In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Francesco Fanfani to discuss secondary cytoreductive surgery in endometrial cancer. Dr. Francesco Fanfani serves as an associate professor in gynecologic oncology at Fondazione Policlinico Universitario Agostino Gemelli, IRCCS in Rome, Italy.

Highlights:

• Secondary cytoreductive surgery with complete gross resection, has the potential to offer significant survival benefits in recurrent endometrial cancer patients.
• Age <65 years, single site recurrence, and nodal or hematogenous recurrence as predictive factors for complete cytoreduction.
• The study’s findings could influence the decision making process in treatment selection, offering valuable insights for future prospective studies and potential impacts on research and clinical practice.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss KEYNOTE-A18 Overall Survival Results: Pembrolizumab and Chemoradiotherapy. 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.

• In a phase 3 trial (ENGOT-cx11/GOG-3047/KEYNOTE-A18), pembrolizumab added to chemoradiotherapy significantly improved progression-free survival and overall survival for patients with locally advanced, high-risk cervical cancer.
• Patient Group: 1060 patients with FIGO 2014 stage IB2–IVA cervical cancer from 30 countries were randomized to receive pembrolizumab with chemoradiotherapy or placebo with chemoradiotherapy.
• Overall Survival: At a median follow-up of 29.9 months, the 36-month overall survival rate was 82.6% in the pembrolizumab group versus 74.8% in the placebo group, with a hazard ratio for death of 0.67 (95% CI 0.50–0.90; p=0.0040).
• Safety Profile: Grade 3 or higher adverse events were reported in 78% of pembrolizumab-treated patients versus 70% in the placebo group, with higher rates of potentially immune-mediated adverse events in the pembrolizumab group (39% vs. 17%).
• Conclusion: These findings confirm pembrolizumab plus chemoradiotherapy as an effective and potentially new standard of care for locally advanced cervical cancer.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Alessandro Santin to discuss Sacituzumab Govitecan (TROPiCS—03) in Advanced Endometrial Cancer. Dr. Alessandro D. Santin, a native of Italy, graduated with honors from the University of Brescia, Italy and received his postgraduate training in Obstetrics & Gynecology at the same University. He served a fellowship in Gynecologic Oncology at the University of California, Irvine and an International Fellowship in the Division of Gynecologic Oncology at the University of Arkansas for Medical Sciences, Little Rock, Arkansas. Dr. Santin joined the faculty in the Section of Gynecologic Oncology in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale University as Professor as of July 2008. Dr. Santin has more than 400 original research and peer-reviewed publications including multiple review articles and book chapters and he has written extensively on various topics, including cancer of the ovary, endometrium and cervix as well as on tumor immunology and immunotherapy. Dr. Santin's clinical interests include the use of immunotherapy in ovarian, cervical and endometrial carcinoma patients with disease resistant/refractory to standard treatment, therapeutic vaccines against Human Papillomavirus (HPV) infected genital tumors, and the development of personalized treatment modalities including monoclonal antibodies and antibody-drug-conjugates (ADC) against chemotherapy resistant gynecologic tumors.

Highlights:

• In the TROPiCS-03 trial Sacituzumab Govitecan demonstrated encouraging clinical activity in recurrent endometrial cancer patients in progression after chemotherapy and immune check point inhibitors
• Sacituzumab Govitecan toxicity profile was manageable with only 5% of patients discontinuing treatment due to TRAEs
• TROP-2 protein was expressed in over 90% of endometrial cancer patients enrolled in the TROPiCS-03 trial and showed limited correlation with efficacy to Sacituzumab Govitecan