IJGC Podcast

Updates and New Options in Advanced Ovarian Cancer

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Katherine Kurnit. Dr. Kurnit is an Assistant Professor at the University of Chicago in the section of Gynecologic Oncology. Her research interests include developmental therapeutics and early phase clinical trials for patients with gynecologic cancers.
Highlights:
Although surgical practices have changed over time, there is still much debate and no consistent consensus about timing or the use of new therapies such as HIPEC.
More options for upfront maintenance therapy are now available for ovarian cancer patients.
We need new treatment approaches for patients with platinum-resistant ovarian cancer.
Finding ways to ensure ovarian cancer care is safe, feasible, and cost-effective in many different settings (nationally and internationally) will be important.
New strategies for screening and prevention are sorely needed

ERAS and MIS for Same-Day Discharge

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Genevieve Bouchard-Fortier. Dr. Bouchard-Fortier is an assistant professor in the Division of Gynecologic Oncology in the Department of Obstetrics and Gynecology at the University of Toronto and a member of the Division of Gynecologic Oncology at the University Health Network/Sinai Health Systems. Her research is focused on improving the quality of care of gynecologic oncology patients as well as developing quality metrics to measure outcomes.
Highlights:
• We implemented a perioperative program to increase same day discharge rate after minimally invasive hysterectomy from 30% to 75% in gynecologic oncology patients.
• ERAS principles significantly improved the same day discharge rate while maintaining a low complication rate.
• Longer surgery, timing of surgery, and narcotic use were significantly associated with overnight admission.

GOG 281: Use of Trametinib in Low-Grade Serous Cancer

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. David M. Gershenson to discuss the use of trametinib in low-grade serous cancer. Dr. Gershenson is Professor and former Chair of the Department of Gynecologic Oncology and Reproductive Medicine at The University of Texas MD Anderson Cancer Center. His major focus is on the clinical and translational research of rare ovarian cancers.
Highlights:
Trametinib represents a new standard for the treatment of recurrent low-grade serous carcinoma of the ovary/peritoneum.
The findings of GOG 281 suggest that women whose tumor harbors a MAPK mutation (KRAS, NRAS, BRAF) may have a greater probability of response to trametinib, but the results are hypothesis-generating, and further studies are needed. Importantly, trametinib should not be withheld from a woman whose tumor lacks MAPK mutations.
Based on the findings of GOG 281 and preclinical studies, future trials will include combinations of a MEK inhibitor plus endocrine therapy and novel agents targeting the MAPK signaling pathway or, more specifically, RAS.

Mentor’s Podcast: Rene Pareja

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Rene Pareja, 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, an Associate Editor for IJGC, and a member of the board of directors of the International Gynecological Cancer Society (IGCS). He is the author of nine book chapters and more than 70 publications in peer-reviewed journals, and at IGCS 2021 he received an award for Community Advancement in Resource-Limited Settings.
Highlights:
Tips for expertise in minimally invasive surgery: (1) learn from an experienced mentor, (2) train all the time, (3) get a formal course, (4) record your surgeries.
The crucial components to do surgery related research: Start to review papers, write protocols/systematic reviews, and try to work the most and tirelessly on an original project.
A successful person is someone who has failed several times.
Secrets and tips on life and professional career.

Neoadjuvant vs Primary Surgery: A NCDB Study with Alex Melamed

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Alex Melamed to discuss neoadjuvant versus primary surgery. Alex Melamed is a gynecologist oncologist and a health services researcher at Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Columbia Irving Medical Center.
Highlights:
- The emergence of evidence supporting non-inferiority of neoadjuvant chemotherapy (NACT) compared with primary surgery for advance ovarian cancer led to increased utilization of NACT.
- However, while some cancer programs in the U.S. doubled their use of NACT, others continued to use this approach infrequently.
- The differential adoption of NACT by cancer programs can be viewed, and analyzed, as a natural experiment using a difference-in-differences study design.
- Compared with programs that continued to use NACT infrequently, high users of NACT had similar improvements in median survival, with greater reductions in 6-month and 12-month mortality.

IJGC Special Issue 2022: Radiation Oncology

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. David Gaffney, Dr. Carien Creutzberg, and Dr. Anuja Jhingran to discuss this month's special issue on radiation oncology. Dr. Gaffney, MD, PhD, Senior Director of Clinical Research, is Professor and Vice-Chair of the University of Utah (U of U) Department of Radiation Oncology. Dr. Gaffney is a distinguished clinician and a long-standing leader in clinical research, and he is also a past president of the American Brachytherapy Society. Dr. Carien Creutzberg is Professor of Radiation Oncology at Leiden University Medical Center, the Netherlands. She specializes in research and treatment of gynecological cancers and has been initiator and principal investigator of the four PORTEC trials and the TransPORTEC consortium. She is current chair of the GCIG Endometrial Cancer Committee and past Council member of ESGO and IGCS. Dr. Anuja Jhingran is a Professor of Radiation Oncology in the Section of Gynecology at The University of Texas MD Anderson Cancer Center. She is the present treasure/secretary for IGCS. She is highly active in GCSC, GCIC, ASCO, and SGO. Her passion is to improve treatment for all women with gynecological cancer throughout the world and she does this through mentoring physicians in underserved regions throughout world.
Highlights:
Stereotactic body radiation therapy (SBRT) is useful in gynecological cancers.
Brachytherapy improves survival in cervix cancer.
Image guidance in radiation oncology decreases morbidity.
Patients with small volume disease and long disease-free interval may be good candidates for SBRT.
Immunotherapy can be combined with radiation therapy.

Tisotumab vedotin (TV) in Advanced or Recurrent Cervical Cancer

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez, is joined by Dr. Robert Coleman to discuss TV in Advanced or Recurrent Cervical Cancer.
HIGHLIGHTS:
Drug development in cervix cancer has undergone a renaissance in recent years with the identification of novel antibody drug conjugates (ADC) and immunotherapy measurably impacting patient survivorship.
Tisotumab vedotin (TV) is an ADC targeting tumor expression of tissue factor delivering the cytotoxic warhead MMAE.
InnovaTV 204/ GOG-3023/ENGOT-cx6 is a single arm phase II trial of TV in patients with recurrent/metastatic previously treatment cervix cancer who had measurable disease seeking assessment of objective response by independent radiological review, duration of response and safety.
101 assessable patients were enrolled demonstrating a ORR of 24%, with median duration of response of 8.3 months.
The regimen was well tolerated with the most common treatment-related adverse events being alopecia, epistaxis, nausea, conjunctivitis, fatigue, and dry eye. A rigorous eye care plan can mitigate high grade ocular toxicity.

The FeMMe Trial with Drs. Andreas Obermair and Monika Janda

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez, is joined by Drs. Andreas Obermair and Monika Janda to discuss the FeMMe trial.
Highlights:
feMMe was a randomised phase 2 trial testing LNG-IUD alone or in combination with a weight loss intervention or metformin for endometrial hyperplasia with atypia or stage 1 endometrial cancer.
Overall complete pathological response at 6 month was 61%.
Women with endometrial hyperplasia with atypia responded much better than women with endometrial cancer.
Weight loss achieved was moderate and BMI was not associated with response – more work on weight loss interventions needed.
Metformin did not improve response – more biomarker research is needed to understand who will respond to LNG-IUD or not.

Reviewing the February Issue with Felix Boria (Spanish version)

In this episode of the IJGC Podcast, Editorial Fellow Felix Boria discusses the contents of the February issue of IJGC in Spanish.

Reviewing the February Issue with Floriane Jochum and Natalie Medley (English version)

In this episode of the IJGC Podcast, Editorial Fellows Floriane Jochum and Natalie Medley discuss the contents of the February issue of IJGC in English.