IJGC Podcast BMJ Podcasts

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

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.

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.

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.

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. 
 

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.