Major clinical advances in gynecologic cancer in 2025: from de-escalation strategies to precision therapies beyond BRCA

Abstract

The landscape of gynecologic cancer management has continued to evolve substantially in 2025, driven by major clinical advances spanning surgical, radiation, and systemic therapies. Recent progress in precision oncology has expanded therapeutic options beyond the BRCA era. Immune checkpoint inhibitors have become integral components of treatment for selected gynecologic malignancies characterized by distinct molecular and histopathologic features, while novel biomarker-driven approaches continue to refine patient selection. In addition, antibody–drug conjugates, which combine tumor-targeted antibodies with cytotoxic payloads, have emerged as a promising therapeutic class, demonstrating encouraging antitumor activity across multiple disease settings. In an effort to overcome the limitations of novel single-agent therapies, clinical research has increasingly focused on combination strategies based on mechanistic rationale. In parallel, advances in surgical and radiation techniques have emphasized functional preservation and improvements in quality of life while maintaining oncologic outcomes. In this review, we summarize the most noteworthy research advances reported in 2025 and discuss their potential implications for future directions in the treatment of gynecologic cancers. © 2026. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.