📬 GYN Oncology Intelligence Digest — Week 2026-W40

A JAMA Network Open appraisal of 11 meta-analyses (12 683 pts) finds most cisplatin-versus-carboplatin guideline recommendations rest on low-certainty evidence, with no PFS difference in ovarian cancer the one high-certainty gynecologic signal; RAMP 201 reports 2-year durability for avutometinib plus defactinib in low-grade serous ovarian cancer, ROSELLA reports an OS gain with relacorilant, and ACOG updates guidance on opportunistic bilateral salpingectomy.

⚡ TL;DR

🐦 Twitter / 🦋 Bluesky

Cisplatin versus carboplatin: a GRADE appraisal of 11 meta-analyses finds ovarian PFS equivalence is the only high-certainty gynecologic signal — The new JAMA Network Open paper examined the certainty of evidence of the 11 major meta-analyses (12 683 pts) on which guidelines based their cisplatin-versus-carboplatin recommendations
RAMP 201 two-year follow-up: avutometinib plus defactinib holds up in recurrent low-grade serous ovarian cancer — The 2-year follow-up of RAMP 201 shows durable efficacy of avutometinib plus defactinib in recurrent low-grade serous ovarian cancer, with no new safety signals

Full details below ↓

📄 What's Being Published

No new manuscripts cleared the relevance bar this week.

🗂 Every paper considered this week, including the ones that didn’t make it →

🗣️ What People Were Discussing This Week

How these are chosen: filtered for clinical relevance, grouped by the new development discussed, then ordered by engagement (bookmarks and reposts).

Cisplatin versus carboplatin: a GRADE appraisal of 11 meta-analyses finds ovarian PFS equivalence is the only high-certainty gynecologic signal

A new JAMA Network Open paper examined the certainty of evidence underlying the 11 major meta-analyses (12 683 pts) on which guidelines based their cisplatin-versus-carboplatin recommendations. The only high-certainty evidence signals identified were cisplatin superior to carboplatin for ORR in urothelial cancer, and no PFS difference between cisplatin and carboplatin in ovarian cancer; most guideline-based recommendations rest on low or very low GRADE evidence. Despite high heterogeneity impacting GRADE across tumour types, toxicities show known correlations, and the authors argue the evidence gap may be closable with access to data from completed studies rather than new trials. The central debate for GYN oncology: if ovarian PFS equivalence is the only high-certainty signal, whether any remaining cisplatin-based regimens can be defended on evidence or only on toxicity profiles and logistics.

Discussed by: @scocmem, @DrMirallas

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Sources cited: JAMA Network

RAMP 201 two-year follow-up: avutometinib plus defactinib holds up in recurrent low-grade serous ovarian cancer

The 2-year follow-up of RAMP 201 demonstrates durable efficacy of avutometinib plus defactinib in recurrent low-grade serous ovarian cancer, with no new safety signals reported. Rachel N. Grisham, MD presented long-term efficacy and safety results for the combination in recurrent LGSOC, including key findings specifically for patients with KRAS mutations. With 2-year durability data now in hand, the clinical debate centres on whether avutometinib plus defactinib should be offered to all patients with recurrent low-grade serous ovarian cancer or whether KRAS mutation status should guide patient selection.

Discussed by: @TeamOvary_MSK, @OncLive

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Sources cited: PubMed · OncLive

🔥 Top Ranked Tweets

Sara Coca Membribes @scocmem

RT @PaulJiL: The eternal question in solid tumor oncology, almost Shakespearean in its persistence

When is Cisplatin better than Carbo? When are they equivalent?

Excited to share our new paper in @JAMANetworkOpen where we examined the certainty of evidence of the 11 major meta-analyses (12 683 pts) on which guidelines based their recommendations

✴️Several efficacy variables have low or very low level of certainty
✳️Only high-certainty evidence signal was found for Cis>Carbo in ORR urothelial, and the no PFS difference Cis=Carbo in ovarian.
🟡Despite high heterogeneity impacting GRADE across tumour types, toxicities show known correlations

The story does not end here, highlighting the utility of meta-data appraisals and current evidence gaps. We might not need new trials, just greater access to data from completed studies
#oncology @myESMO @ASCO

👏An honour to have worked with and learned from this faculty
Prof Harrington @MattGalsky Prof Colombo @EnriquetaFelip Dr Rodon @juditsanz Dr Pereira @DrMirallas

@OncoAlert @brunolarvol @OncBrothers

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