In The Know-October 2025

October 2025
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The October 2025 edition of "Ed’s List: In The Know" highlights pivotal recent advances in gynecologic oncology with a focus on ovarian, cervical, and endometrial cancers. Key studies include mechanistic insights, clinical treatment evaluations, and innovations in immunotherapy and monitoring techniques.<br /><br />A Molecular Oncology study revealed that loss of primary cilia in ovarian tumor endothelial cells promotes endothelial-to-mesenchymal transition (EndMT) via EphA2 activation, fostering a pro-tumor microenvironment. In high-grade serous ovarian cancer (HGSOC), transcription factor SOX9 was identified as a driver of a stem-like state mediating platinum chemotherapy resistance, suggesting a target for overcoming drug tolerance.<br /><br />Immunotherapy advances feature bispecific T cell engager (BiTE)-secreting T cells targeting folate receptor alpha combined with PD-1 blockade and vaccines, which reshaped ovarian tumor immunity and enhanced control. Additionally, CAR-T cells engineered to secrete αPD-L1–IL-12 fusion proteins showed improved antitumor efficacy and safety in ovarian models by modulating the tumor microenvironment.<br /><br />Surgical studies reported that, despite increased morbidity, diaphragmatic resection in advanced ovarian cancer did not delay chemotherapy nor worsen severe complication rates compared to stripping. A German nationwide analysis demonstrated regular hepatic resections for ovarian cancer metastases, primarily at high-volume centers, underscoring expanding aggressive cytoreduction practices.<br /><br />A US population study emphasized federally qualified health centers’ role in serving underscreened groups and modeled that increasing cervical cancer screening there to Healthy People 2030 goals could substantially reduce disparities. A study on time to chemotherapy post-cytoreduction suggested initiation within 28 days may improve survival, especially for advanced-stage patients.<br /><br />Emerging technologies include CloneSeq-SV, combining single-cell and cell-free DNA sequencing to track clonal evolution and drug resistance in HGSOC, revealing pre-existing resistant clones and informing adaptive treatments. In early-stage uterine cancer, circulating tumor DNA detection predicted recurrence more accurately than traditional risk factors, supporting its utility for tailored monitoring.<br /><br />Additional mechanistic work showed cholesterol impairs progestin signaling in endometrial cancer, contributing to resistance, with statins restoring sensitivity. A single-cell atlas of cervical organoids during Chlamydia infection uncovered complex epithelial immune interactions relevant to mucosal defense.<br /><br />Overall, these studies advance understanding of tumor biology, resistance mechanisms, treatment optimization, and biomarker development in gynecologic oncology, guiding future research and clinical strategies.
Keywords
gynecologic oncology
ovarian cancer
cervical cancer
endometrial cancer
immunotherapy
chemotherapy resistance
tumor microenvironment
surgical cytoreduction
cancer screening disparities
circulating tumor DNA