Nadeem Abu-Rustum bio: Dr. Abu-Rustum is a board-certified gynecologic oncologist who specializes in the surgical treatment of gynecologic cancers at Memorial Sloan Kettering Cancer Center. He is also a professor of obstetrics and gynecology at Weill Cornell Medical College. Dr. Abu-Rustum has a special interest in minimally invasive surgery (laparoscopy) for the treatment of cancerous and noncancerous diseases of the female reproductive system, and his clinical research focuses on surgical therapy for gynecologic cancers and innovative surgical approaches to treating gynecologic disorders. Christian Dagher bio: Christian Dagher is a former research fellow at Memorial Sloan Kettering, and current OBGYN resident at the University of Pennsylvania. He holds a master's degree in clinical epidemiology and health-services research from Weill-Cornel. Before moving to the US, he completed an OBGYN residency at the American University of Beirut and is interested in studying survival biomarkers in endometrial cancer.  Highlights: The 2023 FIGO staging system for endometrioid endometrial carcinomas included the extent of lymphovascular invasion as a determinant of stage.The new staging system, groups tumors with no lymphovascular space invasion and those with focal invasion (This study aimed to evaluate the relationship between the extent of lymphovascular invasion and oncologic outcomes in patients with stage I endometrioid endometrial cancer.This study is a retrospective analysis of 1555 patients with FIGO 2009 stage I endometrioid endometrial cancer who underwent total hysterectomy and lymph node assessment at two tertiary centers between 2012 and 2019, categorized by the extent of lymphovascular invasion (no, focal, or substantial invasion as defined by the WHO).Key findings showed that both focal and substantial lymphovascular invasion were linked to lower 5-year progression-free survival (68.7% and 70.5% for substantial and focal invasion, respectively, compared to 90.7% for no invasion). This was true even after limiting the analysis to myoinvasive grades 1 and 2. In conclusion, focal and no lymphovascular invasion have different prognostic outcomes and should not be combined into a single category as proposed by the FIGO staging system. Focal and substantial lymphovascular invasion were not associated with distinct prognostic outcome that could support upstaging of the latter.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Ignace Vergote to discuss Tisotumab Vidotin in Second- & Third-Line Recurrent Cervical Cancer. 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: Patients with recurrent cervical cancer with progression after platinum/paclitaxel, combined if possible with bevacizumab and anti-PD-(L)1 therapy, have a dismal prognosisThe antibody-drug -conjugate tisotumab vedotin showed a statistically significant and clinically meaningful improvement in overall survival, demonstrating a 30% reduction in the risk of death compared with standard of care chemotherapyConsistent benefit in progression-free survival and confirmed response were also observed and supportive of the observed overall survival benefit with tisotumab vedotinThe safety profile of tisotumab vedotin was manageable and tolerable, and consistent with previous experienceBased on these data, tisotumab vedotin should be considered a potential new standard of care for patients with recurrent cervical cancer who have progressed after first-line systemic therapy

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Luis Chiva to discuss the Elikia project in the Democratic Republic of the Congo. Dr. Luis Chiva is the Head of Gynecology and Obstetrics and Director of Gynecologic Oncology at at Clínica Universidad de Navarra.   Highlights: Inspiration: Dr. Luis Chiva began the Elikia project in the DRC in 2016 after seeing the urgent need for cervical cancer screening and maternal health.Screening Approach: The project uses visual inspection with acetic acid, inspired by a successful model from India, to reduce cervical cancer mortality.Team and Challenges: A team of volunteers faces challenges like limited healthcare infrastructure and promoting preventive care.Sustainability: The project relies on donations and grants  to remain sustainable.Personal Impact: The work has profoundly influenced Dr. Chiva, renewing his commitment to humanitarian efforts.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Anuja Jhingran to discuss the role of chemotherapy following chemoradiation after radical hysterectomy. Dr. Anuja Jhingran is a Professor of Radiation Oncology specializing in gynecologic cancers. Her clinical focus includes advanced ovarian, cervical, and endometrial cancers, utilizing advanced radiation techniques to reduce toxicity. Dr. Jhingran is actively involved in research with the Radiation Therapy Oncology Group (RTOG) and Gynecologic Oncology Group (GOG), serving as the national Principal Investigator for several studies. She is passionate about women's health and works internationally to improve healthcare in developing countries.   Highlights: This study assessed the impact of adding adjuvant chemotherapy to chemoradiotherapy (CRT) in patients with high-risk early-stage cervical cancer post-radical hysterectomy. A total of 212 patients were analyzed, with 109 receiving CRT alone and 103 receiving CRT plus chemotherapy. The 4-year disease-free survival (DFS) was 76% for the CRT group and 77% for the CRT plus chemotherapy group (HR = 1.05, 90% CI: 0.65-1.68, p = 0.56). Overall survival (OS) rates at 4 years were 87% for CRT and 89% for the CRT plus chemotherapy arm (HR = 0.91, 90% CI: 0.49-1.69, p = 0.40). The addition of chemotherapy did not significantly improve DFS or OS.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Gregg Nelson to discuss ERAS Guidelines and Outcomes Meta-analysis. Dr. Gregg Nelson is Professor and Chair of Gynecologic Oncology at the University of Calgary, in Calgary, Canada. He is the Physician Lead for ERAS Alberta and is Co-Chair of Enhanced Recovery Canada.  Highlights: Largest meta-analysis of ERAS randomized clinical trials finds hospital length of stay decreased by 1.9 days overall and risk of complications decreased by 29%, in favor of ERASERAS can be applied to both open and minimally invasive surgeryERAS benefits multiple surgery types

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Timo Westermann and Philipp Harter to discuss fertility-sparing surgery in borderline ovarian tumors. Dr. Timo Westermann is a gynecologist and fellow at the Department of Gynecologic Oncology at Kliniken Essen-Mitte. Dr. Philipp Harter is a gynecologic oncologist, working at Kliniken Essen Mitte and Chair of the AGO Study Group.   Highlights:   Fertility-Sparing Surgery in Borderline-Tumors does not negatively impact overall survival.Higher recurrence rates are observed after fertility-sparing surgery, particularly in higher FIGO stages.Long-term follow up is crucial due to potential risk of late recurrences.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Enrique Chacón to discuss the SENECA Study: Molecular profiling and SLN. Dr. Chacón works in the Gynecologic Oncology Unit of the Clínica Universidad de Navarra. Dr. Chacón is an active member of the European Society of Gynecologic Oncology where he is the co-chair of the ENYGO Online Education Committee and the national representative of Spain. In 2021 he completed his editorial fellowship in the IJGC, where today he is serving on the Editorial Board of the journal.   Highlights:   This study, for the first time, reveals significant differences in SLN involvement among more than 2000 patients with early-stage endometrial cancer based on their molecular subtypes, with the p53 abn and MMRd groups having the greatest lymph node involvement. The study defined the risk of SLN involvement for each of the ESGO risk groups. In this sense, the study notes that molecular profiling does not improve the prediction of nodal status with respect to the classical risk factors (FIGO stage and histology). Lymph node staging should not yet be adopted based on molecular profiling as prospective studies are needed to validate whether these differences impact survival (DFS/OS)

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. 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 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. Sentinel lymph node biopsy provided prognostic and therapeutic information in 60.8% of cases. It also allowed for the adjustment of adjuvant therapy in 12.3% of high to intermediate-risk patients without increasing operative time or complication rates. The study suggests sentinel lymph node biopsy can provide valuable prognostic and therapeutic insights in managing atypical endometrial hyperplasia.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Robert Coleman to discuss overall survival of SORAYA trial. Dr. Coleman completed his Obstetrics & Gynecology residency at Northwestern University Medical Center in Chicago, Illinois, and completed his fellowship at The University of Texas MD Anderson Cancer Center in 1993. From 1993-1996, he served as Assistant Professor at Creighton University followed by service as Vice-Chairman, Department of Obstetrics and Gynecology at the University of Texas, Southwestern Medical Center. Dr. Coleman joined as Faculty at MD Anderson Cancer center in 2004 and served as Professor and Executive Director for Cancer Network Research, holding the Ann Rife Cox Chair in Gynecology. In March 2020, he joined US Oncology Research (USOR) as Chief Scientific Officer and served briefly as Chief Medical Officer for Sarah Cannon Research Institute (SCRI). He currently serves as Chief Medical officer for Vaniam Group. Dr. Coleman has authored or coauthored over 750 scientific publications, including over 450 peer-reviewed articles, along with numerous book chapters, monographs, invited articles, and textbooks. He was the 2019 APGO-CREOG awardee for Excellence in Teaching. He serves as Vice President of GOG-Foundation, Inc. He served as President of SGO (2015-2016) and is the immediate Past-President of IGCS. He was recently inducted into MJH Life Sciences™ 2020 class of “Giants in Cancer Care®.”   Highlights: Mirvetuximab soravtansine (MIRV) is a first-in-class antibody-drug conjugate comprising an  FRα-binding antibody, cleavable linker, and maytansinoid DM4, a potent tubulin-targeting agentEarly clinical data suggested efficacy in recurrent platinum-resistant ovarian cancer (PROC) prompting a larger trial to confirm both safety and efficacy in patients with PROCIn this SORAYA trial MIRV demonstrated clinically meaningful antitumor activity in patients with FRα-high platinum-resistant ovarian cancer with an ORR: 32.4% and a median DOR: 6.9 months Remarkably the median OS was 15 months; 37% patients alive at 24 months Efficacy of MIRV was further evaluated with respect to when it was administered (as first treatment for PROC) and in patients receiving prior bevacizumab.  An ORR of 34.8% was documented in the formers, and 31.5% in the latter.The ocular toxicity was new for many treating physicians when the drug first became available. However with mitigating strategies as used in the study the events were predictable, low-grade, and rarely (n=1 patient) led to treatment discontinuationNow with MIRASOL confirming these data and demonstrating efficacy over standard of care for response, PFS, and unprecedently, OS, the agent is a staple of contemporary management.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Kirsten Jorgensen and Alex Melamed to discuss fertility sparing surgery in cervical tumors (   Highlights: -Current guidelines offer mixed recommendations for fertility-sparing surgery for those with a cervical cancer tumor size between 2cm and 4cm -This work sought to critically assess how the oncologic risk changes as tumor size increases without placing artificial cutoffs -Results must be interpreted within the limitations of a database study, but do seem to suggest that there is not a significant inflection of risk at 2cm, or any other size up to 4cm.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Mansoor Mirza and Angélica Nogueira Rodrigues to discuss recent updates on endometrial cancer in Latin America. Dr. Mirza is a highly qualified medical oncologist with expertise in Medical and Radiation Oncology, holding multiple degrees and licenses in these fields. He currently serves as the Chief Oncologist at the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Denmark, and holds the position of Medical Director of the Nordic Society of Gynaecologic Oncology-Clinical Trial Unit (NSGO-CTU). Dr. Mirza is actively involved in numerous medical societies, clinical research, and international trial collaborations, and has contributed significantly to the development of clinical protocols and guidelines for the management of various cancers. Dr. Angélica Nogueira-Rodrigues is the Founder of EVA Group, and President-elect of the Brazilian Society of Medical Oncology. She is also a Researcher and Professor at Federal University, MG, Brazil, and Chair of Gynecology at the Latin America Cooperative Oncology Group (LACOG).   Highlights:   -Detailed epidemiological data on endometrial cancer in Latin America are scant, but GLOBOCAN provides estimates for the incidence of uterine cancer within countries globally. EC is the second gyn cancer in the region, due to the burden of CC which is still the first one. It is estimated that the total number of new cases of uterine cancer in Latin America and the Caribbean will rise from approximately 33,000 in 2020 to an estimated 51,000 in 2040; -The last ten years have been marked by a radical transformation in the understanding of the molecular biology of endometrial cancer, and, including it.  or not  in FIGO staging, this discussion needs to evolve and be incorporated into clinical practice  in Latin America, as it impacts clinical decision, hereditary cancer diagnosis, among others. -The main message for young gynecological oncologists as us to create a future medicine with fewer disparities worldwide is to strive  to get access an implement the best for the patient,  avoiding protocols adapted for low-income countries which can negatively impact the clinical outcomes.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Ann H. Klopp to discuss radiation alone vs chemoradiation in endometrial cancer recurrence. Dr. Ann H. Klopp is a Professor of Radiation Oncology at MD Anderson Cancer Center, the head of the Gynecologic Oncology Section and a physician-scientist specializing in the treatment of gynecologic cancers. Her research focuses on improving outcomes for women with gynecologic cancers by enhancing tumor directed immune response in combination with radiation therapy and using advanced techniques to increase precision of radiation treatment delivery. Highlights: NRG0238 compared chemoradiation to radiation alone for patients with locally recurrent endometrial cancer and found that the addition of chemotherapy did not improve progression-free survival.Radiation therapy is highly effective for treatment for local recurrences of endometrial cancer.The nuances of patients enrolled and treatment delivered are discussed.

In this episode of the IJGC Podcast, Editorial Fellows Melis Canturk and Osnat Elyashiv discuss the contents of the July issue of IJGC.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Christina Uwins to discuss the MIRRORS trial. Christina Uwins is a final year Subspecialty Fellow in Gynaecological Oncology, working together with Mr Simon Butler-Manuel on the MIRRORS study based at Royal Surrey NHS Foundation Trust, Guildford, UK.  Christina has clinical, research and teaching experience and is enthusiastic about continuing her work in Gynaecological Oncology. Highlights: Retrospective studies have suggested that minimally invasive interval debulking surgery is feasible. There are no prospective trials on robotic interval debulking surgery for advanced ovarian cancer. MIRRORS is a prospective cohort study assessing the feasibility of robotic interval debulking surgery for advanced-stage ovarian cancer. MIRRORS demonstrated the feasibility and safety of robotic interval debulking surgery in advanced-stage ovarian cancer. MIRRORS is the first in a series of three planned trials culminating in a multicenter international randomized controlled trial of MIRRORS protocol -versus standard open interval debulking surgery (MIRRORS-RCT). In the UK and Europe, the majority of patients with advanced ovarian cancer have interval debulking surgery performed through an open approach. If non-inferiority of robotic interval debulking surgery with regards to survival (overall and progression free) is confirmed by an adequately powered randomized controlled trial, this could lead to a significant change in practice.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Dimitrios Nasioudis to discuss lymphadenectomy at the time of interval cytoreduction for ovarian cancer. Dimitrios Nasioudis is a gynecologic oncologist at the University of Pennsylvania. Following medical training at the Aristotle University of Thessaloniki, and a research fellowship at the Weill Cornell Medical College he completed his residency and fellowship training at the Hospital of the University of Pennsylvania. His current area of research is translational therapeutics with a focus on low-grade serous ovarian carcinoma. His research interests also include population science and surgical outcomes research. Highlights: The study aimed to evaluate the role of systematic lymphadenectomy during interval cytoreductive surgery in advanced-stage epithelial ovarian carcinoma patients who achieved complete gross resection.An analysis of data from 1060 patients found that those who underwent systematic lymphadenectomy had higher rates of unplanned readmissions and longer hospital stays, with no significant difference in overall survival.Systematic lymphadenectomy was rarely performed and did not provide a survival benefit for these patients.

In this episode of the IJGC Podcast, Editorial Fellows Anna Luzarraga and Natalia Palasz discuss the contents of the June issue of IJGC.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Gabriel Levin and Behrouz Zand to discuss ChatGPT-fabricated abstracts in gynecologic oncology. Dr. Gabriel Levin is a gynecologic oncology Fellow at McGill University. His research encompasses population database studies with clinical implication and  innovations in medical education and health care. He has published more than 180 peer reviewed original articles.. Dr. Behrouz Zand is a gynecologic oncologist at Houston Methodist Hospital's Neal Cancer Center and Department of Obstetrics and Gynecology, and an assistant professor at Weill Cornell College at Houston Methodist Academic Institute. Specializing in innovative cancer care and clinical trials, he is passionate about integrating AI in medicine, a recent alumnus of the physician program at MIT for AI integration in healthcare. Dr. Zand combines cutting-edge research with compassionate patient care to advance the field.   Highlights:   Reviewers had difficulty in discriminating ChatGPT-written abstracts. Reviewers correctly identified only 46.3% of ChatGPT-generated abstracts, with human-written abstracts slightly higher at 53.7%.  Senior reviewers and those familiar with AI had higher correct identification rates, with senior reviewers at 60% and juniors/residents at 45%. Experience and familiarity with AI were independently associated with higher correct identification rates. ChatGPT assists researchers by generating reviews, summaries, and enhancing writing clarity, but it raises ethical concerns and could diminish human expertise. For non-English speaking authors, it improves writing quality and clarity. In scientific writing, it enhances clarity, summarizes concisely, brainstorms ideas, assists with terminology, and offers data interpretation, augmenting human expertise. ChatGPT and AI in scientific writing can lead to ethical issues, factual inaccuracies, and may eventually diminish human expertise and critical thinking.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss the KEYNOTE A18 clinical 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: - Concurrent chemoradiation plus brachiterapy represent the standard of care treatment in locally advanced cervical cancer providing up to 70% 5 years OS - Modern radiotherapy technique (IMRT and VMAT) has reported to further increase OS and reduce toxicity  - Immunotherapy has reported to increase OS in advanced or recurrent cervical cancer when compared to standard treatment - Immunotherapy in combination with concurrent high quality chemoradiation in the treatment of locally advanced high risk cervical cancer further increase PFS and OS with respect to standard chemoradiotherapy and should be considered the new standard of care - The combination appears manageable and no substanciad additional toxicity has been reported