Monday, February 01, 2010
This is a useful website for finding a lot of information relating to drugs, including chemotherapies. It includes drug interactions, warnings, generic names, pill identifier, medical dictionary etc. The website has been around for many years.
"....The fellow asked the oncologist why he was so pessimistic when talking with the patient. Why did he say things to make the patient and her husband cry? Shouldn't he have given the patient more hope? Would it not have been better for the patient to hear this dire news in chunks over the course of several clinic visits? After all, the patient was so young she may just beat the odds....."
"...We previously reported results of tumor mRNA expression studies which suggested that altered expression of a particular set of genes predicted response to chemotherapy among women with advanced-stage high-grade epithelial ovarian cancer.......Conclusions: "Tumor studies can reveal novel genes worthy of follow-up for cancer susceptibility. Here, we found that inherited markers in the gene encoding MSL1, part of a complex that modifies the histone H4, may decrease risk of invasive serous ovarian cancer."
2007 (comparing cancer symptoms) - slide excerpt Benivegna/Pniauskas "Survivors' Debate: The Past Decade in Ovarian Cancer"
full free access: Duration and magnitude of the postoperative risk of venous thromboembolism in middle aged women: prospective cohort study
Note: the full access to this publication is available for free; professional comments included CONCLUSION: The risk of deep vein thrombosis and pulmonary embolism after surgery is substantially increased in the first 12 postoperative weeks, and varies considerably by type of surgery.
Journal of Experimental & Clinical Cancer Research | Full text | Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research
Note: there is a specific section on ovarian cancer
Background: Viscum album L. extracts (VAE, European mistletoe) are a widely used medicinal plant extract in gynaecological and breast-cancer treatment. Conclusion: VAE shows some positive effects in breast and gynaecological cancer. More research into clinical efficacy is warranted.
"There is considerable disagreement in the scientific community about the validity of these models," notes Rosaleen Parsons, M.D., chair of the department of diagnostic imaging at Fox Chase Cancer Center. "And some scientists believe the radiation dose from these CT scans may not lead to any increased risk of cancer."
In the second study, conducted at the University of California-San Francisco, researchers compared CT scan use at four San Francisco Bay area facilities. They found that the amount of radiation from a CT scan may be up to four times greater than estimated in previous studies. In addition, they noted significant differences among different institutions and, in some instances, within the same institution, when looking at the radiation dose associated with CT scans.
Sunday, January 31, 2010
The heterogeneity of epithelial ovarian cancer
Getting it right
David M. Gershenson, MD *
Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
email: David M. Gershenson (DGERSHEN@mdanderson.org)
Epithelial ovarian cancer is heterogeneous and comprises 4 major rare subtypes - mucinous, clear cell, low-grade serous, and endometrioid - all distinct from the more common high-grade serous carcinoma. Women with uncommon histotypes should be triaged to separate clinical trials.
Search results for Dietary Supplement - ovarian cancer:
Acidophilus 1 study
Arginine 1 study
Calciferol 4 studies
Cholecalciferol 3 studies
Citrate 13 studies
Folate 7 studies
Folic Acid 7 studies
Folinic Acid 8 studies
Orange 1 study
Tea 1 study
Tyrosine 1 study
Vitamin B9 7 studies
Vitamin D3 3 studies
"Macmillan Cancer Support said that workers don't realise the Disability Discrimination Act (DDA) also protects cancer patients. A survey for the charity found more than half (53 per cent) of the 1,000 people questioned did not realise the act also applied to cancer patients."
32 minute video
add your opinions cancer patients genetics breast colorectal ovarian health , participatory medicine , video
Note: good article, albeit complicated subject matter - excerpts of important information:
Soy product and isoflavone intake and breast cancer risk defined by hormone receptor status. 2009; Cancer Science
"he association between soy food consumption and breast cancer risk has been inconsistent. A hospital-based case–control study was conducted to assess the relationship between soy food intake and breast cancer risk according to the estrogen receptor (ER) and/or progesterone receptor (PR) status of breast cancer in Chinese women .....The protective effects of soy did not seem to differ by ER and PR breast cancer status."
Note: technical/short abstract
Saturday, January 30, 2010
Note: there are some key videos (free to view) from a variety of subjects
Chemotherapy Foundation Symposium XXVI
November 4 -8, 2008
Marriott Marquis Hotel , New York , NY
November 4 -8, 2008
Marriott Marquis Hotel , New York , NY
Innovative Cancer Therapy for Tomorrow
Friday, January 29, 2010
2007 Open-label safety and efficacy pilot trial of intraperitoneal bevacizumab as palliative treatment in refractory malignant ascites
reference: Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 25, No 18S (June 20 Supplement), 2007: 9043
Intraperitoneal VEGF Inhibition Using Bevacizumab: A Potential Approach for the Symptomatic Treatment of Malignant Ascites? -- The Oncologist
"Despite the very strong preclinical evidence for an obligatory role of VEGF in the formation of malignant ascites and for a possible therapeutic efficacy of anti-VEGF therapies in the setting of malignant effusions, there are currently no reports from clinical studies addressing this point in cancer patients..........To date, only very few patients with malignant ascites have received i.p. bevacizumab and, therefore, this route of administration as well as this particular patient population need to be examined stringently regarding the safety of the treatment. However, we believe that i.p. application might be the route of choice in this particular setting."
Immunotherapy of Cancer: Key Findings and Commentary on the Third Tegernsee Conference -2009- The Oncologist
*the Oncologist now requires a subscription $$/abstracts available for free
FDA Drug Approval Summary: Bevacizumab plus Interferon for Advanced Renal Cell Carcinoma -- The Oncologist
*the Oncologist now requires a subscription $$/abstracts available for free
Patient Safety: note the adverse effects
"In the reviewed trial, serious adverse events and National Cancer Institute Common Terminology Criteria for Adverse Events grade 3 adverse events were reported more frequently in bevacizumab-treated patients (31% versus 19% and 63% versus 47%, respectively). The most common bevacizumab-related toxicities were bleeding/hemorrhage, hypertension, proteinuria, and venous or arterial thromboembolic events."
Combining Targeted Therapies: Practical Issues to Consider at the Bench and Bedside -- The Oncologist
*the Oncologist now requires a subscription $$/abstracts available for free
Predictive Value of Symptoms for Early Detection of Ovarian Cancer -- Rossing et al., 10.1093/jnci/djp500 -- JNCI Journal of the National Cancer Institute
Predictive Value of Symptoms for Early Detection of Ovarian Cancer -- Rossing et al., JNCI Journal of the National Cancer Institute
media news: Symptoms have little value for early detection of ovarian cancer including editorial commentary
Preventing Future Cancers by Testing Women With Ovarian Cancer for BRCA Mutations -- University of British Columbia/MD Anderson
"BRCA testing of women with ovarian cancer based on personal/family history of cancer or Ashkenazi Jewish ancestry is a cost-effective strategy to prevent future breast and ovarian cancers among FDRs (first degree relatives). More inclusive testing strategies prevent additional cancer cases but at significant cost."
WARNING: this information is from a media article and gives virtually no information, so cautions. This obviously is not intended to discredit Johns Hopkins/Wisconsin Cancer Center, but the lack of information in the article.
"Patients interested in enrolling in the G-202 trial may contact the University of Wisconsin Carbone Cancer Center Connect line at (800) 622-8922. Patients who want to be evaluated for eligibility for this study at Johns Hopkins should call 410-955-8964, option #2. "
Expression of interleukin-1 (IL-1) ligands system in the most common endometriosis-associated ovarian cancer subtypes
Note: highly technical paper comparing serous, clear cell and endometrioid ovarian cancer cells type/endometriosis/Interleukins (in research)
Thursday, January 28, 2010
Ovarian Cancer Symptoms Speak Out--But What Are They Really Saying? -- Cass and Karlan, 10.1093/jnci/djp525 -- JNCI Journal of the National Cancer Institute
Ovarian Cancer Symptoms Speak Out--But What Are They Really Saying? -- Cass and Karlan, 10.1093/jnci/djp525 -- JNCI Journal of the National Cancer Institute
language issues: borderline - significant ??
"women reporting the highest apigenin intake had a "borderline significant decrease" in ovarian cancer risk"
This article by Andre Picard of the Globe and Mail is a regurgitated column previously noted media columns. Interestingly enough the SGOC has an 'award' for columnists at the moment so it is highly suspect in its timing.
However, included are comments from both public and healthcare individuals.
"The original plan was to analyze 25 ovarian and 25 gastric tumor/normal pairs by the end of 2009 using the company's Genome Analyzer, including whole-genome sequencing to at least 30-fold coverage, mRNA-seq, methylation sequencing, and chip genotyping. That timeline got delayed somewhat, and the company now expects to finish the ovarian tumors by the end of March and move into a validation phase, and then tackle the gastric cancer samples.
The delay was largely due to a longer-than-expected process of acquiring and qualifying the samples, Heath explained. For the ovarian cancer project, for example, he said the company was looking for stage I or II samples with a tumor content of at least 70 percent from non-smokers who did not have mutations in the BRCA 1 or 2 genes. He also said that the type of consent required for whole-genome sequencing is "quite a bit different from what is normally consented" and required the company, in some instances, to go back and ask for additional consent."
"Contrast-enhanced ultrasound (CEUS) has unique advantages over contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) in the characterization of hepatic tumors."
"Studies need to be conducted to determine the optimal design for using genome-wide profiling to identify putative biomarkers of drug response. To date, most biomarkers of drug response identified through genome-wide profiling have occurred through retrospective analysis of available tissue. To really progress this field, realistic planning for biomarker discovery and validation in clinical trials needs to be conducted. We, as clinical scientists, need to progress from only using convenient clinical cohorts to identify biomarkers to actually planning and following through with prospective clinical trials whose aims are to discover and/or validate putative biomarkers of drug response. To initiate a study without a realistic plan for discovery and validation reflects a lack of serious desire to find robust clinical predictors..... Until this becomes more commonplace, the genomic revolution will be focused on manuscript generation and investigator career development, leaving the benefit to patients nothing more than an unrealized dream."
Patient Participation: Current Knowledge and Applicability to Patient Safety — Mayo Clinic Proceedings
"...Patient-related factors, such as acceptance of the new patient role, lack of medical knowledge, lack of confidence, comorbidity, and various sociodemographic parameters, all affect willingness to participate in the health care process. Among health care workers, the acceptance and promotion of patient participation are influenced by other issues, including the desire to maintain control, lack of time, personal beliefs, type of illness, and training in patient-caregiver relationships. Social status, specialty, ethnic origin, and the stakes involved also influence patient and health care worker acceptance.
add your opinions cancer patients genetics breast colorectal ovarian health , healthcare , participation , patient safety
Cancer Causes and Controls: abstract - Microsatellite instability and survival in rectal cancer (Lynch Syndrome)
Objective High levels of microsatellite instability (MSI-H) have been associated in many studies with improved prognosis in colon cancer. Very few studies have evaluated the effect of MSI-H on rectal cancer survival. We assessed MSI-H and other genetic and epigenetic changes on survival of 990 individuals diagnosed with first primary rectal cancer.
Conclusion The genetic and epigenetic characteristics of MSI-H rectal cancers suggest that they are enriched for Lynch-associated tumors; adverse prognosis associated with MSI-H in these tumors may reflect the relatively high frequency of Lynch-associated cancers and/or the effect of radiation or chemotherapy on Lynch-associated rectal cancers or MSI tumors in general."
The purpose of this pilot study was to describe the decision-making needs of women with ovarian cancer related to treatment of recurrent disease. ..... CONCLUSIONS: The findings provide some beginning direction for an inter-professional decision support approach, as well as implications for future research.
About these guidelinesAdopting appropriate email practices with patients is an important step to safeguarding the integrity of the doctor-patient relationship and maintaining the confidentiality of sensitive patient information.
The email guidelines that you are about to generate will outline when, why and how your patients may use email to contact you.
These guidelines can be:
- printed and used as a patient handout
- used as a patient consent form
- used as a statement of best practices for you and your staff
- saved on your computer
- downloaded from your practice website
"Certain groups of patients have been particularly hard hit: children, patients with rare cancers, patients who would profit greatly from international trials that optimise already existing treatments and which, therefore, do not find commercial sponsorship, and elderly patients with other health problems, including secondary cancers due to earlier treatments."
Wednesday, January 27, 2010
2009 Expert Perspectives on Challenges, Controversies, and Opportunities in Ovarian Cancer Therapy: The Present and the Future | PeerView Press
Includes: Dr's Markman, Armstrong & Coleman
- Expert Perspectives on Challenges, Controversies, and Opportunities in Ovarian Cancer Therapy: The Present and the Future
- Taking Stock of the Current Research: Which New Therapies Are Showing Promise in Ovarian Cancer?
- Audio - Q&A Lightning Round: Expert Opinions on Unanswered Questions and Controversies in Ovarian Cancer
There are 5 clinical trials at NIH that match your search criteria
Cancer by type/disease: Ovarian Cancer
A Phase II Study of Sorafenib and Bevacizumab in Epithelial Ovarian, Fallopian, and Peritoneal Cancer
A Phase II Study of Sorafenib and Bevacizumab in Epithelial Ovarian, Fallopian, and Peritoneal Cancer Clinical, Genetic, Behavioral, Laboratory, and Epidemiologic Characterization of Individuals and Families at High Risk of Breast/Ovarian Cancer
A Phase I Study With an Expansion Cohort of the PARP Inhibitor AZD2281 (KU-0059436) Combined With Carboplatin in Breast and Ovarian Cancer in BRCA 1/2 Mutation Carriers, Familial Breast and Ovarian Cancer, and Sporadic Triple Negative Breast Cancer and Ovarian Cancer
A Phase I, Open-Label Study of MEDI-547 to Evaluate the Safety, Tolerability, Pharmacokinetics, and Biologic Activity of Intravenous Administration in Subjects With Refractory Solid Tumors Associated With EphA2 Expression
A Phase I Study of Dasatinib in Combination With Bevacizumab in Advanced Solid Tumors
"When someone develops an infection at a hospital or other patient care facility that they did not have prior to treatment, this is referred to as a healthcare-associated (sometimes hospital-acquired) infection (HAI).
Healthcare-associated infections (HAIs) are a global crisis affecting both patients and healthcare workers.
According to the World Health Organization (WHO), at any point in time, 1.4 million people worldwide suffer from infections acquired in hospitals."
"Our experiments have revealed strong candidate miRNAs and their target genes that may contribute to the pathogenesis of clear cell ovarian cancer, thereby highlighting alternative therapeutic strategies....."
"Gladwell asks why it is so difficult to acknowledge the fact that each of us comes from a culture with its own distinctive mix of strengths and weaknesses, tendencies, and predispositions. "Who we are cannot be separated from where we are from -- and when we ignore that fact, planes crash."
And patients die."
"...As I read the winning stories, I had a fantasy, which is probably not a good idea to apply literally, but it’s useful as what philosophers would call a thought experiment. My fantasy was that in a doctor’s waiting room, instead of old magazines and public health brochures, patients might pick up stories that the doctor had written—stories not unlike these winning stories. And maybe patients would then bring in their stories and leave copies of those on the rack next to the doctor’s stories. That would open the silent world on both sides."
EDITOR’S KEY POINTS
- Patient-physician communication is central to every physician’s practice and to patient satisfaction. Physicians have been concerned that the introduction of computers into patient consultations will lead to a breakdown of communication.
- This study sought to examine patients’ opinions about the effects of computer use on patient-physician interaction and on their satisfaction with their visits.
- Results of this study suggest that concerns about computer use negatively affecting patient-physician relationships and patient satisfaction are largely unfounded. Most patients had no preference for whether computers were used or not, and computer use actually seemed to have a positive effect on overall satisfaction. Other studies have shown that patients’ main concerns about computer use have to do with privacy, but in this study only 3.4% of respondents were concerned about a "negative" or "very negative" effect on privacy.
"Gilles Frydman is one of the leading ePatients. He started and runs ACOR (Association of Cancer Online Resources) and has discussed the role of engaged patients with rare diseases at the last few Health 2.0 Conferences."
"Conclusion: An extensive multiple-pathway assessment found evidence that inherited differences may play a role in outcome of ovarian cancer patients, particularly in genes within the angiogenesis and inflammation pathways. Our work supports efforts to target such mediators for therapeutic gain."
Tuesday, January 26, 2010
NCI clincial trial: A Targeted Phase I/II Trial of ZD6474 (Vandetanib; ZACTIMA) Plus the Proteasome Inhibitor, Bortezomib (Velcade(Registered Trademark)), in Adults With Solid Tumors With a Focus on Hereditary or Sporadic, Locally Advanced or Metastatic Medullary Thyroi... - Full Text View - ClinicalTrials.gov
Drug: VELCADE, PS-341 (Bortezomib, NSC #681239) Drug: ZACTIMA (Vandetanib) (ZD6474) Phase I Phase II
Forty years into the war on cancer, the death rate for many cancers has not changed significantly. Scientists say a new approach is needed. Midmorning talks with two cancer researchers about the latest and most promising research.
"BACKGROUND: The ethical dilemmas that residents experience throughout their training have not been explored qualitatively from surgical residents' perspectives.
METHODS: Grounded theory methodology was used. All University of Toronto surgical, otolaryngology, and obstetrics and gynecology residents were invited to participate.Twenty-eight face-to-face interviews were conducted. Interviews were transcribed and analyzed by 3 reviewers.
RESULTS: Five encompassing themes emerged: (1) residents prefer operating with another resident while the staff watches; (2) residents felt that patients were rarely well informed about their role; (3) residents develop good relationships with patients; (4) residents felt ethically obliged to disclose intraoperative errors; and (5) residents experience ethical distress in certain teaching circumstances.
CONCLUSIONS: Residents encounter ethical dilemmas leading to moral angst during their surgical training and need to feel safe to discuss these openly. Staff and residents should work together to establish optimal communication and teaching situations."
"A health care system should, first and foremost, be organized to meet the needs of patients rather than the needs of institutions and providers. More often than not, however, the needs of institutions and health providers come first. How often do we see patients repeatedly
return to clinics on different days for poorly coordinated visits for diagnostic tests and follow-up with their physician?..."
Evidence Updates: Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients (advanced cancer)
Evidence Updates: Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients
Girgis A, Breen S, Stacey F, et al. Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients with nonlocalized breast and colorectal cancers. J Clin Oncol. 2009 Dec 20;27(36):6180-90. Epub 2009 Nov 16. PMID: 19917842 (Original)
DISCIPLINE RELEVANCE TO PRACTICE IS THIS NEWS?
Oncology - Breast 3 / 7 3 / 7
Oncology - Gastrointestinal 4 / 7 4 / 7
Oncology - Palliative and Supportive Care 6 / 7 6 / 7
Abstract PURPOSE: Patients with cancer experience considerable symptom burden, psychological morbidity, and unmet psychosocial needs. Research suggests that feedback of patient-reported outcomes to clinicians or caseworkers, alongside management strategies, may result in improved patient functioning. Two intervention models were developed to test this effect in a randomized, controlled trial against usual care (UC): a telephone caseworker (TCW) model and an oncologist/general practitioner (O/GP) model. Primary end points included anxiety, depression, physical/emotional functioning, and unmet supportive care needs.
PATIENTS AND METHODS: Participants with nonlocalized breast or colorectal cancers were surveyed by computer-assisted telephone interview (CATI) at three time points: baseline, 3 months, and 6 months. Data collected from participant CATIs in the supportive care models were used to generate feedback to either each participant`s designated TCW, or their nominated O/GPs. Data obtained from participants in the UC model were used only to assess the impact of supportive care models. In total, 356 participants consented to study participation, completed the baseline CATI, and were randomly assigned to the UC, TCW, or O/GP groups.
RESULTS: No overall intervention effect was observed. Physical functioning was significantly improved at the third CATI for participants in the TCW model (P = .01), and there was a trend toward fewer participants with unmet needs (P = .07). TCW group participants also were more likely to have the following: identified issues of need discussed (P < .0001); referrals made (P < .0001); and strong agreement that the intervention improved communication with their health care team (P = .0005).
CONCLUSION: The TCW model holds some promise; however, additional work in at-risk populations is required before we recommend implementation.
add your opinions advanced cancer , cancer patients genetics breast colorectal ovarian health , models , supportive care
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 (email@example.com)|
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.