Gynecologic Cancer Research at a Crossroads

Abstract

Gynecologic cancer research is currently at a crossroads. Recent changes in the NCI's approach to clinical cancer research have resulted in a complex makeover of the federal clinical research community. This was prompted by perceived inefficiencies in the existing model, as well as the realities of stagnant (or declining) funding for the foreseeable future. Perhaps more than any other discipline, gynecologic cancer research has been dra- matically affected by these changes. The Gynecologic Oncology Group (GOG) was founded in 1971, an outgrowth of President Nixon's War on Cancer and the growing recognition in that era of gynecologic oncology as a separate and distinct subspecialty. In the 43 years since, the GOG has been responsible for virtually every step forward in the treatment of gynecologic can- cers. The following represent just a handful of the GOG's findings: the efficacy of combination chemotherapy with paclitaxel and cis- or carboplatin for ovarian cancer, along chemotherapy with paclitaxel and cis- or carboplatin for ovarian cancer, with intraperitoneal administration of those drugs; the modern concept of surgical staging for endometrial cancer, which was adopted by the International Federation of Gynecology and Obstetrics (FIGO) in 1988, and revised in 2010; the use of chemotherapy in combination with radiation to improve the survival of women with locally advanced cervical cancers; the feasibility of minimally invasive surgery for gy- necologic cancers; and most recently, identifying agents such as bevacizumab, which can be targeted at the molecular level of gyn cancers.