Evolving Role of Antibody–Drug Conjugates in Gynecologic Cancers

Expert faculty examine how antibody drug conjugates are changing the treatment landscape in endometrial cancer as more patients receive chemotherapy and immunotherapy earlier in care. The discussion centers on the growing need for effective therapies after progression and on why targets such as HER2, folate receptor alpha, TROPE2, B7H4, and CDH6 are drawing interest in recurrent disease. Attention is given to the practical questions clinicians face as these agents move closer to routine use, including how to interpret early phase data, how to think about payload differences, and how to integrate newer options with established treatment approaches. The conversation also highlights the importance of matching enthusiasm with realism, because promising response data must still translate into durable benefit and manageable toxicity. Overall, the faculty outline a rapidly evolving therapeutic space in which antibody drug conjugates may expand options for patients with difficult to treat disease while also introducing more complexity into everyday clinical decision making.

Biomarker testing is presented as a central part of treatment planning in advanced and recurrent endometrial cancer. The faculty review why mismatch repair assessment remains foundational while broader molecular profiling, HER2 immunohistochemistry, and next generation sequencing are increasingly important when selecting later line therapy. Particular attention is given to HER2 expression and to the importance of recognizing potential candidates for trastuzumab deruxtecan before progression narrows treatment opportunities. The discussion underscores a major operational challenge in practice, which is that HER2 testing may still depend on an additional request rather than being built into standard workflows. That gap can delay appropriate treatment selection even as new data continue to expand the relevance of biomarker guided care. The broader point is that pathology processes and testing habits must evolve alongside the therapeutic landscape. A more proactive and comprehensive approach to biomarker assessment is becoming essential for individualized management of recurrent endometrial cancer.

Management after progression on immunotherapy remains one of the most difficult areas in endometrial cancer care.

Interest in endometrial cancer extends well beyond HER2, and the faculty review a growing pipeline of antibody drug conjugates directed at additional targets. Discussion includes why TROPE2 and other emerging targets are generating enthusiasm, particularly because they may broaden treatment options for patients who do not meet narrower biomarker criteria associated with some currently available therapies

Sequencing therapy in recurrent endometrial cancer is becoming more complicated as immunotherapy moves earlier and antibody drug conjugates gain momentum.

Important unmet needs remain in endometrial cancer even as antibody drug conjugates begin to expand the therapeutic armamentarium.

In ovarian cancer, treatment selection for platinum resistant disease is increasingly shaped by biomarkers, prior toxicity, and access to targeted therapy.

A major unmet need in ovarian cancer lies in extending disease control after initial treatment, especially for patients with homologous recombination proficient tumors who often derive less benefit from existing maintenance strategies.

Development of new antibody drug conjugates in ovarian cancer continues to expand beyond folate receptor alpha, and the faculty review why both target selection and trial design will be critical to future success.

Sequencing multiple antibody drug conjugates is becoming a central question in ovarian cancer as more patients present with overlapping biomarkers and several possible treatment options.

Although antibody drug conjugates have generated real optimism in ovarian cancer, the faculty stress that several key questions remain unresolved before their long term value can be fully defined.

In cervical cancer, antibody drug conjugates are presented as an important advance in a disease where treatment options after progression have historically been limited.

Tisotumab vedotin is discussed as an important therapeutic step forward for recurrent or metastatic cervical cancer because it offers clinically meaningful activity in a setting where later line treatment has often been disappointing.

Clinical management in recurrent cervical cancer increasingly depends on both practical toxicity prevention and thoughtful biomarker assessment.