IJGC Podcast

PAOLA1 Update Survival Analysis with Domenica Lorusso

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss the survival analysis of the PAOLA1 trial. Dr. Domenica Lorusso, MD, PhD, directs the Gynaecological Oncology Unit at Humanitas Hospital, Milan, and holds a Full Professorship in Obstetrics and Gynaecology at Humanitas University, Rozzano, Milan. She has led/participated in approximately 250 phase I-IV clinical trials. Currently overseeing more than 60 studies as Principal Investigator, Dr. Lorusso also chairs the Clinical Trials Committee of the MITO Group. She serves on the Board of Directors of the GCIG and is an active member of ENGOT, where she chairs the Gynecological Cancer Academy. Additionally, she sits on the Board of Directors of the ESGO. With around 300 international oncology publications and contributions to national and international treatment guidelines, her primary objectives are to ensure optimal patient care, foster clinical research, and advance international collaborations and education in the field.
 
Highlights:
Bevacizumab plus olaparib has reported to increase PFS and OS in advanced stage III-IV, newly diagnosed, high grade serous and endometrioid HRD positive ovarian cancer in the maintenance setting 
Exploratory analysis suggest that the advantage is particularly high in low risk patients (stage III withour residual tumor at primary surgery) where  a 5-year OS more  than 90% has been reported suggesting some of these patients may be cured
In the HRp population the combination of olaparib-bevacizumab did non increase PFS and OS in comparison to bevacizumab alone
The toxicity profile of the combination is in line with what expected with the single drugs

Molecular profile as predictor of endometrial recurrence

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Ana Luzarraga to discuss molecular profiles as predictors of endometrial recurrence. Dr. Luzarraga is a Gynecologic Oncologist currently working in the Vall d'Hebron University Hospital in Barcelona, Spain. She has completed her two years ESGO fellowship in 2023 and is currently finishing her PhD programme about molecular profile in endometrial cancer.
 
Highlights:
Molecular subgroups of endometrial cancer present distinctive recurrence patterns: p53-abn tumors relapse mostly with peritoneal and distant disease and NSMP tumors at distance.
Molecular profile is a stronger independent predictor for vaginal, peritoneal, and distant recurrence than classic histologic factors.
P53-abn is the sole independent predictor of peritoneal relapse.
P53-abn and NSMP are independent predictors of distant recurrence.

Mentor's Podcast: Luis Chiva

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Luis Chiva. Dr. Chiva, Director of Obstetrics and Gynecology at Clinica Universidad de Navarra, is an Honorary Fellow of the American College of Surgeons, a former council member of ESGO, and chaired the Program Committee for ESGO Istanbul 2023. He also serves as Associate Editor for the IJGC.
 
Highlights:
1. Dr. Luis Chiva's career path in gynecologic oncology stemmed from his father's influence and his own passion for surgery.
2. Training in the United States broadened his perspective, leading him to play a pivotal role in advancing gynecologic oncology in Spain.
3. He emphasized personalized patient care and multidisciplinary approaches to oncology, shaping his leadership in professional societies.
4. Dr. Chiva's journey underscores the importance of continual learning, perseverance, and a strong family support system in achieving professional success.
5. Balancing work and personal life, he believes, is essential for maintaining overall well-being and effectiveness in patient care.

Mentor’s Podcast: Jessica Mcalpine

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Jessica Mcalpine. Dr. McAlpine is a surgeon-scientist at the University of British Columbia and BC Cancer and a Tier 1 Canada Research Chair.  
 
Highlights:
• Collaborate! You are stronger together and can refine and improve your research initiatives.
• Choose projects that you believe are clinically impactful—not just for the sake of publishing.
• Find things that bring you joy in life. Gynecologic oncology and research are long journeys, and we need to take care of ourselves and each other.

Reviewing the April Issue with Elena Olearo and Beatriz Navarro Santana

In this episode of the IJGC Podcast, Editorial Fellows Elena Olearo and Beatriz Navarro Santana discuss the contents of the April issue of IJGC.

ARID1A in NSMP Uterine Cancers with Arina Onoprienko and Thomas Bartl

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Arina Onoprienko and Thomas Bartl to discuss ARID1A in NSMP uterine cancers. Dr. Onoprienko is undergoing residency training in OB/GYN and pursuing a PhD in experimental cancer research at the Medical University of Vienna, Austria. Her clinical research primarily focuses on modeling therapeutic outcomes in patients with gynecological cancers and assessing cognitive dysfunction in patients undergoing therapy for disease recurrence. Dr. Bartl completed his residency training in OB/GYN at the Medical University of Vienna, Austria, and is about to commence an ESGO-Fellowship in Gynecologic Oncology. Having completed a PhD program in experimental cancer research, he developed a strong interest in translational cancer research with a focus on precision medicine and definition of new therapeutic targets in rare gynecologic tumors.
 
Highlights:
Approximately one-third of endometrial cancers classified as "no specific molecular profile" (NSMP) harbors _ARID1A_-mutations. As ARID1A has previously been hypothesized to be associated with higher risks of recurrence and more pro-immunogenic tumor phenotypes, _ARID1A_ could qualify as a promising future biomarker for NSMPs.
Consistent with previous research, _ARID1A_-mutations are associated with a significantly higher risk of recurrence within the NSMP subgroup, which translates into impaired progression-free survival.
_ARID1A_ mutations appear not to be associated with impaired disease-specific survival. Based on a small subgroup analysis of patients experiencing disease recurrence, it could be hypothesized that this effect might be partly attributed to a better response to recurrence therapy.

p53abn and no myoinvasion endometrial cancer with Jessica Mcalpine and Amy Jamieson

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Jessica Mcalpine and Amy Jamieson to discuss p53abn and no myoinvasion endometrial cancer. Dr. Jessica McAlpine is a surgeon-scientist at the University of British Columbia and BC Cancer and a Tier 1 Canada Research Chair. Dr. Amy Jamieson is a gynecologic oncologist at Vancouver General Hospital and BC Cancer and an Assistant Professor at the University of British Columbia.
 
Highlights:
• p53abn endometrial cancers are aggressive tumours, responsible for the majority of recurrences and death from this disease. The optimal management of patients with stage IA p53abn endometrial cancer without myometrial invasion is debated.
• We demonstrate the recurrence rates in p53abn endometrial cancer stage IA without myometrial invasion were high at 16% and higher still with residual endometrial tumor (19%).
• Recurrence rates in p53abn stage IA without myometrial invasion did not differ compared to p53abn stage IA with myometrial invasion, where adjuvant treatment is routinely recommended.
• Most recurrences in patients with p53abn endometrial cancer stage IA without myometrial invasion were distant (89%) and fatal.
• High rates of distant and unsalvageable recurrences in stage IA p53abn endometrial cancer without myometrial invasion justify a discussion about adjuvant therapy.

Mirvetuximab in Ovarian Cancer with Giorgio Bogani

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Professor Giorgio Bogani to discuss Mirvetuximab in Ovarian Cancer. Prof. Bogani serves as a consultant in gynecologic oncology at the Fondazione IRCCS Istituto Nazionale dei Tumori di Milano in Milan, Italy. He completed a research fellowship at the Mayo Clinic in Rochester, MN, USA, with a focus on endometrial cancer and gynecologic oncology. Currently, his expertise is centered on gynecological surgery and experimental medicine.
 
Highlights:
Mirvetuximab soravtansine-gynx is a ADC comprising a FRα-directed antibody and DM4 as payload.
High FRα expression is noted in ~35-40% of platinum-resistant high-grade serous ovarian cancer.
Mirvetuximab  showed an objective response rate of about 30-35% in platinum-resistant high-grade serous ovarian cancer with high FRα tumor expression.
A promising activity mirvetuximab splus bevacizumab was observed in platinum-resistant ovarian cancer, regardless of level of FRα expression or prior bevacizumab exposure.
Emerging data highlighted the promising role of mirvetuximab in combination with carboplatin and bevacizumab in platinum-sensitive ovarian cancer patients.

SLN in Endometrial Hyperplasia with Andrea Rosati

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Andrea Rosati. Mr. Rosati is a consultant at the Department of Gynecologic Oncology at Fondazione Policlinico Universitario Agostino Gemelli in Rome (Italy). He is currently attending a second level master "Gynecologic Oncology International Master" at the Catholic University of the Sacred Heart (Rome, Italy) accredited as a Subspecialty Fellowship by the European Society of Gynaecological Oncology. His main interest areas are gynecological cancer, surgical anatomy, and gynecologic oncology surgery.
 
Highlights:
This study evaluated the prevalence of concurrent endometrial cancer in patients with pre-operative diagnoses of atypical endometrial hyperplasia undergoing hysterectomy. 
Among 460 patients, 47.2% were found to have concurrent endometrial cancer.
According to ESGO-ESTRO-ESP classification, 71.4%, were low-risk, 9.7% intermediate, 11.1% high to intermediate and 7.8% high-risk tumors.
Positive Lymph node were found in 12 patients, accounting for the 7.6% of concurrent endometrial cancers who underwent SLN biopsy.
SLN biopsy allowed for the adjustment of adjuvant therapy in 12.3% of high to intermediate-risk patients without increasing operative time or complication rates. 
 

ESGO Vulvar Cancer Guidelines 2023 with Maaike Oonk

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Maaike Oonk to discuss the ESGO Vulvar Cancer Guidelines for 2023. Dr. Oonk is a gynaecological oncologist in the University Medical Center Groningen in the Netherlands. Her research focuses on new treatment options for vulvar cancer patients to improve quality of life. She is PI of the GROINSS-V studies and was chair of the 2023 ESGO vulvar cancer guidelines working group.
 
Highlights:
Inguinofemoral radiotherapy is a safe alternative for a lymphadenectomy in patients with micrometastasis in the sentinel node.
In case of unilateral sentinel node involvement, it is probably safe to omit treatment of the contralateral (sentinel node negative) groin.
Studies are ongoing on application of the sentinel node procedure in locally recurrent disease, tumors > 4cm or multifocal tumors: outside these studies, the sentinel node procedure should only be applied in patients with unifocal primary squamous cell vulvar cancer < 4cm.
In advanced disease, both primary chemoradiation and radical surgery are treatment options. The Vulcanize study is investigating the role of neoadjuvant chemotherapy in these patients.
Given the rareness of this disease, treatment of vulvar cancer should be centralized in specialized centers.