Current and emerging immunotherapies for recurrent cervical cancer.

Approximately 4290 women in the United States and 311,000 women worldwide died of cervical cancer in 2021. The management of advanced, recurrent, and/or metastatic cervical cancer has been a difficult and frustrating task owing to the paucity of available treatments. The year 2021 proved to be a boon for oncologists and their patients with cervical cancer, however, thanks to the release of data from KEYNOTE-826, which led to the approval of pembrolizumab in combination with chemotherapy, as well as the full approval of pembrolizumab alone, in the first-line setting. By January of 2022, it is likely that cemiplimab will be approved for recurrent or metastatic cervical cancer. With the availability of programmed death 1 (PD-1) inhibition in the first-line setting, it becomes important to discuss the future of second-line treatment, given that combination immunotherapy treatment that includes a PD-1 inhibitor after initial PD-1 treatment has been proved effective in the melanoma setting. Proposed and trialed combinations in immunotherapy include PD-1 inhibition with anti-T-cell immunoreceptor with Ig and ITIM domains (TIGIT) agents, anti-cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) agents, and long-peptide vaccine. This review discusses the KEYNOTE-158 and KEYNOTE-826 trials of pembrolizumab, along with the EMPOWER CERVICAL 1 (R2810-ONC-1676/GOG 3016/ENGOT cx9) trial of cemiplimab and a phase 3 trial of balstilimab in cervical cancer. It also discusses the rationale for the use of immunotherapy in the cervical cancer setting, the mechanisms of action of available and currently studied immunotherapies, biomarkers for predicting and assessing response to treatment, and mechanisms of secondary tumoral escape or resistance to immunotherapy.

Niraparib in the maintenance treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer: safety and efficacy.

Introduction: Approximately 300,000 women worldwide are diagnosed each year with ovarian cancer. Frequently diagnosed in late stages with ambiguous symptomatology, ovarian cancer has a low survival rate.Areas covered: Niraparib, a PARP inhibitor, was approved in 2020 for use in the maintenance treatment of ovarian cancer regardless of biomarker status. Included in the review are PRIMA (NCT02655016), NOVA (NCT01847274), AVANOVA2 (NCT02354131), and QUADRA (NCT02354586) trials which herald the advent of using maintenance oral therapies in the treatment of ovarian cancer. Additionally, with new combination drug trials, exciting avenues for treatment are also discussed with the FIRST (NCT03016338) trial.Expert opinion: Maintenance niraparib treatment regardless of genetic profile offers a new modality for the treatment of ovarian cancer with a low side effect profile and importantly oral dosing. New combinations of synergistic immunotherapeutics, and antiangiogenesis therapies with niraparib also offer exciting new frontiers for patients with ovarian cancer.

Endometrial cancer in the morbidly obese: a review.

PURPOSE OF REVIEW: With a worldwide increase in obesity, there has been an increase in obesity-related diseases. Endometrial cancer is a common cause of cancer for women worldwide. Incidence of endometrial cancer has risen worldwide. Accompanying these patients are risk factors and challenges that may prevent standard of care from being delivered. RECENT FINDINGS: The current article describes recent literature describing surgical approaches to the obese patient and special considerations in this population. This article also reviews bariatric surgery and endometrial cancer as well as new updates in radiation, chemotherapy and hormonal therapy research in the obese population. SUMMARY: The current article reviews therapeutics and surgery in the morbidly obese for the treatment of endometrial cancer.

Bevacizumab in Cervical Cancer: 5 Years After.

Over the past 5 years, addition of bevacizumab to combination chemotherapy for advanced, recurrent, and persistent cervical cancer has offered prolonged overall and progression-free survival. Since the original press release announcing the survival benefits of this antiangiogenesis therapy, there has been further study of bevacizumab related to quality of life, combination with other agents, use of imaging to evaluate likelihood of response, and development of biosimilars. This review summarizes publications related to bevacizumab use in advanced, recurrent, and persistent cervical cancer over the past 5 years since initial proof of concept of antiangiogenesis therapy and the initial dissemination of information regarding survival benefits of bevacizumab.

Anti-angiogenesis therapy, synthetic lethality, and checkpoint inhibition in ovarian cancer: state of the science and novel combinations.

Over the last decade, new therapeutics in the form of anti-angiogenic treatment, synthetic lethality, and checkpoint inhibition have offered new options for the treatment of ovarian cancer. This review summarizes studies related to these treatment modalities and additionally novel combinations that offer a veritable therapeutic matrix for clinicians to choose from.