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Cancers
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New Challenges in Gynaecological Cancers Diagnosis and Treatment
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New Challenges in Gynaecological Cancers Diagnosis and Treatment

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (10 November 2023) | Viewed by 5451

Special Issue Editors

Prof. Dr. Giorgio Valabrega

E-Mail Website
Guest Editor
Department of Oncology, University of Turin, Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy
Interests: Immunotherapy in endometrial and cervical cancer; targeted therapies in ovarian cancer; clinical trials in gynaecological cancer
Special Issues, Collections and Topics in MDPI journals
Dr. Valentina Tuninetti

E-Mail Website
Guest Editor
Department of Oncology, University of Turin, Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy
Interests: targeted therapies in gynaecological cancer; PARP inhibitors in ovarian cancer; clinical trials in gynaecological cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The five main types of gynecologic cancers are: cervical, ovarian, uterine, vaginal, and vulvar. Of all the gynecologic cancers, only cervical cancer has screening tests that can help to diagnose cancer early, when treatments can be curative. Since there is no simple and reliable method to screen for any gynecologic cancers, it is important to recognize warning signs and symptoms, especially for ovarian cancer which is often diagnosed in advanced stage.

Over the last five years, a great deal of progress has been made in the diagnosis and treatment of gynaecological cancers the 5-year survival rates have been improved for all gynecologic cancers. The introduction of PARP inhibitors in ovarian cancer (both at diagnosis and at relapse) and the use of immune checkpoint inhibitors in endometrial and cervical cancer have improved the strategies of care for gynaecological cancers. Therefore, more efforts can be made to further increase overall survival.

The aim of our Special Issue is to investigate new challenges diagnosis and treatment of gynaecological cancers. We are pleased to invite you to contribute with original research and comprehensive reviews to our Special issue due to your recognized expertise in the field.

Articles that highlight and inspire the rapid advancements in the field of gynecological cancers are particularly welcome. We are interested in research on gynecological cancer diagnosis, treatment, and molecular mechanisms of development and relapse, mode of action and drug resistance, new targets for personalized therapy of the disease, and models with which to investigate novel therapeutic approaches transferrable to clinical trials.

We look forward to receiving your contributions.

Prof. Dr. Giorgio Valabrega
Dr. Valentina Tuninetti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • new perspectives in gynaecological cancer diagnosis and treatment
  • mechanisms of resistance to drug in gynaecological cancers
  • targeted therapy
  • immune checkpoint inhibitors
  • personalized medicine in gynaecological cancer

Published Papers (4 papers)

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Research

10 pages, 1471 KiB  
Article
Outcomes of Radical Hysterectomy for Early-Stage Cervical Carcinoma, with or without Prior Cervical Excision Procedure
by Dimitrios Nasioudis, Nayla Labban, Stefan Gysler, Emily M. Ko, Robert L. Giuntoli II, Sarah H. Kim and Nawar A. Latif
Cancers 2024, 16(11), 2051; https://doi.org/10.3390/cancers16112051 - 29 May 2024
Viewed by 528
Abstract
Objective: To investigate the impact of a prior cervical excisional procedure on the oncologic outcomes of patients with apparent early-stage cervical carcinoma undergoing radical hysterectomy. Methods: The National Cancer Database (2004–2015) was accessed, and patients with FIGO 2009 stage IB1 cervical cancer who [...] Read more.
Objective: To investigate the impact of a prior cervical excisional procedure on the oncologic outcomes of patients with apparent early-stage cervical carcinoma undergoing radical hysterectomy. Methods: The National Cancer Database (2004–2015) was accessed, and patients with FIGO 2009 stage IB1 cervical cancer who had a radical hysterectomy with at least 10 lymph nodes (LNs) removed and a known surgical approach were identified. Patients who did and did not undergo a prior cervical excisional procedure (within 3 months of hysterectomy) were selected for further analysis. Overall survival (OS) was evaluated following the generation of Kaplan–Meier curves and compared with the log-rank test. A Cox model was constructed to control a priori-selected confounders. Results: A total of 3159 patients were identified; 37.1% (n = 1171) had a prior excisional procedure. These patients had lower rates of lymphovascular invasion (29.2% vs. 34.9%, p = 0.014), positive LNs (6.7% vs. 12.7%, p < 0.001), and a tumor size >2 cm (25.7% vs. 56%, p < 0.001). Following stratification by tumor size, the performance of an excisional procedure prior to radical hysterectomy was associated with better OS even after controlling for confounders (aHR: 0.45, 95% CI: 0.30, 0.66). The rate of minimally invasive surgery was higher among patients who had a prior excisional procedure (61.5% vs. 53.2%, p < 0.001). For these patients, performance of minimally invasive radical hysterectomy was not associated with worse OS (aHR: 1.37, 95% CI: 0.66, 2.82). Conclusions: For patients undergoing radical hysterectomy, preoperative cervical excision may be associated with a survival benefit. For patients who had a prior excisional procedure, minimally invasive radical hysterectomy was not associated with worse overall survival. Full article
(This article belongs to the Special Issue New Challenges in Gynaecological Cancers Diagnosis and Treatment)
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13 pages, 1686 KiB  
Article
Utility of a Multi-Marker Panel with Ultrasound for Enhanced Classification of Adnexal Mass
by Andrew N. Stephens, Simon J. Hobbs, Sung-Woog Kang, Martin K. Oehler, Tom W. Jobling and Richard Allman
Cancers 2024, 16(11), 2048; https://doi.org/10.3390/cancers16112048 - 28 May 2024
Viewed by 1030
Abstract
Pre-surgical clinical assessment of an adnexal mass typically relies on transvaginal ultrasound for comprehensive morphological assessment, with further support provided by biomarker measurements and clinical evaluation. Whilst effective for masses that are obviously benign or malignant, a large proportion of masses remain sonographically [...] Read more.
Pre-surgical clinical assessment of an adnexal mass typically relies on transvaginal ultrasound for comprehensive morphological assessment, with further support provided by biomarker measurements and clinical evaluation. Whilst effective for masses that are obviously benign or malignant, a large proportion of masses remain sonographically indeterminate at surgical referral. As a consequence, post-surgical diagnoses of benign disease can outnumber malignancies up to 9-fold, while less than 50% of cancer cases receive a primary referral to a gynecological oncology specialist. We recently described a blood biomarker signature (multi-marker panel—MMP) that differentiated patients with benign from malignant ovarian disease with high accuracy. In this study, we have examined the use of the MMP, both individually and in combination with transvaginal ultrasound, as an alternative tool to CA-125 for enhanced decision making in the pre-surgical referral process. Full article
(This article belongs to the Special Issue New Challenges in Gynaecological Cancers Diagnosis and Treatment)
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10 pages, 452 KiB  
Article
MITO39: Efficacy and Tolerability of Pegylated Liposomal Doxorubicin (PLD)–Trabectedin in the Treatment of Relapsed Ovarian Cancer after Maintenance Therapy with PARP Inhibitors—A Multicenter Italian Trial in Ovarian Cancer Observational Case-Control Study
by Margherita Turinetto, Andrea Ricotti, Claudia Marchetti, Carmela Pisano, Claudio Zamagni, Chiara Cassani, Paola Malaguti, Alessandra Baldoni, Paolo Scollo, Giuseppa Scandurra, Alessandro Parisi, Grazia Artioli, Innocenza Palaia, Laura Vertechy, Alice Bergamini, Elisa Picardo, Valentina Tuninetti, Giulia Scotto, Giovanni Scambia, Sandro Pignata and Giorgio Valabregaadd Show full author list remove Hide full author list
Cancers 2024, 16(1), 41; https://doi.org/10.3390/cancers16010041 - 20 Dec 2023
Cited by 1 | Viewed by 1101
Abstract
Objective: While PLD-Trabectedin is an approved treatment for relapsed platinum-sensitive ovarian cancer, its efficacy and tolerability has so far not been tested extensively in patients who progress after poly ADP-ribose polymerase inhibitor (PARPi) treatment. Methodology: This multicenter, retrospective analysis had the objective of [...] Read more.
Objective: While PLD-Trabectedin is an approved treatment for relapsed platinum-sensitive ovarian cancer, its efficacy and tolerability has so far not been tested extensively in patients who progress after poly ADP-ribose polymerase inhibitor (PARPi) treatment. Methodology: This multicenter, retrospective analysis had the objective of comparing patients receiving PLD-Trabectedin after being treated with PARP-I (cases) with PARPi-naïve patients. Descriptive and survival analyses were performed for each group. Results: Data from 166 patients were collected, composed of 109 cases and 57 controls. In total, 135 patients were included in our analyses, composing 46 controls and 89 cases. The median PFS was 11 months (95% IC 10–12) in the control group vs. 8 months (95% IC 6–9) in the case group (p value 0.0017). The clinical benefit rate was evaluated, with an HR for progression of 2.55 (1.28–5.06) for the case group (p value 0.008), persisting when adjusted for BRCA and line with treatment. We compared hematological toxicity, gastro-intestinal toxicity, hand–foot syndrome (HFS), fatigue, and liver toxicity, and no statistically significant disparity was noted, except for HFS with a p value of 0.006. The distribution of G3 and G4 toxicities was also equally represented. Conclusion: The MITO39 study showed a statistically significant difference in terms of PFS, suggesting that previous exposure to PARPi might inhibit the efficacy of PLD-Trabectedin. Regarding tolerability, no remarkable disparity was noted; PLD-Trabectedin was confirmed to be a well-tolerated scheme in both groups. To our knowledge, these are the first data regarding this topic, which we deem to be of great relevance in the current landscape. Full article
(This article belongs to the Special Issue New Challenges in Gynaecological Cancers Diagnosis and Treatment)
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11 pages, 964 KiB  
Article
Retrospective Analysis of the Correlation of MSI-h/dMMR Status and Response to Therapy for Endometrial Cancer: RAME Study, a Multicenter Experience
by Valentina Tuninetti, Luca Pace, Eleonora Ghisoni, Virginia Quarà, Francesca Arezzo, Andrea Palicelli, Vincenzo Dario Mandato, Elena Geuna, Gennaro Cormio, Nicoletta Biglia, Lucia Borsotti, Silvia Gallo, Annamaria Ferrero, Elena Jacomuzzi, Luca Fuso, Jeremy Oscar Smith Pezua Sanjinez, Andrea Puppo, Andrea Caglio, Chiara Rognone, Margherita Turinetto, Giulia Scotto, Massimo Di Maio and Giorgio Valabregaadd Show full author list remove Hide full author list
Cancers 2023, 15(14), 3639; https://doi.org/10.3390/cancers15143639 - 15 Jul 2023
Cited by 2 | Viewed by 2077
Abstract
Background: There is poor evidence regarding sensitivity to chemotherapy in endometrial cancer (EC) based on microsatellite instability (MSI)/mismatch repair (MMR) status. Methodology: The RAME study is a retrospective analysis aiming to assess response to chemotherapy in MSI-high (h)/deficient (d) MMR and MSI-low (l)/proficient [...] Read more.
Background: There is poor evidence regarding sensitivity to chemotherapy in endometrial cancer (EC) based on microsatellite instability (MSI)/mismatch repair (MMR) status. Methodology: The RAME study is a retrospective analysis aiming to assess response to chemotherapy in MSI-high (h)/deficient (d) MMR and MSI-low (l)/proficient (p) MMR EC patients. Primary endpoints were recurrence-free survival (RFS) for patients with localized disease and progression-free survival (PFS) and overall survival (OS) in patients with advanced/recurrent disease. Results: A total of 312 patients treated between 2010 and 2022 in four high-volume Multicenter Italian Trial in Ovarian cancer and gynecological malignancies (MITO) centers were selected. In total, 239 patients had endometrioid EC (76.6%), 151 had FIGO stage I at diagnosis (48.9%) and 71 were MSI-h/dMMR (22.8%). Median age was 65 (range 31–91) years. Among patients with localized disease, median RFS was 100.0 months (95% CI 59.4–140.7) for MSI-l/pMMR and 120.9 months (60.0–181.8) for MSI-h/dMMR (p = 0.39). Seventy-seven patients received first-line chemotherapy for advanced/recurrent disease. Patients with MSI-h/dMMR ECs had a significantly worse OS (p = 0.039). In patients receiving platinum-based chemotherapy, no statistically significant differences in PFS (p = 0.21) or OS (p = 0.057) were detected, although PFS and OS were numerically longer in the MSI-l/pMMR population. Conclusions: Patients with metastatic MSI-h/dMMR EC receiving first-line chemotherapy had a significantly worse OS. Full article
(This article belongs to the Special Issue New Challenges in Gynaecological Cancers Diagnosis and Treatment)
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