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Low-dose aspirin in pregnancy: who? when? how much? and why?
Purpose of review The use of low dose aspirin (LDA) has become routine in prenatal care for a variety of diagnoses, most importantly in women with a history of preeclampsia and associated poor pregnancy outcomes. Although LDA is currently indicated in patients considered to be at risk for development of preeclampsia, optimal dosing, timing of treatment initiation, and persons of benefit are under investigation. Several studies have also looked at LDA treatment and its effect on other maternal and fetal outcomes. This review summarizes the current guidelines for the use of LDA, incorporating the most recent research fin...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: EDITORIAL INTRODUCTIONS Source Type: research

Local and regional therapy considerations after preoperative therapy in patients with breast cancer
Purpose of review The starting point of neoadjuvant therapy was to use preoperative chemotherapy in order to provide surgeons and radiotherapists with the possibility of local treatment in patients with locally advanced, primary inoperable or inflammatory disease. Since then, this treatment approach has dramatically evolved and is now a standard of care in patients with high-risk early breast cancer. Recent findings The role of surgery after neoadjuvant therapy is to remove residual disease in the breast and or in the lymph nodes and to provide further treatment possibilities according to pathohistologic finding...
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: BREAST CANCER: Edited by Gottfried E. Konecny Source Type: research

Risk-adapted adjuvant therapy of luminal early breast cancer in 2020
Purpose of review The present review summarizes recent original publications addressing the topic of risk-adapted adjuvant therapy in early breast cancer (EBC). As neoadjuvant therapy has become a standard for triple negative and HER2+ EBC, it focusses on luminal EBC. Recent findings Gene expression assays have become standard of care in luminal EBC, at least for patients with node negative disease. Two prospective randomized clinical trials, TAILORx (Oncotype DX) and MINDACT (MammaPrint) have presented additional analyses underlining the clinical utility of the tests. In times of COVID-19, immunohistochemically...
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: BREAST CANCER: Edited by Gottfried E. Konecny Source Type: research

Frontiers in HER2-positive breast cancer in 2020
Purpose of review The field of HER2-positive breast cancer has seen tremendous advances in the last 2 years with largest number of new drugs in decades. The present review aims to summarize the cutting-edge research of the past 2 years and future directions. Recent findings This review will go over four new drugs, three of which have gained FDA approval within the past 18 months, in the treatment of HER2-positive breast cancer. We will go over early and mature clinical data on these therapeutics and ongoing clinical trials further exploring their role in the treatment of patients with advanced HER2-positive brea...
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: BREAST CANCER: Edited by Gottfried E. Konecny Source Type: research

Innovations in targeted therapies for triple negative breast cancer
Purpose of review Triple negative breast cancer (TNBC) is defined by a lack of targets, namely hormone receptor (HR) expression and human epidermal growth factor receptor 2 amplification. Cytotoxic chemotherapy remains the mainstay of treatment. Though TNBC constitutes approximately 10–15% of breast cancer, it is disproportionally lethal, but it is hoped that outcomes will improve as targetable oncogenic drivers are identified. Recent findings Translational work in TNBC has focused on subsets defined by defects in homologous recombination repair, immune cell infiltration, or programmed death ligand receptor 1 ...
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: BREAST CANCER: Edited by Gottfried E. Konecny Source Type: research

Novel antibody–drug conjugates: current and future roles in gynecologic oncology
Purpose of review Antibody–drug conjugates (ADCs) represent a new class of drugs that combine a surface receptor-targeting antibody linked to a cytotoxic molecule. This review summarizes the current literature demonstrating their tremendous promise as therapeutic agents in the treatment of aggressive gynecologic malignancies. Recent findings Several antigens have proven to be differentially overexpressed in a variety of gynecologic tumors when compared with normal surrounding tissue and serve as novel targets for ADC therapy. In the last few years HER2/neu, folic acid-alpha (FRα) and Trop-2 overexpression hav...
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Current and future landscape of poly (ADP-ribose) polymerase inhibition resistance
Purpose of review To highlight relevant strategies to overcome poly(ADP-ribose) polymerase (PARP) inhibitor resistance and present key clinical trials. Recent findings The use of PARP inhibition (PARPi) for frontline maintenance offers substantial clinical benefit in patients with homologous recombination-deficient tumors. However, expanding PARPi from recurrent therapy to frontline maintenance may potentially result in more PARPi resistant tumors earlier in the treatment continuum and data for the use of PARPi after PARPi remain limited. Clinical evidence demonstrates tumors may develop resistance to PARPi thro...
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Cell-based immunotherapy in gynecologic malignancies
Purpose of review To provide an update on cell-based immunotherapies in solid tumors particularly in gynecological cancers. Recent findings Recent clinical trial results demonstrate safety and tolerability of different cell therapies in gynecological cancers. Novel approaches, such as harnessing the cells of the innate immune system are also under investigation in a phase I trial. Summary Cell-based therapies are gaining widespread attention as evidenced by the increasing number of clinical trials encompassing both, innate and adaptive cells to target gynecological cancers. A majority of these therapeutic...
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Treatment of gestational trophoblastic disease in the 2020s
We present the evidence on atypical placental site nodules, and how they incorporate within the GTN spectrum, as well as updates regarding GTN staging and follow-up. Recent findings First-line treatment for GTN still lies in conventional chemotherapy, although the introduction of anti-PD1/PD-L1 immune checkpoint inhibitors has shown significant promise in management of relapsed disease, with responses reported in multiple relapsed choriocarcinomas as well as epithelioid trophoblastic tumours and placental site trophoblastic tumours (ETT/PSTT). Following completion of treatment, ETT/PSTT still require life-long surve...
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

PARP inhibitors in the treatment of ovarian cancer: a review
This article will review recent changes in the standard of care for olaparib, niraparib, and rucaparib, as well as ongoing trials evaluating this class of drugs in combination with antiangiogenic agents and PD-1/PD-L1 inhibitors. Recent findings Niraparib received FDA approval for use in patients with complete response or partial response to first-line platinum-based chemotherapy regardless of BRCAm or HRD status that was received in April 2020. FDA approval was received for olaparib in combination with bevacizamab for epithelial ovarian cancer patients with complete response/partial response to first-line chemother...
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - January 2, 2021 Category: OBGYN Tags: EDITORIAL INTRODUCTIONS Source Type: research

Updates in treating fecal incontinence in women
Purpose of review Fecal incontinence is a chronic condition that can significantly affect a woman's quality of life. The pathogenesis of fecal incontinence is multifaceted and management ranges from supportive care, medical therapy to more invasive surgical procedures. This review will discuss the recent advancements in treating fecal incontinence. Recent findings The pelvic floor disorder consortium has created a consensus document with recommendations on pelvic floor symptom measurement tools, patient-reported instruments, and questionnaires that should be used when evaluating fecal incontinence. There is new ...
Source: Current Opinion in Obstetrics and Gynecology - November 11, 2020 Category: OBGYN Tags: UROGYNECOLOGY: Edited by Kavita Mishra Source Type: research

A lasting impression: telemedicine in urogynecology during the coronavirus disease 2019 pandemic
Purpose of review Amidst the worldwide coronavirus disease 2019 pandemic, a new medical landscape revolving around telemedicine has arisen. The purpose of this review is to describe and analyze current urogynecologic guidelines for optimizing usage of telemedicine when treating women with pelvic floor disorders. Recent findings Women managed by urogynecologists are on average older, and hence more likely to have comorbidities that make them susceptible to developing coronavirus disease 2019 with severe symptoms. Telemedicine is key in minimizing exposure without sacrificing treatments and quality of life. Recent...
Source: Current Opinion in Obstetrics and Gynecology - November 11, 2020 Category: OBGYN Tags: UROGYNECOLOGY: Edited by Kavita Mishra Source Type: research

What to do after a mid-urethral sling fails
Purpose of review After the Food and Drug Administration Public Health Notification in 2011 regarding transvaginal mesh, there has been a decline in the use of mid-urethral slings (MUS). However, they are an effective treatment option for stress urinary incontinence (SUI) with minimal complications. The management of recurrent SUI after sling continues to be debated. Recent findings Long-term follow-up after primary MUS confirms its efficacy and safety. There remains no level 1 evidence for the best next step after a failed MUS. Preferred treatment strategies include placing a repeat MUS with more recent evidenc...
Source: Current Opinion in Obstetrics and Gynecology - November 11, 2020 Category: OBGYN Tags: UROGYNECOLOGY: Edited by Kavita Mishra Source Type: research