.05–1.55, <em>P</em> = 0.01) and lower survival among the 4754 (73 %) patients not treated with any adjuvant therapy (HR 1.44, 95 % CI 1.09–2.01, <em>P</em> = 0.02) but not among 1723 (27 %) who received adjuvant chemotherapy, radiotherapy and/or immunotherapy (HR 0.89, 95 % CI 0.60–1.33, <em>P</em> = 0.56).</div></div><div><h3>Conclusion</h3><div>In a diverse community-based cohort, epigenetic MMRd characterized 14.3 % of endometrioid endometrial cancers and was associated with older age, obesity, and higher socioeconomic status. Controlling for these factors, epigenetic MMRd tumors were less common among Hispanic patients. Epigenetic MMRd was associated with non-localized stage independent of tumor grade and lower survival among patients who did not receive adjuvant therapy.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 102-109"},"PeriodicalIF":4.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903739","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":"Diverting ileostomy: An ounce of prevention, but when?","authors":"Stuart A. Ostby,&nbsp;William A. Cliby","doi":"10.1016/j.ygyno.2025.04.593","DOIUrl":"10.1016/j.ygyno.2025.04.593","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"196 ","pages":"Pages A1-A3"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089279","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":"Molecular subgroup-specific prognostic value of semiquantitative lymphovascular space invasion in early-stage endometrioid endometrial cancer","authors":"Mikko Loukovaara ,&nbsp;Annukka Pasanen ,&nbsp;Ralf Bützow","doi":"10.1016/j.ygyno.2025.04.589","DOIUrl":"10.1016/j.ygyno.2025.04.589","url":null,"abstract":"<div><h3>Objective</h3><div>Molecular subgroups of endometrial carcinoma represent distinct disease entities, prompting subgroup-specific stratification. Recognizing lymphovascular space invasion (LVSI) as a key parameter in risk assessment, this study evaluates 3-tiered LVSI as a molecular subgroup-specific prognostic factor in stage I–II endometrioid endometrial cancer.</div></div><div><h3>Methods</h3><div>This retrospective study included patients treated at a single tertiary center. Immunohistochemistry and polymerase-ϵ (<em>POLE</em>) sequencing were conducted for molecular classification and determination of estrogen receptor and L1 cell adhesion molecule (L1CAM) expression.</div></div><div><h3>Results</h3><div>Among 843 eligible patients (median follow-up: 70 months), survival outcomes differed by molecular subgroup (<em>P</em> &lt; 0.001 for progression-free survival and disease-specific survival). In MMRd carcinomas (<em>n</em> = 364), both focal (<em>P</em> &lt; 0.001) and substantial (P &lt; 0.001) LVSI were associated with poor progression-free survival. In NSMP carcinomas (<em>n</em> = 359), only substantial LVSI (<em>P</em> &lt; 0.001) was prognostic (focal: <em>P</em> = 0.480). In p53abn carcinomas (<em>n</em> = 62), neither focal (<em>P</em> = 0.248) nor substantial (<em>P</em> = 0.484) LVSI showed prognostic significance. These findings remained after bivariate adjustments for stage (IA vs. IB vs. II), grade (low vs. high), estrogen receptor expression (3-tiered scale), L1CAM expression, age, and adjuvant therapy. Analysis was unfeasible for <em>POLE</em> ultramutated tumors (<em>n</em> = 58) due to a single progression.</div></div><div><h3>Conclusion</h3><div>The prognostic impact of 3-tiered LVSI varied by molecular subgroup in stage I–II endometrioid endometrial cancer, highlighting the need for subgroup-specific risk assessment to improve individualized counceling on treatment decisions and risk of progression.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 96-101"},"PeriodicalIF":4.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890806","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":"Oncologic outcomes of minimally invasive surgery vs. abdominal hysterectomy in patients with low-risk, early-stage cervical cancer: A retrospective analysis of KGOG 1028 data based on SHAPE trial eligibility criteria","authors":"Jaekyung Bae ,&nbsp;Uisuk Kim ,&nbsp;E. Sun Paik ,&nbsp;Myong Cheol Lim ,&nbsp;Moon-Hong Kim ,&nbsp;Yun Hwan Kim ,&nbsp;Eun Seop Song ,&nbsp;Seok Ju Seong ,&nbsp;Dong Hoon Suh ,&nbsp;Jong-Min Lee ,&nbsp;Chulmin Lee ,&nbsp;Chel Hun Choi ,&nbsp;Sokbom Kang","doi":"10.1016/j.ygyno.2025.04.582","DOIUrl":"10.1016/j.ygyno.2025.04.582","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the oncologic outcomes of minimally invasive surgery (MIS) and abdominal hysterectomy in patients with low-risk, early-stage cervical cancer, based on the SHAPE trial eligibility criteria.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed data from the Korean Gynecologic Oncology Group (KGOG) 1028 cohort, including patients with 2009 FIGO stage IB1 cervical cancer who met SHAPE trial criteria and underwent MIS or abdominal hysterectomy. Disease-free survival (DFS) was the primary outcome, whereas secondary outcomes included pelvic recurrence rates and prognostic factors influencing DFS.</div></div><div><h3>Results</h3><div>A total of 508 patients were included (82 in the MIS group and 426 in the abdominal hysterectomy group). The MIS group had significantly shorter DFS (median, 55.4 vs. 66.5 months, <em>P</em> = 0.024) and a higher pelvic recurrence rate (6.10 % vs. 1.88 %, P = 0.024). Multivariable Cox regression analysis identified MIS as an independent predictor of recurrence (HR, 3.26; 95 % CI, 1.054–10.061; <em>P</em> = 0.040), along with a larger tumor size (HR, 3.65 per 1 cm increase; 95 % CI, 1.300–9.854; <em>P</em> = 0.011) and older age (HR, 1.05 per year; 95 % CI, 1.002–1.096; <em>P</em> = 0.043).</div></div><div><h3>Conclusions</h3><div>Even in low-risk, early-stage cervical cancer patients meeting SHAPE trial criteria, MIS was associated with shorter DFS and a higher pelvic recurrence risk than abdominal hysterectomy. These findings are consistent with concerns raised by the LACC trial, suggesting a potential oncologic disadvantage of MIS. Further prospective, randomized studies with standardized patient selection are needed to validate these results and guide decision-making.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 91-95"},"PeriodicalIF":4.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888080","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":"Maintenance olaparib monotherapy in patients with platinum-sensitive relapsed ovarian cancer without a germline BRCA1 and/or BRCA2 mutation: Final overall survival results from the OPINION trial","authors":"Andrés Poveda ,&nbsp;Stéphanie Lheureux ,&nbsp;Nicoletta Colombo ,&nbsp;David Cibula ,&nbsp;Mari Elstrand ,&nbsp;Johanne Weberpals ,&nbsp;Maria Bjurberg ,&nbsp;Ana Oaknin ,&nbsp;Magdalena Sikorska ,&nbsp;Antonio González-Martín ,&nbsp;Radoslaw Madry ,&nbsp;María Jesus Rubio Pérez ,&nbsp;Jonathan Ledermann ,&nbsp;Ignacio Romero ,&nbsp;Ozan Özgören ,&nbsp;Alan Barnicle ,&nbsp;Helen Marshall ,&nbsp;Zahid Bashir ,&nbsp;Erik Škof","doi":"10.1016/j.ygyno.2025.04.580","DOIUrl":"10.1016/j.ygyno.2025.04.580","url":null,"abstract":"<div><h3>Objective</h3><div>Maintenance olaparib demonstrated clinical activity for progression-free survival in patients without a germline <em>BRCA1</em> and/or <em>BRCA2</em> mutation (non-gBRCAm) who had platinum-sensitive relapsed ovarian cancer in the phase IIIb, open-label, single-arm, non-comparator, international OPINION trial (<span><span>NCT03402841</span><svg><path></path></svg></span>). We report final overall survival (OS; secondary endpoint), prespecified secondary endpoint updates and <em>ad hoc</em> OS analysis by homologous recombination deficiency (HRD) and somatic BRCAm (sBRCAm) status.</div></div><div><h3>Methods</h3><div>Patients with non-gBRCAm platinum-sensitive relapsed ovarian cancer, ≥2 prior lines of platinum-based chemotherapy, and in response following their last platinum-based chemotherapy received 300 mg olaparib tablets twice daily until disease progression or unacceptable toxicity.</div></div><div><h3>Results</h3><div>279 patients were enrolled and treated. With a median follow-up in patients censored for OS of 33.1 months (data cut-off September 17, 2021), median OS was 32.7 months (95 % CI 29.5–35.3); the 24-month OS rate was 65.8 %. In <em>ad hoc</em> subgroup analyses, OS rates tended to be higher in patients with HRD-positive tumors; 24-month OS rates were 81.5 %, 74.2 %, 72.0 % and 55.8 % in the sBRCAm, HRD-positive including sBRCAm, HRD-positive excluding sBRCAm, and HRD-negative subgroups, respectively. Grade ≥ 3 treatment-emergent adverse events were reported in 82 patients (29.4 %), most commonly anemia (13.6 %). Overall, two cases of myelodysplastic syndrome were reported (no new cases since the primary analysis).</div></div><div><h3>Conclusion</h3><div>These data provide additional evidence of olaparib as maintenance therapy in patients with non-gBRCAm platinum-sensitive relapsed ovarian cancer, with longer OS observed in those with HRD-positive tumors. The safety profile was consistent with the primary analysis and known safety profile of olaparib, with no new safety findings.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 74-82"},"PeriodicalIF":4.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878627","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":"Pathogenic germline variants among women with uterine cancer by ancestry: A commercial laboratory collaborative research registry study","authors":"Caitlin R. Johnson ,&nbsp;Chinmayi Aryasomayajula ,&nbsp;Alex A. Francoeur ,&nbsp;Chelsea Stewart ,&nbsp;Tiffany Y. Sia ,&nbsp;Kathleen M. Darcy ,&nbsp;Chunqiao Tian ,&nbsp;Daniel S. Kapp ,&nbsp;Ying L. Liu ,&nbsp;John K. Chan","doi":"10.1016/j.ygyno.2025.04.585","DOIUrl":"10.1016/j.ygyno.2025.04.585","url":null,"abstract":"<div><h3>Objective</h3><div>Uterine cancer (UC) is the most common gynecologic cancer in the United States, and 5–15 % of patients harbor a germline pathogenic variant (gPV) in a cancer predisposition gene. This study aims to characterize the germline landscape of patients with UC by self-identified ancestry.</div></div><div><h3>Methods</h3><div>Patients with UC who received germline testing were identified from the publicly available Myriad Collaborative Research Registry. Rates of gPVs were calculated, overall and by self-reported ancestry, with a focus on genes associated with UC, including Lynch syndrome (LS) and homologous recombination-related (HR) genes.</div></div><div><h3>Results</h3><div>Among 35,310 patients with UC, 23,081 (65.4 %) identified as White, 3683 (10.4 %) as Hispanic, 2132 (6.0 %) as Black, 1244 (3.5 %) as Ashkenazi Jewish (AJ), 1093 (3.1 %) as Asian, and 7550 (21.4 %) as Other. Overall, 5141 (14.6 %) patients had a gPV, with highest rates among White (15.5 %) and Asian (17.8 %) compared to Black (10.4 %) and Hispanic (11.6 %) patients, <em>p</em> &lt; 0.0001. LS gPVs were observed in 3155 (8.9 %) patients and was most prevalent in Asian women (12.9 %), particularly <em>MLH1</em> and <em>MSH2</em>-associated LS. HR-related gPVs were found in 1066 (3.0 %) patients overall and were most common in AJ (4.1 %) and Black (4.0 %) patients, with high rates of <em>BRCA1/2</em> gPVs in AJ patients and non-<em>BRCA</em> HR-related gPVs in Black patients.</div></div><div><h3>Conclusions</h3><div>Of the over 35,000 patients with UC, 14.5 % had a gPV identified, supporting consideration of universal germline testing in endometrial cancer given high actionability. We observed heterogeneity in gPVs by self-reported ancestry with Black and Hispanic patients having the lowest rates, potentially contributing to disparities in UC.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 83-90"},"PeriodicalIF":4.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883106","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":"Impact of adding the immune checkpoint inhibitor atezolizumab to first-line chemotherapy on progression-free survival in poor-prognosis ovarian cancer: A retrospective analysis from the IMagyn050 trial","authors":"Benoit You ,&nbsp;Charles Anderson ,&nbsp;Sabrina Chiara Cecere ,&nbsp;Aurore Carrot ,&nbsp;Tashanna Myers ,&nbsp;Florian Heitz ,&nbsp;Sudarshan Sharma ,&nbsp;Fatih Selçukbiricik ,&nbsp;Carol Aghajanian ,&nbsp;Josefin Fernebro ,&nbsp;Stephanie Blank ,&nbsp;Maria Elena Laudani ,&nbsp;Premal H. Thaker ,&nbsp;Mayu Yunokawa ,&nbsp;Lyndsay Willmott ,&nbsp;Alla Lisyanskaya ,&nbsp;Roberto Hegg ,&nbsp;Yvette He ,&nbsp;Charles Landen ,&nbsp;Yvonne G. Lin ,&nbsp;Kathleen N. Moore","doi":"10.1016/j.ygyno.2025.04.577","DOIUrl":"10.1016/j.ygyno.2025.04.577","url":null,"abstract":"<div><h3>Purpose</h3><div>Adding the anti-PD-L1 antibody atezolizumab to frontline chemotherapy-bevacizumab regimen did not improve progression-free survival (PFS) in ovarian cancer (OC) patients in IMagyn050 trial. This post-hoc analysis assessed the efficacy of atezolizumab in a subgroup of patients with particularly poor prognosis, as defined by the GCIG meta-analysis—characterized by a poor chemosensitivity and a suboptimal surgical resection.</div></div><div><h3>Methodology</h3><div>This analysis included 1199 evaluable participants with ≥3 available CA-125 concentrations, as required for KELIM score. The prognostic factors were identified through univariable and multivariable analyses. If both the KELIM score (unfavorable &lt;1.0, vs favorable ≥1.0) and surgical outcome (suboptimal, vs optimal resection) demonstrated independent prognostic value, they were to be combined into prognostic subgroups. The PFS benefit of atezolizumab versus placebo was then evaluated within each of these defined subgroups.</div></div><div><h3>Results</h3><div>Both the KELIM score and surgical outcome were independent prognostic factors. Combining these two parameters generated three distinct prognostic subgroups. In the poor prognosis subgroup (<em>n</em> = 269), defined by both an unfavorable KELIM score (&lt;1.0) and suboptimal cytoreduction, the addition of atezolizumab was associated with a significantly longer median PFS compared to placebo (14.3 vs 11.3 months; HR 0.75, 95 % CI 0.59–0.95). This benefit was observed in both neoadjuvant and adjuvant settings. No significant PFS benefit was observed in the other prognostic subgroups.</div></div><div><h3>Conclusion</h3><div>The poor prognostic OC patient subgroup, may have an extension of PFS from treatment intensification with atezolizumab added to frontline chemotherapy-bevacizumab regimen. This hypothesis-generating outcome warrants further understanding on the added role of ICI in the frontline setting.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 66-73"},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869896","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":"Mesonephric-like adenocarcinoma of the female genital tract: Pathologic diagnosis, clinical outcomes, and novel therapeutics","authors":"Kari L. Ring ,&nbsp;Anne M. Mills ,&nbsp;Brooke E. Howitt ,&nbsp;Rachel N. Grisham ,&nbsp;Elizabeth D. Euscher ,&nbsp;Hyun-Soo Kim ,&nbsp;Ann H. Klopp ,&nbsp;David L. Kolin ,&nbsp;W. Glenn McCluggage ,&nbsp;Jelena Mirkovic ,&nbsp;Kay J. Park ,&nbsp;Eliane Aoun ,&nbsp;Chika Awujo ,&nbsp;Ji Son ,&nbsp;Samuel C. Mok ,&nbsp;Sammy Ferri-Borgogno ,&nbsp;David S. Hong ,&nbsp;Lien Hoang ,&nbsp;Amir A. Jazaeri ,&nbsp;Jeffrey A. How ,&nbsp;Karen H. Lu","doi":"10.1016/j.ygyno.2025.04.583","DOIUrl":"10.1016/j.ygyno.2025.04.583","url":null,"abstract":"<div><div>In 2016, McCluggage and colleagues first defined mesonephric-like adenocarcinoma (MLA) of the uterus and extra-uterine sites. Following this initial description, the World Health Organization officially recognized MLA as a type of uterine and ovarian carcinoma and subsequent studies have further refined the morphologic definition, immunohistochemical profile, molecular underpinnings, and clinical behavior in this rare entity. A consortium of pathologists, gynecologic oncologists, medical oncologists, radiation oncologists, as well as basic science collaborators with expertise in MLA was convened to develop consensus regarding the pathologic diagnosis, and to identify unanswered questions and priority areas for research. Here, we review the current understanding of MLA from a pathologic, molecular, and clinical standpoint.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 57-65"},"PeriodicalIF":4.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869910","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}