Emerging ADCs, Biomarker-Driven Treatments, and Diagnostic Advancements Take Center Stage at the SGO Annual Meeting

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The 2025 SGO Annual Meeting on Women’s Cancer concluded on Monday after 4 days of data-driven discussions on evolving treatment paradigms, emerging therapeutics, and critical advancements across ovarian, endometrial, cervical, and other gynecologic malignancies.

During the meeting, OncLive® asked the following experts to expand on their personal highlights and takeaways from the meeting:

• Shannon N. Westin, MD, MPH, FACOG, The University of Texas MD Anderson Cancer Center, Houston
• Mansoor Raza Mirza, MD, Rigshospitalet, Copenhagen University Hospital, Denmark
• Elizabeth Lee, MD, Dana-Farber Cancer Institute, Boston, Massachusetts
• Rachel N. Grisham, MD, Memorial Sloan Kettering Cancer Center Westchester, New York
• Toon Van Gorp, MD, PhD, Universitair Ziekenhuis Leuven, Belgium
• Jordyn Silverstein, MD, hematology/oncology fellow, UCLA Health, Los Angeles, California
• Stephanie Blank, MD, Mount Sinai Health, New York, New York
• Tashanna K. Myers, MD, Baystate Health, Springfield, Massachusetts
• Alexander B. Olawaiye, MD, University of Pittsburgh Medical Center Hillman Cancer Center, Pennsylvania

Key themes from these discussions included the expanding role of antibody-drug conjugates (ADCs), biomarker-driven treatment selection, novel strategies for endometrial cancer de-escalation, and ongoing efforts in ovarian cancer prevention. Additionally, artificial intelligence (AI) in clinical practice and diagnostic innovations were highlighted as areas of increasing relevance.

For those who missed the meeting in Seattle, Washington, check out their perspectives and insights below!

ADCs Are the Talk of the Town in Gynecologic Oncology

Mirza: There are interesting data coming in from the final overall survival [OS] analysis of the phase 3 MIRASOL trial [NCT04209855], which is encouraging. We have not [previously] seen OS benefit [vs standard of care (SOC) with novel agents] in the platinum-resistant ovarian cancer setting, and now we have [30.5] months of follow-up and strong data showing that mirvetuximab soravtansine-gynx [Elahere] generates a clinically meaningful OS benefit in this difficult-to-manage disease with poor prognosis.

Westin: [The preliminary efficacy demonstrated with] the investigational B7-H4–targeting topoisomerase 1 inhibitor ADC puxitatug samrotecan (AZD8205)—affectionately called p-SAM—is intriguing. There are opportunities to [use that agent] in the second- or third-line settings, as well as to move it earlier in the endometrial cancer treatment paradigm [to help patients] avoid some of the toxicities [associated with other agents] and still get nice activity in a patient population that’s positive for that marker.

Lee:As we’re thinking about the class of ADCs overall and how they’re emerging into our SOC armamentarium, the sequencing is going to be important. I wish we had much more data on whether there’s loss of, for example, folate receptor alpha expression [in patients who receive these agents, or if their efficacy] is more based on the payload mechanism. Overall, we’re trying to move these effective agents closer and closer to the first and second lines of therapy.

Beyond ADCs: Exploratory Analyses Aim to Tease Out Benefit In Biomarker-Selected Subgroups

Lee: ADCs are this huge exploding class, but we cannot neglect biomarkers [that aren’t] cancer cell surface targets; we’re also looking at DNA mutations and copy number alterations, [such as] cyclin E1–amplified ovarian cancer, which remains a significant unmet need, especially [as it is associated with] poor prognosis. In endometrial cancer, we can’t ignore the NSMP and p53 wild-type [subgroups] in favor of only ADCs. There [are so many treatments] out there, and there were a lot of great presentations [at the meeting] trying to home in on more biomarker-directed data.

Grisham:I was impressed by the presentation from Fiona Simpkins, MD, [of the University of Pennsylvania Perelman School of Medicine in Philadelphia], on [data from part 1b of] the phase 2 DENALI study [NCT05128825], giving an update on the activity of azenosertib in platinum-resistant ovarian cancer. This is important because cyclin E1–amplified tumors are a difficult-to-manage [subtype] of ovarian cancer, and we need better biomarkers to see where we can best direct our CCNE1-targeted therapies. Dr Simpkins showed impressive results regarding the [detection of cyclin E1 protein overexpression by] immunohistochemistry as a [potentially] more predictive biomarker for identifying cyclin E1–amplified patients and how best to target [their disease]. We’ll have to take a retrospective look at that presentation, because [its principles] come into effect for so many drugs in development right now.

Van Gorp:I’m involved in the phase 3 KEYLYNK-001 study [(NCT03740165) evaluating pembrolizumab (Keytruda) plus olaparib (Lynparza) in advanced epithelial ovarian cancer]. It’s worthwhile discussing this because we have tried with immunotherapy to treat patients with ovarian cancer over and over again, and every time we failed. This trial showed benefit [with this combination without bevacizumab (Avastin)] in a certain patient subset, but we must be careful. These are not incredibly convincing data, and it’s also a subset analysis, so I don’t know whether we can use [these findings] in the future.

Besides that, there are so many ADC studies ongoing and presenting phase 1/2 results. We will probably see a lot of these studies rolling over to phase 3. I’m looking forward to all these results.

Treatment De-Escalation Gains Traction in Select Endometrial Cancer Subgroups

Silverstein:What was particularly interesting was a small but thought-provoking study of patients with early-stage and mismatch repair–deficient [dMMR] endometrial cancer who were not going to surgery and receiving only a single-agent PD-1 inhibitor. Most patients had a pathologic complete response and didn’t end up needing surgery. Whether patients with early-stage disease could be cured with and should get a PD-1 inhibitor alone is yet to be determined, but it [may be] possible. For younger patients who want fertility preservation, this could be an option for them in the future. I look forward to seeing how single-agent PD-1 inhibition will be incorporated in this dMMR patient population.

Ovarian Cancer Prevention and Risk Reduction Trials Are of Increasing Interest

Blank:I’m excited about preventative trials. We’re not going to have an answer in a year for those, but I’m excited about the long-term effects we’re seeing and the approach we’re taking towards risk-reducing surgery. [We’re also seeing an increasingly] patient-forward approach to salpingectomy, [reflected in the] work from the TUBA-WISP II study [NCT04294927]. Hopefully, we’re going to see [that approach have clinical benefit] too. There’s a lot [of research] going on, and ultimately, our patients are going to have better lives because of this. Look what we’ve done in terms of decreasing the incidence of ovarian cancer.

AI and Diagnostic Innovations Are Poised to Transform Gynecologic Oncology Care

Myers: The session on new ways to diagnose endometrial cancer was interesting. At a time when the rates of endometrial cancer are increasing and access to care is such a challenge, being able to identify new and different tools for identifying endometrial cancer is interesting, and it is exciting to see those come to fruition and potentially make it into the clinics.

Olawaiye: For me, the most important take-home message from this meeting is the way that we’re beginning to see AI become part and parcel of oncology practice. The incorporation of AI technology into a lot of the things we do is going to make the practice of oncology much better. It is going to enhance the safety of our patients, and—if used appropriately—it will allow us to deploy cancer treatment in a much more effective way that benefits patients more than we are currently able to achieve.

When there is a tool that allows us to comb the literature for information and produce the results of that search within seconds, I can then redirect my time to other more gainful things. It would have previously taken maybe 30 to 45 minutes to [search for that] information the traditional way. That [change] is powerful. Like everything, we have to be sure it’s appropriately utilized, because people can always misuse technology. [That caution is] not limited to AI, and we have to guard against that.

To check out more of OncLive’s coverage from the 2025 SGO Annual Meeting on Women’s Cancer, click here.