IJGC Podcast

BMJ Group

The International Journal of Gynecological Cancer (IJGC) podcast explores the latest research on detection, prevention, diagnosis, and treatment of gynecologic malignancies. Enjoy interviews with leading experts as they discuss novel and relevant topics in the field of gynecologic cancer. Join Editor-in-Chief Dr. Pedro Ramirez and his guests for an interactive and educational experience. Subscribe now or listen on your favourite podcast platform. IJGC - ijgc.bmj.com - is the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology. read less
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Episodes

KEYNOTE-A18 Overall Survival Results: Pembrolizumab and Chemoradiotherapy with Domenica Lorusso
Nov 18 2024
KEYNOTE-A18 Overall Survival Results: Pembrolizumab and Chemoradiotherapy with Domenica Lorusso
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. Highlights:  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.
Sacituzumab Govitecan (TROPiCS—03) in Advanced Endometrial Cancer with Dr. Alessandro Santin
Nov 11 2024
Sacituzumab Govitecan (TROPiCS—03) in Advanced Endometrial Cancer with Dr. Alessandro Santin
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 inhibitorsSacituzumab Govitecan toxicity profile was manageable with only 5% of patients discontinuing treatment due to TRAEsTROP-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
Racial and Sociodemographic Disparities with Novel Therapeutics with Drs. Anne Knisely and Nitecki Wilke
Nov 4 2024
Racial and Sociodemographic Disparities with Novel Therapeutics with Drs. Anne Knisely and Nitecki Wilke
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Drs. Anne Knisely and Nitecki Wilke to discuss Racial and Sociodemographic Disparities with Novel Therapeutics. Dr. Knisely is a 3rd year gynecologic oncology fellow at MD Anderson Cancer Center. She is originally from the New York City area and completed her residency training in Ob/Gyn at Columbia University in 2022 where Dr. Jason Wright served as her primary research mentor. Her current research focuses on early phase clinical trials, minimal residual disease in ovarian cancer, and sociodemographic factors that affect oncologic treatment and outcomes. She is a current SGO/GOG-F BRIDGES Research Scholar. In her free time, she mostly chases around her two toddlers, Zoe (3.5) and Isaiah (2). Dr. Nitecki Wilke is a gynecologic oncologist and assistant professor at the department of gynecologic oncology and reproductive medicine at the University of Texas MD Anderson Cancer Center.   Highlights: Of the 6242 patients who met inclusion criteria and were included in the final cohort, 4.4% received a PARP inhibitor, 34% received bevacizumab, and 6% received both. On multivariable analysis, non-Hispanic Black patients were 23% less likely than non-Hispanic white patients to receive either targeted therapyMost patients in the study were treated in the recurrent setting; we suspect that the potential barriers to guideline-concordant prescription of these therapeutics would persist in the upfront treatment setting, but future studies are required to validate this.A key area of focus to reduce disparities in access to targeted therapies should be ensuring adequate reimbursement for genetic/ biomarker testing as well as brainstorming creative solutions to expand access to genetic counseling, including the use of mainstreaming.Use of the SEER-Medicare database specifically reduces external validity of this study, but the results are nonetheless hypothesis generating and should spark conversation regarding potential inequitable receipt of PARP inhibitors and bevacizumab in advanced ovarian cancer
Surgical Complications: Impact on Surgeon with Drs. Andreas Obermair and Rachel Collings
Oct 21 2024
Surgical Complications: Impact on Surgeon with Drs. Andreas Obermair and Rachel Collings
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Andreas Obermair and Rachel Collings to discuss the impact of surgical complications on surgeons. Dr Obermair is an Australian-based gynaecological oncologist, researcher and leader of innovation. He is the PI of numerous investigator-initiated clinical trials and is never tired of finding more effective and less harmful ways to treat patients diagnosed with gynaecological cancer. Dr Rachel Collings is a gynaecologist and fertility specialist working in private practice in Toowoomba, Australia. She has a particular interest gynaecological surgery and doctor wellbeing.    Highlights: While patients are primarily affected by complications, surgeons are second victims when complications develop. Second victim refers to a clinician who experiences emotional trauma when complications develop.Second victims may feel shame, guilt, sadness and a crisis of confidence. In addition, second victims may develop problems with sleep, or develop musculoskeletal and gastrointestinal symptoms.Second victim syndrome is more likely if complications are severe, caused by a perceived mistake, or if the surgeon is concerned that it may attract criticism from colleagues.89% of respondents reported having impacts on their sleep when they are involved in a surgical complication.Younger age, fewer years in practice, and female respondents had higher impacts of stress related to complications.Female surgeons reported higher levels of physical and mental health impacts and higher levels of impact on sleep compared with male surgeons.
LVSI Classification and Impact on Outcomes in Stage I Endometrial Cancer with Drs. Christian Dagher and Nadeem Abu-Rustum
Oct 14 2024
LVSI Classification and Impact on Outcomes in Stage I Endometrial Cancer with Drs. Christian Dagher and Nadeem Abu-Rustum
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.
Role of Chemotherapy following Chemoradiation After Radical Hysterectomy with Dr. Anuja Jhingran
Sep 23 2024
Role of Chemotherapy following Chemoradiation After Radical Hysterectomy with Dr. Anuja Jhingran
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.
IJGC EiC Summer Podcasts: OVHIPEC1 Overall Survival Analysis with Lot Aronson and Willemien J. van Driel
Aug 26 2024
IJGC EiC Summer Podcasts: OVHIPEC1 Overall Survival Analysis with Lot Aronson and Willemien J. van Driel
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.
Overall survival of SORAYA Trial with Robert Coleman
Aug 5 2024
Overall survival of SORAYA Trial with Robert Coleman
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.
Updates on Endometrial Cancer in Latin America with Mansoor Mirza and Angélica Nogueira Rodrigues
Jul 22 2024
Updates on Endometrial Cancer in Latin America with Mansoor Mirza and Angélica Nogueira Rodrigues
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.