Targeted Therapies and Testing: A New Era in Gynecologic Malignancy Management

September is Gynecologic Cancer Awareness Month, an opportunity to highlight cancers that originate in the endometrium, ovary, and cervix, and to recognize efforts to improve patient outcomes for cancer types with poor prognoses and limited treatment options.

Gynecologic Cancer Types 

Endometrial cancer is the fourth most common cancer affecting women in the US, with over 400,000 cases diagnosed per year globally. Affecting mainly postmenopausal women, the average age of women diagnosed with endometrial cancer is 60, and it is more common in Black women than in White women. The 5-year survival rate for all stages of endometrial cancer is 84%, with an advanced (distant) survival rate of 22%.

Ovarian cancer has an incidence rate of 9.9 per 100,000 women in the US, the fifth-leading cause of cancer-related deaths among women. The overall 5-year survival rate for patients with ovarian cancer is approximately 47%, while the survival rate for advanced ovarian cancer at 5 years is 29%. For both endometrial cancer and ovarian cancer, early detection and diagnosis is a challenge, primarily due to the fact that there are currently no recommended screening tests for women without symptoms.

Cervical cancer is most frequently diagnosed in women between the ages of 35 and 44, with an average age of 50, though over 20% of cervical cancers are found in women over 65. Cervical cancer rates have decreased by more than half from the 1970s to the mid-2000s, largely due to increased prevention and screening rates via PAP smears for women age 21 to 65. However, the death rates for Black women and Native American women are approximately 65% higher than for White women.

Advancing Education in Gynecologic Oncology 

Recognizing the gravity of these cancers, ACCC remains steadfast in its mission to equip oncology professionals with the latest knowledge and tools to improve patient outcomes. To that end, ACCC developed a 2-part education video series titled Optimizing Patient Outcomes With ADCs in Gynecologic Malignancies. This series explores the evolving role of antibody-drug conjugates (ADCs) in treatment, delving into their clinical applications, associated toxicities, and strategies for managing adverse effects.

In the first session, Marilyn Huang, MD, MS, professor and director of Gynecologic Oncology at the University of Virginia School of Medicine, provides a comprehensive overview of ADCs, including their indications in gynecologic cancers and emerging therapeutic opportunities. She also addresses the spectrum of adverse effects, with a particular focus on ocular toxicities and preventive strategies.

Premal H. Thaker, MD, director of the Division of Gynecologic Oncology at Washington University School of Medicine in St Louis, then examines HER2 expression in gynecologic malignancies and relevant therapeutic options. Dr. Thaker further discusses the future landscape of ADC research, offering insights into the selection and sequencing of these agents in clinical practice.

The second session shifts attention to the practical aspects of toxicity management. Cynthia Ryan, PharmD, BCPS, clinical oncology pharmacist at University of Colorado Hospital, outlines best practices for monitoring and managing adverse effects associated with ADCs in gynecologic malignancies. Her presentation covers a range of toxicities—including ocular events, pneumonitis, neuropathy, hemorrhage, and cardiac toxicity—and provides actionable strategies for managing infusion-related reactions. She concludes by emphasizing the importance of personalized patient education, highlighting methods to tailor information delivery based on individual learning styles and preferences. 

Biomarker Testing for Gynecologic Malignancies 

ACCC published a guide to provide strategies and resources for oncology practitioners when testing for biomarkers in treatment selection for gynecologic malignancies. This resource offers practical strategies for integrating molecular diagnostics into treatment planning, while addressing systemic challenges such as social determinants of health, care coordination across disciplines, and patient advocacy. This guide underscores the critical role of molecular profiling in improving outcomes for patients with gynecologic cancers—particularly those with historically poor prognoses. 

By fostering a deeper understanding of molecular drivers and promoting equitable access to testing, ACCC aims to empower clinicians to make informed, personalized treatment decisions. Through ongoing education and dissemination of cutting-edge research, ACCC continues to support oncology professionals in navigating the complexities of treatment selection and shared decision-making. 

To provide feedback on the usefulness of ACCC’s guide to biomarker testing for gynecologic malignancies and inform the development of future resources, please fill out this form. 

For more information on these resources, contact Bianca Alvarez, ACCC program manager, at balvarez@accc-cancer.org.