Chair and Presenters Kathleen N. Moore, MD, MS, Floor J. Backes, MD, and Bhavana Pothuri, MD, MS, prepared useful Practice Aids pertaining to endometrial cancer for this CME/MOC/NCPD/AAPA/IPCE activity titled “Redefining Endometrial and Ovarian Carcinoma Care: Maximizing the Clinical Potential of Immunotherapy, ADCs, PARP Inhibitors, and Other Emerging Treatment Strategies.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/3SjJyuH. CME/MOC/NCPD/AAPA/IPCE credit will be available until April 17, 2025.

1. Resources for Providers, Patients, and Caregivers:
The Foundation for Women’s Cancer1
Full abbreviations, accreditation, and disclosure information available at PeerView.com/CVY40
The Foundation for Women’s Cancer (FWC)
provides multilingual gynecologic cancer resources for patients, families, and communities and
steadily pursues its mission of supporting research, education, and public awareness
of gynecologic cancers, risks, prevention, early detection, and optimal treatment
Resources
available in
English,
Spanish, and
Mandarin
Interactive Video Education
Education presented from the patients’ perspective,
with downloadable tools, resources, and checklists
Compassionate Caregivers: Navigating Cancer’s Challenges
This new series aims to help caregivers support loved ones by
becoming active participants in the care team, confidently discussing
stigmatized elements of gynecologic cancer, gaining skills to
balance time and prioritize their own mental health, and more
Clinical Trials: Your Guide
Visit foundationforwomenscancer.org/clinical-trials for brochures and
videos with information, FAQs, and clinical trials currently recruiting
1. foundationforwomenscancer.org.

2. Resources for Providers, Patients, and Caregivers:
National Ovarian Cancer Coalition1
Full abbreviations, accreditation, and disclosure information available at PeerView.com/CVY40
Patient advocacy groups such as the
National Ovarian Cancer Coalition (NOCC)
provide invaluable support to those with
ovarian cancer and their caregivers.
NOCC has a number of resources
available to aid patients at any stage of
their ovarian cancer journey, including
information on biomarkers, clinical trials,
and side effect management.
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Comprehensive Online Education
• Animated Patient Guide videos
• Extensive resource library (English and Spanish)
Ask the Experts - Facebook Live Series
• Online Wellness Symposiums
Peer Support Programs
• Survivor peer-to-peer support group
• Caregiver peer support group
Support Services
• Financial assistance
• Counseling/Coping
• Meal delivery service
• Care packages
Talk to Your Patients About
NOCC’s Education Resources
!
nocc@ovarian.org
888-OVARIAN
Helpful Free Resources
for Healthcare Providers
to Provide Their Patients
1. ovarian.org.

3. Managing Adverse Events in
Gynecologic Cancers1-11
Full abbreviations, accreditation, and disclosure information
available at PeerView.com/CVY40
Safety Considerations
for Immunotherapies
1. Monitor closely for potential
irAEs by evaluating blood
work including liver
enzymes, creatinine, and
thyroid function
2. Ask patients about
symptoms such as cough,
shortness of breath, and
diarrhea, which may be
signs of pneumonitis
or colitis
3. Stay in communication
with patients to help
mitigate and treat more
common AEs such as
fatigue, nausea, and anemia
Pancreatitis,
autoimmune diabetes
Colitis
Enteritis
Encephalitis, aseptic meningitis
Thyroiditis, hypothyroidism,
hyperthyroidism
Dry mouth, mucositis
Hypophysitis
Uveitis
Pneumonitis
Thrombocytopenia,
anemia
Hepatitis
Adrenal insufficiency
Nephritis
Vasculitis
Arthralgia
Neuropathy
Rash, vitiligo
Myocarditis
Any organ system can be affected; commonly occurring irAEs are
pulmonary (pneumonitis), dermatologic (rash, pruritus, blisters, ulcers,
vitiligo), gastrointestinal (diarrhea, enterocolitis, transaminitis, hepatitis,
pancreatitis), and endocrine (thyroiditis, hypophysitis,
adrenal insufficiency)
What Is the Spectrum of Potential irAEs?
• In general, checkpoint inhibitor therapy should be continued
with close monitoring, with the exception of some neurologic,
hematologic, and cardiac toxicities
Minimal or no symptoms; diagnostic changes only
Grade 1
• Hold checkpoint inhibitor therapy for most grade 2 toxicities
• Consider resuming immunotherapy when symptoms and/or
laboratory values revert to grade 1 or lower
• Corticosteroids (initial dose of 0.5-1 mg/kg/d of prednisone or
equivalent) may be administered
Grade 3 toxicities
• Hold checkpoint inhibitor therapy
• Initiate high-dose corticosteroids (prednisone 1-2 mg/kg/d or
methylprednisolone IV 1-2 mg/kg/d)
• If symptoms do not improve with 48-72 hours of high-dose
corticosteroids, infliximab may be offered for some toxicities
• Taper corticosteroids over the course of at least 4-6 weeks
• When symptoms and/or laboratory values revert to grade 1 or
lower, rechallenging with immunotherapy may be offered; however,
caution is advised, especially in those patients with early-onset
irAEs; dose adjustments are not recommended
Grade 4 toxicities
• In general, permanent discontinuation of checkpoint inhibitor
therapy is warranted, with the exception of endocrinopathies that
have been controlled by hormone replacement
Grade 2
Mild to moderate symptoms
Severe or life-threatening symptoms
Grades 3/4
irAE Grading and Management
Safety and Monitoring of Immune-Related Adverse Events
in Patients Receiving Checkpoint Inhibitors

4. Managing Adverse Events in
Gynecologic Cancers1-11
Full abbreviations, accreditation, and disclosure information
available at PeerView.com/CVY40
Consult irAE management guidelines
(eg, ASCO, NCCN, ESMO, SGO)
IO
Pruritus
Pneumonitis
Myocarditis
Adrenal crisis
TKI
Hypertension
Taste changes
Stomatitis
Dyspepsia
Cytopenia
HFSR
Overlapping
Rash
Diarrhea
Hepatitis
Hypothyroid
AMS
Safety and Monitoring of IO + TKI Combination Toxicities
Determine which therapy is causing the AE
in order to plan a management strategy
Hold TKI (shorter half-life than checkpoint inhibitor)
In certain cases, use appropriate supportive care
If symptoms resolve in a few days, TKI was likely the cause
Two mechanisms of action result in two sets of AE
profiles that are not mutually exclusive
PRES
Encephalitis

5. Managing Adverse Events in
Gynecologic Cancers1-11
Full abbreviations, accreditation, and disclosure information
available at PeerView.com/CVY40
• Warnings and precautions: MDS/AML (~1.5%), pneumonitis, VTE, and embryo-fetal toxicity
• Most common AEs (≥10%) in clinical trials
– As a single agent: nausea, fatigue (including asthenia), anemia, vomiting, diarrhea,
decreased appetite, headache, dysgeusia, cough, neutropenia, dyspnea, dizziness,
dyspepsia, leukopenia, and thrombocytopenia
– In combination with bevacizumab: nausea, fatigue (including asthenia), anemia,
lymphopenia, vomiting, diarrhea, neutropenia, leukopenia, UTI, and headache
Niraparib Adverse Events
Rucaparib Adverse Events
• Warnings and precautions: MDS/AML, bone marrow suppression, hypertension,
CV effects, PRES, embryo-fetal toxicity, and allergic reactions to tartrazine
• Most common AEs (≥10%) in clinical trials
– Nausea, thrombocytopenia, anemia, fatigue, constipation, musculoskeletal pain,
abdominal pain, vomiting, neutropenia, decreased appetite, leukopenia, insomnia,
headache, dyspnea, rash, diarrhea, hypertension, cough, dizziness, acute kidney
injury, UTI, and hypomagnesemia
• Warnings and precautions: MDS/AML and embryo-fetal toxicity
• Most common AEs (≥10%) in clinical trials
– Nausea, fatigue (including asthenia), anemia, AST/ALT increased, vomiting,
diarrhea, decreased appetite, thrombocytopenia, dysgeusia, neutropenia, blood
creatinine increased, dyspnea, dizziness, dyspepsia, photosensitivity reaction,
and leukopenia
Olaparib Adverse Events
Safety and Monitoring in Patients Taking PARP Inhibitors

6. Managing Adverse Events in
Gynecologic Cancers1-11
Full abbreviations, accreditation, and disclosure information
available at PeerView.com/CVY40
a
In HER2-positive (including IHC 3+) solid tumors.
1. Schneider BJ et al. J Clin Oncol. 2021;39:4073-4126. 2. NCCN Clinical Practice Guidelines in Oncology. Management of Immunotherapy-Related Toxicities. Version 1.2024. https://www.nccn.org/
professionals/physician_gls/pdf/immunotherapy.pdf. 3. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm. 4. Haanen J et al. Ann Oncol. 2022;33:1217-1238. 5. O'Cearbhaill
RE et al. Gynecol Oncol. 2022;166:25-35. 6. Zejula (niraparib) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/208447s027lbl.pdf. 7. Lynparza (olaparib) Prescribing
Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/208558s028lbl.pdf. 8. Rubraca (rucaparib) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/
label/2022/209115s013lbl.pdf. 9. Tivdak (tisotumab vedotin) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/761208s005lbl.pdf. 10. Elahere (mirvetuximab
soravtansine) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/761310Origs005lbl.pdf. 11. Enhertu (trastuzumab deruxtecan) Prescribing Information.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/761139s028lbl.pdf.
Safety and Monitoring in Patients Taking ADCs
• Warnings and
precautions: ocular
toxicity
• Conduct an ophthalmic
exam at baseline, prior
to each dose, and as
clinically indicated
• Most common AEs
(≥25%) in clinical trials:
decreased hemoglobin,
lymphocytes, and
leukocytes; fatigue;
nausea; peripheral
neuropathy; alopecia;
epistaxis; conjunctival
adverse reactions;
hemorrhage; increased
creatinine and
prothrombin international
normalized ratio; dry eye;
prolonged activated
partial thromboplastin
time; diarrhea; and rash
Tisotumab
vedotin
Mirvetuximab
soravtansine
Trastuzumab
deruxtecan
• Warnings and
precautions: ocular
toxicity
• Conduct an ophthalmic
exam including visual
acuity and slit lamp
exam prior to initiation,
every other cycle for the
first 8 cycles, and as
clinically indicated;
administer prophylactic
artificial tears and
ophthalmic topical steroids
• Most common AEs
(≥20%) in clinical trials:
vision impairment; fatigue;
increased AST, ALT, and
alkaline phosphatase;
nausea; keratopathy;
abdominal pain; decreased
lymphocytes, albumin,
magnesium, leukocytes,
neutrophils, and
hemoglobin; peripheral
neuropathy; diarrhea;
constipation; and
dry eye
• Warnings and
precautions: interstitial
lung disease and
embryo-fetal toxicity
• Monitor for and promptly
investigate signs and
symptoms including
cough, dyspnea, fever,
and other new or
worsening respiratory
symptoms
• Most common AEs
(≥20%) in clinical trials:
nausea; decreased white
blood cell, hemoglobin,
neutrophil, lymphocyte,
and platelet counts;
fatigue; increased AST,
ALT, and blood alkaline
phosphatase; vomiting;
alopecia; constipation;
decreased appetite;
hypokalemia; diarrhea;
and musculoskeletal
paina

7. Numerous Treatment Strategies Under Study in
Advanced Endometrial and Ovarian Cancers
Full abbreviations, accreditation, and disclosure information available at PeerView.com/CVY40
Cytotoxic agents have immunomodulatory
effects, providing a rationale for combining
checkpoint inhibitors with chemotherapy1
ADCs are composed of a monoclonal antibody
covalently attached to a cytotoxic drug via a
chemical linker. They combine both the
advantages of highly specific targeting ability
and highly potent killing effect to achieve
accurate and efficient elimination of cancer cells4
Inhibition of XPO1
results in activation
of tumor suppressor
proteins and
reduction in
oncoprotein levels3
Select Trials With the XPO1 Inhibitor2
Select PARPi + IO + Chemo Trials2
Select IO + Chemo Trials2
Endometrial Cancer
• Phase 3 NRG-GY018 (pembrolizumab + chemo5,a
)
• Phase 3 AtTEnd (atezolizumab + chemo)
• Phase 3 RUBY (dostarlimab + chemo6,a
)
• Phase 3 DUO-E (durvalumab + chemo)
Endometrial Cancer
Selinexor:
• Phase 2 SIGN
• Phase 3 SIENDO
• Phase 3 XPORT-EC
Select ADC Trials2
Endometrial Cancer
• Phase 3 DESTINY PanTumor-02
(trastuzumab deruxtecan [T-DXd]7,a
;
HER2 target)
• Phase 3 MK-2870-005 (TROP2 target)
• Phase 2 TROPION-PanTumor03 (datopotamab
deruxtecan [Dato-DXd]; TROP2 target)
Ovarian Cancer
• Phase 3 DESTINY PanTumor-02
(trastuzumab deruxtecan [T-DXd]7,a
;
HER2 target)
• Phase 3 MIRASOL (mirvetuximab
soravtansine8,a
; FRα target)
• PHASE 3 GLORIOSA (mirvetuximab
soravtansine; FRα target)
• Phase 2/3 REJOICE-Ovarian01 (raludotatug
deruxtecan [R-DXd]; CDH6 target)
• Phase 2 TROPION-PanTumor03 (datopotamab
deruxtecan [Dato-DXd]; TROP2 target)
ADCs
CPIs
XPO1
inhibitor
TSPs,GR,
oncogenic
mRNAs
XPO1
PARP inhibitors exploit the
baseline vulnerability of
cells with inherent DNA
repair deficiency9
Endometrial Cancer
• Phase 3 DUO-E (olaparib + durvalumab + chemo)
• Phase 3 RUBY (niraparib + dostarlimab + chemo)
Ovarian Cancer
• Phase 3 DUO-O (olaparib + durvalumab + chemo
+ bevacizumab)
• Phase 3 KEYLYNK-001 (olaparib + pembrolizumab
+ chemo)
• Phase 3 FIRST (niraparib + dostarlimab + chemo)
PARP
inhibitor
PARP
+
Select PARP Inhibitor Combination Trials2
a
FDA-approved regimen.
1. Bailly C et al. NAR Cancer. 2020;2:zcaa002. 2. clinicaltrials.gov. 3. Azizian NG and Li Y. J Hematol Oncol. 2020;13:61. 4. Drago JZ et al. Nat Rev Clin Oncol. 2021;18:327-344. 5. Keytruda (pembrolizumab) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/
label/2024/125514s160lbl.pdf. 6. Jemperli (dostarlimab) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/761174s010lbl.pdf. 7. Enhertu (trastuzumab deruxtecan) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/
label/2024/761139s028lbl.pdf. 8. Elahere (mirvetuximab soravtansine) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/761310Origs005lbl.pdf. 9. O’Connor MJ. Mol Cell. 2015;60:547-560.