Journal of Gynecologic Oncology最新文献

{"title":"P16/Ki67 dual staining versus cytology for identifying high-grade cervical intraepithelial neoplasia (CIN2+/CIN3+) in triage management of HR-HPV-positive women: a systematic review and meta-analysis.","authors":"Hang Zhou, Yu Dai, Hua Zhang, Yuan Yang, Ruoji Pi, Lingling Zhu, Wen Chen","doi":"10.3802/jgo.2026.37.e68","DOIUrl":"10.3802/jgo.2026.37.e68","url":null,"abstract":"<p><strong>Objective: </strong>The co-expression of P16 and Ki67 suggests the presence of high-grade cervical intraepithelial neoplasia, which makes P16/Ki67 dual staining a promising marker in cervical cancer screening. This study provides a systemic review of the established evidence on the performance of P16/Ki67 versus cytology in detecting cervical intraepithelial neoplasia (CIN)2+/CIN3+ among high-risk human papillomavirus (HR-HPV)-positive women and HR-HPV-positive individuals with cytology-negative results for triage management.</p><p><strong>Methods: </strong>Studies published from database inception to April 26, 2024, were systematically searched. A total of 26 studies were eventually included in the study, comprising 26,424 women, with 14,625 classified as P16/Ki67-positive and 11,799 as P16/Ki67-negative.</p><p><strong>Results: </strong>In the triage management of HR-HPV-positive women, P16/Ki67 achieved sensitivities of 85% for CIN2+ and 88% for CIN3+, with specificities of 63% and 57%, respectively. In comparison, cytology showed lower sensitivities of 76% for CIN2+ and 79% for CIN3+, with lower specificities of 57% and 54%. In triage management of human papillomavirus (HPV)-positive but cytology-negative women, 18.48% of the HPV-positive patients, initially missed by cytology, were correctly retrieved by the addition of P16/Ki67. A negative P16/Ki67 test result reduced the risk of underlying CIN3+ to 4% for HR-HPV-positive individuals and 1% for the HR-HPV-positive individuals with cytology-negative results, prompting a recommendation for follow-up at 1-year intervals.</p><p><strong>Conclusion: </strong>P16/Ki67 exhibits diagnostic superiority over liquid-based cytology in detecting CIN2+/CIN3+, among HR-HPV-positive women. Furthermore, its ability to identify patients missed by cytology highlights its value as a complementary tool for triage of HR-HPV-positive but cytology-negative population. By effectively reducing unnecessary colposcopy referrals, P16/Ki67 conserves healthcare resources and improves outcomes.</p><p><strong>Trial registration: </strong>PROSPERO Identifier: CRD42024567623.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e68"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of the droplet digital PCR POLE mutation test in endometrial cancer: comparison with Sanger sequencing and NGS.","authors":"Yung-Taek Ouh, Hyun-Woong Cho, Kyung-Jin Min, Jae-Kwan Lee, Yikyeong Chun, Jin Hwa Hong","doi":"10.3802/jgo.2026.37.e83","DOIUrl":"10.3802/jgo.2026.37.e83","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic accuracy of droplet digital polymerase chain reaction (ddPCR) for detecting polymerase epsilon (POLE) mutations in endometrial cancer (EC), comparing it with traditional Sanger sequencing and next-generation sequencing (NGS).</p><p><strong>Methods: </strong>Tumor DNA from 132 patients with EC was analyzed initially using both ddPCR and Sanger sequencing. Discordant cases (n=20) underwent further analysis using NGS as the reference standard. This study compared the sensitivity, specificity, and overall concordance of ddPCR against Sanger sequencing results, validated by NGS.</p><p><strong>Results: </strong>Among the 20 discrepant samples, ddPCR detected POLE mutations in 15 cases (75%). All ddPCR results matched exactly with NGS findings, including the detection of 11 low-frequency mutations missed by Sanger sequencing. ddPCR also corrected 2 false-positive results initially identified by Sanger sequencing. No false negatives were detected by ddPCR.</p><p><strong>Conclusion: </strong>ddPCR demonstrated superior sensitivity and specificity in detecting POLE mutations compared to Sanger sequencing and showed perfect agreement with NGS. With its rapid turnaround, simplicity, and cost-effectiveness, ddPCR is highly suitable for routine clinical use, potentially enhancing patient management and outcomes in EC.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e83"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric non-gestational choriocarcinoma: systematic literature review and a multicenter case series.","authors":"Lin Yang, Shen Yang, Jinghao Yan, Haiyan Cheng, Jun Feng, Xin Feng, Xiaofeng Chang, Zhiyun Zhu, Deguang Meng, Xianwei Zhang, Hong Qin, Huanmin Wang, Jianguo Zhang, Wei Yang","doi":"10.3802/jgo.2026.37.e81","DOIUrl":"10.3802/jgo.2026.37.e81","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the key factors affecting the prognosis of pediatric non-gestational choriocarcinoma (PNGC), providing evidence for optimizing clinical treatment and prognosis evaluation.</p><p><strong>Methods: </strong>A systematic literature review was conducted based on online searches of PubMed, Science Direct, and Google Scholar. A retrospective analysis of multi-center pediatric PNGC patients was performed for the period from 2014 to 2024.</p><p><strong>Results: </strong>All four patients in our series achieved complete remission and long - term survival following comprehensive treatment. A total of 19 studies involving 70 patients met the inclusion and exclusion criteria for the Systematic search of the literature. Among the 74 patients in this study, 40 received comprehensive treatment. The 3-year overall survival (OS) rate was 50.8%. Univariate survival analysis indicated that age, primary tumor location, and treatment modality influenced OS. However, multivariate analysis revealed that only single - modality treatment or no treatment was associated with an unfavorable prognosis.</p><p><strong>Conclusion: </strong>PNGC is a rare and aggressive disease associated with therapeutic challenges and a poor long-term prognosis. The prognosis analysis reveals that the comprehensive treatment plays a crucial role in improving the therapeutic outcome.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e81"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of molecular classification on diagnostic biopsy in endometrial carcinoma: the first step for a tailored approach.","authors":"Giulia Spagnol, Matteo Marchetti, Tommaso Vezzaro, Eleonora Panizzolo, Sofia Bigardi, Orazio De Tommasi, Angela Guerriero, Lara Alessandrini, Marco Noventa, Roberto Tozzi, Carlo Saccardi","doi":"10.3802/jgo.2026.37.e67","DOIUrl":"10.3802/jgo.2026.37.e67","url":null,"abstract":"<p><strong>Objective: </strong>To validate the concordance of histologic subtype, tumor grade, molecular classification, and risk group between pre-operative endometrial biopsy and final hysterectomy specimens in patients with endometrial cancer (EC).</p><p><strong>Methods: </strong>The PReOperative MOlecular Biopsy (ProMobi) study is a prospective, monocentric, observational study conducted from September 2023 to March 2024. All patients with suspicious finding for EC were included. Diagnosis was achieved by a pre-operative biopsy. On the latter, histopathology analysis, tumor grade, immunohistochemical (IHC) markers, molecular classification and risk group were determined. The same was performed on the final hysterectomy. Concordance was evaluated using Cohen's κ statistic.</p><p><strong>Results: </strong>A total of 50 consecutive patients were included. Molecular classification showed perfect concordance for <i>POLE</i> mutations (Cohen's κ=1.0) and strong concordance for p53 wild-type and abnormal subtypes (Cohen's κ=0.87). Similarly, mismatch repair-deficient/microsatellite instability and mismatch repair-proficient/microsatellite stable statuses achieved strong concordance (Cohen's κ=0.81), with an overall κ of 0.88 for molecular classification. Histotype agreement was nearly perfect (Cohen's κ=0.90), and tumor grade showed strong concordance (Cohen's κ=0.80). Risk group concordance was strong for group 1 (Cohen's κ=0.91), group 2 (0.94), and group 4 (0.96), with perfect concordance for group 3 (Cohen's κ=1.0). Overall risk group concordance was very high (Cohen's κ=0.95).</p><p><strong>Conclusion: </strong>This study demonstrates a high concordance in molecular classification, histotype, tumor grade and risk group between hysteroscopic biopsy and hysterectomy specimens. These findings establish that a personalized surgical approach to EC patients can be guided by molecular classification on pre-operative biopsy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e67"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant therapy of iparomlimab and tuvonralimab combined with chemotherapy-extenuated for locally advanced cervical cancer (NICE-CC): an investigator-initiated, multicentre, open-label, phase II trial.","authors":"Jie Lin, Qiaoling Wu, Bin Liu, Haixin He, Xinye Guo, Linxia Li, Yu Jiang, Yuxiu Huang, Yingtao Lin, Tongmei He, Xiang Zheng, Sang Li, Lijun Chen, Cuibo Lin, Evangeline Li, Shengtao Zhou, Yang Sun","doi":"10.3802/jgo.2026.37.e70","DOIUrl":"10.3802/jgo.2026.37.e70","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant treatments combining anti-programmed cell death 1 (PD-1) inhibitors with chemotherapy induce higher pathologic response rates than chemotherapy alone in patients with locally advanced cervical cancer (LACC). A dual blocker that targets PD-1 and cytotoxic T lymphocyte-associated protein-4, paired with de-escalated chemotherapy, may improve treatment efficacy while reducing toxicity. This study aims to evaluate the efficacy and safety of neoadjuvant iparomlimab and tuvonralimab in conjunction with reduced courses of chemotherapy for LACC.</p><p><strong>Methods: </strong>In this multi-center, single-arm, open-label, phase II trial, patients with histologically confirmed cervical squamous cell carcinoma, adenocarcinoma, or adenosquamous cell carcinoma are eligible. A total of 43 patients diagnosed with International Federation of Gynecology and Obstetrics 2018 stage IB3, IIA2, IIB, or IIIC1r will receive iparomlimab and tuvonralimab (5 mg/kg, intravenously), nab-paclitaxel (60 mg/m², intravenously), and cisplatin (75-80 mg/m², intravenously) for the first cycle. Then, 2 additional cycles of iparomlimab and tuvonralimab (5 mg/kg, intravenously) were followed at 3-week intervals. After finishing 3 cycles of neoadjuvant treatment, patients who exhibit a complete response (CR) or partial response (PR) will proceed to radical surgery, and subsequent adjuvant therapy will be guided by the National Comprehensive Cancer Network guidelines. Conversely, patients with stable or progressive disease will transition to concurrent chemoradiotherapy. The primary endpoint is the pathological CR. Secondary endpoints include the objective response rate, event-free survival, major PR, disease-free survival rate, and safety. Additionally, the exploratory endpoint will focus on identifying predictive biomarkers associated with tumor response.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT07055399.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e70"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive assessment of incidence, mortality, and lifetime risk of ovarian cancer: a global study with forecasts to 2050.","authors":"Yanping Jiang, Qian Xu, Yanjun Liu","doi":"10.3802/jgo.2026.37.e78","DOIUrl":"10.3802/jgo.2026.37.e78","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to update the latest epidemiology of ovarian cancer.</p><p><strong>Methods: </strong>Incidence and mortality data of ovarian cancer were extracted from 2 databases, the GLOBOCAN 2022 and the Global Burden of Disease 2021, to analyze age-standardized rates across 185 countries. The Age-Mortality-Population method and average annual per cent change (AAPC) were employed to calculate the lifetime risk of incidence (LRI) and lifetime risk of mortality (LRM), and to evaluate temporal trends (2000-2021) for ovarian cancer, respectively. Incidence cases and deaths of ovarian cancer were projected to 2050.</p><p><strong>Results: </strong>The number of incidence cases and deaths of ovarian cancer is projected to rise from 300,000 and 200,000 in 2022 to 477,000 and 337,000 by 2050. Low sociodemographic index (SDI) countries are projected to experience increases of 153% in incidence and 165.2% in mortality, while high SDI countries are expected to see modest increases of 21.8% and 36.4%. The overall trend of LRI and LRM decreased from 2000 to 2021. However, LRI in high SDI countries declined from 1.6% to 1.2%, LRM from 1.1% to 0.85%; LRI in low SDI countries increased from 0.46% to 0.63%, LRM from 0.37% to 0.49%. AAPCs for LRI and LRM both increased by >1% in low and low-middle SDI countries, but declined by >1% in high SDI countries.</p><p><strong>Conclusion: </strong>The incidence and mortality rates for ovarian cancer are expected to rise, but this burden is distributed unevenly across regions and SDI levels. The stark divergence underscores an urgent need for coordinated efforts to ensure equitable cancer care globally.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e78"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of a 3-dimensional printed vaginal dilator in mitigating radiation-induced vaginal stenosis for patients with cervical cancer.","authors":"Sirikorn Kongwattanakul, Petcharat Petroch, Kampheang Nimjaroen, Sarinya Bawornpatarapakorn, Kanyanee Laebua, Danupon Nantajit","doi":"10.3802/jgo.2026.37.e72","DOIUrl":"10.3802/jgo.2026.37.e72","url":null,"abstract":"<p><strong>Objective: </strong>Vaginal stenosis (VS) is a common adverse effect of pelvic radiotherapy. Current guidelines recommend vaginal dilation to maintain tissue elasticity and prevent VS. Previously, patients were instructed to self-dilate using own fingers. The current study assessed the effectiveness of using a 3-dimensional (3D) printed vaginal dilator (VD) for mitigating vaginal narrowing and shortening in cervical cancer patients within 1 year after radiotherapy.</p><p><strong>Methods: </strong>VDs were developed and validated by radiation therapists using a 3D printer. We enrolled 67 female patients diagnosed with cervical cancer at Chulabhorn Hospital to test the dilators. As a baseline, vaginal diameter and length were measured using the dilator before intracavitary radiotherapy. The patients were instructed on the use of VDs and provided with information guides and logbooks. Physical examinations were conducted at intervals of 1, 3, 6, 9, and 12 months post-radiotherapy.</p><p><strong>Results: </strong>The patients' average age was 51.75 years (standard deviation=13.23). 57% of all patients were diagnosed with stage III squamous cell carcinoma, and 66% underwent concurrent chemoradiation therapy. With the use of dilators, patients exhibited shortened and narrowed vaginal canals at 9 months and 1 month after receiving radiotherapy treatment. Most patients went on to develop VS. However, in most cases patients exhibited grade 1 VS according to the Late Effects in Normal Tissues-Subjective, Objective, Management and Analytic classification, with only 15.79% of patients exhibiting grade 2 VS.</p><p><strong>Conclusion: </strong>The use of a VD could potentially lessen the severity of VS induced by radiotherapy/brachytherapy.</p><p><strong>Trial registration: </strong>Thai Clinical Trial Registry Identifier: TCTR20250309001.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e72"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of cervicovaginal microbiome on HPV infection in vaccinated young Korean women.","authors":"Jaehyun Cho, Sorim Do, Kyunghoon Kim, Ha Kyun Chang, Hyun Hoon Chung","doi":"10.3802/jgo.2026.37.e88","DOIUrl":"10.3802/jgo.2026.37.e88","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prevalence of high-risk human papillomavirus (hrHPV) infection and its association with cervicovaginal microbiome (CVM) diversity among young Korean women who received human papillomavirus (HPV) vaccination.</p><p><strong>Methods: </strong>Seventy-two Korean women aged 20-35 years were enrolled in Seoul, South Korea. Cervicovaginal samples were analyzed using liquid-based cytology, HPV genotyping, and 16S rRNA sequencing. Alpha diversity and microbial compositions were compared according to HPV infection and cytology results.</p><p><strong>Results: </strong>The prevalence of hrHPV infection was 44.4% (n=32), with HPV 39 and 52 being the most common types. Women with abnormal cytology or hrHPV positivity exhibited significantly higher microbial alpha diversity (Shannon index, p<0.05). bacterial vaginosis-associated bacteria (BVAB) such as <i>Gardnerella leopoldii</i>, <i>G. vaginalis</i>, and <i>Megasphaera lornae</i> were significantly associated with hrHPV positivity, along with <i>Lactobacillus iners</i> showed a strong positive correlation with microbial diversity, abnormal cytology, and hrHPV infection (p<0.001).</p><p><strong>Conclusion: </strong>Despite national HPV vaccination, hrHPV infection remains common among young Korean women, primarily driven by non-vaccine types. The dominance of <i>L. iners</i> and enrichment of BVAB were key microbial features associated with hrHPV infection and abnormal cytology, suggesting that ecological imbalance in the CVM may contribute to viral persistence. These findings highlight the potential role of microbiome modulation as a complementary approach in post-vaccination HPV management and prevention.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e88"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of prior olaparib use on subsequent platinum-based therapy in recurrent ovarian cancer.","authors":"Kaori Ono, Yusuke Kobayashi, Ayumi Shikama, Genta Irie, Mayu Yoshino, Ayaka Tsuihiji, Mizuki Isayama, Kaori Takeuchi, Takuya Kuboya, Kaoru Fujieda, Asami Suto, Yuri Tenjimbayashi, Azusa Akiyama, Sari Nakao, Takeo Minaguchi, Toyomi Satoh","doi":"10.3802/jgo.2026.37.e74","DOIUrl":"10.3802/jgo.2026.37.e74","url":null,"abstract":"<p><strong>Objective: </strong>Epithelial ovarian cancer (EOC) has the highest mortality among gynecologic malignancies, with frequent recurrences despite initial responsiveness to platinum. Poly(ADP-ribose) polymerase (PARP) inhibitors, such as olaparib, have improved progression-free survival in BRCA-mutated and homologous recombination-deficient EOC. However, emerging evidence suggests that prior exposure to PARP inhibitors may reduce the efficacy of subsequent platinum-based chemotherapy, raising concerns about treatment sequencing. To evaluate whether prior olaparib use affects the sensitivity to subsequent platinum-based chemotherapy in patients with recurrent platinum-sensitive ovarian cancer, and to explore potential predictive biomarkers such as the neutrophil-to-lymphocyte ratio (NLR).</p><p><strong>Methods: </strong>We retrospectively analyzed 46 patients with recurrent ovarian cancer treated between 2008 and 2024. Patients were divided into an olaparib group (n=22) and a control group (n=24) without prior PARP inhibitor use. The primary endpoint was the difference between progression-free survival interval after second- and first-line therapy (PFS2 and PFS1). Secondary endpoints included time to first subsequent therapy (TFST)-time to second subsequent therapy (TSST) and correlations of NLR and CA125 with PFS2-PFS1.</p><p><strong>Results: </strong>The olaparib group had a significantly shorter PFS2-PFS1 (mean 6.40 vs. 11.17 months, p=0.023). TFST-TSST was shorter in the olaparib group (7.73 vs. 11.46 months) but not statistically significant (p=0.156). NLR was inversely correlated with PFS2-PFS1, and was strongest at 4 months (r=-0.515) and 5 months (r=-0.624) post-treatment in the olaparib and control groups, respectively. CA125 showed no significant correlation.</p><p><strong>Conclusion: </strong>Olaparib exposure may impair later chemotherapy efficacy. Careful treatment sequencing and biomarker development are warranted to optimize outcomes.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e74"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of first-line poly(ADP-ribose) polymerase inhibitor on second-line platinum-based chemotherapy in epithelial ovarian cancer.","authors":"Yusuke Toyohara, Mayu Yunokawa, Ryo Nimura, Eitaro Funada, Risako Ozawa, Kei Kato, Shogo Nishino, Mayumi Kamata, Motoko Kanno, Atsushi Fusegi, Akiko Abe, Sachiho Netsu, Makiko Omi, Yoichi Aoki, Terumi Tanigawa, Sanshiro Okamoto, Hidetaka Nomura, Hiroyuki Kanao","doi":"10.3802/jgo.2026.37.e82","DOIUrl":"10.3802/jgo.2026.37.e82","url":null,"abstract":"<p><strong>Objective: </strong>Research on platinum sensitivity after poly(ADP-ribose) polymerase (PARP) inhibitor administration, which offers prognostic benefits for first-line treatment of advanced epithelial ovarian cancer (EOC), is limited. Here, we evaluated the impact of first-line maintenance therapy with PARP inhibitors on the efficacy of second-line platinum-based chemotherapy in patients with advanced EOC.</p><p><strong>Methods: </strong>We retrospectively analyzed 100 patients with platinum-sensitive recurrent EOC who received second-line platinum-based chemotherapy between 2015 and 2024. The PARP inhibitor group included 35 patients who received PARP inhibitors as first-line maintenance, whereas the control group included 65 patients who did not. Overall response rate, post-recurrence progression-free survival (PFS), and post-recurrence overall survival (OS) were compared between the groups. Subgroup analyses were conducted using homologous recombination deficiency status and platinum-free interval (PFI).</p><p><strong>Results: </strong>The overall response rate was significantly lower in the PARP inhibitor group (25.7%) compared with the control group (89.2%, p<0.001). Median post-recurrence PFS and OS were significantly shorter in the PARP inhibitor group compared to that in the control group. In the PARP inhibitor group, homologous recombination deficiency-positive patients did not show better outcomes than homologous recombination deficiency-negative patients. Moreover, the overall response rate for patients with 6-12 months PFI was particularly poor in the PARP inhibitor group.</p><p><strong>Conclusion: </strong>First-line PARP inhibitor maintenance therapy may reduce the efficacy of subsequent platinum-based chemotherapy, potentially inducing platinum resistance. These findings highlight the need to reconsider treatment strategies and predictive biomarkers for second-line therapy following PARP inhibitor exposure in relapsed EOC.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e82"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}