International Journal of Gynecological Cancer最新文献

{"title":"Comparative analysis of adjuvant treatment outcomes in stage III endometrial cancer: overall survival, recurrence-free survival, site of primary recurrence, and toxicity.","authors":"Alex E Rosenthal, Natalie Posever, Anna Modest, Andrew C Wiechert, Joanne W Jang, Katharine M Esselen","doi":"10.1016/j.ijgc.2025.102119","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102119","url":null,"abstract":"<p><strong>Objective: </strong>Adjuvant treatment for stage III endometrial cancer remains controversial due to varying results from large randomized studies. Our objectives were to assess differences in (1) recurrence-free survival and overall survival, (2) initial recurrence site, and (3) acute and long-term toxicities in patients receiving chemotherapy vs chemoradiation as initial adjuvant treatment.</p><p><strong>Methods: </strong>All stage III endometrial cancer patients treated at our institution from 2010 to 2021 were included. Treatment groups were defined as \"chemo\" if treated with upfront chemotherapy with or without subsequent radiation or \"concurrent\" if treated with chemoradiation with or without subsequent chemotherapy. Data were collected through retrospective chart review. Univariate analyses were performed using the Mann-Whitney U test, Fisher exact test, and log-rank test. Multivariate analysis was conducted using Cox proportional hazards and generalized linear regression models.</p><p><strong>Results: </strong>A total of 156 patients were eligible for analysis. After adjusting for stage and histology, there was no difference in 5-year recurrence-free survival (HR 0.5, CI 0.22 to 1.11) with the chemotherapy group as reference. However, overall survival was improved in the concurrent group (HR 0.24 CI 0.06 to 0.90). When restricting the analysis to patients with endometrioid histology, overall survival was significantly improved in the concurrent group (HR 0.11, CI 0.16 to 0.73). In the full cohort, pelvic or para-aortic nodal recurrence (p = .01) and distant recurrence (p < .01) were significantly more likely in the chemotherapy group. There were no significant differences in high-grade toxicities.</p><p><strong>Conclusions: </strong>Patients with stage III endometrial cancer who received upfront concurrent treatment had improved overall survival compared with those who received upfront chemotherapy, without significant differences in high-grade toxicities. These findings should be considered in the design of future clinical trials.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102119"},"PeriodicalIF":4.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058494","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":"Extrapulmonary lymphangioleiomyomatosis: an incidental finding detected in surgery for gynecological malignancies.","authors":"Lourdes Salazar-Huayna, Giulio Bonaldo, Ana Luzarraga Aznar, Martina Aida Angeles","doi":"10.1016/j.ijgc.2025.102118","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102118","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102118"},"PeriodicalIF":4.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053174","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":"Progression-free survival as a surrogate of overall survival in metastatic or recurrent endometrial cancer: an EORTC gynecologic cancer group study.","authors":"Ramon Yarza, Aranzazu Barquin, Giuseppe Caruso, Helena Guedes, Melpomeni Kountouri, Jose Manuel Estrada-Lorenzo, Giorgio Bogani, Corneel Coens, Fernanda Herrera, Judith Kroep, Ainhoa Madariaga","doi":"10.1016/j.ijgc.2025.102115","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102115","url":null,"abstract":"<p><strong>Objective: </strong>The value of progression-free survival as a surrogate marker for overall survival remains a matter of debate. Herein, we evaluated the validity of progression-free survival as a surrogate endpoint for overall survival in trials of recurrent or metastatic endometrial cancer.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Standardized treatment effects (z-scores) for progression-free-survival and overall survival were derived from reported HRs. Pearson's correlation coefficient (r) and surrogate threshold effect (STE) were calculated to assess surrogacy according to German Institute for Quality and Efficiency in Health Care guidelines. Sub-group analyses were performed by treatment modality, line of therapy, and prior radiotherapy exposure.</p><p><strong>Results: </strong>Sixteen randomized trials encompassing 25 treatment comparisons and 10,381 patients with recurrent or metastatic endometrial cancer were included. A strong correlation was observed between z_PFS and z_OS across all studies (r = 0.82, 95% CI 0.63 to 0.92, p < .001). The STE was 3.07, indicating that moderate-to-large progression-free-survival benefits are required to predict overall-survival improvement. Correlation was strongest among chemoimmunotherapy trials (r = 0.87, 95% CI 0.34 to 0.98, p = .011, STE = 3.34), while chemotherapy-alone trials showed a weak and non-significant association (r = 0.42, 95% CI -0.49 to 0.89, p = .35, STE = 3.64). Surrogacy appeared stronger in post-first-line trials and in studies with limited prior radiotherapy exposure.</p><p><strong>Conclusions: </strong>Progression-free survival shows a strong but context-dependent correlation with overall survival among endometrial cancer trials. While it may serve as a valid surrogate marker, particularly in chemoimmunotherapy, its reliability varies by treatment context. These findings support the selective use of progression-free survival as a surrogate in endometrial cancer and underscore the importance of tailored endpoint strategies in oncology trial design.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102115"},"PeriodicalIF":4.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029713","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":"Mechanisms of drug resistance: PARP inhibitors, antibody-drug-conjugates, and immunotherapy.","authors":"Diana Bello Roufai, Richard Toth, Upasana Palo, Giula Scaglione, Ana Tatiana Palacios, Zoltan Novak, Houssein El Hajj, Alexander Shushkevich, Jonathan Ledermann","doi":"10.1016/j.ijgc.2025.102112","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102112","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102112"},"PeriodicalIF":4.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064472","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":"Safety of antibody-drug conjugates in gynecologic cancers: current evidence and management approaches.","authors":"Esteban A Ciliberti, Francisco Javier Calleja-Holgado, Stephanie Lheureux, Toon Van Gorp, Ilaria Colombo, Ainhoa Madariaga","doi":"10.1016/j.ijgc.2025.102117","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102117","url":null,"abstract":"<p><p>Antibody-drug conjugates (ADCs) have emerged as a contemporary targeted therapeutic in gynecologic malignancies, offering novel precision therapy options by linking monoclonal antibodies that target tumor-associated antigens with potent cytotoxic payloads. Several ADCs have demonstrated promising activity in ovarian, endometrial, and cervical cancers, particularly in the recurrent setting. Clinical development has expanded across tumor types and biomarker-defined populations, with ongoing trials exploring ADCs as monotherapy and in combination with immune checkpoint inhibitors, chemotherapy, and antiangiogenics. As ADCs are incorporated as standard-of-care options, understanding their unique adverse event profiles and their management becomes critical. Toxicities are largely influenced by the ADC's structural components, yet most represent off-target toxicities of the cytotoxic payload. Commonly reported adverse events include ocular and gastrointestinal toxicity, hematologic suppression, peripheral neuropathy, and pneumonitis, with type, severity, and onset varying between agents. For instance, tissue-specific toxicities such as keratopathy are prominent with tubulin-directed payloads, while diarrhea and neutropenia are more commonly associated with topoisomerase I inhibitor payloads. Unlike traditional chemotherapy, ADC-associated toxicities often follow a different timeline and may require novel prophylactic and mitigation strategies, including multidisciplinary supportive care. As clinical use of ADCs expands, a thorough understanding of agent-specific toxicities and their management is essential for optimizing therapeutic outcomes. Here, we provide a comprehensive overview of the evolving ADC pipeline in gynecologic cancers, with a particular focus on toxicity patterns, underlying mechanisms, and evidence-based management strategies to support safe and effective integration into routine oncology practice.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102117"},"PeriodicalIF":4.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039712","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 outcomes and subsequent therapy in patients with platinum-sensitive recurrent ovarian cancer deriving long-term benefit from maintenance niraparib: a subgroup analysis of the GEICO-88R study.","authors":"Juan F Cueva, Isabel Palacio, Cristina Churruca, Ana Herrero, Beatriz Pardo, Manuel Constenla, Ana Santaballa, Luis Manso, Purificación Estévez-García, Marta Legerén, Gloria Marquina, Ana de Juan, Josefa Ferreiro Quintana, Santiago González-Santiago, Javier Cassinello, Piedad Reche, Maria Luisa Soriano, Maria Valero, Lydia Gaba, Maria Del Mar Gordón, César Gómez-Raposo, Susana Hernando, Raúl Márquez, José Fuentes, Jesus Alarcón, Alvaro Taus, Cristina Caballero, Miguel Corbellas, Elena Iriarte, Antonio González-Martín","doi":"10.1016/j.ijgc.2025.102116","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102116","url":null,"abstract":"<p><strong>Objective: </strong>To describe characteristics, clinical outcomes, and subsequent therapies in patients receiving long-term maintenance niraparib in the Spanish expanded-access program.</p><p><strong>Methods: </strong>This retrospective observational study (NCT04546373) described patient characteristics, treatment exposure, and clinical outcomes in patients receiving maintenance niraparib for high-grade serous platinum-sensitive recurrent ovarian cancer. Subgroup analyses in patients receiving niraparib for ≥1 year (\"long-term responders\") were prespecified; additional post hoc analyses explored outcomes in patients treated for ≥2 years (\"sustained long-term responders\").</p><p><strong>Results: </strong>In this real-world population of 316 patients (predominantly BRCA wildtype), 107 (34%) were long-term responders and 61 (19%) were sustained long-term responders. Compared with patients discontinuing niraparib within 1 year, the long-term responders subgroup included a higher proportion with primary debulking surgery and no residual disease after cytoreductive surgery and a lower proportion with >4 prior lines of systemic therapy, International Federation of Gynecology and Obstetrics stage IV disease, measurable disease at niraparib initiation, and Eastern Cooperative Oncology Group performance status 1. Tolerability was similar regardless of treatment duration. After discontinuing niraparib, the most frequently administered regimens were platinum-based. Response rates to the first post-niraparib line were 37% to 44%, and median progression-free survival was 7.0 months in non-long-term responders and 7.9 months in long-term responders. Median overall survival was 56.9 months in long-term responders (49.1 months' median follow-up) and was not reached in the sustained long-term responders subgroup.</p><p><strong>Conclusions: </strong>Mature results from the GEICO-88R study continue to support the effectiveness and tolerability of maintenance niraparib in platinum-sensitive recurrent ovarian cancer. A subset of patients experienced long-term disease control. The efficacy of subsequent treatment appeared similar irrespective of niraparib duration.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102116"},"PeriodicalIF":4.7,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102898","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":"Methodological concerns regarding AGO score validation in low-grade ovarian cancers.","authors":"Chong Zhang, Xiaorong Lu","doi":"10.1016/j.ijgc.2025.102111","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102111","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102111"},"PeriodicalIF":4.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992443","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":"Associations between the prognostic nutritional index and response to neoadjuvant chemotherapy in patients with epithelial ovarian cancer.","authors":"Jairo Rubio-Cordero, Guillermo Moreno-Flores, Rebeca Ramirez-Morales, Diddier Prada, Delia Pérez-Montiel, Salim Barquet-Muñoz, Lenny Gallardo-Alvarado, Isabel Sollozo-DuPont, Pamela Martínez-Vega, Carlos Pérez-Plasencia, David Cantú-De León","doi":"10.1016/j.ijgc.2025.102109","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102109","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between the prognostic nutritional index and the response to neoadjuvant chemotherapy in Mexican patients with epithelial ovarian cancer.</p><p><strong>Methods: </strong>Retrospective analyses of 220 patients with epithelial ovarian cancer treated with neoadjuvant therapy. The cutoff points for the prognostic nutritional index at diagnosis and after neoadjuvant therapy were determined via receiver operating characteristic curves. Categorical variables were analyzed with the χ² test, and multivariate analyses were performed with logistic regression. Disease-free survival and overall survival were analyzed via the Kaplan‒Meier method.</p><p><strong>Results: </strong>The median age was 55 years (range; 28-82). The most common histology was high-grade serous carcinoma in 199 cases (90.5%), and 66.4% (n = 146) were International Federation of Gynecology and Obstetrics stage IIIC. The prognostic nutritional index cutoff points at diagnosis and after neoadjuvant chemotherapy for complete or optimal cytoreduction were 40.5 and 45, respectively. High prognostic nutritional index values were associated with higher rates of complete or optimal cytoreduction: 53.6% and 67.7%, respectively. Additionally, high prognostic nutritional index values were associated with platinum sensitivity. According to the multivariate analysis, a high prognostic nutritional index value (OR 6.6, p = .001) was an independent factor associated with complete or optimal cytoreduction. The median overall survival at 3 years was not reached in patients with high prognostic nutritional index values (p = .054 and p = .015). Disease-free survival was not significantly different for high versus low prognostic nutritional index values (p = .9).</p><p><strong>Conclusions: </strong>The prognostic nutritional index may be used as an independent prognostic biomarker for advanced epithelial ovarian cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102109"},"PeriodicalIF":4.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074981","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":"Pelvic recurrence of endometrial cancer treated by laparoscopic laterally extended resection: a clinical case with 3-dimensional-reconstruction and surgical technique.","authors":"Camilla Certelli, Riccardo Oliva, Belen Padial Urtueta, Virginia Vargiu, Francesco Fanfani, Valerio Gallotta","doi":"10.1016/j.ijgc.2025.102105","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102105","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102105"},"PeriodicalIF":4.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953335","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":"Robot-assisted utero-ovarian transposition and reanastomosis in vaginal cancer: a step-by-step description technique.","authors":"Alberto Rafael Guijarro-Campillo, Jose Ramón Rodríguez-Hernández, Laura Cánovas-López, Raquel Oliva-Sánchez, Francisco Jose Barceló-Valcarcel, Aníbal Nieto","doi":"10.1016/j.ijgc.2025.102106","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102106","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102106"},"PeriodicalIF":4.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053122","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}