Dear Colleagues and Friends of IGCS:
Data from important studies assist physicians, patients, and government regulators to make informed decisions. In oncology, we have established clinical research as a routine part of our day to day patient care. Investigators in cancer clinical trials aim to provide results which educate both patients and clinicians, particularly utilizing randomized, usually blinded, clinical trial formats to compare different groups of otherwise-similar patients.
Clinical advances in the area of therapeutics and gynecological malignancies recently published in The Lancet and Nature include the use of PARP INHIBITORS, both in BRCAgm and BRCAwt patients in the setting of recurrent ovarian cancer and, recently, in first line with the results of SOLO-1. Not since the introduction of cis-Platinum 30 years ago have we seen such exciting results in the management of women with ovarian malignancies. These trials have been well designed and conducted, have been published in highly regarded journals and need to be discussed when informing patients about their treatment options. Furthermore, they emphasize the importance of genetic testing in terms of prognosis and treatment options.
Recently, two major surgical studies have been published in The New England Journal of Medicine. The first is a well thought out and rigorous surgical trial published at the end of October entitled “Minimally Invasive versus Abdominal Radical Hysterectomy for Cervical Cancer” by P. Ramirez et al. This study is a prospective randomized Phase 3 Laparoscopic Approach to Cervical Cancer (LACC) trial. The other is “Survival after Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer” by Melamed A. et al, published in November which uses the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database. Both articles show a poorer outcome for patients treated with minimally invasive surgery in early stage cervical cancer. The authors of these studies are to be commended, as surgical trials are difficult and expensive to conduct. Despite all the potential bias, they present clear results about which our patients need advice when making decisions as to the surgical approach options in this clinical situation.
Incorporating clinical trial data into our clinical practice and treatment plans to improve the lives of women with gynecologic malignancies has always been part IGCS members’ approach to patient care. We believe that accurate patient counselling should be mandatory to individualize and tailor therapy based on accurate information about potential risks and benefits.
The use of clinical trials to bring about new approaches and novel therapies to patient care is fundamental to improving the lives of our patients. It is essential that we continue to advocate and support clinical trials in our specialty; our patients surely deserve no less. Where would our specialty be if we did not quickly adapt our clinical practice to reflect the outcomes of such trials?
I wish all of you a very happy holiday season and the best in 2019.
Roberto Angioli, MD