Dr Klobocista on Molecular Testing in Gynecologic Cancers

Merieme Klobocista, MD, explains how molecular testing and biologic markers are moving gynecologic cancer care away from a uniform approach and toward treatment decisions made on an individual patient basis. In this video, Klobocista, of Hackensack Meridian Health, outlines where molecular testing is currently shaping care in ovarian cancer and uterine cancer, and where it has not yet changed the treatment approach.

According to Klobocista, this is an exciting time for cancer treatment. With biologic markers and targeting, treatment is increasingly determined on a patient basis rather than on a pathology or anatomic basis alone.

In ovarian cancer, she explains that molecular testing has helped identify patients who would benefit from certain maintenance treatments. However, she notes that molecular findings have not yet influenced one of the earliest decisions in care: whether surgery is performed upfront or the patient receives neoadjuvant chemotherapy. That decision, she says, is still driven by patient status and disease burden.

Where molecular testing does make a difference is in treatment after surgery. Klobocista points to maintenance treatment as the area most directly affected by molecular results. In the recurrent setting, she adds that certain targeted agents can be applicable to patients who have a biological marker, extending the role of molecular testing across multiple points in the disease course.

Turning to uterine cancer, Klobocista highlights a shift over the last few years: an uptake in the use of immunotherapy driven by targeted molecular therapies. At the same time, findings from molecular testing have led to the de-escalation of certain treatments for endometrial cancer. Together, these developments show molecular testing informing both the expanded use of immunotherapy and the reduction of other treatments, depending on what testing reveals about the individual patient.

Klobocista's overall message is that molecular testing is redefining how gynecologic cancers are treated. Instead of a single cure applied the same way to all patients, care is becoming more personalized, with biologic markers shaping decisions about maintenance treatment, management of recurrence, and the intensity of therapy in endometrial cancer.

Watch the full video for her perspective on how molecular testing, biomarker-driven maintenance treatment, targeted agents, and immunotherapy are changing the treatment landscape in ovarian and endometrial cancers.