In a review of important scientific announcements in the field of gynecological cancer, we find that 2024 was a year highly fruitful in research and with results with immediate application in clinical practice. There has been positive effects of incorporating immunotherapy into chemotherapy in patients with endometrial cancer but also excellent results with the addition of immunotherapy to patients with cervical cancer who receive simultaneous chemotherapy.

More specifically, the endometrial cancer consolidates the need to determine the molecular identity of the tumor, as it not only gives important information on the prognosis of the disease, but also contributes to the choice of more appropriate treatment per patient. This test is easily and quickly performed on the material of either diagnostic scraping or surgery.

Newer data are coming to change the way patients with a local advanced stage of disease are treated post-operatively, which have a specific molecular identity called DMMR or MSI-High. It is noted that this molecular identity is found in one in four patients approximate. These patients until recently received either chemotherapy or a combination of radiotherapy with chemotherapy.

Now, in these cases the addition of immunotherapy to chemotherapy (with or without radiotherapy) and as maintenance after the completion of chemotherapy (for a total of 12 infusions) has proven to reduce the possibility of recurrence of the disease by 69% (Keynote-B21) and is expected to to make the appropriate treatment in the near future.

Similarly spectacular results in the survival itself offers the addition of immunotherapy to chemotherapy even in patients who have metastatic disease or relapse in diagnosis, provided they carry the DMMR or MSI-High molecular identity (Ruby, Gyo-018 studies , Attend).

But even in patients with metastatic disease and aggressive molecular identity, recent data show that when chemotherapy is accompanied by immunotherapy in combination with drugs called PARP inhibitors, the risk of further deterioration of the disease is drastically reduced (DUO-E, RUBY ).

It is therefore clear that molecular identification of the tumor is imperative as it leads to personalized treatment.

Results that come to change daily medical practice also involve patients with local advanced cervical cancer who are not candidates for surgery. In these cases, the usual practice of worldwide is the administration of modern radical chemo-radiotherapy. Newer data shows that the addition of immunotherapy (along with chemo-radinotherapy and after it) significantly reduces the risk of recurrence and the risk of death by the disease by 33% (Keynote-A18).

Easion also has a newer category of factors called “antibodies associated with antibodies”. These drugs are modern Trojan horses, which, after unlocking “doors – proteins” on the surface of cancer cells, primarily invade the interior and release the active drug.

Already in the United States of America, Mirvetuximab Soravtansine are administered with remarkable success in patients with recurrent ovarian cancer and tisotumab Vedotin in patients with cervical cancer in both cases after failure in previous chemotherapy. The latest developments are drugs targeting the TROP1 protein and are tested throughout the spectrum of gynecological malignancies with the first indications being positive. For this reason, international phase 3 studies are underway with these medicines in our country.

It seems therefore that in recent years we have been constantly receiving promising messages related to personalized treatment of patients with gynecological malignancies, and we hope that with the help of artificial intelligence, targeted research will accelerate. All of these developments would be impossible to achieve without the involvement of our volunteer patients in clinical studies, thus opening the way and giving hope to our fellow humans.