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In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Mary McCormack to discuss the INTERLACE trial. Dr. McCormack is an Honorary Consultant Clinical Oncologist at University College London Hospitals NHS Trust and an Honorary Associate Clinical Professor at University College London.   Highlights: • INTERLACE first randomised PH3 trial in Locally advanced cervical cancer in more than 2 decades to demonstrate a clinically meaningful and statistically significant improvement in both OS and PFS . • The IC drugs are widely available and relatively cheap so removing many potential economic barriers to adoption. • Growth factors -GCSF/Filgrastim should be used as needed to ensure patients complete the chemotherapy (IC & cisplatin) • Essential to BEGIN the external beam radiation within 7 days of last dose ( #6) of IC. • Remember OVERALL treatment time for the RADIATION- 96% in trial completed both EXTERNAL BEAM & BRACHYTHERAPY within 56 days.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Professor Em. Ignace Vergote to discuss innovaTV205. Prof. Vergote was Chairman of the Department of Gynaecology and Obstetrics at the Catholic University Leuven from 2003-2020. He published more than 1050 papers on gynecologic cancer in peer-reviewed journals, and his work was cited more than 90,000 times. He served as President of IGCS, ESGO, EORTC-GCG and ENGOT.   Highlights: Tissue factor is almost always highly expressed in cervical carcinoma and can be targeted by tisotumab vedotin (TV), an antibody-drug conjugate. TV combined with bevacizumab, carboplatin, or pembrolizumab demonstrated manageable safety and encouraging antitumor activity in treatment-naive and previously treated recurrent/metastatic cervical cancer. The results show that the combination of TV with current treatments may improve outcomes and provide novel treatment options for patients with first or later recurrences and/or primary metastatic cervical cancer.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Gabriella Schivardi to discuss trends and complications after the LACC Trial. Dr. Schivardi is a first year ESGO fellow at the European Institute of Oncology in Milan and a research collaborator at the Gynecologic Oncology Department at Mayo Clinic, Rochester, United States. In addition, she is a former fellow for the IJGC.   Highlights: The study observed a significant decrease in the use of the minimally invasive approach after the publication of the LACC trial. Within our population the 30-day major complication, minor complication, and unplanned hospital readmission rates remained stable between the pre- and post-LACC periods. The study observed an increased rate accross the publication of the LACC trial limited to the intra and post-operative transfusion rate. The lack of a rise in 30-day complication rates after the LACC trial publication supports the use of laparotomy as the standard of care.

In this episode of the IJGC Podcast, Editorial Fellow Sabrina Piedimonte and Ilaria Capasso discuss the contents of the February issue of IJGC.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Giuseppe Cucinella, Andrea Mariani, and Gretchen E. Glaser to discuss ITCs in low-risk endometrial cancer. Giuseppe Cucinella, MD, is a gynecologist working at Istituto Nazionale Tumori IRCSS Fondazione G.Pascale in Naples, Italy (Department of Gynecologic Oncology). During his residency, he worked as a research fellow at Mayo Clinic in Rochester, Minnesota, where he focused on the study of endometrial cancer. He is currently in the second year of the PhD program in "Experimental Oncology and Surgery - Gynecologic Oncology" at the University of Palermo, Palermo (Italy). Dr. Cucinella's clinical research focuses on the diagnosis and treatment of endometrial cancer and minimally invasive surgery in gynecologic oncology. Dr. Andrea Mariani is a Full Professor in the Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, at Mayo Clinic in Rochester, Minnesota.  Dr. Mariani is the Gynecologic Oncology Division Chair in the Department of Obstetrics and Gynecology.  Dr. Mariani’s research interest is endometrial cancer with a special interest in robotic surgery. He is internationally recognized for his contributions in the advancement of surgical and postoperative treatment of endometrial cancer. Gretchen E. Glaser, MD is a Gynecologic Oncologist at Mayo Clinic specializing in complex surgery for malignant and benign conditions, including minimally invasive and open approaches. In addition to her clinical work, Dr. Glaser focuses her clinical research in endometrial cancer diagnosis, treatment, and outcomes as well as quality improvement of surgical care using enhanced recovery after surgery techniques. She also serves as the Vice Chair and Practice Chair for Obstetrics and Gynecology and has a special interested in patient and physician wellness.   Highlights: • The aim of our study was to evaluate the prognostic value of SLNs-isolated tumor cells in patients with low-risk endometrial cancer who underwent SLN biopsy and did not receive adjuvant therapy. Outcomes were compared with node negative patients. • Our study shows that recurrence free survival among patients with low-risk endometrial cancer and no adjuvant treatment was significantly worse in patients with SLNs–isolated tumor cells compared with negative nodes. However, we did not observe any significant difference in overall survival. • The presence of SLNs-isolated tumor cells, lymphovascular space invasion, and International Federation of Obstetrics and Gynecology (FIGO) grade 2 were significant risk factors for recurrence (any recurrence and non-vaginal recurrence). • Our group has designed a prospective multicenter cohort study called ENDO-ITC with the aim of definitively establishing the prognostic role of ITC in an otherwise low-risk population who undergo SLN biopsy. In addition, we will evaluate a standardized follow-up plan for these patients.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Dimitrios Nasioudis to discuss immunotherapy in vulvar melanoma. Dr. Nasioudis is from the Division of Gynecologic Oncology at the Abramson Cancer Center of the University of Pennsylvania. His current research focuses on translational therapeutics and population-based research with an emphasis on rare gynecologic tumors.   Highlights: • Prognosis of patients with vulvar melanoma and inguinal lymph node metastasis is poor. • In our study using real-world data approximately 1 in 4 patients received adjuvant immunotherapy with no clear overall survival benefit.            • Further research to identify biomarkers to select patients who may benefit from immunotherapy is needed. 

In this episode of the IJGC Podcast, Editorial Fellow Diletta Fumagalli and Beatriz Navarro discuss the contents of the January issue of IJGC.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Professor Gemma Kenter to discuss EORTC 55994. Prof. Kener is emeritus professor in gynae-oncology and was head of the department gynae-oncology in Center of Gynaecological Oncology Amsterdam (Amsterdam University Medical Center and Dutch Cancer Center). Her scientific interest concerns treatment and translational research of carcinoma of the cervix.     Highlights: In Trial EORTC 55994 we found no difference in overall survival between neoadjuvant chemotherapy followed by radical surgery and concomitant chemoradiation in case of bulky cervical cancer.  Regions in the world with a high incidence of cancer of the cervix might have poor access to radiotherapy. For patients in these centers as well as for young women who want to perceive their ovarian function, neoadjuvant chemotherapy followed by radical surgery can be a good alternative.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Lot Aronson and Willemien van Driel to discuss OVHIPEC1 overall survival analysis. Dr. van Driel is a gynecological oncologist at the Netherlands Cancer Institute since 2004 and has, amongst others, a special interest in determining the role of HIPEC in the treatment of patients with advanced ovarian carcinoma and is PI of the OVHIPEC 1 and OVHIPEC 2 study. Dr. Aronson is a medical doctor currently pursuing a PhD in Gynaecological Oncology at the Netherlands Cancer Institute in Amsterdam. Her research focuses on hyperthermic intraperitoneal chemotherapy (HIPEC) as well as immunotherapy in primary advanced ovarian cancer.    Highlights: The long-term survival analysis of the OVIHPEC-1 study confirms the significant improvement in progression-free and overall survival when adding HIPEC to interval cytoreductive surgery in patients with FIGO stage III ovarian carcinoma for whom primary cytoreduction is not considered feasible due to extensive disease. Neither the number of lines nor the type of subsequent treatment for recurrence differed between the treatment groups. Therefore, the observed improvement in overall survival is unlikely to be attributable a difference in subsequent therapies. Identification of biomarkers (e.g. BRCA/HRD status) to select patients for HIPEC and the combination of HIPEC with PARP inhibitors warrants further investigation.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Giuseppe Caruso to discuss PARPi de-escalation in ovarian cancer. Dr. Caruso is a gynecologist, currently working as a research fellow at Mayo Clinic, Division of Gynecological Surgery, in Rochester (MN, USA) under the supervision of Professor William Cliby. He is also a PhD fellow in “Network Oncology and Precision Medicine” at Sapienza University of Rome in Italy and collaborates with the European Institution of Oncology in Milan (Italy) under the mentorship of Professor Nicoletta Colombo. His main areas of interest are ovarian cancer and precision oncology.   Highlights: Systemic therapy de-escalation is a new frontier in personalizing therapy for advanced ovarian cancer. PARPi are so effective that selected patients may require less systemic therapy to achieve the same outcomes. The fundamental key is to limit de-escalation to BRCAm/HRD-positive patients with R0 after surgery. Several de-escalation attempts are under investigation, but none is currently recommended outside of clinical trials.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Rene Pareja, David Viveros-Carreño, and Beatriz Navarro Santana to discuss HIPEC complications. Dr. Viveros-Carreño is a Gynecologic Oncologist at Instituto Nacional de Cancerología, Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo (CTIC), and Clínica Universitaria Colombia in Bogotá, Colombia. Dr. Pareja is a gynecologist-oncologist at Astorga Oncology Clinic in Medellín and the National Cancer Institute in Bogotá, Colombia. Dr. Pareja is a reviewer for more than 20 specialty journals, and one of the Associate Editors for IJGC. He is the author of ten book chapters and more than 90 publications in peer-reviewed journals, and at IGCS 2021 he received an award for Community Advancement in Resource-Limited Settings. Dr. Navarro is a gynecologist-oncologist at Insular University hospital in Las Palmas, Spain. She also completed the ESGO fellowship at Institut Bergonie in France   Highlights: The study aimed to assess the complications associated with HIPEC in cytoreductive surgery for epithelial ovarian cancer, examining two distinct time periods (2004–2013 and 2014–2022). This systematic review analyzed 69 studies and including 4928 patients with advanced primary or recurrent epithelial ovarian cancer. No significant differences were observed in complication rates between the two time periods. Overall, complications, including blood transfusions, gastrointestinal, infectious, respiratory, urinary complications, and thromboembolic events, showed no significant change. Rates of ICU admissions, reoperations, and deaths also remained consistent over time. The study concluded that the overall complications associated with HIPEC in ovarian cancer surgery did not decrease, and there was no reduction in the rates of ICU admissions, reoperations, or deaths.

In this rebroadcast episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Jason Wright to discuss hormone replacement therapy after cervical cancer. Dr. Wright is the Sol Goldman Associate Professor and Chief of the Division of Gynecologic Oncology at Columbia University.   Highlights: -Among cervical cancer patients 50 years of age who underwent surgery including oophorectomy or primary radiation, only 39% received estrogen replacement therapy. -In patients who did receive estrogen replacement therapy the duration of use was short, with a median of only 60 days. -Black patients were significantly less likely to receive estrogen replacement therapy than White patients.