Endometrial cancer is one of the few malignancies rising in both incidence and mortality — a trend that underscores the urgent need for better prevention and treatment strategies. Gynecologic oncologist Paola Gehrig, MD, is building a robust clinical trials program that brings precision medicine to the forefront of care for women with gynecologic cancers.
Gehrig’s research focuses on molecularly driven therapies for endometrial cancer, including a new clinical trial enrolling patients with ARID1A mutations to evaluate potential benefits from bevacizumab and niraparib, a novel PARP inhibitor. Beyond her own research, she’s working to expand opportunities for discovery and collaboration.
Below, Gehrig shares how emerging therapies are reshaping gynecologic oncology — and why creating space for innovation and mentorship drives both her science and her leadership.
What are you working on right now?
We have a robust clinical trials unit within gynecologic oncology. We currently have trials that cover all the major malignancies, including ovarian, endometrial, and cervical cancers. These include both treatment trials (from early phase to phase 3) and surgical trials.
My personal interest is endometrial cancer, and I am the site PI for a phase 3 trial combining molecularly driven therapies for women with advanced or recurrent disease. We have seen an enormous influx of new, paradigm-shifting therapies in the past 10 years, which has been remarkable. Clinical trials are truly how we advance treatment options and improve cancer-related outcomes.
What are the most intriguing potential clinical applications of your work?
The highlight of everything we do is seeing patients experience improved outcomes while maintaining quality of life. Celebrating those moments — recovering from surgery, completing therapy, hitting cancer-free milestones — energizes me every day.
We are entering an era of molecularly directed therapy, where we may soon know which patients need escalation of care and which can safely de-escalate, allowing us to deliver personalized therapy at an entirely new level. These advances are incredibly exciting.
What recent discovery or development has impacted the way you think?
For many in gynecologic oncology, the emergence of immuno-oncology has been revolutionary, improving survival outcomes for patients with endometrial and cervical cancer. Antibody-drug conjugates (which I describe to patients as laser-directed stealth bombs) are also very promising, and I look forward to seeing how these therapies continue to develop and improve outcomes.
What do you wish more people knew about your field?
I wish more people — and healthcare providers — knew the signs and symptoms of gynecologic malignancies. We still see delays in care because individuals don’t realize that irregular vaginal bleeding, especially after menopause, is not normal and requires evaluation. Delays also occur between presentation and referral or diagnosis. Raising awareness is critical.
How did you become interested in your area of research?
It all started right here at UVA Health when I was a resident. My mentor suggested a project on carcinosarcoma of the uterus, as those patients seemed to have worse outcomes. That experience launched my career investigating “atypical” endometrial cancer histologies and committed me to a lifetime in academic medicine.
Since then, I’ve studied surgical staging, radiographic appearance, sequencing of chemotherapy and radiation, and targeted therapies. I’m deeply grateful for that first research project — it transformed my career, and I hope my work has helped a few people along the way.
What made you choose UVA Health for your research?
I completed my OB-GYN residency here, then left for about 25 years to complete my gynecologic oncology fellowship and serve as faculty at another institution. I was thrilled to return to UVA Health as chair of the Department of Obstetrics and Gynecology in 2022. The cancer center and oncology division welcomed me warmly and allowed me to continue both my clinical and research career. The people and the support have been phenomenal.
