Karen Lu, MD, gave the presidential address at the Society of Gynecologic Oncology’s 2026 Annual Meeting. She recalled early in her career seeing a patient with colon cancer who then developed endometrial cancer. This patient had a strong family history of both cancers, yet no one considered her at risk for a hereditary cancer that would now be recognized as Lynch Syndrome (LS).
“Science begins with curiosity and observation about specific patients with careful observations of these patients,” Dr. Lu said. Lynch Syndrome is not new—a description was published in 1913. Dr. Harry Lynch later expanded on those observations. Dr. Lu collaborated with Dr. Lynch to find that endometrial cancer was as likely as colon cancer to be the sentinel disease in LS (hereditary nonpolyposis colorectal cancer syndrome).
“Magic happens through both happy coincidence and the power of cross-disciplinary teams,” Dr. Lu observed. Researchers studying yeast uncovered genes encoding proteins responsible for correcting errors that occur during DNA replication. Deficiency in these DNA mismatch repair genes was found to underly LS.
When tumors with mismatch-repair deficiency were shown in 2015 to be sensitive to immune checkpoint blockade, that discovery helped establish immunotherapy as a pillar of cancer treatment alongside surgery, chemotherapy, and radiation. In addition to targeted therapies like checkpoint blockade for Lynch Syndrome and PARP inhibitors for patients with BRCA1 and 2-realted cancers, risk-reducing strategies are being developed.
“Most importantly, we’re seeing increased access to genetic testing and with that a shift in the patients we care for. Increasingly we’re seeing ‘previvors,’ individuals who carry pathogenic variants who have not developed cancer. That is changing how we think about prevention,” Dr. Lu said.
In the last 25 years the cost of DNA sequencing has decreased dramatically, from $4000 for clinical genetic testing to $250. Dr. Lu participated in the Making Genetic Testing Accessible (MAGENTA) study (NCT02993068) that showed remote genetic testing was feasible and scalable, increasing the ability to identify individuals at risk for cancer before they develop it.
SGO convened a Pathways to Progress Summit in September 2025 during which 85 multi-disciplinary experts identified the most important opportunities to advance gynecologic cancer research to create a comprehensive roadmap for the next 5 years. Key priorities include prevention, early detection, broader adoption of innovative clinical trial designs, integrating bioinformatics and artificial intelligence into research and clinical practice, a commitment to health equity, and global collaboration. A manuscript with specific calls to action arising will be published in Gynecologic Oncology.
Another focus of Dr. Lu’s presidency has been supporting the future of the profession and early career years. This year’s meeting featured the first SGO early career faculty summit. Also of note is a wellness initiative. The SGO workforce survey showed a high rate of burnout. Because peer support is an evidence-based pathway to reduce burnout and protect care quality, the SGO Wellness Task Force has launched a new confidential Peer Support Program for and by SGO members. An initial group of peer support members was trained this year.
Dr. Lederman has no conflicts of interest to report.
Image by GoodStudio / Shutterstock
