Groundbreaking Developments in Gynecologic Cancer Care

By Dineo Khabele, MD, FACOG, FACS, division director, gynecologic oncology

July 10, 2019

Every woman who walks into your office or clinic is at risk of developing a gynecologic cancer. In fact, the American Cancer Society estimated in 2019 that 103,650 women would be diagnosed with a gynecologic cancer – nearly enough mothers, daughters, wives and sisters to fill Kansas City's football and baseball stadiums combined. Of these women, approximately 34% will die from the disease.

Groundbreaking developments in the field of gynecologic cancers could dramatically change those grim statistics. As a National Cancer Institute-designated cancer center, The University of Kansas Cancer Center is dedicated to achieving some of those breakthroughs right here. With leading-edge technology, new drug therapies, renowned specialists and state-of-the-art facilities, we have the ability not only to diagnose and treat many forms of gynecologic cancers, but also to extend patients' lives and protect their family members.

Region’s first cancer center dedicated to women’s care

The only facility of its kind in the region, The Women's Cancer Center at The University of Kansas Cancer Center is dedicated to treating gynecologic and breast cancers and improving the delivery of cancer care for women. Located in Overland Park, Kansas, the center brings compassion and convenience to integrated cancer treatment. Nationally and internationally recognized disease-dedicated specialists will evaluate patients and come together to develop and provide a comprehensive treatment plan for each patient.

Often, one of the most stressful aspects of cancer is waiting to see a specialist. With our commitment to access within 24 hours, women suspected to have or recently diagnosed with cancer will be quickly seen.

Specialty-trained breast and gynecologic nurse navigators guide patients through their care. Each patient receives integrated, multidisciplinary care from our team of academic experts who are fellowship-trained in preventing, diagnosing and treating gynecologic cancers. They represent numerous specialties, including breast and gynecologic surgical oncology, breast medical oncology, breast reconstruction and plastic surgery and onco-psychology. Together, with social workers, case managers, symptom management resources, palliative care and comfort care experts, we develop personalized plans.

Our goal is to address the entire toll cancer takes on the mind, body and spirit, because research shows this approach to cancer treatment produces better patient outcomes.

The power of clinical trials

The University of Kansas Cancer Center provides patients with the latest treatment options, which often aren’t available elsewhere within our region. These options frequently take the form of clinical trials.

There are many reasons to refer patients to a cancer center that also designs and initiates the trials. Our physicians understand the underlying science that leads to the design of the trial. We have more insight into which patients are eligible. Eligible patients have easier access to the trial, with many patients able to receive this advanced cancer care close to home. Additionally, the Midwest Cancer Alliance (MCA) collaborates with the cancer center's Clinical Trials Office to offer access to advanced clinical trials to MCA members throughout the state.

We belong to the national NRG/GOG clinical trials cooperative group and are home to investigator-initiated clinical trials run by the physicians who wrote them. These leading-edge trials focus on ovarian cancer:

  • This trial builds advances in using PARP (enzyme poly ADP ribose polymerase) inhibitors to treat ovarian cancer. PARP inhibitors are a new class of drugs that target and kill cancer cells without affecting normal cells and are most effective in patients with BRCA mutations.

    A landmark international clinical trial, released October 2018, involved 391 women with stage III or IV ovarian cancer who also had BRCA mutations. The women received standard chemotherapy and then were given a PARP inhibitor for up to 2 years or until the cancer returned. Those in the PARP inhibitor group experienced an extended, disease-free interval for 3 years longer than the placebo group.

    My research focuses on extending the remarkable success of PARP inhibitors to women who do not have BRCA mutations. My group discovered that when PARP inhibitors are combined with histone deacetylase inhibitors, we can force ovarian tumors that do not have the BRCA mutation to act as though they do. The combined drug therapies work together to halt tumor growth, reduce cancer gene expression, decrease proliferation and increase the incidence of cell death. Based on these findings, we designed a clinical trial in collaboration with Vanderbilt-Ingram Cancer Center, another NCI-designated cancer center. This trial is expected to open at The University of Kansas Cancer Center in the next few months.

  • Another trial involves innovative hyperthermic intraperitoneal chemotherapy (HIPEC). HIPEC delivers heated chemotherapy drugs inside the patient’s abdomen to help destroy microscopic cancer cells and tumors that traditional chemotherapy may miss.

    This trial was designed and written by one of my colleagues, gynecologic oncologist Andrea Jewell, MD, director of clinical trials for gynecologic oncology. The goal of the study is to test the safety of HIPEC and the ability to deliver additional chemotherapy after HIPEC, with the ultimate hope of preventing cancer cells from returning.

    Patients diagnosed with advanced-stage ovarian cancer are screened to determine if they are eligible for HIPEC, which is administered after radical tumor debulking surgery. All trial participants receive the HIPEC therapy if optimal tumor debulking is accomplished. The HIPEC trial is currently recruiting patients.

Hope for women with gynecologic cancer

From our in-depth knowledge of gynecologic cancers, leading-edge clinical trials and unparalleled commitment to prevention of women's cancers through collaboration and individualized treatment planning, we are ready to serve your patients and support them in winning the battle against gynecologic cancers.

Dr. Khabele, division director, gynecologic oncology, is a gynecologic oncologist, physician and surgeon who specializes in treating women diagnosed with ovarian and other gynecologic cancers. She is also a physician scientist who leads a research program focused on ovarian cancer.

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