Program Notes — SGO 2026¶

One-month retrospective of the 2026 SGO Annual Meeting on Women's Cancer (San Juan, Puerto Rico · April 10 – 13, 2026). Tracks, headline readouts by disease, discussant framing, and what the meeting did to the GYN-oncology trial cycle going into AACR/ASCO 2026.

Status: Scaffold (post-meeting) — ready for retrospective bulk extraction. The shape, headline framings, and cross-vault hooks are locked here; the per-trial deep extraction lives in trials/index.md and the per-trial files to follow.

Day-by-day map¶

Day 1 — Friday April 10 (Plenary I, opening + ovarian platinum-resistant)¶

Plenary I was the headline session of the meeting. ROSELLA opened the meeting and set the tone — a Phase 3 OS win in platinum-resistant ovarian cancer is a rare event, and Corcept's relacorilant (Lifyorli) had already been FDA-approved one month before the presentation (March 2026), making the SGO talk a victory-lap plus mechanism deep-dive.

ROSELLA (LBA) — Relacorilant + nab-paclitaxel vs nab-paclitaxel monotherapy in platinum-resistant ovarian cancer post-bevacizumab. mOS 16.0 vs 11.9 mo (HR 0.65, p=0.0004); mPFS HR 0.70 (p=0.0076). Simultaneous Lancet publication on day-of-presentation. GOG-3073 / ENGOT-ov72 / APGOT-Ov10 / LACOG-0223 / ANZGOG-2221 — five cooperative-group sponsors, the signature gyn-onc multi-region design. Mechanism class: glucocorticoid receptor antagonism — first GR-antagonist Phase 3 solid-tumor win.
KEYNOTE-B96 (encore) — Pembrolizumab + paclitaxel ± bevacizumab in platinum-resistant ovarian (ENGOT-ov65). Recently FDA-approved (Feb 2026). SGO presentation was the post-approval data deep-dive plus subgroup analyses.
NRG-GY019 (Amanda Fader, MD) — Letrozole alone vs paclitaxel/carboplatin + letrozole in low-grade serous ovarian. Failed non-inferiority — chemo retained in LGSOC SOC. The "negative" Plenary trial that nonetheless drove practice: settles a long-running debate about chemo elimination in HR+ LGSOC.

Discussant framing for Day 1: ROSELLA reframed platinum-resistant ovarian as a setting where mechanism diversity (GR antagonism alongside ADCs and pembro combinations) is now generating real OS gains — the 10-year stagnation in this setting broke in early 2026.

Day 2 — Saturday April 11 (ovarian platinum-sensitive + endometrial early sessions)¶

ADC day for ovarian cancer. Three distinct ADC targets with material clinical readouts in the same 24 hours.

Mirvetuximab + carboplatin → MIRV maintenance (AbbVie, IMGN853-0420 Ph2 LBA) — Platinum-sensitive recurrent ovarian (FRα+). 81% continued to MIRV monotherapy maintenance; ORR 68% in maintenance phase; 63.9% ORR in PARPi-pretreated subgroup — the headline number, because it justifies moving ELAHERE earlier into PSOC, including post-PARPi. Manageable safety (grade ≥3 neutropenia 15%, blurred vision 10%, thrombocytopenia 10%; pneumonitis 15% over prolonged therapy — needs monitoring).
Raludotatug deruxtecan REJOICE-Ovarian01 (Daiichi Sankyo, Ph2/3) — Platinum-resistant high-grade serous/endometrioid ovarian. ORR 50.5% — first CDH6 ADC clinical efficacy at scale. Cross-link to AACR 2026 ADC mechanism sessions (CDH6 as a kidney-and-ovarian-restricted target).
RAMP-201 follow-up (Verastem) — Avutometinib + defactinib in low-grade serous. DOR 31 mo; PFS 12.9 mo overall, 19.6 mo in KRAS-mut. The mature DOR is the headline — durable responses in a setting where chemo barely moves the needle.
BNT-324 (BioNTech, anti-B7-H3 ADC Ph1/2) — Active in both platinum-sensitive and platinum-resistant ovarian. Early signal.
BEHOLD-1 (Ph1/2) — ORR 62% in platinum-resistant — early ADC signal.
GLORIOSA / TroFuse-022 / RAINFOL-04 / FRAmework-01 / TROY — Ph3 ADC maintenance designs across PSOC; the SGO 2026 "ADCs are now maintenance" thesis.

Day 3 — Sunday April 12 (endometrial + cervical early sessions)¶

Plenary III was the endometrial Plenary. The headline was RUBY's mature 4-year OS update, simultaneously published. The undercard was puxitatug samrotecan — the first-in-human B7-H4 ADC clinical efficacy data.

RUBY 4-year OS (GSK, ENGOT-EN6-NSGO/GOG-3031, Plenary III) — Dostarlimab + carboplatin/paclitaxel vs placebo + chemo in 1L advanced/recurrent endometrial. dMMR/MSI-H subgroup: HR 0.32 (95% CI 0.17–0.63) — 68% mortality reduction; ~73% 4-year OS. MMRp HR 0.79 (95% CI 0.60–1.04) — 7-mo median OS gain, trend toward benefit. Confirms dostarlimab + chemo as 1L SOC for dMMR endometrial; the mature OS in dMMR is among the steepest survival curves in any solid-tumor Phase 3.
Puxitatug samrotecan BLUESTAR Ph1/2a (AstraZeneca, AZD8205, LBA — Stephanie Gaillard, MD, Johns Hopkins) — B7-H4 topoisomerase-1 ADC, first-in-human endometrial. ORR 34.6% @ 2.0 mg/kg, 38.5% @ 2.4 mg/kg; 12-wk DCR 80.8% / 84.6%; mPFS 7.0 mo. First clinical efficacy data for the B7-H4 ADC class — a target with read-through to breast and ovarian (AZ presented the basket BLUESTAR design at AACR 2026).
D-RT (GSK) — Dostarlimab + radiotherapy in adjuvant stage III-IVA dMMR endometrial (no residual disease). Chemo-free adjuvant approach — feasibility data; sets up Ph3 design.
GOG-3039 (GOG) — Abemaciclib + letrozole in HR+ endometrioid endometrial. 6-mo PFS 57%; ORR 39%. Defines CDK4/6 + AI signal in HR+ endometrial; potential SOC for the molecular subset.
Destiny-Endometrial01 / 02 / TroFuse-033 — Ph3 ADC designs in adjuvant + 1L endometrial; defines next-line SOC.
BEHOLD-01 — ORR 67% in recurrent endometrial — early-phase signal.

Day 4 — Monday April 13 (cervical + surgical innovation + scientific Plenary V)¶

Plenary V was the cervical Plenary + surgical innovation.

KEYNOTE-A18 mature OS (Merck, ENGOT-cx11/GOG-3047) — Pembrolizumab + chemoradiation followed by pembrolizumab in high-risk LACC (stage IB–IVA). Long-term follow-up: OS HR 0.73 (95% CI 0.57–0.94); 36-mo OS 81.8% vs 74.4%; 48-mo OS 75.4% vs 70.2%. No new safety signals. Confirmatory of the new SOC.
InnovaTV 205 Arm H (Pfizer/Seagen · Genmab) — Tisotumab vedotin + carboplatin + pembrolizumab ± bevacizumab in 1L recurrent/metastatic cervical. ORR 66%; mDOR 13 mo. TV moves into 1L combinations.
TroFuse-036 (Merck/Kelun) — Sacituzumab tirumotecan + pembrolizumab ± bevacizumab in cervical maintenance post-CCRT. Novel maintenance strategy.
IBI130 (Innovent, Ph1/2) — Anti-TROP2 ADC in recurrent/metastatic cervical. ORR 53%; manageable safety. China-origin TROP2 ADC entry.
Surgical innovation: SLN-mapping ultra-staging in early-stage endometrial; robotic-platform long-term outcomes after the LACC trial reassessment; fertility-sparing trachelectomy/conization outcomes in early cervical.
Uterine sarcoma: Leiomyosarcoma combination Ph2 data — small-N novel combinations.

Cross-cutting themes¶

1. ADC class explosion across all three gyn cancers¶

Six distinct ADC targets with 2026 clinical efficacy data at SGO:

Target	Drug	Indication	SGO 2026 signal
FRα	Mirvetuximab soravtansine (ELAHERE)	PSOC (moving earlier)	ORR 68% in MIRV maintenance; 63.9% post-PARPi
CDH6	Raludotatug deruxtecan (R-DXd)	Platinum-resistant HGSOC	ORR 50.5% (REJOICE-Ovarian01)
B7-H4	Puxitatug samrotecan (AZD8205)	Endometrial	ORR 34.6–38.5% (BLUESTAR Ph1/2a)
B7-H3	BNT-324	Ovarian (both settings); cervical	Early signal
TROP2	Sacituzumab tirumotecan; IBI130	Cervical maintenance; cervical recurrent	ORR 53% (IBI130)
Tissue Factor	Tisotumab vedotin (Tivdak)	Cervical 1L	ORR 66% (InnovaTV 205 Arm H)

This is the AACR linker-chemistry-payload mechanism story landing in the clinic — and SGO 2026 is where it all consolidates into a class-level practice shift.

2. Glucocorticoid receptor antagonism as a solid-tumor class¶

ROSELLA's relacorilant Phase 3 win is the first GR-antagonist Phase 3 in solid tumor — read-through to cortisol-axis biology in HR-modulated cancers (breast, prostate, ovarian). Corcept's Lifyorli (relacorilant) FDA approval in March 2026 was the cycle-defining regulatory event.

3. Chemo-immunotherapy 1L SOC is locked in across gyn-onc¶

Endometrial: Dostarlimab + chemo (RUBY) — mature 4-yr OS HR 0.32 in dMMR — practice-changing confirmed.
Cervical (LACC): Pembrolizumab + CCRT (KEYNOTE-A18) — 48-mo OS 75.4% vs 70.2% — durable benefit confirmed.
Ovarian (platinum-resistant): Pembrolizumab + paclitaxel ± bev (KEYNOTE-B96) — FDA-approved Feb 2026.

The 1L chemo-IO debate in gyn-onc is closed by SGO 2026.

4. Cooperative-group multi-region sponsorship¶

ROSELLA's five-group authorship (GOG-3073 / ENGOT-ov72 / APGOT-Ov10 / LACOG-0223 / ANZGOG-2221) exemplifies gyn-onc's unique trial-design culture. RUBY (ENGOT-EN6/GOG-3031), KEYNOTE-A18 (ENGOT-cx11/GOG-3047), NRG-GY018, NRG-GY019, GOG-3039 — every major Phase 3 had cooperative-group co-sponsorship. This authorship density translates directly to faster NCCN-guideline incorporation than industry-only Phase 3 designs.

5. Biomarker subgroups define every Phase 3¶

The "all-comer" gyn-onc trial is extinct. Every 2026 Phase 3 reported a molecular subgroup:

dMMR/MSI-H (RUBY)
FRα+ (mirvetuximab)
BRCA / HRD (PARPi maintenance follow-ups)
KRAS-mut LGSOC (RAMP-201)
B7-H4+ (BLUESTAR — IHC-selected)
CDH6+ (REJOICE-Ovarian01)
PD-L1+ (KEYNOTE-A18 / KEYNOTE-B96 subgroups)
p53-abn, POLE-mut (RUBY endometrial subgroups)

6. China-origin assets surface in gyn-onc¶

IBI130 (Innovent anti-TROP2 cervical) and BNT-324 (BioNTech B7-H3, Mainz/Berlin) crossed into US trade-press at SGO. Echoes the JPM 2026 "China is the story" thread — anbenitamab, daraxonrasib partner activity, ivonescimab class influence on the gyn-onc pipeline.

7. Surgical Plenary distinguishes SGO from ASCO/ESMO¶

SGO's preservation of a dedicated surgical-innovation Plenary (sentinel-node mapping, robotic platforms, fertility-sparing) makes it one of the few oncology meetings where the surgical-decision discussant has institutional weight equal to the medical-oncology discussant. NCCN surgical-guideline updates often trace back to SGO Plenary V data.

Forward continuity — what SGO 2026 sets up for AACR / ASCO / ESMO 2026¶

[Forward-looking — flagged]

AACR 2026 (Apr 17–22, one week after SGO closed): B7-H4, CDH6, B7-H3, FRα ADC mechanism sessions provide the preclinical scaffold. Relacorilant GR-antagonism mechanism sessions reinforce ROSELLA's clinical win.
ASCO 2026 (May 29–Jun 2): GYN-track sequels include ROSELLA subgroup analyses + PRO endpoints; RUBY long-term safety; REJOICE-Ovarian01 dose-cohort comparisons; BLUESTAR ovarian + breast basket cohorts; KEYNOTE-A18 biomarker correlates.
ESMO 2026 (Oct 16–20): European subgroup follow-ups; mature ADC follow-ups (R-DXd, AZD8205, BNT-324); ROSELLA EU regulatory milestone (EMA decision likely H2 2026).
SABCS 2026 (Dec 8–11): Cross-tumor B7-H4 + CDH6 ADC follow-ups (BLUESTAR breast cohorts) anchored by SGO BLUESTAR endometrial data.
ASH 2026 (Dec 12–15): No direct gyn-onc tie; secondary cross-link through ADC linker-chemistry mechanism sessions only.

What's missing from the scaffold (queue for bulk extraction)¶

Per-trial Markdown files (rosella.md, keynote-b96.md, nrg-gy019.md, mirvetuximab-imgn853-0420.md, rejoice-ovarian01.md, ramp-201.md, bnt-324.md, behold-1.md, behold-01.md, ruby-4yr-os.md, bluestar-puxitatug.md, d-rt.md, gog-3039.md, destiny-endometrial-01.md, destiny-endometrial-02.md, trofuse-033.md, keynote-a18-mature-os.md, innovatv-205-arm-h.md, trofuse-036.md, ibi130-cervical.md) — each following the template in trials/index.md.
Surgical innovation per-topic files (SLN ultra-staging, robotic LACC follow-up, fertility-sparing trachelectomy).
Discussant / Plenary moderator identification per trial — captures the NCCN-panel framing.
Simultaneous publication DOIs verified per trial (Lancet for ROSELLA confirmed; others pending journal-page lookup).