Advances in Ovarian and Endometrial Cancer Care: 2026 ASCO Insights
New clinical data from the 2026 ASCO Annual Meeting highlights potential breakthroughs in gynecologic oncology, ranging from curative predictions in endometrial cancer to novel antibody-drug conjugates (ADCs) for platinum-resistant ovarian cancer. Researchers presented findings on four key studies, offering a roadmap for how clinicians may refine treatment strategies for patients with advanced or recurrent disease.
Can Dostarlimab Cure Advanced Endometrial Cancer?
Model-based predictions from the phase 3 ENGOT-EN6-NSGO/GOG-3031/RUBY trial suggest that the combination of dostarlimab-gxly (Jemperli) and chemotherapy may offer a path to a cure for patients with mismatch repair–deficient (dMMR)/microsatellite instability–high (MSI-H) endometrial cancer. According to the study (Abstract 5501), mixture cure models estimated that 54% of patients receiving the dostarlimab regimen had potential for cure, compared with 14% of those in the placebo arm.
This represents a 3.9-fold increase in the rate of curative potential, according to the researchers. Lucy Gilbert, MD, MSc, FRCOG, of McGill University, noted that the durability of response in the dMMR population allows clinicians to use the term “cure” for metastatic recurrent disease for the first time.
Why Is TUB-040 Emerging as a Competitor in Ovarian Cancer?
The phase 1/2a NAPISTAR 1-01 trial (Abstract 5513) reported an objective response rate (ORR) of 58.2% for the NaPi2b-targeting ADC TUB-040 in patients with platinum-resistant ovarian cancer. Data showed a median progression-free survival (PFS) of 11 months, with 79% of responses lasting at least 6 months.
Toon Van Gorp, MD, PhD, of University Hospital Leuven, described the findings as “unprecedented” for an ADC in this setting. Jordyn Silverstein, MD, of the University of California, Los Angeles, emphasized that the drug showed clinical activity across all dose spectrums, allowing investigators to select a dosage with minimal adverse effects.
What Happened with the MIROVA Trial?
The phase 2 MIROVA/AGO-OVAR 2.34 trial (Abstract 5506) failed to meet its primary PFS endpoint in patients with recurrent, folate receptor alpha (FRα)–high platinum-sensitive ovarian cancer. Findings showed a median PFS of 9.53 months for those receiving mirvetuximab soravtansine-gynx (Elahere) plus carboplatin, compared with 9.79 months for those receiving standard platinum-based chemotherapy.
Dr. Van Gorp noted that the academic community expected the combination to improve patient prognosis. He stated that further investigation is required to understand the negative result, highlighting the importance of academic-led research in identifying which treatment combinations do not yield clinical improvements.
Could Short-Term Fasting Improve Chemotherapy Outcomes?
A phase 2 pilot trial (Abstract 5517) suggests that short-term fasting may be a feasible, well-tolerated strategy for patients with high-grade serous ovarian cancer undergoing neoadjuvant chemotherapy. Patients who fasted 36 hours before and 24 hours after chemotherapy showed improved tumor debulking and a potential for prolonged PFS (HR, 0.257) compared to a free diet, according to Linda Mileshkin, MBBC, FRACP, Mbioeth, of the Peter MacCallum Cancer Centre. While the study was small, it demonstrated that fasting helped prevent insulin spikes and improved metabolic markers during treatment.
Frequently Asked Questions
What is the significance of the RUBY trial findings?
The trial indicates that adding dostarlimab to chemotherapy significantly increases the probability of long-term cure for dMMR/MSI-H endometrial cancer patients.
Why did the MIROVA trial fail to meet its goals?
The study did not achieve a superior PFS compared to standard platinum-based chemotherapy. Researchers are still analyzing the data to determine why the addition of mirvetuximab did not improve outcomes in this specific setting.
Is short-term fasting safe during ovarian cancer treatment?
The pilot trial found the approach to be feasible and well-tolerated, though patients should always consult their primary oncology team before making dietary changes during chemotherapy.
Which ADC is currently showing the most promise for platinum-resistant ovarian cancer?
Based on the NAPISTAR 1-01 trial, TUB-040 is gaining attention due to its 58.2% ORR and 11-month median PFS.
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