The rare gynecologic cancers were covered in one Master Class on the first day of the SGO Annual meeting. It took me a bit of time getting back into the swing of tweeting from a live meeting - it has been two years- so most of this post will be from the notes I took instead my Tweets.
NE Tumors of the Cervix – Speaker: M. Frumovitz
I had not heard of Neuroendocrine gynecologic tumors before this first presentation. Many of the trials for neuroendocrine treatments are basket trials. They are looking at Anti-CTLA-4 and Anti-PdL1 treatments. One that is open now uses Cadonilimab. Patients have used groups on Facebook to share information and crowdfund for research projects. There is a neuroendocrine registry at MDAnderson.
Uterine Serous Carcinoma – Speaker: A. Nickles-Fader
Uterine serous carcinoma is different from endometrial carcinoma in their molecular makeup. USC has high genomic instability , low tumor burden and 90% have TP53 mutations. Minimally invasive surgery is OK for USC. Checking for HER-2 is important. Trials using trastuzumab ( HER-2 inhibitor) have shown an improvement in PFS ( progression free survival) and OS (Overall survival). Other drugs being tested include Pertuzumab with ERBB2 amplification, Wee inbhibitor Adavosertib, tyrokinase inhbitors and PIKC3A inhibitors and antidrug conjugates.
Germ Cell Tumors – Speaker: L. Frazier
Germ cell tumors are most common in adolescent and young adults. Current treatment with Vinblastine,Bleomycin and a platinum drug causes late side effects. Experts formed MaGIC https://magicconsortium.com/ to work together. Current trial includes using carboplatin instead of cisplatin.
Low Grade Serous Ovarian Cancer – Speaker: R. Grisham
1000 women a year diagnosed with Low Grade Serous OC.Phase II study of enzalutamide in women who were Andogen receptor+ demonstrated PFS of 4.6 months versus HGSOC with PFS of 1.7 months. In the MILO trial ( recurrent LGSOC, binimetinib) those with a MAPK mutation had improved outcomes.International Consortium for Low Grade Serous Ovarian Cancer group established.
Vulvar/Vaginal Melanoma – Speaker: D. Vicus
1 -3% of all melonomas are mucosal and of those 20% are vaginal/vulvar melanoma . Dasatinib trial for recurrent disease had 7.5 months PFS . AntiPDL-1 being studied. February 2022 study AO91903 w/ nivulomab opened.
Vulvovaginal Melanoma or Vulvar and Vaginal Melanoma: Can These Tumors be Considered The Same? – Speaker: A. Wilhite
Debate: Should Gynecologic Cancer Trials be Conducted Based on Histology or Molecular Features? (Histology) – Speaker: J. Brown
GOG established a Rare Tumor committee in 2005. Basket umbrella trials might be best.
Debate: Should Gynecologic Cancer Trials be Conducted Based on Histology or Molecular Features? (Basket) – Speaker: I. Ray-Coquard
GOG-3051 Bouquet enrolling
Innovative Biostatistical Designs for Overcoming Logistical Barriers – Speaker: M. Krailo
Interesting presentation on using historic data in rare cancer clinical trials.
Clear Cell Carcinoma/ARID1a/PI3K – Speaker: S. Gaillard & L. Shih
Ovarian Clear Cell Caricinoma is underrepresented in clinical trials.ARID1a deletion and PIK3CA mutation found in OCCC.
Glutumase over expression is seen in recurrent clear cell.
DNA Methylating Drug Temozolomide Sensitizes ARID1A-Mutated Tumors to PARP Inhibitors – Speaker: T. Wang
ARID1a knock out cells are more sensitive to Temozolomide and PARPi.
Bridging the Translational Interface in Rare Ovarian Cancers: Endometrioid Ovarian Cancer – Speaker: C. Gourley & R. Hollis
Endometrioid OC makes up about 11% of all ovarian cancer cases. University of Edinburgh has set up an ovarian cancer database for endometriod OC. TP53 and CTNNB1 are most prevelant mutations
Ovarian and Uterine Carcinosarcoma Cell Lines Show Preclinical Sensitivity to BAY 1895344, a Novel Ataxia-Telangiectasia and Rad3-related (ATR) Kinase Inhibitor – D. Manavella
Carcinosarcomas are agressive cell types. This was a Cell line study using Elimusertib (BAY-1895344), a selective ATR kinase inhibitor. 40% of ovarian carcinosarcoma have an HRD signature
The session ended with a panel of patient advocates, J. Ludemann, K. Richardson, S. Madsen, L. Laughlin talking about the needs of patients and additional clinical trials being designed for rare gyn cancers.
Next up Disparities and Equity Research Across Gyn Cancers. That post will be reports of various presentations over the days of the conference.
Dee
