Gynecologic Oncology Research Updates

This review covers rare gynecologic tumors—gestational trophoblastic neoplasia, ovarian germ cell tumors, and ovarian clear-cell carcinoma—summarizing clinical features, staging, and current treatments which largely follow ovarian cancer paradigms while increasingly incorporating targeted therapies. It notes gestational trophoblastic tumors are usually curable even when widely metastatic, whereas ovarian clear-cell carcinoma is characterized by intrinsic chemoresistance and distinct molecular features, prompting movement toward biologically aligned strategies using molecular selection and microenvironmental modulation for future therapeutic development.

In a chart review of 65 women with Lynch syndrome (age >30, intact uterus/ovaries, no prior uterine/ovarian cancer) at a safety-net hospital and a university medical center, uptake of risk-reducing gynecologic surgery was higher at the safety-net hospital (67.9% vs 35.1%) and occurred sooner. After controlling for age and prior non-gynecologic cancer, being treated at the safety-net hospital remained associated with greater likelihood of surgery (HR 2.43, p = 0.02); age, parity, Lynch gene, benign gynecologic diagnosis, family history, race/ethnicity, and language preference were not significantly associated with surgery uptake.

This review discusses how increasing use of neoadjuvant systemic therapy (NAC) in breast cancer is enabling response-adapted de-escalation of locoregional treatment. It summarizes emerging practices and trials evaluating omission of sentinel lymph node biopsy after NAC in selected cN0 patients, use of sentinel lymph node biopsy alone (and potential omission of regional nodal irradiation) for cN+ patients who achieve nodal pathologic complete response, and radiation adjustments including omission of tumor-bed boost in exceptional responders and use of premastectomy radiotherapy to facilitate reconstruction.