Immune checkpoint inhibitors (ICIs) have demonstrated marked clinical effects worldwide, and “cancer immunotherapy” has been recognized as a feasible option for cancer treatment. Significant treatment responses have already been attained for malignant melanoma and lung cancer, ahead of gynecologic cancer. In cervical cancer, however, results are only available from phase II trials, not from phase III trials. Cervical cancer is a malignant tumor and is the fourth most common cancer among women worldwide. Since the introduction of angiogenesis inhibitors, treatment for recurrent and advanced cervical cancers has improved in the past five years, but median overall survival is 16.8 months for advanced cervical cancer, and all-stage five-year overall survival rate is 68%, indicating that treatment effects remain inadequate. For this reason, the development of new therapeutic approaches is imperative. We describe herein the KEYNOTE-158 and CheckMate 358 clinical trials, which were conducted for cervical cancer, and discuss future directions, including potential combinations with concurrent chemoradiation therapy (CCRT), as noted for other types of cancer.

By measuring the adult human head during carotid endarterectomy, we investigate the depth sensitivity of two methods for deriving the absorption coefficient changes $\left(\Delta {\text{μ}}_a\right)$ from time-resolved reflectance data to absorption changes in inhomogeneous media: (1) the curve-fitting method based on the diffusion equation (DE-fit method) and (2) the time-independent calculation based on the modified Lambert–Beer law (MLB method). Remarkable differences in the determined values of $\Delta {\text{μ}}_a$ caused by clamping the external carotid artery and subsequently clamping the common carotid artery were observed between the methods. The DE-fit method was more sensitive to ${\text{μ}}_a$ changes in cerebral tissues, whereas the MLB method was rather sensitive to ${\text{μ}}_a$ changes in the extracerebral tissues. Our results indicated that the DE-fit was useful for monitoring the cerebral blood circulation and oxygenation during neurosurgical operations. In addition, the combined evaluation of ${\text{μ}}_a$ changes with the DE-fit and MLB methods will provide us with more available information about the hemodynamic changes in the depth direction.

We try a new approach with near-IR time-resolved spectroscopy, to separate optical signals originated in the upper layer from those in the lower layer and to selectively determine the absorption coefficient $(μa)$ of each layer in a two-layered turbid medium. The difference curve in the temporal profiles of light attenuation between a target and a reference medium is divided into segments along the time axis, and a slope of each segment is calculated to determine the depth-dependent $μa$. The depth-dependent $μa$ values are estimated under various conditions in which $μa$ and the reduced scattering coefficient $(μs′)$ of each layer are changed with a Monte Carlo simulation and in phantom experiments. Temporal variation of them represents the difference in $μa$ between two layers when $μs′$ of a reference is the same as that of the upper layer of the target. The discrepancies between calculated $μa$ and the real $μa$ depend on the ratio of the real $μa$ of the upper layer to that of the lower layer, and our approach enables us to estimate the ratio of $μa$ between the two layers. These results suggest the potential that $μa$ of the lower layer can be determined by our procedure.

The incidence of ovarian cancer, which has had a poor prognosis, is increasing annually. Currently, the prognosis is expected to improve with the use of molecular-targeted drugs and immune checkpoint inhibitors as maintenance therapies after the first-line chemotherapy. The GOG218 and ICON7 studies reported the usefulness of bevacizumab and the SOLO-1 and PRIMA (A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study of Niraparib Maintenance Treatment in Patients With Advanced Ovarian Cancer Following Response on Front-Line Platinum-Based Chemotherapy) studies have reported the usefulness of olaparib and niraparib, respectively. The ATHENA study investigating the usefulness of rucaparib is currently ongoing. Although clinical studies of immune checkpoint inhibitors are lagging in the field of gynecology, many clinical studies using programmed death cell-1 (PD-1) and PD-1 ligand 1 (PD-L1) antibodies are currently ongoing. Some biomarkers have been identified for molecular-targeted drugs, but none have been identified for immune checkpoint inhibitors, which is a challenge that should be addressed in the future.

Serous psammocarcinoma is a rare subtype of serous carcinoma in which a significant number of psammoma bodies are present histologically. Because it is an extremely rare disease, the pathogenesis of the disease remains unclear. Here we present a case of primary ovarian serous psammocarcinoma in which computed tomography (CT) imaging of the abdomen was useful for the diagnosis. A female patient was referred to our department with a complaint of abdominal distention. Pelvic magnetic resonance imaging revealed a multifocal tumor with a papillary enhancement in the right appendicular region, and abdominal CT imaging exhibited marked calcification of the enhancement. She underwent a laparotomy for suspected right ovarian cancer. As postoperative pathological examination revealed dominant stromal infiltration of psammoma bodies beneath peritoneum, this case was diagnosed as primary ovarian serous psammocarcinoma at FIGO Stage IIB. The patient was treated with six courses of paclitaxel plus carboplat in after the surgery. She is currently under outpatient observation without any signs of recurrence after 8 years of treatment. The case of significant calcification of the intra cystic enrichment on CT imaging is considered to be a case of this disease.