Category: 3. Business

Suspected scam investment companies are exploiting Trustpilot’s review system by giving themselves five-star ratings to persuade would-be investors that they are legitimate businesses, a report has warned.

An investigation by the verification firm KwikChex found operators using fake reviews, forged certificates and stolen corporate identities to lure victims.

One operator posed as a regulated law firm able help investors recover lost money, despite having no listing with the Solicitors Regulation Authority (SRA).

“These scammers see Trustpilot as a vital part of their playbook,” said Chris Emmins, KwikChex’s co-founder.

According to the report, scammers are deploying networks of fake reviewers, who leave glowing endorsements for multiple linked companies while attacking rivals.

Patterns in posting behaviour and use of language revealed clusters of suspicious reviews, while cross-checks of business information raised red flags such as virtual office addresses and falsified incorporation documents.

In many cases, KwikChex said it had discovered the scam companies using cloned websites and counterfeit certificates.

Trustpilot responded to the report by launching an investigation and removing several reviews that had a significant impact on the companies’ ratings. One review page was also taken down.

Fake reviews have become a business, with companies dedicated to selling positive or negative feedback online.

In response, regulators such as the UK’s Competition and Markets Authority have made it illegal to commission or host fabricated feedback. These measures are aimed at restoring consumer confidence, but critics have questioned whether the marketplace can be policed, because of its sheer scale.

Trustpilot uses artificial intelligence software to spot fake reviews. The company removed 7.4% of reviews submitted in 2024, compared with 6.1% the year before.

The vast majority of removed reviews were taken down automatically by AI as it identified patterns that flagged concerns.

One company that carried a 4.7-star rating was Crypto-Benefits247. After the company was flagged by the Guardian, Trustpilot removed some of its positive ratings and its score fell to 2.8. The Financial Conduct Authority has warned that the firm may be operating illegally. KwikChex found Crypto-Benefits247’s incorporation certificate was a forgery, crudely edited from another company’s legitimate document.

There is a one-star score from someone who said they lost more than £65,000 to Crypto-Benefits247 after being lured in with small, successful withdrawals before the company began inventing fees for certificates, upgrades and “activation keys”.

Another company, Oakvests Crypto, had a 4.5-star score but used a video of the chief executive of a different business, Oakvest, on its website. Oakvest’s finance director, David Wells, said: “We are grateful to KwikChex for alerting us to this identity theft and wish them success in tracking down the fraudsters.”

Since the account was flagged to Trustpilot, Oakvests Crypto’s rating has dropped to 3.2, with a number of reviews taken down.

Quantum Recovery Law Group, rated 4.1 stars from 82 reviews, presented itself as a wealth recovery law firm. The SRA has issued a scam alert against it. Trustpilot removed the account after being presented with the findings of KwikChex’s report.

The exact names of companies are used in this article, as such entities often imitate or reference real businesses.

Emmins said: “The successful use of fake reviews undermines every legitimate business that works to earn a genuine reputation. Meanwhile, scammers use Trustpilot to polish their lies.”

KwikChex has called on Trustpilot to drop its slogan “find a company you can trust” and to stop using “verified” banners on reviews, warning that the platform’s system is too easily exploited. In response to this specifically, Trustpilot said: “As we have not seen the mentioned report we cannot comment on its findings at this time.”

None of the companies identified by KwikChex responded to the Guardian’s attempt to reach them for a comment.

A spokesperson for Trustpilot said it takes the integrity of reviews extremely seriously, adding that its systems were always learning and it did not “always get it right”. They said that was why the community was encouraged to flag suspicious reviews.

“We have previously taken action against the companies mentioned, removing fabricated reviews and issuing both warnings and legal cease and desist letters for guideline breaches,” the spokesperson said.

“Since further concerns have been raised we have launched a deeper investigation and removed further fabricated reviews from each profile. Each profile now displays a consumer alert, warning consumers about these companies. Our investigation is ongoing.”

Trustpilot said it was continuing “strengthening” its systems to stay ahead of “evolving tactics”.

Sacituzumab govitecan (Trodelvy) reduced the risk for disease progression or death by 38% vs chemotherapy in patients with previously untreated, locally advanced, unresectable or metastatic triple-negative breast cancer (TNBC) who are ineligible for PD-1 or PD-L1 inhibitors, according to a presentation of the phase 3 ASCENT-03 trial (NCT05382299) at the 2025 ESMO Annual Congress.^1,2

In addition to its statistically significant and clinically meaning improvement in progression-free survival (PFS), the agent induced a superior duration of response (DOR) with no new safety signals.

“This data might support a potential new standard, potential good option for patients with triple-negative breast cancer when they develop metastasis and are unable to receive immune checkpoint inhibitors,” Javier C. Cortés, MD, PhD, head of the International Breast Cancer Centre in Barcelona, Spain, said during a presentation of the data.

How did sacituzumab govitecan perform against chemotherapy in mTNBC?

Among patients treated with sacituzumab govitecan, median PFS by blinded independent central review (BICR) was 9.7 months (95% CI, 8.1-11.1) compared with 6.9 months (95% CI, 5.6-8.2) with chemotherapy (HR, 0.62; 95% CI, 0.50-0.77; P <.001). Further, PFS rates were superior with sacituzumab govitecan compared with chemotherapy at 6 months (65% [95% CI, 59%-71%] vs 53% [95% CI, 47%-59%], respectively) and 12 months (41% [95% CI, 34%-47%] vs 24% [95% CI, 19%-30%)].

When assessed by the investigators, PFS in the sacituzumab govitecan arm was 9.6 months (95% CI, 8.3-10.6), compared with 6.8 months with chemotherapy (95% CI, 5.6-7.2; HR, 0.64; 95% CI, 0.52-0.79). The 6- and 12-month PFS rates with sacituzumab govitecan were 65% (95% CI, 59%-70%) and 52% (95% CI, 46%-58%), respectively, compared with 38% (95% CI, 32%-44%) and 22% (95% CI, 17%-27%) with chemotherapy.

PFS benefit was observed across all patient subgroups, including by age, ECOG PS, geographic region, disease state, PD-L1 status, and chemo selection prior to randomization.

In addition, the objective response rate (ORR) with sacituzumab govitecan was 48% (95% CI, 42%-54%) compared with 46% (95% CI, 40%-52%) for those received chemotherapy (stratified odds ratio [OR], 1.1; 95% CI, 0.8-1.6). In the sacituzumab govitecan and chemotherapy arms, respectively, 20 patients (7%) and 15 patients (5%) experienced a complete response, 115 (41%) and 112 (40%) had a partial response, 113 (41%) and 101 (36%) had stable disease, and 14 (5%) and 36 (13%) developed progressive disease.

“Objective response rates were similar in both treatment groups; however, duration of response was substantially longer with sacituzumab govitecan vs chemo,” Cortés noted. Median DOR was 12.2 months (95% CI, 9.7-13.8) with sacituzumab govitecan compared with 7.2 months for chemotherapy (95% CI, 5.7-8.4).

Time to response by BICR was 1.6 months in both the sacituzumab govitecan (95% CI, 0.7-16.7) and chemotherapy (95% CI, 0.9-6.8) groups.

Overall survival (OS) data was not mature at the time of the presentation; however, Cortés acknowledged that, of the 179 patients who initiated subsequent treatment after chemotherapy, 147 (82%) received sacituzumab govitecan.

At the time of the presentation, median OS was 21.5 months (95% CI, 17.7-not reached [NR]) and 20.2 months (95% CI, 18.2-NR), respectively (HR, 0.98; 95% CI, 0.75-1.30).

Median PFS2 was 18.2 months (95% CI, 15.9-NR) and 14.0 months (12.5-17.4) with sacituzumab govitecan and chemotherapy, respectively (HR, 0.70; 95% CI, 0.55-0.90).

What are the adverse events (AEs) associated with sacituzumab govitecan?

The median duration of treatment with sacituzumab govitecan was 8.3 months (range, <0.1-28.7).

Treatment-emergent AEs (TEAEs) occurred in 99% and 97% of patients in the sacituzumab govitecan and chemotherapy arms, respectively, with grade 3 or higher events occurring in 66% and 62%, with 61% and 53% being treatment related.

In total, 71 serious TEAEs occurred in the sacituzumab govitecan arm, 46 of which were treatment related. TEAEs let to treatment discontinuation in 10 patients, while 181 and 101 patients experienced dose interruptions and reductions, respectively. There were 7 TEAEs leading to death with sacituzumab govitecan. Cortés noted that the majority were due to infections, including 5 infections that were secondary to neutropenia. None of the 5 patients, who each had risk factors for febrile neutropenia, received prophylaxis with G-CSF

The most common grade 3 or higher AEs included neutropenia (43%), diarrhea (9%), and leukopenia (7%). The incidence of AEs that led to discontinuation of sacituzumab govitecan or chemotherapy was 4% and 12%, respectively.

What are the unmet needs in advanced TNBC?

“Chemotherapy for many years, has been the mainstay of treatment for metastatic triple-negative breast cancer compared to other subtypes, and the absolute improvements in median overall survival have been relatively modest over time,” Ana C. Garrido-Castro, MD, medical oncologist, Dana-Farber Cancer Institute and assistant professor of medicine, Harvard Medical School, in Boston, said during an invited discussion of the presentation.

“…And the sobering truth is that across studies in the US and Europe, approximately 25% to 30% of patients diagnosed with metastatic TNBC are no longer alive at 6 months from their metastatic diagnosis, and 6 months is just about the median PFS of first-line chemotherapy. So, if there is a new drug that is able to significantly improve PFS with an acceptable toxicity profile, this should be sufficient to change the current standard of care in the first-line setting.”

According to Cortés, most patients with previously untreated metastatic TNBC are not candidates to receive treatment with a PD-(L)1 inhibitor. Further, about half of the patients treated in the first line do not go on to receive a second line of therapy. “Unfortunately, the great majority of our patients will experience progressive disease, and we need to treat them with subsequent lines of therapies,” he added. “There is an urgent need for improved therapeutic options in earlier lines of therapy to delay progression and time to next line of treatment.”

How was the ASCENT-03 trial conducted?

Sacituzumab govitecan is approved to treat metastatic TNBC in the second-line setting and beyond, as well as for the treatment of patients with pre-treated HR-positive/HER2-negative metastatic breast cancer globally.

The investigators conducted the international, phase 3, open-label, randomized trial of sacituzumab govitecan in patients with previously untreated, locally advanced, unresectable or metastatic TNBC who are not candidates for immune checkpoint therapy.

In the trial, investigators randomized patients 1:1 to receive either 10 mg/kg IV sacituzumab govitecan on days 1 and 8 of 21-day cycles (n = 279) or one of the following chemotherapy regimens (n = 279): 90 mg/m² paclitaxel or 100 mg/m² nab-paclitaxel on days 1, 8, and 15 of 28-day cycles, or 1000 mg/m² gemcitabine plus carboplatin AUC2 on days 1 and 8 of 21-day cycles.

Treatment was continued until BICR-verified progression or unacceptable toxicity. Eligible patients were offered to cross over to receive second-line sacituzumab govitecan following BICR-verified disease progression.

Patients were eligible for the trial if they were not candidates for PD-(L)1 inhibitors and were 6 months or less since treatment in the curative setting. Previously treated, stable central nervous system metastases were allowed.

“Knowing that sacituzumab govitecan crossover could impact their final OS results and complicate, potentially, their path towards regulatory approval, the study team should be applauded,” Garrido-Castro commented. “In my opinion, inclusion of crossover should be considered for therapies with known overall survival advantage, particularly in those patient populations with poor prognosis, though we and regulatory agencies must be thoughtful then of how to interpret the results and the impact of crossover.”

PFS, assessed by BICR, served as the primary end point of the study. Secondary end points included OS, ORR, DOR, time to response (TTR) by BICR, safety, and quality of life.

In the sacituzumab govitecan and chemotherapy arms, median age was 56 (range, 22-84) and 54 years (range, 23-86), respectively; and the majority were White (64% each), had an ECOG PS of 0 (66% vs 67%), were PD-L1 negative (99% each), had lung metastases (59% vs 61%), and received prior neoadjuvant therapies (66% vs 68%). Further, 48% of patients in each arm experienced recurrence after 12 months or more following curative treatment

References

1. Cortés JC, Bardia A, Punie K, et al. Primary results from ASCENT-03: A randomized phase III study of sacituzumab govitecan (SG) vs chemotherapy (chemo) in patients (pts) with previously untreated advanced triple-negative breast cancer (TNBC) who are unable to receive PD-(L)1 inhibitors (PD-[L]1i). Presented at: 2025 ESMO Annual Congress; October 17-21, 2025; Berlin Germany. Abstract LBA20.
2. Cortés J, Punie K, Barrios C, et al. Sacituzumab Govitecan in Untreated, Advanced Triple-Negative Breast Cancer. N Engl J Med. 2025. doi:10.1056/NEJMoa2511734

TUB-040 demonstrated promising response rates of more than 50% across doses of the NaPi2b-targeted antibody-drug conjugate (ADC) administered to patients with platinum-resistant high-grade serous ovarian cancer, according to findings from the phase 1/2a NAPISTAR1-01 study (NCT06303505) presented at the European Society for Medical Oncology (ESMO) Congress 2025.¹

In the proof-of-concept dose escalation study, responses were seen at all doses higher than 1.67 mg/kg, including a complete response at the 2.5 mg/kg dose. At dose levels ranging from 1.67 mg/kg to 3.3 mg/kg, the objective response rate (ORR) was 59% and the disease control rate (DCR; ORR plus stable disease) was 96%. The confirmed ORR was 50%, with responses still ongoing for 93% of patients.

“We had a high rate of good responses, and 80% of patients remain on treatment, indicating durable benefit. TUB-040 demonstrated significant efficacy in [patients with] biomarker unselected, heavily pretreated platinum-resistant ovarian cancer,” principal investigator Antonio Gonzalez-Martin, MD, PhD, Director of the Cancer Center Clínica Universidad de Navarra, said during a presentation of the results. “Responses occurred early and were deepening over time, as we will show in a future presentation.”

TUB-040 is comprised of an Fc-silenced IgG1 antibody targeted to NaPi2b, an antigen that is highly overexpressed in ovarian cancer. The antibody is connected to the cytotoxic agent exatecan using a P5 linkage and a peptide-cleavable linker developed by the maker of the drug, Tubulis. The ADC has a drug-antibody ratio of 8 to 1. NaPi2b is also expressed in lung adenocarcinoma, with another arm of the NAPISTAR1-01 study also exploring the agent for patients with non–small cell lung cancer (NSCLC).

In the study, 67 patients with ovarian cancer were enrolled to received TUB-040 across doses ranging from 0.5 mg/kg to a planned dose as high as 5.3 mg/kg. Data presented at ESMO focused on the 46 patients enrolled at dose level 1.67 mg/kg (n = 10), 2.1 mg/kg (n = 12), 2.5 mg/kg (n = 12), and 3.3 mg/kg (n = 12) but also included select information for the other doses.

Across all doses, the median exposure to TUB-040 was 161 days, and only a minority (n = 15; 22%) had discontinued treatment. The main causes of treatment discontinuation were disease progression (n = 13) and adverse events (n = 2).

Across all dose cohorts (n = 67), the median age was 62 years (range, 34.0-81.0). The ECOG performance status was 0 (55.2%) and 1 (44.8%), and the time from first diagnosis was a median of 5.3 years. Patients had received a median of 4 prior lines of therapy (range, 1-7). Most patients had prior exposure to bevacizumab (83.6%; Avastin) and a PARP inhibitor (76.1%), with 13.4% of patients also having received prior mirvetuximab soravtansin (Elahere). The median H score for NaPi2b expression was 175 (range, 95-295).

The median follow up was 7.8 months (range, 1.0-19.2), and confirmed ORRs were 40%, 58%, 58%, and 42% at the 1.67, 2.1, 2.5, and 3.3 mg/kg doses, respectively. The ORR in each group consisted primarily of partial responses, except for 1 confirmed complete response at the 2.5 mg/kg dose. The CA125 response rate was 81%.

More than half of patients (56.2%) remained free of a PFS event across the 1.6, 2.0, and 2.4 doses. Efficacy data in the 3.3 mg/kg were not yet fully mature, González-Martín noted in his slides. Of the 4 patients who received mirvetuximab soravtansin, there were 2 partial responses to the 2.1 mg/kg dose and 2 patients with stable disease in the 3.3 mg/kg arm.

Activity was also seen across those with high and low levels of folate receptor alpha expression.

All patients enrolled in the study experienced a treatment-emergent adverse events (TEAE). In the 46 patients receiving the dose of 1.67 to 3.3 mg/kg, the rate of grade 3 or higher TEAE was 35%. The grade 3 or higher TEAE rate was 49% across the full cohort of the study (N = 67).

Grade 3 or higher serious TEAEs were experienced by 15% of patients in the 1.67 to 3.3 mg/kg dose group and were seen in 21% of those enrolled across the full study. Dose-limiting toxicity was observed at the 5.3 mg/kg dose. The maximum tolerated dose was determined to be 4.4 mg/kg. The phase 2a portion of the study will be focused on further dose optimization.

The most common TEAE were nausea (78.3%), fatigue (47.8%), neutropenia (41.3%), anemia (34.8%), diarrhea (32.6%), constipation (32.6%), decreased appetite (28.3%), vomiting (26.1%), alopecia (26.1%), abdominal pain (26.1%), and urinary tract infection (21.7%). These events were mostly grade 1/2 in severity. Grade 3/4 TEAEs included neutropenia (21.7%), anemia (8.7%), thrombocytopenia (4.3%), nausea (4.3%), constipation (2.2%), and abdominal pain (2.2%).

“There were no clinically relevant bleeding, pneumonitis, ocular toxicity, stomatitis, or neuropathy,” González-Martín noted. The only major ocular TEAE was dry eye, which was seen at a rate of 13%. Antiemetic therapy was not required at the outset of the study, he noted.

There were 2 cases of asymptomatic transient pneumonitis that occurred at dose levels 1.67 mg/kg and 2.1 mg/kg. These each were grade 1 in severity and resolved without issues. “Both were short and resolved without treatment discontinuation,” González-Martín said.

In June 2024, TUB-040 received a fast track designation from the FDA for platinum-resistant ovarian cancer, based on early promise demonstrated for the agent.² Tubulis noted plans to initiate additional studies, based on the early results presented at the ESMO meeting. They indicted plans to present data on the NSCLC cohort of the study at a future medical meeting.³

References

1. González-Martín A, Sehouli J, Braicu EI, et al. NAPISTAR 1-01: A phase I dose escalation study of TUB-040, a novel NaPi2b-targeting exatecan antibody-drug conjugate (ADC) in patients with platinum-resistant ovarian (PROC) high grade serous carcinoma (HGSC). Presented at: 2025 ESMO Congress; October 17-21, 2025; Berlin, Germany. Abstract LBA43.
2. Tubulis receives FDA fast track designation for antibody-drug conjugate candidate TUB-040 in platinum-resistant ovarian cancer. News release. Tubulis. June 27, 2024. Accessed October 19, 2025. https://tubulis.com/news/tubulis-receives-fda-fast-track-designation-for-antibody-drug-conjugate-candidate-tub-040-in-platinum-resistant-ovarian-cancer/
3. Tubulis Presents First Clinical Data from Phase I/IIa Trial for TUB-040 in Platinum-Resistant Ovarian Cancer (PROC) at ESMO 2025. News release. Tubulis. October 19, 2025. Accessed October 19, 2025. https://tubulis.com/news/tubulis-presents-first-clinical-data-from-phase-i-iia-trial-for-tub-040-in-platinum-resistant-ovarian-cancer-proc-at-esmo-2025/

By Tomi Kilgore

Repeating patterns of higher highs and holding support show bulls continue to succeed – but a break of mid-September support would be the first sign of failure

Despite concerns that a stock-market correction is imminent, repeating patterns of success by bulls show the uptrend is still intact – for now.

Those who believe a stock-market correction is imminent may have plenty of reason to do so, except the one thing that may matter the most for chart watchers – failure.

That’s why the S&P 500’s SPX 6,550 level is so important in the short term. There’s a tendency to look at the benchmark stock index’s chart for a signal suggesting that its uptrend is ending – but around market tops, it’s often what the index couldn’t do that confirms a reversal. And despite credit worries, a prolonged government shutdown and renewed tariff fears – which recently triggered the S&P 500’s biggest one-day selloff in six months – the charts still suggest bulls are in control.

What needs to happen for bulls to lose confidence, and confirm that a correction is in the works, is that the S&P 500 has to start failing to make higher highs while failing to hold support.

“Going back to the end of April, there have been multiple instances that [the S&P 500] looked ready to roll over; each one appeared ominous and threatened to flip momentum from positive to negative,” wrote Frank Cappelleri, technical analyst at CappThesis LLC, in a note to clients. “So far, none of those setups have confirmed, though, and that includes the current potential bearish pattern taking shape now (so far).”

As the following chart shows, there are some S&P 500 behaviors that have repeated in those previous and current “instances” that continue to confirm the uptrend.

Each potential reversal area, defined by different colors in the above chart, has been above the previous area. And in each colored area, the second peak has been higher than the first.

What that shows is that bulls continue to succeed in making higher highs – and as the saying among charts watchers goes, there’s nothing more bullish than a new high.

Additionally, the chart support created by the low of the pullback from the first peak in each colored area was successful in stopping the decline from the second peak.

Basically, each time bulls bought the dip, they were rewarded with a higher high. And success breeds the confidence to keep buying.

In the current setup, what would “confirm” a correction in the works is if the S&P 500 falls below the mid-September low, at 6,550, before the index can make a higher high. So the key upside levels to watch while the S&P 500 stays above 6,550 is the Oct. 15 intraday high of 6,724.12 and the Oct. 9 record high of 6,764.58.

If support would give way first, it would create a modified version of the widely known reversal pattern referred to as a “head and shoulders” – with the key component of that pattern being that the second shoulder is below the head.

It would also end what the Dow Theory, which has remained relevant on Wall Street for more than a century, defines as an uptrend – a repeating pattern of higher peaks and higher troughs.

CappThesis’s Cappelleri wrote that if support gives way, the initial measured-move target would be 6,335. He derived that target by measuring the height of the previous pattern, from support to the record high – 215 points – and then subtracting that from the broken support level.

While that might not seem too worrisome, as it would mark a pullback of just 6.4% from the record close, Cappelleri noted that it would be nearly double the size of any pullback since the April lows.

A correction – which many on Wall Street define as a decline of 10% to 20% from a significant high – would start if the S&P 500 falls to 6,088.

Keep in mind, however, that another tenet of the Dow Theory is that a trend remains in place until it provides a clear signal that it has reversed.

“Again, this has not happened yet, but it’s a scenario we need to stay alert to, as a confirmed breakdown would clearly shift the market’s complexion in a meaningful way,” Cappelleri wrote.

Basically, investors shouldn’t play the correction card yet – but they should be prepared, so they can act fast if that signal flashes.

-Tomi Kilgore

This content was created by MarketWatch, which is operated by Dow Jones & Co. MarketWatch is published independently from Dow Jones Newswires and The Wall Street Journal.

  (END) Dow Jones Newswires

  10-19-25 0900ET
Copyright (c) 2025 Dow Jones & Company, Inc.

Investors can approximate the average market return by buying an index fund. While individual stocks can be big winners, plenty more fail to generate satisfactory returns. That downside risk was realized by PepsiCo, Inc. (NASDAQ:PEP) shareholders over the last year, as the share price declined 12%. That’s well below the market return of 16%. Zooming out, the stock is down 11% in the last three years. On the other hand, we note it’s up 8.8% in about a month.

So let’s have a look and see if the longer term performance of the company has been in line with the underlying business’ progress.

We’ve found 21 US stocks that are forecast to pay a dividend yield of over 6% next year. See the full list for free.

There is no denying that markets are sometimes efficient, but prices do not always reflect underlying business performance. One flawed but reasonable way to assess how sentiment around a company has changed is to compare the earnings per share (EPS) with the share price.

Unhappily, PepsiCo had to report a 20% decline in EPS over the last year. The share price fall of 12% isn’t as bad as the reduction in earnings per share. So the market may not be too worried about the EPS figure, at the moment — or it may have expected earnings to drop faster.

You can see how EPS has changed over time in the image below (click on the chart to see the exact values).

It might be well worthwhile taking a look at our free report on PepsiCo’s earnings, revenue and cash flow.

As well as measuring the share price return, investors should also consider the total shareholder return (TSR). The TSR incorporates the value of any spin-offs or discounted capital raisings, along with any dividends, based on the assumption that the dividends are reinvested. So for companies that pay a generous dividend, the TSR is often a lot higher than the share price return. In the case of PepsiCo, it has a TSR of -8.8% for the last 1 year. That exceeds its share price return that we previously mentioned. This is largely a result of its dividend payments!

Investors in PepsiCo had a tough year, with a total loss of 8.8% (including dividends), against a market gain of about 16%. However, keep in mind that even the best stocks will sometimes underperform the market over a twelve month period. Longer term investors wouldn’t be so upset, since they would have made 5%, each year, over five years. It could be that the recent sell-off is an opportunity, so it may be worth checking the fundamental data for signs of a long term growth trend. While it is well worth considering the different impacts that market conditions can have on the share price, there are other factors that are even more important. Even so, be aware that PepsiCo is showing 3 warning signs in our investment analysis , and 1 of those is a bit concerning…

If you would prefer to check out another company — one with potentially superior financials — then do not miss this free list of companies that have proven they can grow earnings.

Please note, the market returns quoted in this article reflect the market weighted average returns of stocks that currently trade on American exchanges.

Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email editorial-team (at) simplywallst.com.

This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.

The ALEX trial (NCT02075840) represents one of the most pivotal studies in the evolution of treatment for anaplastic lymphoma kinase–positive (ALK+) non–small cell lung cancer (NSCLC). The trial’s earlier findings led to the global approval of alectinib as the first-line standard of care, demonstrating significant improvements in progression-free survival (PFS) and central nervous system (CNS) disease control compared with crizotinib.

At the ESMO Congress 2025, investigators presented the final overall survival (OS) and duration of response (DoR) results from ALEX, alongside updated long-term safety findings. These mature data confirm the sustained clinical benefit of first-line alectinib over crizotinib, with remarkable long-term survival extending beyond 80 months in the overall population and consistent benefit across all CNS subgroups.

Methods

The ALEX study was a randomized, phase 3, open-label trial enrolling 303 patients aged ≥18 years with previously untreated, advanced ALK+ NSCLC. Participants were randomized 1:1 to receive either:

• Alectinib 600 mg twice daily (BID), or
• Crizotinib 250 mg BID,

administered until disease progression, unacceptable toxicity, withdrawal, or death.

Randomization was stratified by ECOG performance status (0–1 vs 2), race (Asian vs non-Asian), and baseline CNS metastases (yes vs no). Notably, crossover between treatment arms before disease progression was not permitted, ensuring the validity of survival comparisons.

The key secondary endpoints included overall survival (OS), duration of response (DoR), and safety.

Results

At the final data cutoff of April 28, 2025, a total of 152 patients had been assigned to alectinib and 151 to crizotinib. After a median follow-up of 53.5 months for alectinib and 23.3 months for crizotinib, the median OS was significantly prolonged with alectinib, reaching 81.1 months (95% CI, 62.3–not estimable) compared with 54.2 months (95% CI, 34.6–75.6) for crizotinib. This corresponds to a hazard ratio (HR) of 0.78 (95% CI, 0.56–1.08), reflecting a 22% reduction in the risk of death.

Extended Overall Survival and Crossover Considerations

At a median follow-up of 53.5 months for the alectinib arm and 23.3 months for the crizotinib arm, the 7-year overall survival (OS) rate reached 48.6 % with alectinib compared with 38.2 % with crizotinib, confirming a durable long-term benefit. The OS hazard ratio (HR 0.78; 95 % CI 0.56–1.08) favored alectinib, reflecting a clinically meaningful 22 % reduction in the risk of death. While the difference did not reach formal statistical significance, this is likely due to crossover of crizotinib-treated patients to subsequent ALK TKI therapy, a factor known to confound late-phase survival outcomes. These findings underscore the robustness of alectinib’s efficacy, even in the context of real-world treatment sequencing.

CNS Subgroup Analysis

A particularly compelling aspect of the ALEX trial is the long-term CNS efficacy of alectinib, a known CNS-penetrant ALK inhibitor.

• Among patients with baseline CNS metastases and prior radiation, median OS was 92.0 months with alectinib vs 39.5 months with crizotinib.
• In those with CNS metastases but no prior radiation, median OS was 46.9 months vs 23.7 months, respectively.
• In patients without baseline CNS metastases, median OS reached 94.0 months vs 69.8 months, underscoring the durability of systemic and intracranial control with alectinib.

Duration of Response

The median duration of response (DoR) was 42.3 months (95% CI, 31.3–51.3) with alectinib compared to only 11.1 months (95% CI, 7.9–13.0) with crizotinib (HR 0.41; 95% CI, 0.30–0.56).**

This nearly fourfold improvement in DoR illustrates the sustained and deep responses achieved with alectinib, consistent with its superior CNS efficacy and tolerability profile.

Safety Profile

Alectinib demonstrated a favorable and manageable safety profile, consistent with prior analyses and its established global experience.

• Median treatment duration was 28.1 months with alectinib versus 10.8 months with crizotinib, reflecting prolonged disease control.
• Grade 3–5 adverse events (AEs) occurred in 57.9% (alectinib) and 57.6% (crizotinib) of patients.
• Serious AEs were reported in 46.1% (alectinib) and 31.8% (crizotinib).
• Treatment discontinuation due to AEs occurred in 17.8% vs 14.6%, respectively.

Importantly, no new or unexpected safety concerns emerged, affirming the long-term tolerability of alectinib in prolonged use.

Interpretation

The final analysis from the ALEX trial confirms that first-line alectinib delivers durable, clinically meaningful survival benefit over crizotinib, with median overall survival surpassing 6.5 years. These results are particularly striking given that crossover was not allowed before disease progression, ensuring that the OS benefit reflects true treatment effect rather than post-progression therapy influence.

Furthermore, the robust CNS efficacy of alectinib remains a defining feature, addressing one of the key unmet needs in ALK+ NSCLC—prevention and long-term control of brain metastases.

Patients with CNS involvement achieved median OS approaching 8 years when treated with alectinib, compared to just over 3 years with crizotinib, underscoring the clinical importance of CNS-active targeted therapy.

Long-Term Follow-Up and Analytical Considerations

The ALEX final OS analysis at ESMO 2025 provides the most mature survival data for any first-line ALK inhibitor to date. With a median follow-up exceeding four years, the survival curves for alectinib versus crizotinib remain distinctly separated, showing no late convergence, which supports the long-lasting disease control achieved with alectinib.

These results also emphasize the reliability of long-term ALK inhibition and suggest that continuous blockade of ALK signaling may delay the emergence of resistance mechanisms that typically limit the efficacy of earlier-generation TKIs.

From a methodological standpoint, the no-crossover design strengthens the validity of the OS findings by minimizing confounding from post-progression therapy. The consistent DoR benefit further supports the durable and deep responses achievable with alectinib.

The trial’s safety monitoring over more than five years confirms the absence of cumulative toxicity, reaffirming alectinib’s suitability for prolonged therapy. These findings collectively reinforce alectinib as the definitive first-line standard of care for patients with advanced ALK-positive NSCLC.

 

Read Full Abstract on ESMO Congress 2025 Website

Written by Armen Gevorgyan, MD

October 19, 2025 8:46 am EDT

An objective response rate of 50.5% was observed with raludotatug deruxtecan across all dose levels in these patients in the phase 2 part of REJOICE-Ovarian01

Phase 3 part of REJOICE-Ovarian01 to evaluate 5.6 mg/kg dose of raludotatug deruxtecan versus investigator’s choice of chemotherapy

BASKING RIDGE, NJ AND RAHWAY, NJ, October 19, 2025 – Results from the phase 2 (dose optimization) part of the REJOICE-Ovarian01 phase 2/3 trial showed that raludotatug deruxtecan (R-DXd) demonstrated clinically meaningful response rates in patients with recurrent platinum-resistant ovarian, primary peritoneal or fallopian tube cancer. These data were presented today during a late-breaking proffered paper session (LBA42) at the 2025 European Society for Medical Oncology (#ESMO25) Congress.

Raludotatug deruxtecan is a specifically engineered, potential first-in-class CDH6 directed DXd antibody drug conjugate (ADC) discovered by Daiichi Sankyo (TSE: 4568) and being jointly developed by Daiichi Sankyo and Merck (NYSE: MRK), known as MSD outside of the United States and Canada.

The median overall survival for advanced ovarian cancer following recurrence can be as little as two years, with a five-year survival rate of 31.8% for those with distant stage disease.^1,2 Between 70% and 80% of patients diagnosed with advanced ovarian cancer will experience disease progression following standard treatment with platinum-based chemotherapy regimens, highlighting the need for new treatment options.³

A confirmed objective response rate (ORR) of 50.5% (95% confidence interval [CI]: 40.6-60.3) was observed in patients (n=107)with platinum-resistant ovarian cancer receiving raludotatug deruxtecan across three doses (4.8 mg/kg, 5.6 mg/kg and 6.4 mg/kg) as assessed by blinded independent central review (BICR). There were 3 complete responses (CRs) and 51 partial responses (PRs) seen, and a disease control rate (DCR) of 77.6% (95% CI: 68.5–85.1) was observed.

In patients receiving the 5.6 mg/kg dose (n=36), a confirmed ORR of 50.0% (95% CI: 32.9–67.1) was observed as assessed by BICR with two CRs (5.6%), 16 PRs (44.4%) and a DCR of 80.6% (95% CI: 64.0–91.8). Clinically meaningful tumor responses were seen irrespective of dose and across a range of CDH6 expression levels.

The safety profile of raludotatug deruxtecan observed in REJOICE-Ovarian01 is consistent with safety findings from the phase 1 trial with no new safety signals identified. Nausea, anemia, asthenia and neutropenia were the most common treatment-emergent adverse events (TEAEs) across all doses. Treatment discontinuations due to treatment-related TEAEs occurred in 8.3% (n=3), 0.0% (n=0) and 8.6% (n=3) in the 4.8 mg/kg, 5.6mg/kg and 6.4 mg/kg groups, respectively. Grade 3 or higher treatment-related TEAEs occurred in 27.8% (n=10), 30.6% (n=11), and 48.6% (n=17) of patients in the 4.8 mg/kg (n=36), 5.6 mg/kg (n=36), and 6.4 mg/kg (n=35) groups, respectively.

The most common TEAEs (≥10% of total population) in the 5.6 mg/kg cohort included nausea (69.4%), anemia (58.3%), asthenia (50.0%), neutropenia (44.4%), vomiting (33.3%), constipation (27.8%), decreased appetite (25.0%), thrombocytopenia (19.4%), AST increase (16.7%), diarrhea (16.7%) and leukopenia (13.9%). Four (3.7%) interstitial lung disease (ILD)/pneumonitis events were confirmed as treatment-related across all doses as determined by an independent adjudication committee. The majority of ILD events (one with 5.6 mg/kg, two with 6.4 mg/kg) were low grade (grade 1 or 2). One grade ≥3 (4.8 mg/kg) ILD event was reported. Based on these efficacy and safety results, the 5.6 mg/kg dose has been selected for the phase 3 part of the trial.

“When ovarian cancer becomes resistant to platinum-based chemotherapy, treatment options for patients become limited,” said Isabelle Ray-Coquard, MD, PhD, President, ENGOT (European Network of Gynecological Oncology Trial) Group, Trial Leader, National Group of Investigators on the Studies of Ovarian and Breast Cancer (GINECO), and Medical Oncologist, Centre Léon Bérard, Lyon, France. “These promising results from the first part of REJOICE-Ovarian01 suggest that raludotatug deruxtecan may have an important role in treating patients with platinum-resistant ovarian cancer and support further evaluation in the phase 3 portion of this trial.”

“In this dose optimization analysis, rapid responses with impressive disease control have been observed with raludotatug deruxtecan across a range of CDH6 expression levels,” said Ken Takeshita, MD, Global Head, R&D, Daiichi Sankyo. “These results, which contributed to the recent Breakthrough Therapy Designation in the U.S., reinforce the potential for raludotatug deruxtecan to become a new treatment option for certain types of patients with platinum-resistant ovarian cancer.”

“While we have seen targeted treatment advancements and improved outcomes in ovarian cancer in recent years, there is still a high unmet need for additional options for patients,” said Eliav Barr, MD, Senior Vice President, Head of Global Clinical Development and Chief Medical Officer, Merck Research Laboratories. “CDH6 is highly expressed in ovarian cancer, which underscores the potential of raludotatug deruxtecan to make an impact.”

In September 2025, raludotatug deruxtecan was granted Breakthrough Therapy Designation by the U.S. Food and Drug Administration for the treatment of adult patients with platinum-resistant epithelial ovarian, primary peritoneal or fallopian tube cancers expressing CDH6 who have received prior treatment with bevacizumab.

Median follow-up for the 4.8-mg/kg, 5.6-mg/kg and 6.4-mg/kg cohorts was 5.6 months (95% CI: 4.7–6.3), 5.6 months (95% CI: 4.6–5.8), and 5.2 months (95% CI: 4.9–5.8), respectively. A majority of patients (51.4%) in REJOICE-Ovarian01 received three prior lines of treatment, including bevacizumab (n=89; 83.2%), PARP inhibitor (n=75; 70.1%) and mirvetuximab soravtansine (n=3; 2.8%). As of the data cut-off of February 26, 2025, 66 patients (61.7%) remain on treatment with raludotatug deruxtecan.

Summary of REJOICE-Ovarian01 Results

Efficacy Measure	Raludotatug Deruxtecan Across 4.8, 5.6 and 6.4 mg/kg (n=107)	Raludotatug Deruxtecan 6.4 mg/kg (n=35)	Raludotatug Deruxtecan 5.6 mg/kg (n=36)	Raludotatug Deruxtecan 4.8 mg/kg (n=36)
Confirmed ORR, % (95% CI)1	50.5% (40.6–60.3)	57.1% (39.4–73.7)	50.0% (32.9–67.1)	44.4% (27.9–61.9)
CR, n (%)	3 (2.8%)	0	2 (5.6%)	1 (2.8%)
PR, n (%)	51 (47.7%)	20 (57.1%)	16 (44.4%)	15 (41.7%)
SD, n (%)	42 (39.3%)	10 (28.6%)	15 (41.7%)	17 (47.2%)
PD, n (%)	8 (7.5%)	4 (11.4%)	2 (5.6%)	2 (5.6%)
NE, n (%)	3 (2.8%)	1 (2.9%)2	1 (2.8%)3	1 (2.8%)2
DCR, % (95% CI)	77.6% (68.5–85.1)	77.1% (59.9–89.6)	80.6% (64.0–91.8)	75.0% (57.8–87.9)
TTR, weeks, median (range)	7.1 weeks (5.1–19.1)	7.2 weeks (5.3–19.1)	6.6 weeks (5.1–18.3)	7.1 weeks (5.4–18.7)

Data cutoff: February 26, 2025.

¹As accessed by BICR. ²Patient had no adequate post-baseline tumor assessment by BICR per RECIST 1.1. ³Patient had no adequate post-baseline tumor assessment by BICR.

BICR, blinded independent central review; CR, complete response; DCR, disease control rate; ORR, objective response rate; PD, progressive disease; PR, partial response; RECIST 1.1, Response Evaluation Criteria in Solid Tumors version 1.1; SD, stable disease; TTR, time to response

About REJOICE-Ovarian01

REJOICE-Ovarian01 is a global, multicenter, randomized, open-label phase 2/3 trial evaluating the efficacy and safety of investigational raludotatug deruxtecan in patients with platinum-resistant, high-grade ovarian, primary peritoneal or fallopian tube cancer, with disease progression following at least one but no more than three prior lines of systemic therapy, including prior treatment with mirvetuximab soravtansine for those with documented high-folate receptor alpha expression. Maintenance therapy (e.g., bevacizumab, poly ADP-ribose polymerase [PARP] inhibitors) is considered part of the preceding line of therapy.

The phase 2 part of REJOICE-Ovarian01 is assessing the safety and tolerability of three doses of raludotatug deruxtecan (4.8 mg/kg, 5.6 mg/kg, or 6.4 mg/kg) to identify the recommended dose for the phase 3 part of the trial. The primary endpoint of the phase 2 part of the trial is ORR as assessed by BICR. Key secondary endpoints include ORR as assessed by investigator, DoR, PFS and DCR – all assessed by both BICR and investigator.

The phase 3 part of REJOICE-Ovarian01 is assessing the efficacy and safety of raludotatug deruxtecan at the selected dose (5.6 mg/kg) compared to investigator’s choice of chemotherapy (paclitaxel, pegylated liposomal doxorubicin, gemcitabine or topotecan). The dual primary endpoints of the phase 3 part of the trial are ORR and PFS as assessed by BICR. Secondary endpoints include PFS and ORR as assessed by investigator, DoR and DCR as assessed by both BICR and investigator, and OS. Pharmacokinetic and biomarker endpoints also will be assessed in both parts of the trial.

REJOICE-Ovarian01 is expected to enroll approximately 710 patients across Asia, Europe, North America, and Oceania. For more information, please visit ClinicalTrials.gov.

About Ovarian Cancer

More than 324,000 women were diagnosed with ovarian cancer worldwide in 2022.⁴ The median overall survival for advanced ovarian cancer following recurrence can be as little as two years, with a five-year survival rate of 31.8% for those with distant stage disease.^1,2

The introduction of targeted therapies has expanded treatment options and improved survival outcomes for some patients with ovarian cancer, but additional options are needed for patients with tumors that progress on available medicines.⁵ Between 70% and 80% of patients diagnosed with advanced ovarian cancer will experience disease progression following standard treatment with platinum-based chemotherapy regimens.³  For patients who develop platinum-resistant ovarian cancer, defined as disease progression less than six months after completion of last platinum-based chemotherapy, prognosis is particularly poor and treatment options are limited.^6,7

About CDH6

CDH6 (human cadherin-6) is a cadherin family protein overexpressed in several cancers, including ovarian tumors.⁸ An estimated 65% to 94% of patients with ovarian cancer have tumors that express CDH6.^9,10,11 In addition, CDH6 expression is observed more frequently in high-grade serous carcinomas.^9,10,11 There is currently no CDH6 directed medicine approved for treatment of any cancer.

About Raludotatug Deruxtecan

Raludotatug deruxtecan is an investigational, potential first-in-class CDH6 directed ADC. Designed using Daiichi Sankyo’s proprietary DXd ADC Technology, raludotatug deruxtecan is comprised of a humanized anti-CDH6 IgG1 monoclonal antibody attached to a number of topoisomerase I inhibitor payloads (an exatecan derivative, DXd) via tetrapeptide-based cleavable linkers.

About the Daiichi Sankyo and Merck Collaboration

Daiichi Sankyo and Merck (known as MSD outside of the United States and Canada) entered into a global collaboration in October 2023 to jointly develop and commercialize patritumab deruxtecan (HER3-DXd), ifinatamab deruxtecan (I-DXd) and raludotatug deruxtecan (R-DXd), except in Japan where Daiichi Sankyo will maintain exclusive rights. Daiichi Sankyo will be solely responsible for manufacturing and supply. In August 2024, the global co-development and co-commercialization agreement was expanded to include gocatamig (MK-6070/DS3280), which the companies will jointly develop and commercialize worldwide, except in Japan where Merck & Co., Inc., Rahway, N.J., USA will maintain exclusive rights. Merck & Co., Inc., Rahway, N.J., USA will be solely responsible for manufacturing and supply for gocatamig.

About the ADC Portfolio of Daiichi Sankyo

The Daiichi Sankyo ADC portfolio consists of seven ADCs in clinical development crafted from two distinct ADC technology platforms discovered in-house by Daiichi Sankyo.

The ADC platform furthest in clinical development is Daiichi Sankyo’s DXd ADC Technology where each ADC consists of a monoclonal antibody attached to a number of topoisomerase I inhibitor payloads (an exatecan derivative, DXd) via tetrapeptide-based cleavable linkers. The DXd ADC portfolio currently consists of ENHERTU^®, a HER2 directed ADC, and DATROWAY^®, a TROP2 directed ADC, which are being jointly developed and commercialized globally with AstraZeneca. Patritumab deruxtecan (HER3-DXd), a HER3 directed ADC, ifinatamab deruxtecan (I-DXd), a B7-H3 directed ADC, and raludotatug deruxtecan (R-DXd), a CDH6 directed ADC, are being jointly developed and commercialized globally with Merck & Co., Inc., Rahway, N.J., USA. DS-3939, a TA-MUC1 directed ADC, is being developed by Daiichi Sankyo.

The second Daiichi Sankyo ADC platform consists of a monoclonal antibody attached to a modified pyrrolobenzodiazepine (PBD) payload. DS-9606, a CLDN6 directed PBD ADC, is the first of several planned ADCs in clinical development utilizing this platform.

Ifinatamab deruxtecan, patritumab deruxtecan, raludotatug deruxtecan, DS-3939 and DS-9606 are investigational medicines that have not been approved for any indication in any country. Safety and efficacy have not been established.

About Daiichi Sankyo

Daiichi Sankyo is an innovative global healthcare company contributing to the sustainable development of society that discovers, develops and delivers new standards of care to enrich the quality of life around the world. With more than 120 years of experience, Daiichi Sankyo leverages its world-class science and technology to create new modalities and innovative medicines for people with cancer, cardiovascular and other diseases with high unmet medical needs. For more information, please visit www.daiichisankyo.com.

Merck’s Focus on Cancer

Every day, we follow the science as we work to discover innovations that can help patients, no matter what stage of cancer they have. As a leading oncology company, we are pursuing research where scientific opportunity and medical need converge, underpinned by our diverse pipeline of more than 25 novel mechanisms. With one of the largest clinical development programs across more than 30 tumor types, we strive to advance breakthrough science that will shape the future of oncology. By addressing barriers to clinical trial participation, screening and treatment, we work with urgency to reduce disparities and help ensure patients have access to high-quality cancer care. Our unwavering commitment is what will bring us closer to our goal of bringing life to more patients with cancer. For more information, visit www.merck.com/research/oncology.

About Merck

At Merck, known as MSD outside of the United States and Canada, we are unified around our purpose: We use the power of leading-edge science to save and improve lives around the world. For more than 130 years, we have brought hope to humanity through the development of important medicines and vaccines. We aspire to be the premier research-intensive biopharmaceutical company in the world – and today, we are at the forefront of research to deliver innovative health solutions that advance the prevention and treatment of diseases in people and animals. We foster a diverse and inclusive global workforce and operate responsibly every day to enable a safe, sustainable and healthy future for all people and communities. For more information, visit www.merck.com and connect with us on X (formerly Twitter), Facebook, Instagram, YouTube and LinkedIn.

Forward-Looking Statement of Merck & Co., Inc., Rahway, N.J., USA

This news release of Merck & Co., Inc., Rahway, N.J., USA (the “company”) includes “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. These statements are based upon the current beliefs and expectations of the company’s management and are subject to significant risks and uncertainties. There can be no guarantees with respect to pipeline candidates that the candidates will receive the necessary regulatory approvals or that they will prove to be commercially successful. If underlying assumptions prove inaccurate or risks or uncertainties materialize, actual results may differ materially from those set forth in the forward-looking statements.

Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation in the United States and internationally; global trends toward health care cost containment; technological advances, new products and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approval; the company’s ability to accurately predict future market conditions; manufacturing difficulties or delays; financial instability of international economies and sovereign risk; dependence on the effectiveness of the company’s patents and other protections for innovative products; and the exposure to litigation, including patent litigation, and/or regulatory actions.

The company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in the company’s Annual Report on Form 10-K for the year ended December 31, 2024, and the company’s other filings with the Securities and Exchange Commission (SEC) available at the SEC’s Internet site (www.sec.gov).

Media Contacts:

Merck

Julie Cunningham

(617) 519-6264

julie.cunningham@merck.com

John Infanti

(609) 500-4714

john.infanti@merck.com

Daiichi Sankyo

Global/US Media:

Jennifer Brennan

jennifer.brennan@daiichisankyo.com

(908) 900-3183

Japan Media:

DS-PR@daiichisankyo.co.jp

(732) 594-1579

peter.dannenbaum@merck.com 

Steven Graziano

(732) 594-1583

steven.graziano@merck.com

Daiichi Sankyo:

DaiichiSankyoIR_jp@daiichisankyo.com

References:

1. Shimokawa M, et al. J Cancer. 2018; 9(5):872.  
2. National Cancer Institute. Cancer Stat Facts: Ovarian Cancer. Updated 2021. Accessed September 2025.  
3. Pignata S, et al. Ann Oncol. 2017 Nov 1;28(suppl_8):viii51-viii56. 
4. Global Cancer Observatory. Population Fact Sheet. Updated 2022. Accessed September 2025. 
5. Kurnit K, et al. Obstetrics and Gynecology. 2021; 137(1): 108-121. 
6. Davis, et al. Gynecological Oncology. 2014; Jun;133(3):624-31. 
7. Mor G, et al. Cancer biology & therapy. 2011;11(8), 708–713.  
8. Bartolome RA, et al. Mol Oncol. 2021 Jul; 15(7): 1849-1865.  
9. Shintani D, et al. Gynecol Oncol. 2022;166(Suppl 1): S116. 
10. Suzuki H, et al. ESMO 2021 (poster #919).
11. Isabelle Ray-Coquard, et al. ESMO 2025 (LBA42).