{'fraction_non_alphanumeric': 0.01900739176346357, 'fraction_numerical': 0.0021119324181626186, 'mean_word_length': 5.719858156028369, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Clinical Trials in Gynecologic Oncology: Past, Present, and Future

Groundbreaking, practice-changing clinical trials in women's cancers have historically been run through the Gynecologic Oncology Group (GOG). Clinical trials completed within the GOG group structure have determined the current standard of care for initial treatment of ovarian, endometrial, cervical, and trophoblastic cancers. Clinical trial design for gynecologic oncology has markedly changed in recent decades to make the newest drugs available as early as possible to patients—with emphasis on streamlining drug development toward specific patient populations and indications for investigational agents. There has been a shift toward the phase 2/3 design and smaller trial size. Targeting selected patient populations using biomarkers and other novel strategies allows a larger effect size to achieve with a small number of patients. With these changes in trial design, a more seamless process is possible for moving promising regimens from early phase clinical trials (phase 2 or even phase 1) and accelerates approval by the US Food and Drug Administration (FDA). Biomarker-driven clinical trials enrolling selected patients may complete faster and show greater differences, leading to earlier FDA review. For example, strong preclinical and clinical data linking germline BRCAmutations with increased responsiveness to poly–ADP ribose polymerase inhibitors led to rapid development and availability of rucaparib and olaparib. Focusing on key biological drivers and vulnerabilities in women's cancers allows translating from the bench to personalized therapies. Physician scientists are well positioned to drive new discoveries to patients. Smarter clinical trial design will get the right drugs to the right patients expeditiously, improve outcome for women with gynecologic cancers, and give them hope for the future.