Madrid, May 18, 2022 – Although the incidence of gynecologic cancers is not particularly high, it is an ongoing challenge for specialists. So, ovarian, endometrial-uterine, cervical and vulvar tumors are at the center of the debate at the VIII MD Anderson International Congress on Gynecologic Oncology, organized by MD Anderson Cancer Center Madrid in collaboration with MD Anderson Cancer Center in Houston, and which aims to publicize the latest advances in the diagnosis and treatment of gynecologic cancers.
In recent years, there have been major changes in the surgical treatment of gynecologic cancer. "Although previously in radical surgery for gynecologic cancer, the emphasis was placed on intraoperative and perioperative morbidity and mortality, subsequently decisions have been based on the impact on disease-free survival and overall survival," says Dr. Javier de Santiago, head of the Gynecologic Oncology Service at MD Anderson Madrid and co-organizer of the event. Now, as Dr. de Santiago points out, interest is also focused on achieving a good quality of life for the patient, and that is the basis for the individualization of radical surgical according to the risk factors, or on the application of chemotherapy treatments that can reduce the radical nature of surgery and the impact on quality of life, without affecting the survival rate.
So, at the congress, which will be presential and streamed between May 18-20 in Madrid, issues related to the conservative treatment of cervical cancer and the individualization of endometrial cancer treatment according to molecular factors will be addressed - which allow patients to be chosen to modulate treatments - or the use of the sentinel node, which avoids the need to perform a complete lymphadenectomy on the patient (removal of the lymph nodes).
Unfortunately, some gynecologic cancers recur over time, and choosing the right treatment at that time is critical to survival. In many cases, these patients benefit from inclusion in clinical trials which allow the usefulness of new treatments to be established. These clinical trials, which MD Anderson Madrid regularly participates in, will also be the subject of debate by international experts, like Dr. Pedro T. Ramirez, who is Director of Research in Minimally Invasive Surgery and Education with the Gynecologic Oncology Department at MD Anderson Cancer Center in Houston, and is also a co-organizer of the congress.
Pharmacological advances by tumor type
At this international congress, the views of experts in gynecologic cancer from Europe and the United States come together and the most important news on each type of cancer is shared. For example, Dr. Raul Marquez, head of the Gynecologic Tumor Section at MD Anderson Madrid and co-organizer of the congress states that, “in cervical cancer, a type of tumor with nearly 2,500 new cases expected this year in this country1, immunotherapy has been established as a first-line standard in those patients who express PDL-1. On the other hand, other immunotherapies take over after a progression to platinum-based treatment and antiangiogenic agents. And new drugs, based on vaccines, are making progress in this type of highly aggressive tumor”.
For its part, "the great revolution has been with the new molecular classification of endometrial cancer, the fourth most common cancer in women in Spain2, by virtue of which risk and treatment are defined," warns Dr. Marquez, who points out the role of immunotherapy in patients who present microsatellite instability (MSI), as well as the combination of immunotherapy and antiangiogenic agents in those who do not present MSI (MSS).
PARP inhibitors have been the first line in the treatment of ovarian cancer (with an estimated 3,600 new cases for 2022 in Spain1) with spectacular benefits, above all in tumors that present a BRCA mutation or homologous recombination deficiency (HRD). "At the congress, the current problem of when our patients progress to platinum-based treatment and PARP inhibitors will be discussed in detail, with resistance to them posing a biological challenge," says Dr. Marquez. And "despite the fact that immunotherapy has not yielded the expected results, the next frontiers will be raised in patients with advanced disease,” he explains.
Spanish and American experts will also discuss rare gynecologic tumors and those that have exhausted their treatment lines and for which molecular study may provide new opportunities for personalized precision medicine.