Monday, January 25, 2010
Note: the use of surgical site checklists stemmed from WHO's Patient Safety group/s.
"For many cancer survivors, the fear of recurrence is oppressive. It hinders them from enjoying everyday activities and profoundly affects their quality of life. However, by learning to manage their anxieties, patients can become more confident about their survivorship."
"Women can explore clinical trials by visiting the Ovarian Cancer National Alliance Clinical Trials Matching Service online or by calling (800) 535-1682."
press release: Women's College Hospital (Toronto) offers Jewish women genetic screening for breast cancer
“Our study identified two major concerns with current breast cancer screening guidelines,” says Dr. Kelly Metcalfe, adjunct scientist at the Women’s College Research Institute and associate professor at the University of Toronto. “The first is that over half of the women we identified with a mutation would never have known that they were at an increased risk of cancer because they were not eligible for genetic testing outside of this study. The second concern was that although 45 per cent of the women with mutations were eligible for genetic testing based on their family history of cancer, none were referred by their health-care provider for screening. "
NCCN updates their guidelines annually - the guidelines on a variety of subjects (cancers/genetics etc) can be found at: http://www.nccn.org
Access requires registration but is free. There is a specific area for the genetics of breast/ovarian but to find genetics relating to Lynch Syndrome you need to go to the colorectal cancer section.
A Study Comparing Oral Picoplatin With Intravenous Picoplatin in Subjects With Solid Tumors - Full Text View - ClinicalTrials.gov
A Study Comparing Oral Picoplatin With Intravenous Picoplatin in Subjects With Solid Tumors - Full Text View - ClinicalTrials.gov:
"This study has been completed.
First Received: April 23, 2007 Last Updated: September 23, 2009
Sponsor: Poniard Pharmaceuticals
Information provided by: Poniard Pharmaceuticals
ClinicalTrials.gov Identifier: NCT00465725"
Pharma press release: re Phase 2 Trial of Picoplatin in Metastatic Colorectal Cancer Meets Primary Endpoint and Study Objectives
"Our ultimate goal is to secure a strategic partnership to support further development of picoplatin in CRC and other solid tumor indications, including prostate and ovarian cancers.'"
"In theory, Dooley said the technique could be used on any organ that could be "held relatively still." Scientists are now working to integrate heat-sensitive nanotechnology that would more precisely target cancer cells. They also plan to study a byproduct of the rapid disintegration of the tumor – a boosted immune system."
Sunday, January 24, 2010
"Experimental studies have suggested that one mechanism for chemoprevention with green tea may be its impact on insulin-like growth factors."
Search of: Open Studies | Interventional Studies | solid tumors | Adult | Phase II III IV - List Results - ClinicalTrials.gov
search results = 137 clinical trials
Simple chart: possibleresults1big.jpg (JPEG Image, 945x582 pixels)
Saturday, January 23, 2010
full free access: Early-onset breast cancer in a Lebanese family with Lynch syndrome due to MSH2 gene mutation
"Background: There are still controversies about the integration of breast cancer as a part of the disease spectrum in Lynch syndrome."
full free access: Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems
"Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems."
- "People with mutations in the MSH2
gene have an increased risk of developing several other types of cancer (colorectal),
including cancers of the endometrium (lining of the uterus), ovary,
stomach, small intestine, liver, gallbladder duct, upper urinary tract,
brain, and skin.
Some mutations in the MSH2 gene increase the likelihood of several uncommon skin tumors occurring in addition to colorectal cancer, a combination called Muir-Torre syndrome. These rare skin tumors include sebaceous adenomas and carcinomas, which occur in skin glands (sebaceous glands) that produce an oily substance called sebum. Multiple, rapidly growing skin tumors called keratoacanthomas may also occur, usually on sun-exposed areas.
Jan 5th, 2010 Q&A: Understanding and Managing Lynch Syndrome - Cancerwise | Cancer blog from M. D. Anderson Cancer Center
Understanding the problem of inadequately staging of early ovarian cancer (subanalysis of ACTION trial)
CONCLUSIONS: Even in a randomised trial in which comprehensive surgical staging was strongly advised in the study protocol the majority of patients (66%) were incompletely staged. Factors relating to a lack of surgical skills attributed most to the number of incompletely staged patients, but insufficient knowledge of the tumour behaviour and routes of spread of ovarian cancer also contributed substantially to this problem. Multicentre trials recruiting patients from many institutes with small volume contribution to the study, run the risk of inadequate adherence to the study protocol.
Venous Thromboembolism Risk and Prophylaxis in the Acute Care Hospital Setting (ENDORSE Survey): Findings in Surgical Patients
Note: study of data from 2004
"Use of prophylaxis varied according to major surgery type from 86.0% for orthopedic surgery to 53.8% in urologic/gynecologic...." "Conclusions: The majority of surgical patients are at high-risk for VTE. Despite long-standing recognition of the high-risk for VTE in surgical patients, thromboprophylaxis remains underutilized."
Conundrums in screening for cancer
B. Miller *|
Lana School of Public Health, University of Toronto, ON, Canada|
Anthony B. Miller (firstname.lastname@example.org)|
This article is based upon the Joint International Journal of Cancer and Meyenburg-Stiftung Lectureship, delivered at Deutsches Krebsforschungszentrum, February 18, 2009.
for cancer • breast cancer • cervix cancer • prostate cancer|
|Screening for cancer has to be
carefully organized for maximum effectiveness, and introduced in full
understanding of the natural history of the disease. There are major
potential harms as well as benefits from screening. The current state of
art for breast, cervix and prostate cancer screening is reviewed, only
for breast and cervix are policies of screening in the population
Friday, January 22, 2010
Note: free access (sign up):
Neoadjuvant_Bevacizumab_May Increase Serious Surgical Complications
"Most complications started in the immediate postoperative period, stuttered along, then worsened weeks later when bevacizumab was restarted, according to Dr. Golshan." "This observation caused one audience member to quip, “Perhaps these wounds, even though they may appear to be healed, should receive more respect and less bevacizumab.”"
Ten-year follow-up of a phase 2 study of dose-intense paclitaxel with cisplatin and cyclophosphamide as initial therapy for poor-prognosis, advanced-stage epithelial ovarian cancer
"METHODS:: Patients with stage III/IV EOC received cyclophosphamide 750 mg/m(2), followed by a 24-hour infusion of paclitaxel 250 mg/m(2) and cisplatin 75 mg/m(2) on Day 2. Filgrastim began on Day 3 at 10 mug/kg daily for 9 days. Patients received 6 cycles of all drugs." CONCLUSIONS:: The studied regimen yielded a high response rate and encouraging overall survival."
"This is a great day for all of our stakeholders as well as women who will benefit from OVA1,' said Gail Page, executive chair of Vermillion. 'We are in a position to resume development of our other programs in ovarian cancer and peripheral arterial disease,' she added."
full free access
full free access: Progress in Cancer Care: A Rational Call To Do Better - CA: A Cancer Journal for Clinicians
Editorial by incoming American Cancer Society President - Dr Alan G. Thorson
Study Finds Omission of Axillary Lymph Node Dissection Safe for Patients with Sentinel Node Micrometastases (early stage breast cancer)
full free access: link: http://caonline.amcancersoc.org/cgi/reprint/60/1/2.pdf
abstract: Review The potential of biologic network models in understanding the etiopathogenesis of ovarian cancer
"Consequently, understanding early genotypic and phenotypic changes in the context of high risk disease may provide a better understanding of the mechanism of mutation-associated ovarian cancer and provide new targets for therapeutic intervention."
"Therapy consisted of low-dose subcutaneous IL-2 and oral RA, administered on intermittent schedules for up to 5 years."
"Conclusions:Alternatives to traditional phase II trial design including alternative end points, randomized designs, biomarkers, and imaging tools should allow ineffective agents to be discarded and promising agents to undergo further investigation."
Phase II study of gefitinib in combination with paclitaxel (P) and carboplatin (C) as second-line therapy for ovarian, tubal or peritoneal adenocarcinoma
"Conclusion: Gefitinib, administered in combination with paclitaxel and carboplatin, provides a good clinical response but associated with an increased risk of hematologic disorders."
Nurses oppose the Ontario government's physician assistant role citing inadequate education, concerns over patient safety and unnecessary cost
Note: the RNAO also made the same statement regarding pharmacists (2009)
Toronto, January 22, 2010
"Members of the public will not be well served if the provincial government pursues a plan to allow physician assistants (PAs) to work in hospitals, family health teams, community health centres, and family physician offices. The board of directors of the Registered Nurses' Association of Ontario (RNAO) has unanimously endorsed a position statement, which raises serious questions about the level of education and regulatory oversight physician assistants have and how these could jeopardize patients..."
Note: this study is not specific to ovarian cancer but may be of interest for those deciding on Sorafenib:
"AUTHORS' CONCLUSIONS: We conclude that despite promising immunological responses no clinically effective antigen-specific active immunotherapy is yet available for ovarian cancer. Furthermore, the adoption of guidelines to ensure uniformity in trial conduct, response definitions and trial reporting is recommended to improve quality and comparability of immunotherapy trials."
"AUTHORS' CONCLUSIONS: Since no relevant studies were identified, we are unable to make recommendations regarding the management of drains for malignant ascites in women with gynaecological cancer. Large, multi-centre RCTs are required to evaluate the efficacy and safety of the management of ascitic drains when in situ and their impact on QOL."
"The OVATURE trial is a major multi-center international Phase III clinical trial of orally-administered investigational drug phenoxodiol in combination with carboplatin in women with advanced ovarian cancer resistant or refractory to platinum-based drugs, to determine its safety and effectiveness when used in combination with carboplatin.......The Company expects the final analysis will be performed strictly according to the protocol and now is expected to be completed in the second quarter of 2010"
Search of: Open Studies | Interventional Studies | ovarian cancer | Adult | received from 01/01/2010 to 01/22/2010
Results = 3 (new interventional studies since Jan 1/10)
The cost-effectiveness of genetic testing strategies for Lynch Syndrome among newly diagnosed patients with colorectal cancer
"This finding provides support for a recent US recommendation to offer testing for Lynch syndrome to all newly diagnosed patients with colorectal cancer."
"CONCLUSION. The goal of imaging in ovarian cancer detection is to expeditiously distinguish benign adnexal lesions from those requiring further pathologic evaluation for malignancy. For lesions indeterminate on ultrasound, MRI increases the specificity of imaging evaluation, thus decreasing benign resections. CT is useful in diagnosis and treatment planning of advanced cancer. Although 18F-FDG-avid ovarian lesions in postmenopausal women are considered suspicious for malignancy, PET/CT is not recommended for primary cancer detection because of high false-positive rates."
"CONCLUSION. Endometriotic cysts with enhanced mural nodules are not always complicated with malignancy. In elderly patients, the presence of large enhanced nodules on large endometriotic cysts is more likely to indicate malignancy."
"CONCLUSION. To offer potentially life-saving interventions for at-risk family members, we propose that every woman newly diagnosed with ovarian cancer be offered genetic testing for BRCA1 and BRCA2 genes because mutations in these genes are the strongest known predictors of ovarian cancer risk."
CONCLUSION. Borderline tumors are considered to be precursors of low-grade ovarian cancers. Accurate diagnosis and staging facilitate optimal patient management particularly in patients desiring to preserve fertility.
MRI in the planning of initial lumpectomy for invasive breast carcinoma: effect on ipsilateral breast tumor recurrence after breast conserving therapy
CONCLUSION: MRI evaluation of invasive carcinoma in the planning of initial lumpectomies was not associated with improved local outcomes after BCS (breast conserving surgery) with RT in this cohort of patients.
Thursday, January 21, 2010
abstract/study of 5 patients
Jan 2009 full free access - Development of PARP inhibitors in oncology; Expert Opinion on Investigational Drugs + Expert Opinion
Note: highly technical but worth reviewing (BRCAness, sporadic, specific therapies (combination/single agent/+radiotherapy), those in clinical studies (Table 1),
differing cancers etc
Wednesday, January 20, 2010
The DCLG indentifies and responds to issues and challenges facing the Institute at the request of the Director. The DCLG provides relevant, non-scientific skills and perspectives in order to improve research outcomes by identifying new approaches, promoting innovation, recognizing unforeseen risks or barriers, and identifying unintended consequences that could result from NCI decisions.
full free access: Identifying the barriers to conducting outcomes research in integrative health care clinic settings
"..... as IHC clinics are often complex systems, a whole systems approach to research should be used taking into account the multidimensional and complex nature of such treatment systems so that the results are useful and reflect real life."
Dec 2009 article: Influenza Vaccination in Immune Compromised Persons: Practical Advice for Oncologists - OncologySTAT
Note: if you are unable to view the full article then you need to register (it's free)
abstract: Combining Targeted Therapies: Practical Issues to Consider at the Bench and Bedside -- The Oncologist
"Recent and continuing developments in high-throughput and multiplexed assay platforms as well as in disciplines such as bioinformatics and biostatistics will surely shape the future of clinical trials. Application of novel techniques in a comprehensive approach, revealing the interrelations among targets and the mechanisms of action underlying cancer (systems biology), may lead to comprehensive diagnostic tools (systems pathology) and specific combinations of drugs (cocktails of monoclonal antibodies, RNA therapeutics, or others) in what has been called the actualization of personalized medicine. We know that momentum in the era of targeted therapy will continue to accelerate, bringing new hope to our patients
with cancer and their families"
Abstract/free full access: High penetrances of BRCA1 and BRCA2 mutations confirmed in a prospective series
define: deleterious = harmful
Note: genetic modifying factors of penetrance = factors which result in lower or high risks of cancer
These are important issues for us as patients/caregivers:
"Less than half were based on an explicit definition of quality of dying and death and even fewer relied on a conceptual model that incorporated multidimensionality and subjective determination.The specified duration of the dying and death phase ranged from the last months to hours of life."
Will Myriad's Marketing to Mammogram Centers Ease or Fan Over-Testing Concerns with BRACAnalysis? | Pharmacogenomics Reporter
Tuesday, January 19, 2010
Pharma Pipeline News: Preliminary results from Nektar Therapeutics' NKTR-102 Phase 2 study in platinum-resistant ovarian cancer
Note: conference reporting news item
Jan 19, 2009: I’m a Cancer Patient. Should I Ask About PARP Inhibitors? - Health Advice Deborah K. Armstrong
Q. I’m a Cancer Patient. Should I Ask About PARP Inhibitors?
By Deborah K. Armstrong, M.D.
pdf file - application/criteria
abstract: Safety and efficacy results of the advanced renal cell carcinoma Sorafenib expanded access program in North America
Note: while this is not specific to ovarian cancer knowing the side effects which patients experienced may be helpful
abstract: Clinicopathological features of 67 cases of endometriosis-associated epithelial ovarian carcinoma (China)
"CONCLUSION: Patients of endometriosis-associated epithelial ovarian carcinoma, especially patients with tumors arising from endometriosis, were found to be younger, having a significant lower stage and a better survival, and were mostly diagnosed with the subtype of clear-cell."
abstract: Understanding the support needs of patients accessing test results online. PHRs offer great promise, but support issues must be addressed to
Understanding the support needs of patients accessing test results online. PHRs offer great promise, but support issues must be addressed to ensure appropriate access.
CA-125; C-reactive protein (CRP); serum amyloid A (SAA); interleukin 6 (IL-6); and interleukin 8 (IL-8)
"CONCLUSIONS: The use of a panel of plasma biomarkers for the identification of women with ovarian cancer delivers a significant increase in diagnostic performance when compared to the performance of CA-125 alone."
Consistency of self-reported first-degree family history of cancer in a population-based study - Brazil
"The prevalence of cancer history in an FDR (first degree relative) was similar to previous reports in other populations. Consistency and reliability of the self-reported information was high, regardless of educational level."
Note: numerous different treatments are discussed
"In only 10% of cases was a living will involved -- and in fully 35% of cases, the physician did not know if there was a living will or not."
2010 full free access: The prosurvival activity of ascites against TRAIL is associated with a shorter disease-free interval in patients with ovarian c
( highly technical )The prosurvival activity of ascites against TRAIL is associated with a shorter disease-free interval in patients with ovarian cancer
Monday, January 18, 2010
Abstract/full free access: Endometriosis-associated ovarian cancer: A ten-year cohort study of women living in the Estrie Region of Quebec, Canada
excerpts of interest:
searchable database: eg. green tea oil, fish oil....
abstract (in research) HMGA2: a potential biomarker complement to P53 for detection of early-stage high-grade papillary serous carcinoma in FT
"Our findings of immunoreactivity for HMGA2 may lead to a novel, useful biomarker to complement p53 in the detection of early-stage serous carcinoma."
Who is OMRF?
"Founded in 1946, OMRF is one of the nation’s oldest and most respected nonprofit biomedical research institutes. Located in Oklahoma City, OMRF fosters a worldwide reputation for excellence by following an innovative cross-disciplinary approach to medical research."
Note: this one was all over the news this past week: partial excerpt: "A new drug called dabigatran prevents more strokes with less bleeding than warfarin." Dr. Atlas says: "Dabigatran may be a game changer, but there is one thing the story didn't mention. The group that got Dabigatran had more heart attacks than those who got coumadin. Oops! This could be the real game changer from the FDA's perspective. Note it's still under review there."
abstract: The treatment of menopausal symptoms by traditional East Asian medicines: Review and perspectives
Note: abstract provides very limited information
"At its most basic level, participatory medicine means shared decision-making and deep patient engagement. Because of the rise in technology use -- as well as an increase in out-of-pocket health care expenses -- this has gone well beyond the traditional tell-me-where-it-hurts conversation between patient and doctor in the exam room....Physicians "are afraid this is something that will cost them time and money, and it will create arguments with patients," Dr. Greene said."
abstract: Body mass index as a prognostic factor in epithelial ovarian cancer and correlation with clinico-pathological factors (1994–2003)
"The prognostic impact of BMI on survival was only noted for underweight patients with serous tumors."
Sunday, January 17, 2010
epigentics: The study of heritable changes in gene function that occur without a change in the DNA sequence
"CONCLUSIONS: Other mechanisms of variability, including epigenetic control of gene expression and copy number variation, may play important roles. In addition, nongenetic influences such as concurrent medications, and physiological and environmental factors could also affect individual responses to taxane and platinum therapy."
August 2009: Safety of (Avastin) Bevacizumab in Advanced Ovarian and Müllerian Cancers: A Review: Bevacizumab and Ovarian Cancer
"To date, several investigators (Table 1) have explored bevacizumab as a single agent or in combination with metronomic chemotherapy in the management of advanced ovarian cancer. All studies to date with bevacizumab as a single agent or in combination with chemotherapy have shown promising responses. The concern is centered on whether the benefit of this therapeutic agent outweighs its potential toxicity."
Note: long article
Note: not yet recruiting for patients - An interesting study bringing together genetics and immune system. Location: New York, U.S.A.
Clinical Trials Search of: Open Studies ovarian cancer Adult- new studies received from 12/01/2009 to 01/17/2010
13 new studies shown (non specific)
"Dr. Dizon is a medical oncologist specializing in women's cancers. He takes care of both breast and gynecologic cancers and has interests in new treatments, survivorship, and sexuality, and is Director of Medical Oncology at the Program in Women's Oncology at Women and Infants hospital of Rhode Island. He is also an Assistant Professor of Obstetrics-Gynecology and Internal Medicine at Alpert Medical School of Brown University."
free full access: JAMA -- Funding of US Biomedical Research, 2003-2008, January 13, 2010, Dorsey et al. 303 (2): 137
Note: charts for quick overviews
"...Small RNA cDNA libraries were constructed from RNA sample pools....and epithelial ovarian cancer specimens of serous, clear cell and endometrioid histologies....This report expands the body of miRNAs known to be expressed in epithelial ovarian cancer and provides a useful resource for future studies of the role of miRNAs in the pathogenesis and early detection of ovarian cancer."
"...The team made the discovery partly by accident. They were studying short pieces of RNA called micro RNAs in human tissue samples. These tiny pieces of RNA, discovered only a few years ago, play a big role in regulating genes, and are now known to be altered in cancer..... In a large majority of the cases, just by measuring the amount of micro RNA in the blood, we could tell who had cancer and who didn’t,” Tewari says."
Eva Longoria, Meryl Streep, Mario Batali, Stephen Colbert, Malcolm Gladwell, Yo-Yo Ma, Mike Nichols, Kristi Yamaguchi, Elizabeth Alexander, Queen Noor and Louise Erdrich have all submitted DNA tests for a new PBS television series FACES OF AMERICA.
Faces of America with Henry Louis Gates, Jr. airs on Wednesdays, February 10 – March 3, 2010 from 8-9 p.m. ET on PBS.
abstract: An effect from anticipation also in hereditary nonpolyposis colorectal cancer families without identified mutations.(Lynch Syndrome)
Note: this would apply to the many with no known mutations in the many genetic syndromes (eg. BRCA, Peutz-Jeghers Syndrome...)
"This observation suggests that anticipation may apply also to families without identified mutations and serves as a reminder to initiate surveillance programmes at young age also in HNPCC families with undefined genetic causes."
Saturday, January 16, 2010
Note: This abstract is highly technical, but the significance is that there is a focus on clear cell ovarian cancer.
"...Our experiments have revealed strong candidate miRNAs and their target genes that may contribute to the pathogenesis of clear cell ovarian cancer..."
Hereditary breast and ovarian cancer: Referral source for genetic assessment and communication regarding assessment with nongenetic clinicians in the
Hereditary breast and ovarian cancer: Referral source for genetic assessment and communication regarding assessment with nongenetic clinicians in the community setting:
"One-third of ovarian tumours show loss of WWOX expression, and this loss significantly associates with clear cell and mucinous histology, advanced stage, low progesterone receptor expression and poor survival, suggesting that WWOX status affects ovarian cancer progression and prognosis."
Friday, January 15, 2010
The tool answers questions such as (and more):
How and where do I find out if a drug is approved for use?
Why are there still food recalls?
How do I report a pet food compliant?
You can also submit your own questions, provide feedback, and view interviews with FDA staff.
Bazedoxifene, a selective estrogen receptor modulator: effects on the endometrium, ovaries, and breast from a randomized controlled trial in osteoporo
Bazedoxifene, a selective estrogen receptor modulator: effects on the endometrium, ovaries, and breast from a randomized controlled trial in osteoporotic postmenopausal women
Note: further research required
Note: Immunohistochemical = tumour sample; hMLH1 and hMSH2 (2 of) Lynch Syndrome genes
"Our results suggest that hMLH1 and hMSH2 proteins may be involved in ovarian carcinogenesis."
"The study of epigenetic mechanisms in cancer, such as DNA methylation, histone modifications, nucleosome positioning and non-coding RNA expression, has revealed a plethora of events that contribute to the neoplastic phenotype through stable changes in the expression of genes critical to transformation pathways...Therefore, improved understanding of normal epigenetic programs is necessary to better understand malignancy-specific epigenetic alterations.....numerous other clinical applications of the field being explored in areas such as cancer screening and early detection, prevention, classification for epidemiology and prognostic purposes, and predicting outcomes after standard therapy."
"....demonstrated the feasibility and value of a new strategy for identifying relatively rare genetic variants that may cause or contribute to disease....The new strategy involves isolating and sequencing all exons which are the parts of the human genome that contain the information needed to produce proteins, the building blocks of the body. The complete set of exons – referred to as the "exome" – makes up only one percent of the human genome. By selecting only the exome to sequence, the important information about an individual can be obtained at a much lower cost than sequencing a person's entire genome."
Note: Good plain english article generalizing the issues - $$/capacity/knowledge
Thursday, January 14, 2010
Note: advances in the imaging of ovarian cancer
Surgery duration linked to infectious complications, hospital stay - Anesthesiology Videos - The Doctor's Channel
not specific to ovarian cancer
Note: this was posted in November, but I have brought the posting date forward to coincide with other like articles, so both can be viewed at the same time. Access to this article requires that you sign on to the website (free).
Targeted Therapy in Ovarian Cancer
Lyndsay J. Willmott and John P. Fruehauf
Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA 92868, USA Academic Editor: Charles F. Levenback
Defective Mismatch Repair, Microsatellite Mutation Bias, and Variability in Clinical Cancer Phenotypes -- Shah et al. 70 (2): 431 -- Cancer Research
"Microsatellite instability is associated with 10% to 15% of colorectal, endometrial, OVARIAN, and gastric cancers, and has long been used as a diagnostic tool for hereditary nonpolyposis colorectal carcinoma–related cancers. Tumor-specific length alterations within microsatellites are generally accepted to be a consequence of strand slippage events during DNA replication, which are uncorrected due to a defective postreplication mismatch repair (MMR) system. Mutations arising within microsatellites associated with critical target genes are believed to play a causative role in the evolution of MMR-defective tumors. In this review, we summarize current evidence of mutational biases within microsatellites arising as a consequence of intrinsic DNA sequence effects as well as variation in MMR efficiency. Microsatellite mutational biases are generally not considered during clinical testing; however, we suggest that such biases may be clinically significant as a factor contributing to phenotypic variation among microsatellite instability–positive tumors."
Comment: Before Erythropoiesis-stimulating agents were introduced, blood transfusions were widely used for the improvement of platelet counts etc. With recent negative research regarding Erythropoiesis-stimulating agents, blood transfusions will be a choice - seek professional/oncologist opinion. This article from the ACS describes some of the concerns with blood transfusions.
Phase III Randomized Study of Glutathione for the Prevention of Paclitaxel/Carboplatin-Induced Peripheral Neuropathy in Patients With Ovarian, Fallopi
Phase III Randomized Study of Glutathione for the Prevention of Paclitaxel/Carboplatin-Induced Peripheral Neuropathy in Patients With Ovarian, Fallopian Tube, and/or Primary Peritoneal Carcinoma
What are interleukins?
"Like interferons, interleukins (ILs) are cytokines that occur naturally in the body and can be made in the laboratory. Many interleukins have been identified; interleukin-2 (IL–2 or aldesleukin) has been the most widely studied in cancer treatment. IL–2 stimulates the growth and activity of many immune cells, such as lymphocytes, that can destroy cancer cells. The FDA has approved IL–2 for the treatment of metastatic kidney cancer and metastatic melanoma.
Researchers continue to study the benefits of interleukins to treat a number of other cancers, including leukemia, lymphoma, and brain, colorectal, ovarian, breast, and prostate cancers."
Wednesday, January 13, 2010
Molecular Cancer | Full text | Methylation and protein expression of DNA repair genes: association with chemotherapy exposure and survival in sporadic ovarian and peritoneal carcinomas
CA-125 Response Patterns in Patients With Recurrent Ovarian Cancer Treated With Pegylated Liposomal Doxorubicin (PLD)
Conclusions: "Our ROC analysis did not demonstrate any reliable CA-125 cutoff on response. Discontinuation of the therapy before cycle 3 may exclude some patients who will benefit from PLD."
"CAN you name the six basic emotions? Take a straw poll of your friends and we guarantee that you will find no consensus. Yet psychologists are unequivocal: joy, sadness, anger, fear, surprise and disgust...."
media item: new anti-cancer drug called "COTI-2" TD2 and Critical Outcome Technologies Inc. Develop Novel Anti-Cancer Drug
"....small molecule compound was discovered and developed by COTI of London, Ontario, Canada. This working relationship resulted through the expanded relationship between Canadian companies and the Phoenix-based Translational Genomics Research Institute (TGen). TD2, TGen's Scottsdale-based drug-development subsidiary, will work with COTI to complete the Investigational New Drug (IND) enabling research necessary to gain U.S. Food and Drug Administration approval of clinical trials,perhaps by the end of 2010, and eventually move the drug to market where it can benefit patients.....Researchers hope to demonstrate that this oral pill will be especially beneficial for patients with small- cell lung cancer (SCLC), endometrial cancer and ovarian cancer, but may also help treat those with colorectal and pancreatic cancers."
Beyond the history, at the bottom of the page, there are a number of links which you may find interesting such as:
* 100 Best Blogs for Living Healthy on a Budget
* The Surgery is Over… Now What? 4 Tips for A Successful Rehab
* Top 100 Doctor Bloggers
* 100+ Ways to Spring Clean Your Mind and Body
* The Top 50 Surgeon Bloggers
* What Does a Surgical Technician Do?
full free access: Is no news good news? Inconclusive genetic test results in BRCA1 and BRCA2 from patients and professionals' perspectives
Small study but included view of patients and physician views.
Use of Four Biomarkers to Evaluate the Risk of Breast Cancer Subtypes in the Women's Contraceptive and Reproductive Experiences Study
"Our findings offer evidence of differences in the hormone-related risk factors between triple-negative cancers and other ER/PR/HER2-defined subtypes of breast cancer."
Collaborating or co-existing: a survey of attitudes of medical oncologists toward specialist palliative care
Vandetanib, Designed to Inhibit VEGFR2 and EGFR Signaling, Had No Clinical Activity as Monotherapy for Recurrent Ovarian Cancer and No Detectable Modulation of VEGFR2
"Twelve patients entered the study, and accrual was terminated in the first stage because of lack of response or disease stabilization beyond 6 months."
NCI Cancer Bulletin: PARP Inhibitor and Metronomic Chemotherapy for Refractory Cancer - Phase I Study of ABT-888 and Metronomic Cyclophosphamide ....
Name of the Trial:
Phase I Study of ABT-888 and Metronomic Cyclophosphamide in Patients with Refractory Solid Tumors or Lymphoma (NCI-09-C-0048).
For More Information (read the article to see direct links to the information):
See the lists of eligibility criteria and trial contact information or call the NCI Clinical Trials Referral Office at 1-888-NCI-1937. The call is toll free and confidential.
Tuesday, January 12, 2010
"New research by Samir Hanash, Ross Prentice and colleagues, recently published in Genome Medicine, suggests that the different proteomic effects of estrogen-alone and estrogen plus progestin treatments may explain the distinctive clinical effects of each therapy."
UC Academic Health News : Findings: UC Gynecologic Cancer Team Expands Services to Northern Kentuck-Dayton
"His goal is to recruit three additional double board-certified gynecologic oncologists who are qualified to perform both cancer care as well as advanced pelvic surgery. This team will cover a wide range east and west of the I-75 stretch between Northern Kentucky and Dayton."
abstract: Identification of an ovarian clear cell carcinoma gene signature that reflects inherent disease biology and the carcinogenic processes
definitions we need to know when reading this abstract:
1) microenvironment: a specific set of physical, biological, and chemical factors immediately surrounding the organism;
2) epigenetic: - something that affects a cell, organ or individual without directly affecting its DNA.
"Conclusions: The rates of optimal cytoreduction vary among surgeons. A universally applicable clinical model that can predict which patients will undergo optimal cytoreduction remains elusive. More research is needed to devise a set of uniform criteria that can be used to predict ovarian cancer resectability among different patient populations."
June 17-19, 2010
Marriott Wardman Park Hotel
The Biennial Cancer Survivorship Research Conference, initiated in 2002 by the National Cancer Institute’s Office of Cancer Survivorship and the American Cancer Society’s Behavioral Research Center, brings together investigators, clinicians, and survivors to share and learn about the most up-to-date cancer survivorship research. In 2010, the 5th biennial conference is co-sponsored by the National Cancer Institute, the American Cancer Society, LIVESTRONG, and the Centers for Disease Control and Prevention.
press release: Nektar Announces Positive Topline Results for NKTR-102 From First Stage of Phase 2 Study in Platinum-Resistant Ovarian Cancer
"The first stage of the NKTR-102 Phase 2 study showed an overall GCIG response rate of 32% (6/19) in the once every 14 days (q14 day) dose schedule and 35% (7/20) for the once every 21 days (q21 day) dose schedule.
Confirmed objective response rates using RECIST were 21% (4/19) and 22% (4/18) for the q14 day and q21 day dose schedules, respectively.
CA-125 response rates were 31% (5/16) and 38% (6/16), for each dose schedule, respectively.
The Phase 2 study has now completed enrollment with a total of 71 patients. Approximately one-third of the patients in the study remain on NKTR-102 treatment, including a number of patients in the first stage of the study."
abstract: Generational risks for cancers not related to tobacco, screening, or treatment in the United States
Despite declining overall cancer death rates, adults are experiencing increased incidence of cancers that are not associated with tobacco or screening relative to their parents. Future research should examine whether similar patterns are exhibited in other modern nations and should identify population-wide avoidable risks that could account for unexplained increases in these residual cancers."
this link is the actual research article and from which the media item was based (abstract/only-pay-per-view)
My response, assuming it gets posted:
"As a cancer (ovarian) survivour, the value of the research and 'weight' concerns are ever present. However, at this very moment weight issues in cancer are primarily a health issue with many unknowns as it relates to specific implications in specific cancers. I see many websites/programs who arbitrarily have included 'weight' issues as a risk factor. Until the exact mechanisms and results are known, I urge great caution as this adds to significant burdens on patients who at this very moment are fighting to survive. It is not ethically or morally appropriate to add to these burdens for those dying of cancer."
It should be emphasized that the FDA release focuses solely on patients with chronic renal disease, not cancer. It's a different population, so nothing in this release applies to the anemia of chemotherapy or patients with myelodysplastic syndrome. Right now, the ASCO/ASH ESA guideline committee is looking at present data to see if they need to make any modifications in the guidelines for the use of ESAs. The NCCN modified its guideline about a year ago and agree with the FDA recommendations that ESAs shouldn't be used in a standard fashion in patients being treated for curative intent. That's become standard of care, and for patients on chemotherapy, nothing has changed in the past year.
- Samuel Silver, MD, PhD
HemOnc Today Editorial Board member"
Special Report: NCI Cancer Bulletin - Ovarian Cancer