Bhavana Pothuri: Department of Obstetrics and Gynecology and Medicine, Perlmutter Cancer Center, NYU Langone Health, NYU Grossman School of Medicine, New York, USA
Citation: EMJ Oncol. 2026; https://doi.org/10.33590/emjoncol/H941NWEF
What first drew you to gynaecologic oncology, and what has kept you committed to the field throughout your career?
I was initially enticed by gynaecologic oncology because of the high-level technical rigor required in the operating room. However, what has sustained my passion throughout my career is the holistic complexity of patient care and the inspiring strength shown by these women. Beyond surgery, the ongoing, rapid advances in medical oncology and targeted therapies excite me deeply and reinforce my commitment to delivering comprehensive, state-of-the-art care.
Ovarian cancer is often diagnosed at an advanced stage. What do you think are the biggest challenges in catching it earlier, and where do you see the most room for progress?
Ovarian cancer is difficult to catch early, because it originates in an open abdominal space with patients presenting with vague, routine symptoms, like bloating, that delay diagnosis, but has aggressive, rapid-spreading biology. Additionally, traditional tools like cancer antigen 125 (CA-125) tests and transvaginal ultrasounds lack the sensitivity and specificity needed to detect early-stage disease or microscopic precursor lesions.
Future progress maybe driven by multi-omic liquid biopsies that are capable of detecting tiny fragments of tumour DNA and proteins in the blood long before tumours are visible on scans. Furthermore, recognising that most ovarian cancers actually start in the fallopian tubes has led to preventive removal of the tubes during routine surgeries, along with direct uterine fluid sampling. Finally, AI models are now combining clinical, genetic, and imaging data to catch subtle risk patterns earlier than static test scores ever could.
Widespread adoption of genetic testing and risk-reducing bilateral salpingo-oophorectomy in high-risk individuals, such as BRCA1/2 pathogenic variant carriers, alongside opportunistic salpingectomy in average-risk patients, has significantly driven down ovarian cancer incidence in the USA by removing the fallopian tubes where these cancers typically originate. Combined with high historical oral contraceptive use, these prophylactic surgical strategies have successfully transformed population-level prevention.
You lead gynaecologic oncology clinical trials at NYU Langone Health, New York, USA. What makes a new treatment promising enough to take from the laboratory into a clinical trial?
Taking a new treatment from bench to bedside requires a multifaceted evaluation. A drug or biologic moves from the laboratory into a first-in-human (Phase I) clinical trial when it satisfies a balance of mechanistic validation, favourable pharmacokinetics, acceptable safety margins, and manufacturing viability.
You perform both minimally invasive and extensive debulking surgeries. How do you approach deciding which surgical strategy is right for an individual patient?
Choosing between minimally invasive surgery (MIS) and extensive open debulking depends on achieving complete gross tumour removal, while balancing patient safety. Extensive open surgery is the standard for advanced disease with widespread tumours, provided the patient is fit enough to tolerate a complex operation and that it can be completely resected. If it cannot be completed resected, or at least to optimal cytoreduction, which is less than 1 cm of residual tumour, then I utilise neoadjuvant chemotherapy (NACT). I utilise MIS if there is low-volume disease after NACT. I also utilise MIS primarily for early-stage staging, or initial diagnostic triage to assess resectability.
Cancer treatment can have a major impact on a patient’s life beyond the disease itself. How do you incorporate quality of life into treatment decisions?
Incorporating quality of life into ovarian cancer treatment means tailoring care to individual patient priorities rather than focusing just on survival data. I do this by tracking side effects, choosing treatments that minimise physical strain, such as NACT or adjusted drug doses to reduce neuropathy and fatigue, and introducing palliative care early for continuous support. Ultimately, the treatment plans with my patients are guided by open, shared decision-making to balance drug efficacy versus the patient’s daily functional goals, quality of life, and overall wellbeing. I firmly believe that prolonging life is only valuable if the patient has the physical and emotional wellbeing to live that extra time with real dignity and joy.
Your work brings together surgery, medical oncology, radiation oncology, genetics, nursing, and other specialties. What does effective collaboration look like when caring for a patient with complex cancer?
Effective collaboration in complex ovarian cancer care relies on a synchronised, multidisciplinary approach where gynaecologic oncologists, pathologists, geneticists, nurses, and support specialists work as a unified team. Through regular multidisciplinary tumour boards, the team aligns surgical, medical, radiation, and genetic strategies into a single personalised care plan. Supported by nurse navigators and shared communication systems, this integrated approach ensures that complex treatments are seamlessly sequenced, while holistically addressing the patient’s physical, emotional, and practical needs.
You’re also a professor who trains medical students, residents, and fellows. What is one lesson about caring for patients that you hope the next generation of doctors takes away from you?
The core lesson I hope the next generation of doctors takes away from me is that compassion is just as critical as surgical precision. While mastering complex science and technical skills is essential, our true job is to treat the human sitting in front of us, not just the disease or the scan. We meet these patients on what is often the most terrifying day of their lives, and asking them to trust us is an absolute privilege. Technology and treatments will continue to evolve rapidly, but the need for a physician who sits down, truly listens, and walks alongside a patient with unwavering grace and empathy will never change. In the end, clinical excellence is meaningless if we lose sight of the patient’s individual goals, fears, and humanity.
Looking ahead 5–10 years, what development in gynaecologic cancer research or treatment are you most excited about, and what could it change for patients?
What excites me the most about the next decade is how genomics and precision medicine will allow us to truly personalise care for every patient. While antibody–drug conjugates and immunotherapies have already made a strong impact in gynaecologic oncology, we are just scratching the surface. Looking ahead, I am thrilled about the next frontier, including novel small molecule inhibitors, T cell engagers, bispecific antibodies, radioligand therapies, and ‘off-the-shelf’ CAR-T cells. By combining deeper genomic profiling with these advanced therapeutic platforms, we can tailor hyper-individualised treatments from Day 1, overcome drug resistance, and minimise unnecessary toxicity. It is an exciting time to be involved in gynaecologic cancer research, as the pace of discovery has accelerated and we have been able to bring more new medicines to our patients in the last decade than in the last 50 years combined.
