The last two years have been prolific in pelvic gynecologic oncology, particularly for ovarian cancer, considering the results of large prospective randomized studies. The first, published in the NEJM by Van Driel et al. in January 2018, revealed for the first time the benefits of hyperthermic intraperitoneal chemotherapy (HIPEC) in the initial management of advanced ovarian cancers. These benefits involved both disease-free survival and overall survival without significantly increasing the surgery’s morbi-mortality. The second, also published in the NEJM in December 2018, demonstrated the undeniable benefits of PARP inhibitors (Olaparib) in the initial management of patients with advanced ovarian cancer carrying a BRCA 1 or 2 mutation. The third study, published in February 2019 by Harter et al., showed quite surprisingly that routine lymphadenectomy during cytoreductive surgery for advanced ovarian cancer (Stage IIB-IV) did not provide any benefits in terms of disease-free survival and overall survival. Even in the lymphadenectomy group, half of the patients exhibited lymphnode involvement. Finally, in September 2019, for two other PARP inhibitors tested in the initial management of advanced ovarian cancer, their indisputable usefulness was confirmed.

In 2019, we welcomed several major advances made in the management of kidney disease. We have decided to highlight herein two major developments. Firstly, pregnancy can now be considered in a patient upon chronic dialysis. Secondly, two new potassium binders are on the horizon, which is great news for patients with chronic kidney disease requiring renin angiotensin system (RAS) blockade.

Pregnancy, which is in fact rare in women with end-stage kidney failure, is associated with increased feto-maternal morbidity. Recent data, along with our own experience, highlight that pregnancy can now be considered in women on maintenance hemodialysis, who are ready to perform intensive home hemodialysis, along with a strict and regular obstetrical follow-up.

Hyperkalemia is common in chronic kidney disease patients, especially in those under RAS blockade, and can be life-threatening. Since the old K-binders have limited efficacy and are poorly tolerated, RAS blockade is frequently discontinued in such patients. Nevertheless, two new K-binders are on the horizon. The first one, patiromer, has been reimbursed since 2019 for the treatment of chronic hyperkalemia. The other one, sodium cyclosilicate of zirconium (SZC), has been approved for use in Europe, though this drug is not yet reimbursed in Belgium. We briefly review these molecules’ efficacy and safety and discuss their role in maintaining RAS blockade, especially in CKD patients with proteinuria or heart failure.

The current treatment of hemophilia relies on intravenous administration, repeated several times a week, of clotting factor VIII (FVIII) or factor IX (FIX) concentrates, either derived from plasma or produced by biotechnology. This preventive treatment is burdensome, expensive, and only allows for transient and partial corrections of the clotting factor deficiencies. Moreover, it is associated with the risk of developing neutralizing antibodies, termed inhibitors.

The FVIII and IX concentrates with a longer half-life, such as a bispecific monoclonal antibody mimicking the action of FVIII, as well as various strategies modifying the physiological regulation of coagulation, whilst being administered subcutaneously, represent new treatment options, either already validated or being evaluated. The first results of gene therapy studies also look very promising.

These developments offer patients with hemophilia new perspectives of treatment, if not cure, which this article proposes to review.

In 2019, major advances have been made in the field of fertility preservation in women. Our research mainly focused on improving ovarian tissue cryopreservation and transplantation, and the development of an artificial ovary.