Thomas C. Krivak, MD

Panelists discuss recent data on emerging antibody-drug conjugates in advanced and recurrent endometrial cancer, including anti-TROP2 agents like sacituzumab govitecan from the TROPiCS-03 trial, datopotamab deruxtecan from TROPION-PanTumor03, and sacituzumab tirumotecan, as well as anti–folate receptor agents like luveltamab tazevibulin and rinatabart sesutecan, while offering future perspectives and closing thoughts on the evolving role of these agents in the treatment landscape for endometrial cancer.

Panelists discuss the recent tumor-agnostic approval of trastuzumab deruxtecan (T-DXd) based on findings from the DESTINY-PanTumor02 trial, exploring its implications for treatment approaches in advanced endometrial cancer, how to integrate T-DXd into treatment algorithms, patient selection criteria, and which patients are most likely to benefit from this therapy compared to lenvatinib/pembrolizumab.

Panelists discuss emerging data from ongoing trials evaluating innovative combination strategies for endometrial cancer, including insights from the LEAP trial (pembrolizumab + lenvatinib) and the KEYNOTE-B21 trial (pembrolizumab + chemotherapy with or without radiotherapy). They also address treatment considerations for patients with sentinel lymph node–positive disease.

Panelists discuss recent updates from the DUO-E trial, highlighting key efficacy and safety data that led to the FDA’s approval of durvalumab for endometrial cancer while examining how this new indication influences treatment strategies for advanced or recurrent cases.

Panelists review available treatment options for recurrent endometrial cancer, discussing their typical treatment approaches and the factors influencing treatment selection. Panelists also address insights from the RUBY trial, its updates, and the expanded FDA indication for dostarlimab, including the implications of these developments on treatment strategies and the potential benefits and challenges of broader use in patients.

Panelists discuss their approach to biomarker testing in advanced endometrial cancer, including the timing and types of testing performed, the specific biomarkers assessed (such as mismatch repair/microsatellite instability, POLE, and TP53), and how these results inform treatment decisions.

Panelists discuss the integration of tisotumab vedotin into ovarian cancer therapy, covering its role in treatment approaches, patient selection, adverse event management, clinical pearls, challenges in practice, and the implications of the drug’s payload on treatment efficacy.

Panelists discuss key findings from the KEYNOTE-A18 trial, which evaluated pembrolizumab in combination with chemoradiotherapy for high-risk locally advanced cervical cancer, highlighting the implications for treatment approaches in this patient population.

Panelists discuss recent data on various antibody-drug conjugates (ADCs) in ovarian cancer, including mirvetuximab soravtansine from trials like FORWARD II, MIRASOL, and PICCOLO; luveltamab tazevibulin and rinatabart sesutecan from STRO-002-GM1 and REFRαME-O1; and raludotatug deruxtecan from REJOICE-Ovarian01, highlighting the evolving role of these agents in the treatment landscape for ovarian cancer.

Panelists discuss the recent tumor-agnostic approval of trastuzumab deruxtecan (T-DXd) based on findings from the DESTINY-PanTumor02 trial, its potential impact on treating advanced ovarian cancer given HER2 data, and how T-DXd may fit into the current treatment algorithm for ovarian cancer.

Panelists discuss strategies to address PARP inhibitor (PARPi) resistance in ovarian cancer, including emerging combinations like gotistobart + pembrolizumab from the PRESERVE-004 trial, insights from the SOPRANO trial on managing oligometastases or oligoprogression, and approaches to mitigate or manage common adverse events associated with PARPi maintenance therapy.

Panelists discuss how emerging maintenance strategies for advanced/metastatic disease increasingly focus on novel combination approaches, including immunotherapy combinations with PARP inhibitors (rucaparib + nivolumab), anti-angiogenic agents (atezolizumab + bevacizumab), and dual targeted therapy (olaparib + cediranib), with ongoing evaluation of optimal patient selection and sequencing in the treatment paradigm.

Panelists explore emerging combination therapies in maintenance treatment for advanced ovarian cancer, including rucaparib + nivolumab; atezolizumab + bevacizumab; and olaparib + cediranib, also discussing how these strategies fit into the current treatment paradigm and in which patient populations they may be considered.

Panelists discuss optimal durations for PARP inhibitor maintenance therapy in ovarian cancer, exploring how long patients are typically kept on PARPi in both first-line and second-line maintenance settings.

Panelists discuss frontline maintenance therapies for advanced ovarian cancer, focusing on the impact of BRCA and HRD statuses on treatment selection and the choice between combination therapy (PARPi + bev) and monotherapy.

The panel closes their discussion by highlighting challenges in the treatment of cervical cancer, emphasizing the need for more focus on clinical trials and therapies, as well as addressing disparities in cancer care, particularly for patients of color.

Bradley Monk, MD, shares the promising potential of anti-HER2 therapy in cervical cancer and discusses encouraging results from recent trials, emphasizing the importance of testing for HER2 and considering anti-HER2 antibody drug conjugates as a treatment option.

Experts in gynecologic oncology discuss the positive results of TV-301, a confirmatory trial for TV-204, raising the possibility of moving tisotumab vedotin earlier in the treatment of patients with cervical cancer, and the potential to combine it with pembrolizumab.

Experts detail the management of ocular toxicity associated with tisotumab vedotin in patients with cervical cancer, emphasizing the need for eye care professionals and a team approach, along with addressing peripheral neuropathy.

Dana M. Chase, MD, FACOG, discusses the antibody-drug conjugate tisotumab vedotin including its mechanism of action, its accelerated approval for patients with recurrent cervical cancer and at least one prior line of therapy, and the management of toxicities such as neuropathy and pneumonitis.

Leslie M. Randall, MD, reviews updates to the NCCN guidelines for cervical cancer, including the use of pembrolizumab in the second and third-line settings, the results of the KEYNOTE-826 trial, and the potential role of induction chemotherapy with weekly carboplatin and paclitaxel in the treatment of locally advanced cervical cancer.

David M. O’Malley, MD, discusses cervical cancer epidemiology, risk factors, and diagnosis, highlighting the importance of HPV vaccinations, regular PAP smears, and the use of various biomarkers for treatment decision making.

Experts are enthusiastic about the potential of antibody drug conjugates to de-escalate therapy and reduce toxicity in advanced and recurrent endometrial cancer treatment, with a focus on the importance of diversity plans in clinical trials to ensure broader applicability.

The panel highlights recent data on antibody drug conjugates targeting TROP2 in patients with advanced or recurrent endometrial cancer and the need for dose optimization.

Key opinion leaders share excitement about antibody-drug conjugates targeting HER2 in advanced or recurrent endometrial cancer, and debate optimal HER2 testing methods, with some preferring gastric cancer scoring criteria over breast cancer criteria.

The panel reviews results from the ATTEND and DUO-E trials in advanced endometrial cancer, suggesting pembrolizumab remains the standard for the dMMR patient subset while combinations with PARP inhibitors may improve outcomes in pMMR.

Dr Thomas C. Krivak highlights key data from the GY018 trial investigating chemotherapy plus pembrolizumab in both dMMR and pMMR advanced endometrial cancer, confirming and extending the findings from the RUBY trial supporting pembrolizumab's approval and use in both dMMR and pMMR populations.

Thomas C. Krivak, MD, shares the positive results from the RUBY trial of pembrolizumab plus chemotherapy followed by maintenance in patients with dMMR advanced endometrial cancer, supporting its approval and use in this population.

David M. O’Malley, MD, details the definition of dMMR (mismatch repair deficiency), its prevalence in advanced endometrial cancer, and current treatment approaches for dMMR patients, with a focus on the potential for cure in recurrent/metastatic dMMR patients based on clinical trial data.

The panel discusses factors to consider when determining best treatment options for patients with recurrent or advanced endometrial cancer, including traditional clinical trial endpoints, cost, chance for cure versus disease control, and most importantly, patient preference.