- N Engl J Med 2022; 387:727-736
Lesions of the ovary and fallopian tube are common and may be acute or chronic. Diagnostic assessment is designed to distinguish benign from malignant causes. Referral to a gynecologic oncologist is often necessary.
- N Engl J Med 2022; 386:544-555
Cervical cancer that relapses after platinum-containing chemotherapy is often refractory to salvage therapy. Cemiplimab, a fully human antibody to PD-1, was compared with single-agent chemotherapy with pemetrexed, gemcitabine, irinotecan, topotecan, or vinorelban. Among 608 patients, median overall survival was 8.5 months with chemotherapy and 12.0 months with cemiplimab.
- N Engl J Med 2022; 386:437-448
Women with advanced endometrial cancer that progressed during platinum-containing therapy were randomly assigned to lenvatinib plus pembrolizumab or physician’s choice of chemotherapy (doxorubicin or paclitaxel). The median progression-free survival was 7.2 months with lenvatinib plus pembrolizumab and 3.8 months with chemotherapy; the median overall survival was 18.3 months and 11.4...
- N Engl J Med 2022; 386:e3
A 45-year-old woman presented to the colposcopy clinic with vulvar pain, pruritus, and a wartlike lesion. A biopsy specimen showed vulvar squamous-cell carcinoma associated with human papillomavirus.
- N Engl J Med 2021; 385:2123-2131
Patients with platinum-sensitive relapsed ovarian cancer who had undergone complete resection were assigned to undergo surgery and then receive chemotherapy or to receive chemotherapy alone. The median overall survival was 54 months with surgery and chemotherapy, and 46 months with chemotherapy alone.
- N Engl J Med 2021; 385:2187-2188
The combination of surgery and chemotherapy is a hallmark of the management of ovarian cancer.1 Although surgery is an integral component of management of this disease, its role in recurrent disease has been a topic of debate. After the collection of decades of data from retrospective studies,2
- N Engl J Med 2021; 385:1908-1918
This article reviews recent evidence from the International Agency for Research on Cancer on the best methods of screening for cervical cancer, including by means of conventional cytology, visual inspection with acetic acid, human papillomavirus (HPV) nucleic acid testing, and combinations of these tests. HPV nucleic acid testing was superior...
- N Engl J Med 2021; 385:1856-1867
A randomized, double-blind trial compared pembrolizumab with placebo in patients with advanced cervical cancer who were also receiving platinum-based chemotherapy with or without bevacizumab. The median progression-free survival was 10.4 months with pembrolizumab and 8.2 months with placebo. Overall survival at 2 years was 50.4% and 40.4%, respectively.
- N Engl J Med 2021; 384:1669-1671
The results of the Laparoscopic Approach to Cervical Cancer Trial, published in 2018, showed that in patients with cervical cancer, minimally invasive surgery was associated with poorer outcomes than open radical hysterectomy. Subsequently, the use of minimally invasive surgery decreased by 73% in academic centers and by 19% in nonacademic...
- N Engl J Med 2021; 384:42-50
Bronchial-based cancers developed in two boys who had been delivered vaginally by mothers with cervical cancer. The paired maternal and filial cancers resembled each other histologically and shared oncogenic driver mutations and other unique maternal genes not inherited in their germline. Neither boy’s tumor carried a Y chromosome.
- N Engl J Med 2020; 383:2053-2064
Endometrial carcinoma is diagnosed in about 58,500 women in the United States per year. It is linked with obesity, excess estrogen, and the Lynch syndrome. Oral contraceptives lower the risk by 30 to 40%. Most patients undergo surgery with or without radiation therapy.
- N Engl J Med 2020; 383:1340-1348
In this Swedish registry study, quadrivalent human papillomavirus vaccination was associated with a substantially reduced risk of invasive cervical cancer among girls and women up to 30 years of age.
- N Engl J Med 2020; 383:286-288
A proposed etiologic index, based on genomic variation in tumor cells and matched normal cells, suggests the possibility of involvement of variant BRCA1 and BRCA2 in types of cancer other than those with the “established” tumor types, such as breast cancer.
- N Engl J Med 2019; 381:2391-2402
Patients with newly diagnosed advanced ovarian cancer were randomly assigned to receive daily niraparib, a PARP inhibitor, or placebo as maintenance therapy after having had a response to platinum-based chemotherapy. Progression-free survival was significantly longer in the niraparib group than in the placebo group, with some increase in the frequency...
- N Engl J Med 2019; 381:2403-2415
The addition of veliparib, a PARP inhibitor, to induction chemotherapy and maintenance therapy in women with advanced ovarian cancer significantly improved progression-free survival over induction chemotherapy alone without maintenance therapy. The improvement was especially notable in patients with mutated BRCA or homologous-recombination defects.
- N Engl J Med 2019; 381:2416-2428
When used as maintenance therapy, the PARP inhibitor olaparib provided a significant progression-free survival benefit in women with ovarian cancer who had a response to primary chemotherapy, particularly in those whose tumors were deficient in homologous recombination (e.g., BRCA-mutated tumors). Hematologic toxic effects were observed.
- N Engl J Med 2019; 381:2471-2474
The introduction of “personalized medicine” has spurred major changes in oncology, but success has been spread unevenly across the spectrum of solid tumors. Although prognoses for adenocarcinoma of the lung and melanoma have been profoundly altered, other diseases, such as colon cancer and ovarian cancer, have lagged behind owing to...
- N Engl J Med 2019; 381:1929-1939
An NCI-sponsored, randomized clinical trial tested whether patients with relapsed ovarian cancer might benefit from surgical debulking of tumors followed by chemotherapy, as compared with chemotherapy alone. No significant outcome differences were noted between the patients who underwent surgery and those treated with chemotherapy alone.
- N Engl J Med 2019; 381:1378-1386
The authors use 40 years of data on cancer incidence and mortality to produce curves that show changes in cancer incidence (decreasing, increasing, or staying stable) and the effect of early detection efforts on cancer incidence and that help to distinguish treatment advances from overdiagnosis.
- N Engl J Med 2019; 380:2317-2326
After a median of nearly 4 years of follow-up, the use of radiotherapy combined with chemotherapy in patients with stage III or IVA endometrial carcinoma was not associated with longer relapse-free survival than the use of chemotherapy alone.