In The Know-September 2025

September 2025

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This September 2025 edition of "Ed’s List: In The Know - Gynecologic Oncology Literature of Significance" highlights pivotal research advancing understanding and treatment in gynecologic cancers.<br /><br />A major focus is on serous tubal intraepithelial carcinoma (STIC), a precursor to high-grade serous carcinoma (HGSC). A Canadian multicenter study found that after expert pathology review, the 5-year cumulative incidence of progression from confirmed isolated STIC to HGSC was 2.6%, underscoring the need for diagnostic precision to guide management. Commentary emphasized the challenges differentiating STIC from microscopic invasive carcinoma and called for standardized pathological criteria.<br /><br />In ovarian cancer immunotherapy, a mouse model study showed that triple checkpoint blockade (targeting PD-1, Tim-3, and Lag-3) enhances adoptive T cell therapy efficacy versus single or dual blockade by preventing T cell exhaustion. Another immunology study identified targeting the retinoblastoma protein pocket in tumor-associated macrophages as a novel therapeutic approach to shift the tumor microenvironment and inhibit ovarian cancer progression.<br /><br />Clinical treatment advances include evidence that gemcitabine, especially combined with bevacizumab, improves outcomes in platinum-resistant ovarian clear cell carcinoma. A nationwide cohort study confirmed fertility-sparing surgery in early-stage cervical cancer yields higher recurrence rates but similar overall survival compared to hysterectomy.<br /><br />Studies showed disparities in timely cervical cancer treatment based on insurance status, with Medicaid patients experiencing delays mainly between biopsy and staging. A phase 3 trial of adjuvant chemoradiotherapy with simultaneous integrated boost in cervical cancer improved 3-year progression-free survival without added toxicity.<br /><br />Other highlights encompass early detection advances such as circulating tumor HPV DNA sequencing enabling detection of HPV-related oropharyngeal cancer years before diagnosis, and genomic studies revealing the molecular landscapes of endometrioid and mucinous ovarian cancers aiding targeted therapies.<br /><br />A provocative perspective article argued for a separate gynecologic surgery residency distinct from obstetrics-gynecology training, citing the volume-outcome relationship and reimbursement inequities harming gynecologic surgical care.<br /><br />Collectively, these studies advance diagnostics, therapeutics, and health equity in gynecologic oncology, employing multi-institutional cohorts, innovative molecular techniques, and real-world data to refine care and improve patient outcomes.

Keywords

gynecologic oncology

serous tubal intraepithelial carcinoma

high-grade serous carcinoma

ovarian cancer immunotherapy

triple checkpoint blockade

tumor-associated macrophages

gemcitabine and bevacizumab

fertility-sparing surgery

cervical cancer treatment disparities

circulating tumor HPV DNA