IJGC Podcast

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

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.

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

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 therapy Most 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

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Rongyu Zang and Yulian Chen to discuss the SOC-1 trial. Dr. Rongyu Zang is the Director of the Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, & Institute for Ovarian Cancer, Fudan University and is the Principal investigator of the SOC-1 and SUNNY trials. Dr. Yulian Chen is an Attending Physician at the Department of Gynecologic Oncology, Fudan University Zhongshan Hospital.   Highlights: The SOC-1 trial concluded that in patients with platinum-sensitive, relapsed ovarian cancer, surgery did not increase overall survival in the intention-to-treat population, but resulted in a prolongation of survival after adjustment of crossover. Surgery may provide an obviously higher proportion of long-term relapse-free survivors than chemotherapy alone. An active preoperative evaluation for all patients with platinum-sensitive first relapsed ovarian cancer is suggested in specialized centers.

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.  

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 (

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 prognosis The 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 chemotherapy Consistent benefit in progression-free survival and confirmed response were also observed and supportive of the observed overall survival benefit with tisotumab vedotin The safety profile of tisotumab vedotin was manageable and tolerable, and consistent with previous experience Based 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 ERAS ERAS can be applied to both open and minimally invasive surgery ERAS 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 agent Early clinical data suggested efficacy in recurrent platinum-resistant ovarian cancer (PROC) prompting a larger trial to confirm both safety and efficacy in patients with PROC In 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 discontinuation Now 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 (

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, and an assistant professor at the Hebrew University of Jerusalem. His research encompasses population database studies with clinical implication and innovations in medical education and health care. 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

Podcast Description: In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Mueller and Manning-Geist to discuss molecular classification in ovarian preservation for uterine cancer. Jenny Mueller MD is a gynecologic oncologist and an associate attending in the department of surgery at Memorial Sloan Kettering Cancer Center.  She leads the endometrial cancer research team at MSKCC with an emphasis on prospective, translational and collaborative efforts within and across institutions. Beryl Manning-Geist is a Gynecologic surgery fellow at Memorial Sloan Kettering Cancer Center and will be joining Emory University Division of Gynecologic Oncology in 2024 as an assistant professor. Her research focuses on how to leverage the molecular underpinnings of gynecologic cancers for tailored treatment. Highlights: -Patients with microsatellite instability-high/mismatch repair-deficient or copy number-high/TP53abnormal endometrial cancer were at increased risk of concurrent ovarian disease. -The presence of lymphovascular space invasion and positive cytology were also associated with an increased risk of concurrent ovarian disease. -Integrating molecular tumor profiling with pathologic characteristics of disease may help to better risk stratify pre-menopausal patients with endometrial cancer for ovarian preservation.

Podcast Description: In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Christhardt Köhler and Achim Schneider to discuss radical vaginal trachelectomy. Prof. Christhardt Köhler is a highly accomplished gynecologist and obstetrician specializing in oncological gynecology. He is the Chief Physician of the Department of Gynecology at Asklepios Hospital Altona Hamburg and has won the Briker Award and the Robert B. Hunt Endowed Award. Dr. Kohler is a member of several professional associations, including the German Society for Gynecology and Obstetrics. His expertise is recognized worldwide, and he is listed in the FOCUS top list of physicians for gynecological operations and tumors. He has 1381 scientific publications focusing on spinal muscular atrophy, cervical cancer, and innovative gynecological surgery approaches. Achim Schneider, born on September 17, 1950, in Augsburg, is a distinguished German gynecologist and obstetrician. He earned his doctorate in 1975 and has since made significant contributions to the field, including pioneering new laparoscopic surgical techniques in gynecological oncology in Germany. Schneider held prestigious professorships at the Friedrich Schiller University in Jena and the Charité in Berlin. He has focused on the diagnosis and treatment of genital neoplasms, HPV-associated ano-genital neoplasms, and fertility-preserving surgery for cervical cancer patients. Currently, he heads the dysplasia consultation at the Medical Care Center in Berlin, continuing his impactful work in minimally invasive procedures and cancer prevention. Highlights: Radical vaginal trachelectomy is a fertility-preserving treatment for early cervical cancer, but large studies on its outcomes are lacking. In a study of 471 patients (median age 33), 62% sought pregnancy with a 73% success rate, and 46% experienced pre-term delivery; recurrences occurred in 3.4% of cases, with a 2.1% mortality rate. The study confirms the oncologic safety of the procedure and suggests that high pre-term delivery rates may be due to cervical volume loss, providing a benchmark for future surgical modifications

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Koji Matsuo to discuss new FIGO staging of endometrial cancer. Dr. Matsuo is a clinician-scientist in the area of gynecologic oncology in the United States. His research interest is population-based, heath service outcome research for gynecologic malignancies. Highlights: (1) Survival effect of adjuvant therapy differed between stage IA3 and IIIA1. (2) In new stage IA3 disease, omission of adjuvant therapy had comparable overall survival compared to combination chemotherapy and external beam radiotherapy or chemotherapy alone. (3) In stage IIIA1, omission of adjuvant therapy was associated with decreased overall survival compared to chemotherapy-based approach. (4) 5-year overall survival of adjuvant therapy omission group in new stage IA3 was nearly 90%. (5) These hypothesis-generating observation suggested that treatment de-escalation of well-staged stage IA3 may not adversely affect survival. 

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Shitanshu Uppal to discuss the impact of closure of small fascial bites on incisional hernia rates in gynecologic oncology patients. Dr. Uppal is the George W. Morley Collegiate Professor of Obstetrics and Gynecology and the Division Chief of Gynecologic Oncology at the University of Michigan. Dr. Uppal is recognized for his research in surgical outcomes and quality improvement, alongside his pivotal role in leading educational initiatives for Gynecologic Oncology.   Highlights:   - This quality improvement study validates prior RCT data in gynecologic oncology population - Adoption of Small-Bite Fascial Closure Reduced Hernia rates by 50% - Obesity and adjuvant chemotherapy are independent risk factors for hernia development

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

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.

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.

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.

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.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Mr. Hani Marcus to discuss the IDEAL Framework. Mr. Marcus is a Consultant Neurosurgeon at the National Hospital for Neurology and Neurosurgery and Honorary Associate Professor at the UCL Queen Square Institute of Neurology.   Highlights: - The development of the next generation of surgical robotics presents unique challenges in evaluation due to their complexity, integration with AI, and potential for system disruption. - The IDEAL (Idea, Development, Exploration, Assessment, and Long-term monitoring) Robotics colloquium suggests practical recommendations for evaluating surgical robots at different stages: development, comparative study, and clinical monitoring. - These recommendations are aimed at developers, clinicians, patients, and healthcare systems, considering multiple aspects like economics, training, ethics, and sustainability.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Christina Fotopoulou, Ane Gerda Z. Eriksson, Glauco Baiocchi, and Oliver Zivanovic to discuss the 2024 Special Issue of IJGC, “Novel Surgical Approaches in Gynecological Oncology”. Dr. Fotopoulou is the Chair of Gynaecological Cancer Surgery at the Department of Surgery and Cancer at Imperial College London, UK. She has served as an elected ESGO council member and Chair of the ESGO and BGCS guidelines committee. Dr. Eriksson is the chair of the endometrial cancer and gyn sarcoma group at the Department of Gynecologic Oncology at the Norwegian Radium Hospital. She is currently an elected ESGO Council member and chair of the ESGO accreditation committee. Dr. Eriksson also serves on the NSGO-CTU Foundation Board.  Dr. Glauco Baiocchi is the head of the Department of Gynecologic Oncology at the AC Camargo Cancer Center. He is also the president of the Brazilian Gynecologic Oncology Group – EVA Group. Oliver Zivanovic MD is a Gynecologic Oncologist and Chairman of the Department of Obstetrics and Gynecology at the Women's Heidelberg University Hospital, Germany.    Highlights: Surgery is the cornerstone of treatment in gynecologic oncology. Surgery is being incorporated and adapted to the evolving treatment landscape in gynecologic oncology.  This special issue highlights the opportunities of tailoring surgical approaches to individual patients both in regard to radically and novel surgical techniques. It brings together out of the box topics such as surgery for lymphedema, uterine transposition, imaging, quality of life, and medico-legal aspects.  All articles were written by respected and well-known experts on each topic. Our hope and intention is that this Special Issue will become a significant resource in surgery for gyn oncology and may support and inspire surgeons to deliver better treatment.