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The September issue of ONCOLOGY features a rare case study on glioblastoma, discussions on end-of-life care, and insights into the field of pediatric oncology. 

September ONCOLOGY Publication

There is a lot of excitement among experts in the field of antibody-drug conjugates as new developments continue to come out in various disease states.

During the 16th Annual World Antibody-Drug Conjugate (ADC) Summit in San Diego, CA, top ADC experts gathered to discuss the hottest and most relevant topics in the field. Among them was Greg Thurber, PhD, a professor in chemical engineering at the University of Michigan School of Biomedical Engineering, who presented a seminar titled, “Contextualizing learnings from translational profiles of approved ADCs to unlock best approaches to preclinical dosing in mouse models”.

At the Summit, Thurber spoke with CancerNetwork® regarding his seminar, as well as other hot topics in the space of ADCs. From mouse models and patient-derived xenograft (PDX) models to new advancements, the conversation covered various facets of the space. Read here to catch the highlights:

CancerNetwork: What was the rationale for your seminar on contextualized learnings from the translational profiles of ADCs?

: We’ve seen a lot of progress and a lot of new approvals, and there’s a lot of excitement in the field of ADCs. One of the challenges the field has struggled with in previous years, because it’s taken a while to get to the current point, is why some molecules look so promising in preclinical models and then end up failing in the clinic. The take-home message from my talk was that if we dose these preclinical models at the correct level, close to the clinically tolerated doses, then the results do match what we see in the clinic. That could be a good marker moving forward to select molecules that will have success.

What takeaways from that seminar do you want to highlight?

The other aspect that I discussed was some of our more recent work looking at multiple target-independent mechanisms of action, because there are a lot of reports in the literature and in mouse models of how target-independent effects might be playing a role in the clinic. In that work, what we did was we took all these different factors, whether it’s immune effects, extracellular protease cleavage, macrophage uptake and payload release, and free payload in the blood, and put all of them into a single framework. This is another advantage of the simulations—we can take clinical data, in vitro cellular data, and preclinical animal data, put them all in the same framework, so we have an apples-to-apples comparison. That allowed us to look at the magnitude of these impacts. This helps put the clinical data into context. One of the important things that came out of that, however, was that the target-mediated uptake is the biggest driver of efficacy. All the effort that’s being put into identifying the right targets and getting local delivery into the cells is worth it in the end because that’s going to far outweigh any of these other effects. Those other effects can be important, and they can help us understand some of the clinical data more clearly.

What are the most significant disconnects between mouse model pharmacokinetics/efficacy and human clinical outcomes?

A traditional way of approaching the preclinical models is to do dose escalation until you see your response, but one of the underappreciated facts in the field is that mice tolerate extremely high doses of these molecules. Many of these payloads don't work very well on mouse cells, and so the mice tolerate very high doses. If you're using a xenograft model that's growing a human tumor inside the mouse and the tumor is very sensitive, you have this artificially high therapeutic window, and you end up getting these complete responses in mice. Once you go into humans, the tissues are much more sensitive. You have to dose much lower, and then you don't get the uptake and the distribution of the ADC in the tumor tissue, and you don't end up with responses.

How can efficacy results sometimes be counterintuitive in animals and in the clinic?

One of the things the field is learning more from these newer agents is that there’s no one-size-fits-all ADC that will work for any given target. You have to design it with purpose, for a given target. We’ve had a few different counterintuitive scenarios that we’ve shown in preclinical models where, for instance—and this also translates to the clinic—the most potent compound that kills cells easily in a petri dish when you’re just growing a monolayer of cells looks the best 

 on cells, but that also comes with this liability of high toxicity. What might look good with some of the ultra-potent payloads, once you get to the clinic, you don’t end up with a therapeutic window. By selecting lower potency payloads—and this is one of the major reasons why the topoisomerases have been so successful—is that they have a low enough potency that you can dose high in the clinic. That allows you to penetrate the tumor tissue, reach all the cells, and drive much higher efficacy. There are other counterintuitive examples that we’ve shown in the past. Sometimes, very rapid internalization can hurt efficacy. Now, this is a unique case. This is not in all cases, but sometimes, at these lower doses, fast internalization can limit the tissue penetration, so you don’t reach all the cells. In other cases, we’ve shown that slower internalization allows the molecule to penetrate deeper and reach more cells, and you end up with higher efficacy.

How can lower toxicity be achieved in the development of ADCs?

One of the things that I've argued for, for many years, is lowering the drug-to-antibody ratio [DAR], particularly with the more potent compounds, or adding in an extra antibody to make sure that your antibody dose is high enough. With some of these more potent compounds, that is one way to improve the therapeutic window: by dosing more antibody. Now there's a lot of interest in alternative and new payloads. In those cases, I don't think you'll necessarily want to go with a lower DAR. Off the bat, you need to figure out what the potency of your compound is. If you have much lower potency, let's say lower potency than even a topoisomerase inhibitor, then you might want to go on the other end of the spectrum and try to use these very high DARs if you have a low potency compound that also might have better tolerability. Finding that right balance of the potency of the compound and the delivery will then maximize your therapeutic window and help improve its tolerability.

How do PDX and computational models help understand patient responses in settings with various approved ADCs?

The computational models are very nice [being] able to forecast what you expect to happen in the clinic. I often argue for running a parallel campaign where you’re making computational predictions of these [ADCs] at the same time as you’re doing the experimental work. What the computational work allows you to do is to forecast what you expect to happen in the clinic. Even at the early discovery stages, you might look at a new target, and you might understand something about the biology, and you can look at the internalization rate and forecast what that is ultimately going to do in terms of your efficacy in the clinic. As you’re screening for antibodies, you might find one that internalizes much faster or much slower, and then you can plug that into your computational model and predict what the impact is going to be at the clinical stage. As you move along the pipeline, once you get into your animal studies, you can update the model with any sort of differences from your predictions. It gives you more confidence to move forward, that things are behaving as you expect, and that you already have this clinical forecast. That’s one of the strong advantages of doing the computational work in parallel with the experimental work.

How does this affect the development of ADCs?

We have enough understanding now to know that we can't blindly go into these screens and pick the most potent compound. We need to understand how we're developing the animal models to pick the molecules that are going to have the greatest efficacy. Just because you can get a complete response in the mouse doesn't mean that it's going to be a good compound in the clinic. That translation during the development phase and selecting for molecules, or on the contrary, if a molecule is not giving you efficacy at a dose that you expect to be able to give in the clinic, to stop that program and move on to a more promising agent. That can help you and help companies harness the resources and focus on the most promising molecules.

What new advancements are you most excited about in the field of ADCs?

A lot of us are looking at different combination therapies and how that will impact clinical efficacy. One of the areas where our lab is interested is understanding how these molecules interact with the immune system, because these are targeted chemotherapeutics. I would argue that they have a lot of ideal properties for driving a strong immune response, and we're seeing that with some of the combinations of immune checkpoint inhibitors and ADCs. What other combination partners can we leverage to drive that immune response? Because if you can drive a strong immune response, you can get a very durable response over years, as opposed to months. That's the future of where we went ahead with cancer therapy, and ADCs are a great mechanism of doing that.

Thurber G. Contextualizing learnings from translational profiles of approved ADCs to unlock best approaches to preclinical dosing in mouse models. Presented at the 16th Annual World ADC Summit; November 3-6, 2025; San Diego, CA.

Articles

The Latest and Hottest Topics in ADCs: A Discussion With a Chemical Engineer

"DC vaccination plus atezolizumab demonstrated a favorable safety profile with long-term survivors," according to the study authors.

Combining dendritic cell (DC) vaccination with atezolizumab (Tecentriq) produced long-term survival in a small cohort of patients with extensive-stage small cell lung cancer (ES-SCLC), according to findings from a phase 1b/2 trial (NCT04487756) presented in a poster session at the 

Society for Immunotherapy of Cancer 2025 Annual Meeting

After a median follow-up of 25.7 months among 18 patients who received DC vaccination at a median of 3 doses (range, 1-6), data showed a median progression-free survival (PFS) of 4.7 months (95% CI, 4.2-6.9) and a median overall survival (OS) of 11.2 months (95% CI, 6.3-17.9). Survival beyond 24 months occurred in 33% (n = 6) of patients; 22% (n = 4) achieved progression-free status at this time. Investigators reported no significant differences in long-term survival outcomes based on clinical features, PD-L1 expression, molecular subtype of SCLC, or tumor mutational burden (TMB).

Investigators observed an expansion of XCR1-positive conventional type 1 dendritic cells (cDC1s; 

 = .03) and CXCR5-positive, PD-1–positive, CD8-positive T cells (

 = .05) following induction in patients with long-term survival. The median OS was 6.7 months (95% CI, 5.0-11.6) in patients with CXCR5-positive, PD-1–positive T cell changes of less than 0.42 vs 26.0 months (95% CI, 6.8-not accessible [NA]) in those with a change of 0.42 or higher. Regarding the expansion of XCR1-positive DCs within cDC1, the median OS was 6.3 months (95% CI, 5.0-11.6) in those with a change of less than 0 vs 19.0 months (95% CI, 6.8-NA) in those with a change of 0 or higher.

The median OS was 16.2 months (95% CI, 7.0-NA) in patients with a DC1 percentage expansion of 0.77 or lower following DC vaccination and 6.5 months (95% CI, 6.3-6.8) in those with a change of more than 0.77. Regarding percentage expansion of DC2 following vaccination, the median OS was 26.0 months (95% CI, 6.3-NA) in patients with a change of 9 or lower compared with 8.9 months (95% CI, 6.3-11.6) in those with a change of more than 9.

“DC vaccination plus atezolizumab demonstrated a favorable safety profile with long-term survivors,” Maria Gonzalez-Cao, MD, from Dexeus University Hospital in Barcelona, Spain, wrote with coauthors in the poster.

 “Results suggest a role of [XCR1-positive] cDC1s as mediators of response to atezolizumab.”

Investigators of the multicenter, open-label study assessed DC vaccination as a therapeutic agent and as a potential mediator of immune response elicited with atezolizumab among 20 patients with ES-SCLC. Patients received standard induction with chemotherapy plus atezolizumab followed by a maximum of 6 doses of 10 x 10

 mature DCs via intradermal administration and atezolizumab at 1200 mg intravenously every 3 weeks. Investigators assessed DC populations and exhausted CD8-positive T cell subsets in patient blood samples using flow cytometry, defining long survival at an 18-month cut-off.

The trial’s primary end points included PFS at 6 months and the frequency and severity of adverse effects (AEs) and serious AEs.

 Secondary end points included duration of clinical benefit, OS, and objective response rate.

Patients 18 years and older with histologically confirmed ES-SCLC and centrally confirmed tumor tissue viability for vaccine preparation were eligible for enrollment on the trial. Other eligibility criteria included having no prior cancer treatment in the advanced setting, a minimum life expectancy of 16 weeks, and an ECOG performance status of 0 or 1.

Investigators categorized 6 patients as “long survivors” and 12 others who were not “long survivors.” The median age was 60 years (range, 53-75) and 62 years (range, 54-73), and most in each respective group were female (50% vs 58%). More patients with long survival had brain metastases (50% vs 17%), while a higher proportion of those without long survival had bone metastases (0% vs 50%). Among 3 and 9 evaluable patients in each group, the median TMB was 29 (range, 24-30) and 23 (range, 20-29), respectively.

Gonzalez-Cao M, Sistere-Oro M, Moran T, et al. Long term survivors from phase Ib-II trial of tumor-loaded monocyte-derived dendritic cell vaccination plus atezolizumab in ES-SCLC. Presented at the Society for Immunotherapy of Cancer 2025 Annual Meeting; National Harbor, MD; November 5-9, 2025. Abstract 350.

Combination of atezolizumab with dendritic cell vaccine in patients with lung cancer (VENEZO-LUNG). ClinicalTrials.gov. Updated April 3, 2024. Accessed November 13, 2025. https://tinyurl.com/598uuhw9

Data show that XCR1-positive conventional type 1 dendritic cells may play a role as mediators of response to atezolizumab in extensive-stage SCLC.

Atezolizumab/Vaccine Combo May Show Long-Term Survival in ES-SCLC

How do PDX and Computational Models Assist in the Development of ADCs?

Patient-derived xenograft (PDX) and computational models have been valuable tools for researchers when developing antibody-drug conjugates (ADCs). When used in tandem with experimental work, they can help a developer achieve a greater understanding of the biology or the internalization rate of an ADC at the early discovery stages.

Leading ADC experts, from researchers to engineers to oncologists, gathered at the 16th Annual World ADC Summit in San Diego, CA, to discuss topics like this and everything else prominent in the space of ADCs. Greg Thurber, PhD, a professor in chemical engineering at the University of Michigan School of Biomedical Engineering, was one of such experts who spoke with CancerNetwork® at the conference about topics of note from his seminars.

Thurber’s first seminar was titled “Contextualizing learnings from translational profiles of approved ADCs to unlock best approaches to preclinical dosing in mouse models”, and he also hosted a workshop about the multiscale mechanisms of ADCs, among other topics.

During his presentation, Thurber discussed the importance and helpfulness of computational and PDX models in development, even at the earliest stages. For example, when screening for antibodies, if one internalizes at a notably different speed than the others, it can be input into a computational model, which can then predict what impact it may have at the clinical stage. The models can then be adapted and modified when moving further along the development pipeline to account for results from animal models.

Videos

Computational models help researchers anticipate how ADCs may behave in later lines of development, while they are still in the early stages.

The Aliya PEF ablation procedure achieved local tumor control in 96% of patients and was well-tolerated with no delays to SOC therapy.

Aliya pulsed electric field (PEF) ablation may promote local tumor control and modulate systemic immune function without impact on subsequent standard-of-care therapy in patients with metastatic solid tumors, according to 6-month results from the interventional AFFINITY trial (NCT05890872) published in 

During the trial, 2 cohorts of patients emerged: cohort 1, which included patients treated with ablation alone (n = 12), and cohort 2, which enrolled patients receiving additional systemic and/or focal therapies (n = 16). The distribution of patients who had solitary, oligofocal, and multifocal cases was similar between the groups (

<.99). The investigators noted that the study was not designed to randomize patients into these groups, but that the distinct cohorts emerged during data analysis.

Six months after ablation, 33% (n = 4/12) of patients who did not receive additional therapy achieved local partial responses (PR), and 67% (n = 8/12) achieved local stable disease (SD). In the additional therapy cohort, 6% (n = 1/16) of patients achieved local complete responses (CRs), 50% (n = 8/16) achieved local PRs, and 38% (n = 6/16) achieved local SD. One patient had local disease progression and died due to respiratory failure about 7.3 months after ablation.

Of the 13 patients in the cohort analyzed by flow cytometry, all achieved local control by 6 months; 5 achieved local PRs and 8 achieved local SD. Analysis found that natural killer (NK)-cells increased during the middle phase and activated CD4+ CD28+ T-cells were significantly elevated at all time points; Activated Memory B-cells were significantly increased in the early and middle phases, and plasmablasts were increased across all 3 time points. Decreases were identified in Regulatory T-cells in the late phase, naïve CD8+ T-cells during the middle and late phases, naïve B-cells in the middle phase, and Central Memory CD4+ T-cells at the middle and late phases. Twenty additional immunocyte populations among the 29 analyzed did not show significant changes compared with baseline.

In the 12 patients who did not receive additional therapy, 9 had matched serum and biopsy samples to assess biopsy-specific IgG, and 11 had baseline and follow-up serum available for assessing changes in tumor-associated antigen (TAA)-specific IgG. Of the 9 patients assessable for biopsy-specific IgG, 33% had a rise of 20% or more in their biopsy-specific IgG1 and 1 or more post-treatment time points. No patients exhibited statistically significant modulation of IgG levels at the chronic time point, but 1 with a late time point rise had no chronic time point sample available for analysis. Magnitude of response varied from a 41% to 96% increase over baseline; a single patient had a 19% decrease in biopsy-specific IgG at the late time point. Regarding statistically significant TAA-specific IgG level changes, reduced MAGE-A3–, WT1–, and NY-ESO-1–specific IgG was observed in 7, 5, and 5 patients, respectively.

In a press release on the findings, Michael A. Pritchett, DO, MPH, director of the Chest Center of the Carolinas and interventional pulmonologist at First Health of the Carolinas and investigator in the study, stated, “These data provide encouraging evidence that Aliya PEF ablation can achieve meaningful local control even in patients with advanced, metastatic disease. Equally important, we're seeing evidence that Aliya PEF may also trigger systemic immune activation. These findings suggest a promising opportunity to provide focal ablation adjunctive with immunotherapy to potentially enhance outcomes.”

A total of 31 patients were enrolled in the trial, though 28 patients were included in the analysis. Eligible patients had a diagnostic lung biopsy for suspected malignancy, were not surgical candidates for curative-intent, had not previously received treatment for their targeted tumors, and were indicated for first-line therapy for their targeted tumor.

The median age at consent was 66 years (range, 28-85), 50% of patients were female, and 71.4% of patients had an ECOG performance status of 0. Included malignancy groups were colorectal (17.9%), neuroendocrine (10.7%), non–small cell lung cancer (14.3%), other (32.1%), renal (17.9%), and sarcoma (7.1%).

Patients received ablation either bronchoscopically or percutaneously, with follow-up occurring on days 3, 10, and 30, as well as months 3, 6, 9, and 12. Adjuvant systemic therapy and/or focal therapy were administered at the discretion of the treating physician.

Previously, data on the study’s safety end points were reported, and demonstrated an acceptable safety profile.

 The ablation procedure was well-tolerated, including in patients with bilateral lung lesions. One procedure-related serious adverse event (AE) of pneumothorax resolved without sequelae, no AEs delayed first-line standard of care therapy initiation, and CTT scans at 30 days showed limited parenchymal changes around the ablation zone.

"The AFFINITY results further heighten our confidence in the Aliya PEF ablation technology," added Doug Godshall, chief executive officer of Galvanize Therapeutics in the release.

 "We are compelled to find ways to improve the lives of the patients our clinical partners treat and we continue to invest in research to demonstrate Aliya PEF's ability to effectively ablate tumors locally while also stimulating the body's immune system."

Moreno-Gonzalez A, Nafie EHO, Pastori C, et al. Six-month local control rates and immune responses after pulsed electric field ablation in metastatic cancer. 

. 2025;17(21):3495. doi:10.3390/cancers17213495

New study shows Aliya® pulsed electric field ablation achieved local control of lung tumors in metastatic cancer patients and may induce an immune response. News release. Galvanize Therapeutics. November 11, 2025. Accessed November 13, 2025. https://tinyurl.com/4vvkr9zw

Pritchett MA, Reisenauer JS, Fernandez-Bussy S, et al. The safety of pulsed electric field ablation before standard of care treatment for patients with metastatic cancer. 

. 2025;32(4):e01027. 2025;32(4):e01027. doi:10.1097/LBR.0000000000001027

PEF Ablation Yields Local Control, May Elicit Immune Response in Solid Tumors

"The data we reviewed showed that patients who received follow-up transplants or tumor removal after immunotherapy reduced the size of their tumors lived much longer than patients who just remained on immunotherapy," according to study author Ju Dong Yang, MD.

Curative treatment conversion (CTC), although infrequent, correlated with significantly improved survival in patients who received prior immunotherapy for hepatocellular carcinoma (HCC), according to findings from a representative cohort study published in 

Among 4765 patients with HCC, 3.2% (n = 138) received curative therapy following immunotherapy, which included resection in 54.3% (n = 75), local ablation in 25.4% (n = 35), and transplantation in 20.3% (n = 28). Compared with 4101 patients who did not undergo curative therapy, those who received CTC experienced significantly prolonged overall survival (OS) outcomes (HR, 0.15; 95% CI, 0.11-0.22; 

 <.001), with the highest survival probabilities in those who underwent resection, followed by transplantation and local ablation (

Based on multivariate analysis, receipt of CTC independently correlated with better OS outcomes (HR, 0.20; 95% CI, 0.11-0.37; 

 <.001), as did receiving treatment at an academic center vs a nonacademic facility (HR, 0.70; 95% CI, 0.59-0.82; 

 <.001). CTC using ablation (HR, 0.21; 95% CI, 0.05-0.86; 

 = .03), resection (HR, 0.18; 95% CI, 0.08-0.40; 

 <.001), and liver transplantation (HR, 0.28; 95% CI, 0.09-0.87; 

 = .03) were all independently correlated with improvements in OS. Following additional analyses, investigators noted that the OS benefit seen in an academic center occurred independently of CTC.

“The data we reviewed showed that patients who received follow-up transplants or tumor removal after immunotherapy reduced the size of their tumors lived much longer than patients who just remained on immunotherapy…. Performing liver transplant following immunotherapy isn’t yet common practice,” senior study author Ju Dong Yang, MD, medical director of the Liver Cancer Program at Cedars-Sinai, stated in a press release on these findings.

 “This is unfortunate, as patients with advanced liver cancer often die without such treatment—even if their cancer is under control—because they also have other liver ailments. A transplant leaves the patient with a healthy liver.”

Investigators collected information from the US National Cancer Database on patients with HCC who received immunotherapy in the frontline setting between 2017 and 2020. The study included a collection of demographic, socioeconomic, and clinical information related to these patients, which were summarized via standard descriptive measures and compared based on receipt of subsequent CTC using Pearson’s chi‐squared test for categorical variables and the Mann‐Whitney‐Wilcoxon test for continuous variables. Additionally, investigators estimated survival outcomes based on the Kaplan-Meier method.

Overall, the median age of patients was 66 years, and most were male (81%). The most common disease stages per AJCC criteria were stage T4 (33%), followed by M1 (32%) and N1 (22%). Patients experienced a median of 3.0 months (IQR, 1.3-5.5) from the time of immunotherapy to initiating curative treatment.

In patients who received CTC and those who did not, respectively, the median age was younger (63 years vs 66 years; 

 = .004), and the median tumor size was smaller (57 mm vs 75 mm; 

 = .002). Additionally, those in the CTC population were more likely to receive care in academic health facilities (78% vs 48%; 

 <.001), and in the northeast region (35% vs 25%) or south region (44% vs 39%; 

Multivariate logistic regression analyses revealed that factors correlating with receipt of curative treatment after immunotherapy included the absence of node metastases (OR, 0.16; 95% CI, 0.02-0.56; 

 = .02) and receipt of treatment at an academic health center (OR, 3.40; 95% CI, 1.68-7.38; 

In 138 propensity score-matched pairs of patients between the CTC and non-CTC populations, receipt of CTC correlated with significantly longer OS (HR, 0.22; 95% CI, 0.14-0.33; 

 <.001). Additional matching analyses showed improved OS outcomes with the receipt of resection (HR, 0.05; 95% CI, 0.02-0.11; 

 <.001), local ablation (HR, 0.19; 95% CI, 0.09-0.38; 

 <.001), and transplantation (HR, 0.16; 95% CI, 0.07-0.36; 

 <.001). In inverse probability of treatment weighting analysis, receipt of CTC showed a significant association with improved OS (HR, 0.20; 95% CI, 0.14-0.29; 

“When our physician-scientists create studies based on patient needs and then apply their findings to patient care, it improves outcomes for everyone we serve and for patients around the world. As an academic medical center, that is our mission,” Robert Figlin, MD, FACP, interim director of Cedars-Sinai Cancer, stated in the press release.

Choi GH, Kim HS, Luu M, et al. Curative treatment after immunotherapy leads to excellent outcomes in patients with hepatocellular carcinoma. 

. Published online July 24, 2025. doi:10.1159/000547230.

Elston C. Surgery after immunotherapy boosts survival for liver cancer patients. News release. Cedars-Sinai. November 13, 2025. Accessed November 13, 2025. https://tinyurl.com/595zhjy5

Receiving treatment at an academic center may improve the probability of receiving subsequent curative care among those with hepatocellular carcinoma.

Post-IO Curative Treatment Conversion May Prolong Survival in Liver Cancer

After a median follow-up of 18 months, the median time to recurrence was not reached with nurse-led telehealth follow-up vs 21.4 months with SOC, and the risk of recurrence per month was 1.6% (95% CI, 0.6%-4.2%) in both arms.

Nurse-led telehealth follow-up using the Measure of Ovarian Symptoms and Treatment Concerns (MOST-S26) patient-reported index exhibited feasibility for patients with ovarian cancer following completion of chemotherapy, according to findings from a phase 2 trial (ACTRN12620000332921) presented at the 

2025 European Society of Medical Oncology (ESMO)

Specifically, although the study was underpowered, with 22 patients having undergone nurse follow-up vs 11 having undergone standard-of-care (SOC) oncology clinic follow-up, findings suggested that nurse-led follow-up was associated with high patient and nurse satisfaction without any apparent impact on diagnosis of recurrence. Furthermore, non-significant improvements in functional and social well-being, as well as role and social functioning, were observed. The study authors suggested that the findings warranted the evaluation of the telehealth method using MOST-S26 in a larger phase 3 trial.

Additionally, after a median follow-up of 18 months, the median time to recurrence was not reached (NR) with nurse-led telehealth follow-up vs 21.4 months with SOC (HR, 0.63; 95% CI, 0.17-2.36); the risk of recurrence per month was 1.6% (95% CI, 0.6%-4.2%) in both arms. Additionally, no referrals were observed in the SOC arm vs 16 (72.7%) in the nurse-led telehealth arm. Referrals included 5 (22.7%) to a clinical psychologist, 1 (4.5%) to a sexual counsellor, 2 (9.0%) to a dietician, 4 (18.2%) to a physiotherapist, and 4 (18.2%) to an occupational health specialist.

Furthermore, 3 overarching themes emerged among response data compiled from 14 women with ovarian cancer and 6 study nurses. The first, classified as key patient-centered benefits, included:

and a dedicated space for patient disclosure of experiences and emotions

Additionally, a patient reported, “I just [have not] been abandoned after going through treatment. That’s a nice thing to have that connection.”

The second overarching theme, identified as challenges to delivery from nurses’ perspectives, included:

a lack of transparent referral pathways for serious symptoms

an inability to observe physical cues to inform care

an emotional impact on nurses when presented with disease recurrence

and difficulties for patients with low literacy or language barriers

One nurse expressed, “It does make it harder to get that rapport sometimes when you [cannot] see them face to face.”

Furthermore, the last overarching theme established the usefulness of MOST-S26 in supporting consultations, with the authors claiming that nurses “reported MOST-S26 provides a useful tool to guide consultations and referrals; detect early signs of recurrence; track symptoms over time and flag symptoms for discussion; and help patients reflect on their symptoms.”

Another nurse reported that MOST-S26 gave structure to their consult and helped to focus on symptoms that were potentially impactful or problematic.

“The study suggests that nurse-led telehealth follow-up for ovarian cancer using the MOST is feasible, has high patient and nurse satisfaction, and does not appear to delay diagnosis of recurrence,” Paul A. Cohen, FRANZCOG, MD, clinical professor in the Division of Obstetrics and Gynaecology and Clinical Research Fellow at the Harry Perkins Institute of Medical Research of The University of Western Australia, wrote in the publication with study coinvestigators.

 “Maintenance therapy with PARP [inhibitors] does not preclude nurse follow-up. Barriers and challenges to changing attitudes to nurse-led follow-up [emerged].”

Across 6 Australian sites, patients 18 years and older with stage I to IV, high-grade serous, grade 3 endometroid, clear cell, or mucinous ovarian cancer with an ECOG performance status of 0 to 2 and normalized CA125 at the completion of chemotherapy were eligible for trial enrollment. Patients were initially stratified based on receipt of PARP inhibition or bevacizumab (Avastin) and were subsequently randomly assigned 2:1 to undergo nurse-led telehealth with MOST-S26 or routine clinic follow-up once monthly or every 3 months.

Among patients in the investigational (n = 22) and SOC cohorts (n = 11), the median age was 62 years (range, 32-79) vs 62 years (range, 27-76). Most patients had an ECOG performance status of 0 (32.0% vs 54.5%) or 1 (68.0% vs 36.5%), stage III disease (54.5% vs 54.5%), grade 3 disease (86.4% vs 90.9%), and serous histology (90.9% vs 81.8%). A total of 63.6% vs 72.7% of patients had wild-type germline status, 59.1% vs 63.6% had undergone primary surgery, 40.9% vs 36.4% received neoadjuvant chemotherapy, 40.9% vs 45.5% underwent maintenance therapy, and 45.5% vs 45.5% had R0 margins.

The primary end point of the study was emotional well-being at 6 months. Secondary end points included feasibility and safety, health-related quality of life, patient satisfaction, fear of recurrence, referrals for symptom management, acceptability, and progression-free survival.

Cohen PA, Obermair A, Gebski V, et al. A phase II randomized trial of nurse led telehealth follow-up including patient reported outcomes using the MOST (Measure of Ovarian Symptoms and Treatment Concerns) vs routine clinic based or telehealth follow-up after completion of chemotherapy in patients with ovarian cancer. Presented at: 2025 ESMO Congress; October 17–20, 2025; Berlin, Germany. Abstract CN88.

Cohen PA, Obermair, Gebski V, et al. A phase II randomized trial of nurse led telehealth follow-up including patient reported outcomes using the MOST-S26 (measure of ovarian symptoms and treatment concerns) versus routine clinic based or telehealth follow-up, after completion of chemotherapy in patients with ovarian cancer. 

2025;36(suppl 2):S1650. doi:10.1016/j.annonc.2025.08.1166

Although the study was underpowered due to a small sample size, non-significant improvements in functional and social well-being occurred with MOST-S26.