Gynecologic Oncology Reports最新文献

{"title":"Interval debulking with HIPEC in patient with VP shunt","authors":"R. Shanoada,&nbsp;J. Stephens,&nbsp;Z.R. Al-Wahab","doi":"10.1016/j.gore.2026.102173","DOIUrl":"10.1016/j.gore.2026.102173","url":null,"abstract":"<div><h3>Background</h3><div>Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery has demonstrated survival benefits in advanced ovarian cancer. However, the safety of HIPEC administration in patients with indwelling ventriculoperitoneal (VP) shunts remains unknown, as no prior cases have been reported. Theoretical risks include shunt infection, chemical ventriculitis, and potential central nervous system (CNS) metastasis via retrograde flow through the shunt catheter. The absence of established management guidelines poses a significant challenge for clinicians treating ovarian cancer patients with concurrent VP shunts.</div></div><div><h3>Case Presentation</h3><div>A 60-year-old G1P1 with a 6-year history of a programmable VP shunt for hydrocephalus secondary to cerebellar <u>hemangioblastoma</u> presented with high-grade serous ovarian carcinoma, FIGO stage IIIA2. Following neoadjuvant chemotherapy, she underwent interval debulking surgery with cisplatin-based HIPEC. A multidisciplinary approach was employed: neurosurgery externalized the VP shunt catheter from the peritoneal cavity and wrapped it in metronidazole-soaked gauze during HIPEC administration and the shunt was replaced at case completion. Postoperative vancomycin, cefepime, and metronidazole were provided for five days for meningitis prophylaxis. The patient experienced no shunt-related complications and was discharged on postoperative day 4. At 10-month follow-up, she demonstrated excellent oncologic response with CA-125 normalization and no evidence of shunt malfunction or CNS involvement.</div></div><div><h3>Conclusion</h3><div>This case demonstrates that HIPEC can be safely performed in patients with indwelling VP shunts when a multidisciplinary strategy incorporating intraoperative shunt externalization and antimicrobial prophylaxis is utilized. This approach expands treatment options for ovarian cancer patients with VP shunts who may otherwise be excluded from potentially beneficial HIPEC therapy.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102173"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148625058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary ovarian synovial sarcoma in an adolescent mimicking a germ cell tumor: A case report and diagnostic challenge","authors":"Dyah Listyaningtyas,&nbsp;Hari Nugroho,&nbsp;Bagus Ngurah Brahmantara,&nbsp;Heriyawati,&nbsp;Ayu Farikha Nandiaty","doi":"10.1016/j.gore.2026.102172","DOIUrl":"10.1016/j.gore.2026.102172","url":null,"abstract":"<div><h3>Background</h3><div>Primary ovarian synovial sarcoma is an exceedingly rare malignancy that may mimic more common ovarian tumors, particularly in adolescents, posing significant diagnostic challenges.</div></div><div><h3>Case presentation</h3><div>A 14-year-old girl presented with progressive abdominal distension and respiratory compromise. Imaging revealed a large mixed solid–cystic adnexal mass with ascites and pleural effusion. Serum CA-125 was elevated, while AFP and CEA were normal. The patient underwent right salpingo-oophorectomy and omentectomy. Histopathology showed a monophasic spindle cell neoplasm with focal cartilaginous differentiation. Immunohistochemistry demonstrated diffuse nuclear positivity for SS18 and TLE1, with co-expression of BCL-2, CD99, and EMA, while inhibin, calretinin, and WT-1 were negative. The positive SS18 immunohistochemical staining provided additional diagnostic confirmation of synovial sarcoma, supporting the diagnosis in conjunction with the characteristic histopathologic findings. The patient deteriorated rapidly and died before initiation of chemotherapy.</div></div><div><h3>Conclusion</h3><div>Primary ovarian synovial sarcoma is a rare and aggressive tumor that can mimic germ cell neoplasms. Accurate diagnosis requires careful integration of histopathology and immunohistochemistry. Although molecular confirmation remains the diagnostic gold standard, SS18 fusion-specific immunohistochemistry provides a reliable diagnostic surrogate when molecular testing is unavailable.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102172"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148625077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world clinical outcomes of Trastuzumab Deruxtecan in HER2-expressing ovarian and endometrial Cancer","authors":"Jordyn Silverstein,&nbsp;Oladunni Alomaja,&nbsp;Deandra Chatram,&nbsp;Maryam Hajiabbasi,&nbsp;Eliya Shachar,&nbsp;Chi-Hong Tseng,&nbsp;Shivani Thaker,&nbsp;Aditya Bardia,&nbsp;Beth Karlan,&nbsp;Andrea Wahner Hendrickson,&nbsp;Gottfried E. Konecny","doi":"10.1016/j.gore.2026.102183","DOIUrl":"10.1016/j.gore.2026.102183","url":null,"abstract":"<div><div><strong>Objective</strong></div><div>Trastuzumab deruxtecan (T-DXd), a HER2-directed antibody-drug conjugate, received FDA approval on April 5, 2024 for HER2-expressing solid tumors based on the phase II DESTINY-PanTumor02 trial (<em>n</em> = 40 per tumor type). Despite rapid clinical adoption, real-world evidence in gynecologic cancers remains limited. This study aims to address this gap.</div><div><strong>Methods</strong></div><div>This single-center retrospective cohort study included patients with ovarian cancer (OC) or endometrial cancer (EC) who received T-DXd between September 2022 and January 2026. Primary outcomes were real-world progression free survival (rwPFS) and real-world response rate (rwRR). Secondary outcomes included real-world disease control rate (rwDCR), safety, and time on treatment (TOT). Exploratory analysis aimed to evaluate predictors of progression or death on T-DXd using multivariate cox regression.</div><div><strong>Results</strong></div><div>As of February 2026, 40 patients (20 OC, 20 EC) received T-DXd, with a median follow-up of 23 months. All 40 were analyzed for PFS; 37 were response evaluable. HER2 IHC expression was 12.5% 1+, 62.5% 2+, and 20% 3+. Median rwPFS was 6.2 months (95% CI, 3.3–8.6), with a rwRR of 45.9% and rwDCR of 67.6%. rwRR increased significantly with HER2 expression (1+ 16.7%, 2+ 39.1%, 3+ 86%, <em>p</em> = 0.03). In multivariate analysis, PARP inhibitor exposure was associated with significantly shorter PFS (HR 4.36, <em>p</em> = 0.04). Four patients (10%) developed pneumonitis: three (7.5%) grade 1/2, and one (2.5%) grade 3.</div></div><div><h3>Conclusions</h3><div>T-DXd demonstrated promising real-world clinical outcomes in OC and EC that mirror DESTINY-PanTumor02. Responses were observed across HER2 IHC expression levels (1+ to 3+), with highest rwRR among HER2 3+. Prior PARP inhibitor exposure was associated with significantly shorter PFS, warranting further exploration.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102183"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-treatment ctDNA dynamics in locally advanced cervical cancer: pilot study from a safety-net hospital","authors":"Maya Yasukawa,&nbsp;Adrian Kohut,&nbsp;Diana C. Joseph,&nbsp;Jaisa Miller,&nbsp;Nicole Hurtado,&nbsp;Nancy Preston,&nbsp;Chrissy Liu,&nbsp;Lindsey Nguy,&nbsp;Vaagn Andikyan,&nbsp;Thomas Rutherford,&nbsp;Matthew L. Anderson","doi":"10.1016/j.gore.2026.102186","DOIUrl":"10.1016/j.gore.2026.102186","url":null,"abstract":"<div><h3>Objective</h3><div>Real-time kinetics of circulating tumor DNA (ctDNA) during active concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC) remain poorly characterized. We evaluated peri-treatment ctDNA dynamics in a real-world safety-net cohort using a commercially available tumor-informed assay.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed serial ctDNA measurements (Signatera) in 17 LACC patients who underwent definitive CCRT, with or without induction chemotherapy and immune checkpoint inhibitor therapy. Patients were classified by longitudinal ctDNA kinetics as Sustained clearance, Persistent/<em>Re</em>-positive, or Negative.</div></div><div><h3>Results</h3><div>Baseline ctDNA was detectable in 15 of 17 patients (88%); patients were classified as Sustained clearance (<em>n</em> = 8), Persistent/<em>Re</em>-positive (<em>n</em> = 7), or Negative (<em>n</em> = 2). With mean follow-up of 273 ± 148 days, all 5 clinical recurrences occurred in the Persistent/<em>Re</em>-positive group (5/7 vs 0/8; Fisher's exact <em>P</em> = 0.007), representing a strong but preliminary association. Among 8 non-induction-treated patients with detectable baseline ctDNA and ≥ 2 assessments spanning baseline and intra-CCRT, molecular clearance during active CCRT occurred in 5 (62.5%), first observed between days 27 and 43; none developed recurrence. Trajectories were frequently non-monotonic, with isolated negative results within otherwise-positive courses. ctDNA preceded imaging-based recurrence in three of five recurrent patients by a median of 124 days (range 70–240). Three recurrent patients were considered candidates for total pelvic exenteration.</div></div><div><h3>Conclusions</h3><div>Detectable ctDNA declined rapidly during CCRT but frequently followed a non-monotonic trajectory. Serial rather than isolated measurements appear necessary to interpret molecular response during active treatment. Prospective studies are warranted to determine whether trajectory-based ctDNA monitoring can improve risk stratification and recurrence detection.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102186"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148776632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pretreatment CT-defined sarcopenia is associated with worse survival in cervical cancer","authors":"Leandro Santos de Araujo Resende,&nbsp;Miguel Soares Conceição,&nbsp;Rodrigo Menezes Jales,&nbsp;Patrick Nunes Pereira,&nbsp;Luis Otávio Sarian,&nbsp;Glauco Baiocchi,&nbsp;Sophie Derchain,&nbsp;Agnaldo Lopes da Silva Filho","doi":"10.1016/j.gore.2026.102174","DOIUrl":"10.1016/j.gore.2026.102174","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the prevalence and prognostic relevance of pretreatment computed tomography-defined sarcopenia in women with cervical cancer treated with definitive radiotherapy with or without concurrent chemotherapy.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included women aged 18 years or older with FIGO 2018 stage IB2 to IVA cervical cancer who initiated definitive radiotherapy, with or without radiosensitizing chemotherapy, between January 2016 and December 2018 at CAISM/UNICAMP, Campinas, Brazil. Follow-up continued through 2022 to ensure a minimum follow-up period to evaluate 5-year survival outcomes. Women with prior malignancy treated with chemotherapy or radiotherapy, unavailable or non-measurable pretreatment computed tomography, pregnancy, or death before treatment initiation were excluded. Pretreatment sarcopenia was defined as skeletal muscle index &lt;38.9 cm²/m² using bilateral psoas and paraspinal linear measurements at L3 on planning computed tomography. Treatment response followed World Health Organization response definitions. Progression-free survival and overall survival were estimated using Kaplan-Meier methods and compared with log-rank tests. Cox proportional hazards models and multivariable logistic regression were performed to estimate hazard ratios (HR), odds ratios (OR), and 95% confidence intervals.</div></div><div><h3>Results</h3><div>Among 210 included women, 79 (37.6%) had pretreatment sarcopenia. Most patients had squamous histology (176/210, 83.8%), advanced FIGO stage III/IV disease (120/210, 57.1%), and received chemotherapy (177/210, 84.3%). Sarcopenia was more frequent among women aged &lt;50 years, premenopausal women, women with body mass index &lt;25 kg/m², and women with anemia. Complete or stable response occurred in 100 patients, whereas progression or recurrence occurred in 110; sarcopenia was more common among patients with progression or recurrence. In univariable analysis, pretreatment sarcopenia was associated with worse progression-free survival (HR 1.70, 95% CI 1.15 to 2.51) and overall survival (HR 1.75, 95% CI 1.11 to 2.75). In multivariable Cox regression, complete response to treatment was the only factor independently associated with overall survival (HR 0.07, 95% CI 0.02 to 0.18, <em>p</em> &lt; 0.0001). Multivariable logistic regression showed a trend for higher sarcopenia prevalence in women aged &lt;50 years (OR 1.73, 95% CI 0.98 to 3.05, <em>p</em> = 0.057).</div></div><div><h3>Conclusion</h3><div>Pretreatment CT-defined sarcopenia was common and associated with poorer survival outcomes in univariable analysis, although treatment response remained the strongest independent prognostic factor in women with cervical cancer treated with definitive chemoradiotherapy.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102174"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting homologous recombination deficiency in rare gynecological cancers: A case of primary mucinous endometrial adenocarcinoma of gastrointestinal type","authors":"Farhia Kabeer,&nbsp;Dawn Cochrane,&nbsp;Cam Grisdale,&nbsp;Branden J. Lynch,&nbsp;Melissa K. McConechy,&nbsp;Juliana Sobral de Barros,&nbsp;Lindsay Zibrik,&nbsp;Janine Senz,&nbsp;Amy Jamieson,&nbsp;Jessica N. McAlpine,&nbsp;Blake Gilks,&nbsp;Marco A. Marra,&nbsp;Janessa Laskin,&nbsp;Yvette Drew","doi":"10.1016/j.gore.2026.102180","DOIUrl":"10.1016/j.gore.2026.102180","url":null,"abstract":"<div><h3>Background</h3><div>Mucinous endometrial carcinoma of gastric type (MCG) is a rare and aggressive malignancy with no established standard of care. Biomarkers of homologous recombination deficiency (HRD), including <em>BRCA1/2</em> alterations and genomic signatures, are increasingly used to predict sensitivity to platinum-based chemotherapy and poly(ADP-ribose) polymerase inhibitors (PARPi), but their utility in rare gynecologic cancers remains unclear.</div></div><div><h3>Case presentation</h3><div>We report a 52-year-old female with metastatic <em>TP53</em>-abnormal endometrial MCG. Whole-genome and transcriptome analysis identified a pathogenic germline BRCA1 mutation with somatic loss of heterozygosity (LOH), resulting in biallelic <em>BRCA1</em> loss. A high HRDetect score (0.96) further supported an HRD phenotype. The patient achieved an initial partial response to frontline platinum-based chemotherapy. However, despite genomic evidence predicting PARPi sensitivity, she experienced rapid disease progression within three months of completion of platinum and starting maintenance niraparib. Retrospective copy-number signature analysis classified the tumor as a non-HRD signature characterized by high ploidy rather than classic <em>BRCA</em>-associated genomic scarring. To further investigate treatment response, a patient-derived xenograft (PDX) model was established. The model faithfully recapitulated the clinical phenotype, showing response to cisplatin but intrinsic resistance to the PARP inhibition.</div></div><div><h3>Conclusion</h3><div>This case demonstrates a discordance between genomic HRD biomarkers and therapeutic response. Despite germline <em>BRCA1</em> mutation, somatic LOH, and a high HRDetect score, platinum response was not durable and PARPi sensitivity was not observed. These findings highlight the limitations of current HRD biomarkers in rare gynecologic cancers and support integrating functional and genomic approaches to guide precision oncology.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102180"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world efficacy and safety of cemiplimab in Japanese patients with recurrent or metastatic cervical cancer: A single-center retrospective cohort study","authors":"Keisuke Ichida,&nbsp;Kasumi Yamamoto,&nbsp;Yukiko Suzuki,&nbsp;Mayuka Mitsuoka,&nbsp;Katsunori Matsui,&nbsp;Keitaro Yamanaka,&nbsp;Syouhei Tanabe,&nbsp;Kyoko Hamasaki,&nbsp;Mayu Ukai,&nbsp;Takashi Shibutani,&nbsp;Takaya Shiozaki,&nbsp;Yasuhito Tanase,&nbsp;Satoshi Yamaguchi","doi":"10.1016/j.gore.2026.102185","DOIUrl":"10.1016/j.gore.2026.102185","url":null,"abstract":"<div><div>Objective: To evaluate the real-world efficacy and safety of cemiplimab monotherapy in Japanese patients with recurrent or metastatic cervical cancer (R/M CC), including patients from subgroups underrepresented in clinical trials.</div><div>Methods: We conducted a single-center, retrospective cohort study of 25 consecutive patients with R/M CC treated with cemiplimab between April 2023 and April 2025. Outcomes included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. Responses were assessed by RECIST version 1.1, and treatment-emergent adverse events (TEAEs) were graded according to CTCAE version 5.0.</div><div>Results: The median follow-up was 12.6 months. The ORR was 16.0% (95% CI, 4.5–36.1%) and the DCR was 64.0% (95% CI, 42.5–82.0%). The median PFS was 2.8 months (95% CI, 2.1–3.5), and the median OS was 12.6 months (95% CI, 5.1–20.1). All patients with recurrence confined to a previously irradiated field achieved disease control. No treatment-related deaths occurred.</div><div>Conclusions: Cemiplimab demonstrated manageable toxicity and clinically meaningful disease control in routine practice, including patients with biologically aggressive tumors or recurrences in previously irradiated fields.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102185"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in estrogen replacement therapy use among younger gynecologic cancer survivors, 2013-2021","authors":"Christine Hsu Wang,&nbsp;Yong Shan,&nbsp;Gwyn Richardson,&nbsp;Fangjian Guo,&nbsp;Victor Adekanmbi,&nbsp;Thao N. Hoang,&nbsp;Abbey B. Berenson","doi":"10.1016/j.gore.2026.102178","DOIUrl":"10.1016/j.gore.2026.102178","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate temporal trends in estrogen replacement therapy (ERT) utilization among younger gynecologic cancer survivors.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study using the Merative MarketScan Research Database from January 1, 2013, through December 31, 2021. We included female patients aged 18–51 years with a diagnosis or history of gynecologic cancer. Annual prevalence of ERT use was calculated, and trends over time were assessed using annual percent change (APC) and 95% confidence intervals (CIs). Results were assessed across cancer types and age groups.</div></div><div><h3>Results</h3><div>ERT utilization increased from 10.9% in 2013 to 14.1% in 2021 among all gynecologic cancer survivors (APC 3.41%, 95% CI 2.13–4.71%). Increasing ERT use was observed across all gynecologic cancer subgroups and age categories during the study period. Ovarian cancer survivors consistently had the greatest prevalence of ERT use, whereas uterine cancer survivors had the lowest prevalence across the study period. Among the age sub-groups, the 18–34 years old age group had the largest increase in ERT utilization, from 6.8% to 10.5% (APC 5.68%, 95% CI 3.1–8.33) over the study period.</div></div><div><h3>Conclusions</h3><div>ERT utilization among younger gynecologic cancer survivors increased between 2013 and 2021. As ERT use continues to rise in this population, further research is needed to identify patient-, provider-, and system-level factors associated with prescribing and uptake and to evaluate gaps in menopausal survivorship care.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102178"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148738358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durable response to pembrolizumab plus axitinib in platinum-resistant ovarian clear cell carcinoma: A case report","authors":"Nikhil S. Patel,&nbsp;Joshua J. Cook,&nbsp;Danielle E. Valcana,&nbsp;Michael J. Poiesz,&nbsp;Shailesh J. Patel","doi":"10.1016/j.gore.2026.102170","DOIUrl":"10.1016/j.gore.2026.102170","url":null,"abstract":"<div><h3>Introduction</h3><div>Ovarian clear cell carcinoma (OCCC) is a rare and aggressive histologic subtype of epithelial ovarian cancer characterized by intrinsic chemoresistance and limited treatment options in the platinum-resistant setting. Immune checkpoint inhibitors and VEGFR-targeted therapies have demonstrated synergistic activity across multiple malignancies, though their role in OCCC remains incompletely defined. Axitinib is a selective VEGFR1–3 tyrosine kinase inhibitor approved for renal cell carcinoma but not OCCC.</div></div><div><h3>Case Presentation</h3><div>We report a 39-year-old female with FIGO stage IVA platinum-resistant OCCC who achieved durable disease control with pembrolizumab plus axitinib, despite prior mixed response to first-line therapies including bevacizumab. Tumor profiling demonstrated microsatellite stability, low tumor mutational burden, PD-L1 expression (TPS 5%), ARID1A mutation, and TP53 alteration. Serial imaging demonstrated sustained radiographic improvement followed by imaging findings suspicious for disease progression after approximately 23 months of disease control.</div></div><div><h3>Conclusion</h3><div>This case highlights the potential therapeutic relevance of VEGFR inhibition combined with immune checkpoint blockade in platinum-resistant OCCC. In a setting with limited effective options, this combination strategy may provide meaningful clinical benefit in selected patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102170"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rescuing a refractory Leiomyosarcoma: ALK-DCTN1 fusion as a gateway to long-term control with Ceritinib","authors":"Francis Yew Fu Tieng,&nbsp;Sri Kisha Subramaniam,&nbsp;Po Lin Ooi","doi":"10.1016/j.gore.2026.102175","DOIUrl":"10.1016/j.gore.2026.102175","url":null,"abstract":"<div><h3>Background</h3><div>Uterine leiomyosarcoma (uLMS) is an aggressive malignancy with limited advanced-stage treatments. Actionable molecular alterations like ALK fusions are extremely rare but present critical opportunities for targeted therapy.</div></div><div><h3>Case Presentation</h3><div>A 59-year-old woman with stage IV uLMS, initially misdiagnosed as uterine fibroids, underwent a hysterectomy in 2008. Recurrence was confirmed in 2011. Over the following decade, she developed progressive pelvic disease requiring multiple debulking surgeries, arterial embolizations, and pembrolizumab, which was stopped due to progression and adrenal insufficiency. Her course was complicated by obstructive uropathy and bowel perforation. Next-generation sequencing identified an ALK-DCTN1 fusion. She was commenced on the ALK inhibitor ceritinib at 450 mg daily, later reduced to 300 mg due to transaminitis. Treatment yielded significant tumour regression and durable partial remission. A May 2025 PET-CT showed no FDG-avid disease and no evidence of new local recurrence or distant metastasis, consistent with a metabolic complete response, although stable residual pelvic lesions persisted.</div></div><div><h3>Conclusion</h3><div>This case underscores the importance of comprehensive molecular profiling in advanced uLMS. It demonstrates that targeting rare ALK rearrangements with ceritinib can achieve sustained disease control after conventional therapies have failed or were poorly tolerated.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102175"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148625078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}