Friday, March 19, 2010
Note: genes/disease relevance/links to further information
BRCA2 breast cancer 2, early onset 13q12.3
* Breast-ovarian cancer, familial, 2
* Fanconi anemia, complementation group D1
* Prostate cancer
* Breast cancer, male, susceptibility to
* Wilms tumor
* Pre-B-cell acute lymphoblastic leukemia
* Pancreatic cancer
MSH2 mutS homolog 2, colon cancer, nonpolyposis type 1 (E. coli) 2p22-p21
* Colorectal cancer, hereditary nonpolyposis, type 1
* Muir-Torre syndrome
* Mismatch repair cancer syndrome
Medical News: SGO: New Option for Recurrent Ovarian Cancer? - in "Carboplatin-PLD" Meeting Coverage, SGO
Source reference: Pujade-Lauraine E, et al "Pegylated liposomal doxorubicin and carboplatin versus paclitaxel and carboplatin in patients with platinum-sensitive ovarian cancer in late relapse" SGO 2010; Abstract SAS 2
Translational research in the Gynecologic Oncology Group: Evaluation of ovarian cancer markers, profiles, and novel therapies.
The BRCAPRO 5.0 model is a useful tool in genetic counseling and clinical management of male breast cancer cases.
"BRCAPRO version 5.0 can be particularly useful in dealing with non-familial MBC, a circumstance that often represents a challenging situation in genetic counseling."
AUTHORS' CONCLUSIONS: We are unable to make any evidence-based recommendations as we found no comparative studies assessing the effectiveness of tamoxifen in women with recurrent ovarian cancer. There is limited evidence on anti-tumour activity from phase 2 studies, but these contain no data on the effect of tamoxifen on symptom control, QOL or the prolongation of life.
Plain language summary
No evidence to suggest tamoxifen benefits patients with relapsed ovarian cancer
Ovarian cancer often spreads before symptoms show. Cytotoxic drugs are often only partly effective and cause severe side-effects. The main aims of treatment for relapsed disease are symptom control and prolongation of life. No data from RCTs or non-RCTs were found, so there was no evidence that tamoxifen was effective and safe as a treatment for relapsed ovarian cancer. Laboratory studies suggest tamoxifen may be effective as a treatment for women with ovarian cancer. Although, uncontrolled non-comparative trials on patients with relapsed ovarian cancer showed tamoxifen may shrink or stabilise tumours in a small number, there is a strong need for an RCT or good quality non-randomised comparative studies to determine the effectiveness and safety of tamoxifen in terms of overall survival, tumour response, symptom control, quality of life and adverse events.
"The researchers concluded that temsirolimus may have modest cytostatic activity in patients with prior chemotherapy and should be investigated further. Dr. Behbakht suggested that the agent might be combined with bevacizumab for increased activity and is already being studied in combination with paclitaxel. He noted that isolation, enumeration, and characterisation of CTCs from patients should also be investigated in further trials."
News - Bevacizumab Plus Docetaxel Shows Promise for Ovarian Cancer, No Surprising Toxicities: Presented at SGO
"...The clinical trials will use Agendia's MammaPrint test and TargetPrint Her2 risk scores, as well as estrogen receptor and progesterone receptor status information and MRI to help determine eligibility for the trial.
The large-scale trial will involve more than twenty university hospitals and medical centers spread around the country, including The University of Texas MD Anderson Cancer Center, the Mayo Clinic in Arizona and Minnesota, the Fred Hutchinson Cancer Research Center, and a number of others...."
NIH Plans Genetic Testing Registry
March 18, 2010
"NEW YORK (GenomeWeb News) – The National Institutes of Health is starting a public database on genetic testing that will allow consumers, researchers, health care providers, and others search through information submitted by genetic test providers, NIH said today....The GTR, which is expected to be available in 2011, will be overseen by NIH's Office of the Director, and its development will be handled by the National Center for Biotechnology Information."
MRI for breast cancer: who benefits, who is harmed? Cancer World - Education & knowledge through people & facts
full access: Lovastatin induces apoptosis of ovarian cancer cells and synergizes with doxorubicin: potential therapeutic relevance - U of T
The results of this research provide pre-clinical data to warrant further evaluation of statins as potential anti-cancer agents to treat ovarian carcinoma. Many statins are inexpensive, off-patent generic drugs that are immediately available for use as anti-cancer agents. We provide evidence that lovastatin triggers apoptosis of ovarian cancer cells as a single agent by a mevalonate-dependent mechanism. Moreover, we also show lovastatin synergizes with doxorubicin, an agent administered for recurrent disease. This synergy occurs by a novel mevalonate-independent mechanism that antagonizes drug resistance, likely by inhibiting P-glycoprotein. These data raise important issues that may impact how statins can best be included in chemotherapy regimens.
Thursday, March 18, 2010
ScienceDirect - Gynecologic Oncology : The molecular genetic basis of ovarian cancer and its roadmap towards a better treatment
Note: subscription required )$$$)
The molecular genetic basis of ovarian cancer and its roadmap towards a better treatment
Re: judging based on clothing/dress
Drug Information Portal - U.S. National Library of Medicine - Quick Access to Quality Drug Information (searchable)
Note: (from Wiki) Qatar, also known as the State of Qatar or locally Dawlat Qaṭar, is an Arab emirate in the Middle East, occupying the small Qatar Peninsula on the northeasterly coast of the larger Arabian Peninsula. It is bordered by Saudi Arabia to the south; otherwise the Persian Gulf surrounds the state. A strait of the Persian Gulf separates Qatar from the relatively nearby island nation of Bahrain. “Every woman is at risk for developing a gynaecologic cancer,” said Dr Jeremie Arash Rafii Tabrizi, assistant professor of genetic medicine in obstetrics and gynecology at WCMC-Q. “This year, over 78,000 women in the United States will be diagnosed, and over 28,000 will die from gynecologic cancer — and the numbers, percentage-wise, are similar in the Middle East,” he said at a lecture on Women and Cancer as a part of the WCMC-Q’s Medicine and U lecture series, recently.
“The perception of cancer is different in each society. In the Middle East in particular, the diagnosis of any cancer is associated with a high level of anxiety—and it is often viewed as having a shameful disease. The loss of fertility related to cancer treatment also can have a significant impact on women and their families.”
"Median PFS was almost 14 months with combination therapy, while sequential administration of docetaxel (Taxotere) and carboplatin was associated with a median PFS of about eight months."
Note: full text is pay-per-view
Conclusions The inclusion of newly discovered genetic factors modestly improved the performance of risk models for breast cancer. The level of predicted breast-cancer risk among most women changed little after the addition of currently available genetic information.
Wednesday, March 17, 2010
"Scientists have discovered numerous gene variants that slightly boost the risk of breast cancer, heart disease, and other common illnesses in recent years. It’s pioneering science. But is the deluge of genetic data useful for doctors and patients?..."
press release: New Data Indicate Effectiveness of Clarient's Ovotax(TM) Test for Ovarian Cancer "TLE3"
The study summary and results may be found at http://www.clarientinc.com/Ovotax
ALISO VIEJO, Calif., March 17 /PRNewswire-FirstCall/ -- Clarient, Inc. (Nasdaq: CLRT), a premier technology and services resource for pathologists, oncologists and the pharmaceutical industry, today announced that data from a new study shows that Clarient's Ovotax™ assay may effectively predict which ovarian cancer patients will respond favorably to taxane therapy and could, therefore, be spared the potential side effects of this rigorous and sometimes toxic chemotherapy agent. The study was presented yesterday at the national meeting on Women's Cancer of the Society of Gynecologic Oncologists by Janelle Fauci, M.D. of the Department of Obstetrics and Gynecology at the University of Alabama, Birmingham (UAB).
The study, titled "Expression of TLE3 Predicts Response to Taxane Therapy in Ovarian Carcinoma," included 293 carcinoma samples. Ovotax is a single antibody immunohistochemistry test created to detect the expression of TLE3 in an ovarian tumor and thereby indicate whether the patient will respond favorably to taxane therapy.
"You know what is missing in all of this is, which is the most important thing, which is what we worry about, what the minister of health worries about, is the patient. Where's the patient in all of this? Did Mr. Ritter or Dr. Lewis, or anybody who is trying to point the finger at the minister, talk about the patient?"
Wednesday, March 24
Thursday, March 25
Friday, March 26
2:00 p.m. to 5:00 p.m.
8:30 a.m. to 5:00 p.m.
8:30 a.m. to 12:30 p.m.
CONCLUSIONS: This first-ever reported case series suggests that omega-3 fatty acids may be of benefit in the management of patients with neuropathic pain. Further investigations with randomized controlled trials in a more specific neuropathic pain population would be warranted.
J Minim Invasive Gynecol. 2010 March - April
Bilateral Oophorectomy versus Ovarian Conservation: Effects on Long-term Women's Health.
John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California.
Bilateral oophorectomy at the time of hysterectomy for benign disease is commonly practiced to prevent the subsequent development of ovarian cancer. Currently, bilateral oophorectomy is performed in 55% of all U.S. women having a hysterectomy, with approximately 300 000 prophylactic oophorectomies performed every year. Observational studies show that estrogen deficiency, resulting from premenopausal or postmenopausal oophorectomy, is associated with higher risks of coronary artery disease, stroke, hip fracture, Parkinsonism, dementia, cognitive impairment, depression, and anxiety. These studies suggest that bilateral oophorectomy may do more harm than good. In women not at high risk for development of ovarian or breast cancer, removing the ovaries at the time of hysterectomy should be approached with caution.
eg. books, social media Entertaining video prepared by the UK branch of Dorling Kindersley Books. Originally meant solely for a DK sales conference, the video was such a hit internally that it is now being shared externally. ...
abstract: Should access to fertility treatment be determined by female body mass index? Human Reproduction
"Studies have shown that the direct costs per live birth are no greater for overweight and obese women..... Restricting fertility treatment on the grounds of BMI would cause stigmatization and lead to inequity, feelings of injustice and social tension as affluent women manage to bypass these draconian restrictions."
In research - selected notes:
Stem cells exist in ovarian tumors.
Tuesday, March 16, 2010
Medical News: SGO: Hint of Chemoprevention Potential for Lynch Syndrome (endometrial cancers) - in Meeting Coverage, SGO
SAN FRANCISCO -- Oral contraceptives and medroxyprogesterone acetate (MPA, DepoProvera) may have potential as chemopreventive agents for endometrial cancer in women with Lynch syndrome, biomarker data from a small randomized trial suggest.
"Despite the favorable results, Lu noted that the trial required six years to complete, as investigators in the multicenter study had to screen 708 patients to identify 51 who met entry criteria and agreed to participate, including undergoing two endometrial biopsies three months apart."
"To examine the chemopreventive effects of oral contraceptives and DepoProvera in women with Lynch syndrome, investigators conducted a randomized phase II clinical trial. They screened women with diagnosed Lynch syndrome and evaluated them with transvaginal ultrasound and endometrial biopsy."
A Phase 1 First-in-Human Study Evaluating AMG 900 in Advanced Solid Tumors - Full Text View - ClinicalTrials.gov
LOUISVILLE, Ky., (October 18, 2009)
NanoMark Therapeutics wins Ballard Morton New Venture Competition with kinder, gentler chemotherapy concept
also: Product Pipeline (2011)
(in research) as per the website:
"To alleviate the fear and provide relief to those brave patients battling with ovarian cancer, Nanomark Therapeutics (NMT) has developed the revolutionary and first product of its kind, AUra. The drug formulation is the only targeted ovarian cancer therapy in the world and works by selectively binding to receptors found exclusively on cancer cells, using the receptor as a docking station and the nanoparticles as vehicles of entry into the cell for the cancer medication.
“The absence of reporting about hospice and palliative care is significant, given the numerous well-documented benefits for patients and family members,” the researchers wrote. “Specifically, hospice programs deliver high-quality care at the end of life, with excellent patient and family satisfaction, reduced costs and decreased suffering at the end of life.”
Note: Cryotherapy "Interventional Radiologists Pioneer Potential Treatment for Cancer That Has Metastasized to Soft Tissues (Such as Ovarian Cancer) and Bones; Seen as Option for Those Who Are Not Candidates for Surgery"
Note: factors/needs affecting physicians taking care of patients
Impact of the Cost of Cancer Treatment: An Internet-Based Survey -- Markman and Luce 6 (2): 69 -- Journal of Oncology Practice
Note: abstract only, did not include ovarian cancer patients Conclusion: This survey suggests that a substantial proportion of patients and their families experience considerable distress associated with the cost of cancer care delivery. Furthermore, these costs affect the decision of patients with cancer to receive recommended treatment. This is a particularly serious issue for individuals with a modest annual income.
"...many surgical treatments have become far less disfiguring."
"However, the ACS experts note that researchers have yet to find screening tests and effective therapies for other highly lethal types of cancer, such as lung, liver, ovarian, pancreatic, and brain cancer."
"The epidemic of overweight and obesity—which is associated with the incidence of many types of cancer—during the past 2 decades in the United States has created a new public health challenge, and it is unclear how it is affecting cancer incidence rates currently and in the future," Gapstur and Thun write.
Note: full access (pdf)
"Between 2002 and 2005 in Ontario, 91 561 patients died of cancer and were included in our cohort."
"...The other highly ranked diagnoses that were common to both periods were abdominal pain, dyspnea, pneumonia, malaise and fatigue, and pleural effusion. A notable difference between the two time periods was the rank of cardiac arrest, which ranked 16th among diagnoses made for visits during the final two weeks but 61st among those made for visits during the final six months. Palliative care, dehydration and altered level of consciousness ranked much higher for the final two-week period than for the six-month period. No specific code exists for pain-related crisis...".
"Clinical descriptions of patients or families as no longer “coping” at home are common."
In today’s Science Times, Harriet Brown discusses how, in a time of public acceptance and tolerance of differences, the stigma of being obese may be at an all-time high:
"Public attitudes about fat have never been more judgmental; stigmatizing fat people has become not just acceptable but, in some circles, de rigueur. I’ve sat in meetings with colleagues who wouldn’t dream of disparaging anyone’s color, sex, economic status or general attractiveness, yet feel free to comment witheringly on a person’s weight."
(links to articles) A special issue of Science Times looks at the explosion of information about health and medicine — on the Web, in medical journals, in the doctor’s office and over the air — and offers some guidelines on how to sort it all out.
You’re Sick. Now What? Knowledge Is Power.
Are patients swimming in a sea of health information? Or are they drowning in it?
Searching for Clarity: A Primer on Medical Studies
You Can Find Dr. Right, With Some Effort
What’s Behind an F.D.A. Stamp?
Logging On for a Second (or Third) Opinion
Applying Science to Alternative Medicine
While sweeping claims are often made for alternative medicine treatments, the scientific evidence for them often lags behind.
How a Patient Can Help a Doctor Give the Best Care
Note: this article has free access (with free registration)
"..The notion that individuals who adopt a positive outlook improve their chances of surviving cancer has been controversial among the medical community, but is widely accepted in patient culture...."
Note: This blog also gives lists of links to other sites such as: patient assistance programs (meds), receipes, healthy lifestyle, common myths, vegetarians etc
Monday, March 15, 2010
EvidenceUpdates: A randomized, double-blind, placebo-controlled trial evaluating the efficacy and safety of ABT-594 in patients with diabetic peripheral neuropathic pain.
Note: meds in diabetic neuropathic pain are also used in cancer related neuropathic pain (consult oncologist)
Medical News: SGO: Drug Combination Slows Recurrent Ovarian Cancer - in Meeting Coverage, SGO (Avastin)
2009 full free access: New Roles for Copper Metabolism in Cell Proliferation, Signaling, and Disease (chelation)
Sunday, March 14, 2010
"Mirtazapine is a promising agent for the treatment of CRCA."
The effect of primary cytoreduction on outcomes of patients with FIGO stage IIIC ovarian cancer stratified by the initial tumor burden in the upper abdomen cephalad to the great omentum
The effect of primary cytoreduction on outcomes of patients with FIGO stage IIIC ovarian cancer stratified by the initial tumor burden in the upper abdomen cephalad to the greater omentum.
definition: cephalad ceph·a·lad (sěf'ə-lād') adv. Toward the head or anterior section.
- Canadian Residents only, please direct all Billing inquiries to
Low probability of malignancy <5.0
High probability of malignancy ≥5.0
Low probability of malignancy <4.4
High probability of malignancy ≥4.4
The OVA1™ Test is an aid to further assess the likelihood that ovarian malignancy is present when the physician's independent clinical and radiological evaluation does not indicate malignancy.
The OVA1 test uses results of 5 biomarkers (β2-microglobulin, apolipoprotein A1, CA 125, transferrin, transthyretin [prealbumin]) to generate a single numerical score between 0 and 10 that indicates the likelihood of malignancy.
The OVA1 test was validated using a blood sample from 269 women, 72 of whom had a pathology-determined malignancy. When pre-surgical assessment was combined with results from the OVA1 test, the following results were concluded:
- Sensitivity for malignancy increased by 20% from 72% to 92% In all women, and as high as 96%in postmenopausal women,
- Approximately 70% of the malignancies missed by pre-surgical assessment alone were identified by OVA1
- A high negative predictive value (NPV-93%) strengthened the prediction that cancer is absent
- NPV was similar in pre- and postmenopausal women."
Saturday, March 13, 2010
Sorafenib in combination with carboplatin and paclitaxel as neoadjuvant chemotherapy in patients with advanced ovarian cancer.
RESULTS: .....Four patients were enrolled. After preoperative treatment and cytoreductive surgery, all patients were excluded from protocol due to severe toxicities. Three patients had life threatening events (cardiac output failure, myocardial infarction, anastomotic leak); two patients had primary progressive disease.
CONCLUSION: The addition of sorafenib to carboplatin/paclitaxel chemotherapy was not feasible within this neoadjuvant regimen in primary advanced ovarian cancer. Although the occurrence of serious adverse events might have emerged at random, a detrimental effect of preoperative study medication could not be denied. Further evaluations of sorafenib in ovarian cancer are warranted.
abstract/free full text: MicroRNA profiling of BRCA1/2 mutation-carrying and non-mutation-carrying high-grade serous carcinomas of ovary
CONCLUSIONS/SIGNIFICANCE: High grade serous ovarian carcinomas with and without BRCA1/2 abnormalities demonstrate very similar miRNA expression profiles. High grade serous carcinomas as a group exhibit significant miRNA dysregulation in comparison to tubal epithelium and the levels of miR-34c and miR-422b appear to be prognostically important. full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2749450/?tool=pubmed
abstract: Administration of cisplatin in three patients with carboplatin hypersensitivity: is skin testing useful?
In Research: Gene Expression Profile for Predicting Survival in Advanced-Stage Serous Ovarian Cancer Across Two Independent Datasets (Japan)
Patients with advanced-stage ovarian cancer generally undergo primary debulking surgery followed by platinum/taxane-based chemotherapy. Although postoperative introduction of taxane drug has improved the 5-year survival rate for advanced-stage ovarian cancer..... Clinicopathological characteristics, such as debulking status after primary surgery, are clinically considered important indicators of prognosis. However, recurrence after optimal debulking surgery occurs in some patients, while disease-free status after incomplete surgery is maintained in others......Therefore, these clinicopathological factors alone are insufficient for predicting prognosis and elucidating the pathological mechanisms of disease progression or recurrence. Molecular biology approaches can be used to identify new prognosis-related profiles leading to elucidation of pathological issues of advanced-stage serous ovarian cancer.
Meanwhile, there are no microarray kits for clinical diagnosis and management in patients with ovarian cancer yet."
TORONTO -- 03/12/10 -- The Ontario Institute for Cancer Research (OICR) today announced a significant investment toward the development of two new promising cancer therapies. The recipients of the awards are:
Sunnybrook Health Sciences Centre, for Kullervo Hynynen's low-cost focused ultrasound system. This system can find and destroy tumors without surgery, increasing quality of life and lowering the cost of treatment for patients with inoperable bone and liver cancer. Hynynen will use the investment from OICR to develop a complete prototype and perform pre-clinical testing of the new system.
OncoTek Drug Delivery Inc., for Joseph Elliot's preclinical development of PoLi-PTX, an intraperitoneal ovarian cancer therapy invented by Drs. Christine Allen and Micheline Piquette-Miller at the University of Toronto, which would deliver localized cancer killing agents to the abdominal cavity with fewer side effects than traditional systemic chemotherapy.
"Both these therapies promise to provide patients and physicians with new tools to treat cancer that are less expensive or more effective than traditional treatments while vastly improving patients' quality of life," said Dr. Tom Hudson, President and Scientific Director of OICR. "This investment will help to make both therapies a reality."...cont'd
Phase 2 study of canfosfamide in combination with pegylated liposomal doxorubicin in platinum and paclitaxel refractory or resistant epithelial ovarian cancer
Abstract/full free pdf: published March 11, 2010
Women who were at least 18 years old with recurrent, histologically confirmed epithelial ovarian, primary peritoneal, or fallopian tube cancer; measurable disease as defined
by RECIST; had received at least 1 but fewer than 4 prior platinum-containing chemotherapy regimens; at least 1 prior paclitaxel-containing regimen; and considered platinum refractory or resistant disease according to the standard GOG criteria (had progressed during or had persistent disease after completion of platinum-based therapy or had a platinum-free interval of < 6 months) were enrolled. There were no additional limits to lines of therapy.
Difficulty Accepting a Terminal Prognosis Linked with Depression, Anxiety, and Suffering -- A Cancer Journal for Clinicians
Note: VERY SENSITIVE TOPIC Dissenting Opinion
Not all clinicians agree with the foregoing interpretations of these findings. "I've certainly seen people who denied dying up to their last breath and somehow never accepted it," Dr. Holland tells CA. "Were they more upset? I'm not sure."
She cautioned against allowing the findings by Dr. Thompson and colleagues to set a tone in which nonaccepting patients are viewed as dysfunctional. Death is as individualized as is life, she argues, invoking Sir William Osler, who said "Basically, people die as they have lived."
Note: variety of different types of studies/locations
Friday, March 12, 2010
Approaches to Phase 1 Clinical Trial Design Focused on Safety, Efficiency, and Selected Patient Populations: A Report from the Clinical Trial Design Task Force of the National Cancer Institute Investigational Drug Steering Committee — Clinical Cancer Research
Abstract: Approaches to Phase 1 Clinical Trial Design Focused on Safety, Efficiency, and Selected Patient Populations: A Report from the Clinical Trial Design Task Force of the National Cancer Institute Investigational Drug Steering Committee — Clinical Cancer Research Steering Committee 1. S. Percy Ivy1, 2. Lillian L. Siu2, 3. Elizabeth Garrett-Mayer3 and 4. Larry Rubinstein1 + Author Affiliations 1. Authors' Affiliations:1Investigational Drug Branch and Biometrics Research Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland; 2Princess Margaret Hospital, Toronto, Canada; and 3Medical University of South Carolina, Charleston, South Carolina 1. Corresponding Author: S. Percy Ivy, Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, 6130 Executive Blvd, Suite 7131, Rockville, MD 20852. Phone: 301-496-1196; Fax: 301-402-0428; E-mail: firstname.lastname@example.org.
Abstract The goals and objectives of phase 1 clinical trials are changing to include further evaluation of endpoints such as molecular targeted effects, in addition to dose-toxicity profile of the investigational agent. Because of these changes in focus, the National Cancer Institute and Investigational Drug Steering Committee's Task Force on Clinical Trial Design met to evaluate the most efficient ways to design and implement early clinical trials with novel therapeutics. Clinical approaches discussed included the conventional 3 + 3 cohort expansion phase 1 design, multi-institutional phase 1 studies, accelerated titration designs, continual reassessment methods, the study of specific target patient populations, and phase 0 studies. Each of these approaches uniquely contributes to some aspect of the phase 1 study, with all focused on dose and schedule determination, patient safety, and limited patient exposure to ineffective doses of investigational agent. The benefit of labor-intensive generation of preliminary biomarker evidence of target inhibition, as well as the value of molecular profiling of the study population, is considered. New drug development is expensive and the failure rate remains high. By identifying patient populations expected to respond to the study agent and tailoring the treatment with a novel drug, investigators will be one step closer to personalizing cancer treatment. The “fail early and fast” approach is acceptable if the appropriate patient population is evaluated in the phase 1 trial. The approaches outlined in this overview address the merits, advantages, disadvantages, and obstacles encountered during first in human studies. Clin Cancer Res; 16(6); 1726–36
FDA Reassures on Osteoporosis Drugs
"Bisphosphonate drugs for osteoporosis do not seem to increase the risk of femoral fractures, the FDA announced Wednesday, though the agency will continue to evaluate that possibility.
Even as the FDA was making its announcement in Washington, orthopedic surgeons gathered in New Orleans were hearing news of a study showing an eventual decline in bone quality among patients who took bisphosphonates for more than four years.
The FDA issued its statement as a result of case reports suggesting that "atypical" subtrochanteric femur fractures were occurring at higher-than-expected rates in women taking bisphosphonate drugs for osteoporosis....."
Breast cancer susceptibility variants alter risks in familial disease -- Latif et al. 47 (2): 126 -- Journal of Medical Genetics
This study confirms that susceptibility variants in FGFR2, TOX3 and MAP3K1 and on chromosome 8q are all associated with increased risk of cancer in individuals with a family history of breast cancer, whereas CASP8 is protective in this context. The level of risk is dependent on the strength of the family history and the presence of a BRCA1/2 mutation and contributes to the understanding of the use of these variants in clinical risk prediction."
"FREMONT, Calif., March 12, 2010 /PRNewswire via COMTEX/ -- Vermillion, Inc. (Pink Sheets: VRML) today announced that Medicare will cover OVA1(TM), a test to help assess the likelihood that an ovarian mass is benign or malignant. Highmark Medicare Services is the CMS contractor that will process Medicare claims for OVA1. Yesterday Highmark announced its decision to cover this new service....."
financial news: short excerpts/overview from article: Avastin- UPDATE 3-Roche's Avastin fails in prostate cancer study (see comments ovarian)
UPDATE 3-Roche's Avastin fails in prostate cancer study
Fri Mar 12, 2010 6:35am EST
* Treatment doesn't prolong life in late stage patients prostate cancer patients (combination therapy phase 111)
* Some adverse effects seen, already noted in other trials
* Follows recent ovarian cancer success and gastric failure
By Martin de Sa'Pinto and Ben Hirschler
"ZURICH/LONDON, March 12 (Reuters) - Roche Holding AG's (ROG.VX) Avastin did not help men with late stage prostate cancer live longer in a clinical trial, marking another setback for the Swiss group as it tries to extend use of the blockbuster drug into new areas.
The miss in prostrate cancer, announced on Friday, follows similar disappointment last month with Avastin in gastric cancer but success in ovarian cancer. (note: GOG trials prior blog postings)
Thursday, March 11, 2010
NO abstract:CA-125 Monitoring in Ovarian Cancer: Patient Survey Responses to the Results of the MRC/EORTC CA-125 Surveillance Trial
Future Oncology-full text: DNA methylation-based fecal biomarkers for the noninvasive screening of GI cancers
"The next obvious question is “Are we there yet?”
Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners' Oral Contraception Study -- Hannaford et al. 340: c927 -- BMJ
Objective: To see if the mortality risk among women who have used oral contraceptives differs from that of never users.
Design: Prospective cohort study started in 1968 with mortality data supplied by participating general practitioners, National Health Service central registries, or both.
Setting: 1400 general practices throughout the United Kingdom.
Participants: 46 112 women observed for up to 39 years, resulting in 378 006 woman years of observation among never users of oral contraception and 819 175 among ever users.
....1747 deaths occurred in never users of oral contraception and 2864 in ever users. Compared with never users, ever users of oral contraception had a significantly lower rate of death from any cause (adjusted relative risk 0.88, 95% confidence interval 0.82 to 0.93). They also had significantly lower rates of death from all cancers; large bowel/rectum, uterine body, and ovarian cancer; main gynaecological cancers combined; all circulatory disease; ischaemic heart disease; and all other diseases...cont'd
click on the title to view the pdf file:
"Special Concerns About Bisphosphonates"
Reduced Registration Rate for Patient Advocates (for non-exhibitors)
If you represent a patient advocacy organization, you may be eligible for the discounted patient advocate registration rate of $255 per person on or before April 28, 2010, and $330 per person beginning April 29, 2010. Up to two representatives per organization may register at this discounted rate. The discounted registration rate for patient advocates is reserved exclusively for advocates who work or volunteer for not-for-profit patient advocacy organizations that provide programs, services, and support for people with cancer. People that register under this category may be asked to provide a curriculum vitae or resume, outlining their advocacy roles and experience. Please download a patient advocate registration form if you are a patient advocate and meet the registration criteria.
ASTRO has just completed a new section on radiation therapy for brain metastases.
We’d love any feedback from patient educators or patients on how we can make it better.
Katherine Egan Bennett
Director of Communications
American Society for Radiation Oncology
"Many patients find themselves asking: What now?
"When you lose the security of knowing that you're acting toward curing your cancer, it's really scary," said Barbara Platzer, 72, of Chesterfield, who finished treatments for ovarian cancer three years ago. "Every time I'd go for chemotherapy, I'd have a doctor looking at me and doing lab tests where I'd see that my (cancer antigen-125) numbers were improving. And that made me feel secure, like I had control over what was happening. I felt like we were actively killing the cancer.""
Mar 2010 abstract: Incidence and management of (Avastin) bevacizumab-associated gastrointestinal perforations in patients with recurrent ovarian carcinoma
METHODS: We identified all patients who received bevacizumab off protocol from August 2004-August 2008. We examined their medical records for reports of confirmed GI perforation, associated clinicopathological factors, treatment, and outcomes. RESULTS: Six (4%) of 160 patients with ovarian carcinoma who had been treated with bevacizumab developed GI perforation.
"These studies provide further information that regular dietary soy as part of a normal diet is probably safe and, in fact, may be beneficial for women with breast cancer. These studies, as well as others, create a growing body of evidence that the current advice that all soy foods should be removed from the diet of a woman diagnosed with breast cancer is probably untrue.
The role of non-dietary soy products such as soy supplements, powders or pills and the use of heavily processed soy items such as soy cheese, soy hot dogs or soy turkey remain unclear and should be avoided.
As the research to date is observational in nature, future randomized trials are needed to verify if a beneficial effect truly exists for the use of dietary soy."
Note: this is not new news but has been reported over the past few years
PHILADELPHIA -- March 10, 2010 -- An article published in the March/April issue of The Journal of Minimally Invasive Gynecology suggests that bilateral oophorectomy may do more harm than good.
Deficiency of knowledge of genetics and genetic tests among general practitioners, gynecologists, and pediatricians: A global problem
Conclusion: The overall knowledge levels of genetics in many nongeneticist health care providers show clear deficiencies. This is in line with reports from other countries, showing that these deficiencies are a global problem.
The Missing Voice of Patients in Drug-Safety Reporting
A patient wants to know about symptoms she may have from a prescription drug she is taking. Consulting the label’s “Adverse Reactions” section, she finds a wealth of data. Little does she realize that this information, largely collected during clinical trials, is based almost entirely on clinicians’ impressions of patients’ symptoms — not on patients’ own firsthand reports of their experiences with the drug.
The current drug-labeling practice for adverse events is based on the implicit assumption that an accurate portrait of patients’ subjective experiences can be provided by clinicians’ documentation alone. Yet a substantial body of evidence contradicts this assumption, showing that clinicians systematically downgrade the severity of patients’ symptoms, that patients’ self-reports frequently capture side effects that clinicians miss, and that clinicians’ failure to note these symptoms results in the occurrence of preventable adverse events.1,2...continued
Wednesday, March 10, 2010
Note: Medscape requires registration (free)
References: Citation: Oktay K, Kim JY, Barad D, et al. Association of BRCA1 mutations with occult primary ovarian insufficiency: a possible explanation for the link between infertility and breast/ovarian cancer risks. J Clin Oncol. 2009;28:240-244. Available at: http://www.medscape.com/medline/abstract/19996028.
Public release date: 10-Mar-2010 AACR conference
Scientists identify microRNA as possible cause of chemotherapy resistanceDEAD SEA, Jordan — Scientists may have uncovered a mechanism for resistance to paclitaxel in ovarian cancer, microRNA-31, suggesting a possible therapeutic target for overcoming chemotherapy resistance.
Mohamed K. Hassan, Ph.D., a postdoctoral fellow at Hokkaido University in Japan, completed the research as a collaborative study with his colleagues when he was a professional assistant in South Valley University in Egypt. Results of this study were presented at the second AACR Dead Sea International Conference on Advances in Cancer Research: From the Laboratory to the Clinic, held March 7-10, 2010.
"MicroRNAs do not code protein, but they regulate other proteins' expression," said Hassan. "So identifying any microRNA as responsible for chemoresistance is, in fact, introducing a real reason for the mechanism."
Ovarian cancer is typically responsive to chemotherapy with paclitaxel, but sometimes cancer cell lines become resistant, which renders chemotherapy useless. Hassan's research team analyzed a set of microRNAs and identified microRNA-31 as being responsible for this chemoresistance. MicroRNA-31 regulates the protein IFITM-1.
"We need to further verify this observation in clinical ovarian cancer samples and find a way to inhibit this target protein to improve the effect of paclitaxel and prevent the risk of recurrence," he said.
full free access: Journal of Hematology & Oncology - Ovarian cancer immunotherapy: opportunities, progresses and challenges
Due to the low survival rates from invasive ovarian cancer, new effective treatment modalities are urgently needed. Compelling evidence indicates that the immune response against ovarian cancer may play an important role in controlling this disease. We herein summarize multiple immune-based strategies that have been proposed and tested for potential therapeutic benefit against advanced stage ovarian cancer.(see tables 2 & 3)
Note: the EGAPP group published several papers in 2009
(EGAPP supplementary evidence review DNA testing strategies aimed at reducing morbidity and mortality in Lynch Syndrome; Methods of the EGAPP Working Group Lynch Syndrome; Recommendations EGAPP Working Group testing strategies to reduce morbidity and mortality in Lynch Syndrome)
Also: search this blog for 'EGAPP' for additional references such as:
Saturday, June 27, 2009
"The EGAPP Working Group concluded that all people with a new diagnosis of colorectal cancer should be offered counseling and educational materials about genetic testing for Lynch syndrome.
The EGAPP™ Working Group is an independent, non-governmental panel of scientists and health care experts from universities, industry, clinical practice, insurance companies, and public health who review available research and evidence to make recommendations about the use of genetic tests."
Lynch Syndrome Associated Breast Cancers: Clinicopathologic Characteristics of a Case Series from the Colon Cancer Family Registry Clinical Cancer Research
Purpose: The recognition of breast cancer as a spectrum tumor in Lynch syndrome remains controversial. The aim of this study was to explore features of breast cancers arising in Lynch syndrome families.
(Breast cancers were reviewed by one pathologist. Tumor sections were stained for MLH1, PMS2, MSH2, and MSH6, and underwent microsatellite instability testing)
Conclusions: MMR deficiency was identified in 51% of breast cancers arising in known mutation carriers. Breast cancer therefore may represent a valid tissue option for the detection of MMR deficiency in which spectrum tumors are lacking.
Defective mismatch repair, microsatellite mutation bias, and variability in clinical cancer phenotype
Cancer Res. 2010 Jan 15
Shah SN, Hile SE, Eckert KA.
Department of Pathology, Gittlen Cancer Research Foundation, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
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 (Lynch Syndrome) 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.
Comparison of treatment received versus long-standing guidelines for stage III colon and stage II/III rectal cancer patients diagnosed in Alberta, Sas
Comparison of treatment received versus long-standing guidelines for stage III colon and stage II/III rectal cancer patients diagnosed in Alberta, Saskatchewan, and Manitoba in 2004
CONCLUSION: The percentage of patients receiving guideline-recommended treatment is low. Reasons for lack of adherence to guidelines need to be addressed.
Note: the microsatellite test (MSS = stable; MSI-L = low; MSI-H = high) is a blood test and has also been studied in ovarian cancers
"Recent body mass index (people over 30 kg/m2 or more, the cut off for obesity) was positively associated with overall risk of colorectal cancer for men and women combined. It was also associated with risk of MS-stable and MSI-low colorectal tumors, but not with the risk of MSI-high tumors."
A High Proportion of DNA Variants of BRCA1 and BRCA2 Is Associated with Aberrant Splicing in Breast/Ovarian Cancer Patients
Conclusions: An important fraction of DNA variants of BRCA1/2 presents splicing aberrations that may represent a relevant disease-causing mechanism in HBOC.
Note: short news report "The data cover 1970 (the year before President Nixon declared a "War on Cancer") through 2006."
Tuesday, March 09, 2010
Phase I trial of ATRA-IV and Depakote in patients with advanced solid tumor malignancies.
David KA, Mongan NP, Smith C, Gudas LJ, Nanus DM.
Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College - New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA.
Retinoic acid derivatives have shown their greatest benefit in acute promyelocytic leukemia, but have also demonstrated pre-clinical anti-cancer effects in some solid tumors. Histone deacetylase inhibitors, by upregulating gene expression, are able to limit cancer cell proliferation and induce apoptosis. The combination of all-trans retinoic acid (ATRA) and the histone deacetylase inhibitor valproic acid has been previously studied in hematologic malignancies. We conducted a phase I two-step dose escalation trial of the liposomal ATRA analog ATRA-IV and divalproex sodium (Depakote((R))) in nine patients with advanced solid tumors refractory to prior therapy. Side effects attributed to therapy had a severity =grade 2 and included skin toxicity and thrombocytopenia. The best disease response seen was disease stabilization in one patient. Expression of cellular retinoic acid binding protein-2 in peripheral blood mononuclear cells was detected as a marker of drug effect. The maximum tolerated dose (MTD) of both drugs in combination could not be established due to early closure of the trial resulting from a halt in the commercial availability of ATRA-IV.
"According to a recent NCI survey, the public’s trust in their physicians has continued to rise in spite of the fact that people report turning to the Internet first for their health information needs. In contrast, trust in the Internet and other more traditional sources such as television has been on the decline. The survey also showed a consistent increase in the number of Americans who communicate with their doctors through e-mail. A letter about the findings from staff who oversee NCI’s Health Information National Trends Survey (HINTS) appeared March 4 in the New England Journal of Medicine.
NCI U.S. - NCI Recovery Act Web Site Features Comparative Effectiveness Research and ACTNOW Trial Details
NCI’s Recovery Act Web site also features a list of the clinical trials supported by NCI’s Accelerating Clinical Trials of Novel Oncologic PathWays (ACTNOW) initiative. The ACTNOW trials are high-priority, early-phase clinical trials of new cancer treatments being studied on an accelerated timeline in a variety of cancer types. The accelerated timeline is intended to shorten the time between drug discovery and approval and safe use of these treatments by cancer patients. The trials include a significant number of correlative studies, including studies of biologic and imaging tests.
The Web page lists the ACTNOW trials by cancer type and contains links to descriptions of the trials, including the objectives, patient enrollment criteria, and current trial locations.
- Case Scenarios
news: Colorado's Online News Leader - Making sure those with breast cancer get help (and ovarian cancer COCA)
"The BWRC Fund has also helped expand cancer education programs across the state. Survivors Teaching Students, a program sponsored by the Colorado Ovarian Cancer Alliance (COCA), brings ovarian cancer survivors into the lives of medical students with the goal of helping them become more sensitive to the symptoms of and risk factors for ovarian cancer.
"The majority of ovarian cancer cases are not diagnosed until the disease is advanced and women's survival is compromised, so the key to treatment is early diagnosis," said Lucy Trujillo, COCA executive director and ovarian cancer survivor."
"Range of gynecologic oncology research is as impressive as pace" "These abstracts are indicative of the high-quality research being conducted in our sub-specialties," said Dr. David G. Mutch, president of the SGO. "It is very encouraging to see the frequency with which important results are becoming available and we are thrilled to be able to showcase these studies at our Annual Meeting, where our colleagues from across the country and the world can evaluate the findings and learn about the latest approaches."
The Clinical Trials and Translational Research Advisory Committee (CTAC) meets three times annually to provide strategic advice regarding NCI’s clinical trials and translational research portfolio and processes. In order to make this dialogue transparent and available to the public these meetings will be webcast at http://videocast.nih.gov/. The next meeting is scheduled for Wednesday, March 10th from 8a to 3:30pm. We encourage you to tune in and learn more. This meeting will include: · A report from the Operational Efficiency Working Group on how to make the clinical research process more efficient · An update from the NCI Director · An update on Comparative Effectiveness Research (CER) funding and a future vision for CER and Cancer · Information about the new NCI Cancer Human Biobank or caHUB A full agenda is available at http://deainfo.nci.nih.gov/advisory/ctac/0310/agenda.pdf. Shannon K. Bell, MSW Director, Office of Advocacy Relations, NCI Bldg 31 Rm 10A28, 301-451-3393 Key info about NCI: http://www.cancer.gov/aboutNCI/servingpeople
CONCLUSIONS: With surveillance intervals of 1-2 years, members of families with Lynch Syndrome have a lower risk of developing CRC than with surveillance intervals of 2-3 years. Because of the low risk of CRC in non-Lynch Syndrome families, a less-intensive surveillance protocol can be recommended.
"Overall, 34 organizations were identified, 7 international organisations, and 27 organisations operating on the national level in four different countries (Australia, Canada, UK and United States).....Indeed, the consistency of end-of-life choices with the patient's wishes, as well as completion and meaningfulness at the end of life is given only a minor relevance."
full access: Journal of Ovarian Research BRCA1/2 genetic background-based therapeutic tailoring of human ovarian cancer : hope or reality?
All together these findings introduce a provocative novel scenario where BRCA1/2 carcinogenetic process in the hereditary setting produces novel opportunities for pharmacological intervention. Apart novel drugs like PARP inhibitors, these findings may allow a different and more rational approach for the treatment of BRCA1/2 related ovarian tumors by currently available drugs.
Outcomes of Fertility-Sparing Surgery for Stage I Epithelial Ovarian Cancer: A Proposal for Patient Selection -- abstract
Conclusion: Our data confirm that fertility-sparing surgery is a safe treatment for stage IA patients with favorable histology and suggest that stage IA patients with clear cell histology and stage IC patients with favorable histology can be candidates for fertility-sparing surgery followed by adjuvant chemotherapy.
full access: The Prognostic Value of BRCA1 mRNA Expression Levels Following Neoadjuvant Chemotherapy in Breast Cancer
Background A fraction of sporadic breast cancers has low BRCA1 expression. BRCA1 mutation carriers are more likely to achieve a pathological complete response with DNA-damage-based chemotherapy compared to non-mutation carriers. Furthermore, sporadic ovarian cancer patients with low levels of BRCA1 mRNA have longer survival following platinum-based chemotherapy than patients with high levels of BRCA1 mRNA. Conclusions/Significance We provide evidence for a major role for BRCA1 mRNA expression as a marker of time to progression and overall survival in sporadic breast cancers treated with anthracycline-based chemotherapy. These findings can be useful for customizing chemotherapy
CONCLUSIONS/SIGNIFICANCE: We provide evidence for a major role for BRCA1 mRNA expression as a marker of time to progression and overall survival in sporadic breast cancers treated with anthracycline-based chemotherapy. These findings can be useful for customizing chemotherapy.
Note: selected cases (Oncotype DX test)
Monday, March 08, 2010
"....This story illustrates one of many ways of healing. Healing is always possible, even when cure is beyond reach, even when physical pain cannot be relieved. Healing, in this sense, involves restoring a sense of sacredness and wholeness that no living experience, including terminal disease, can take away. Healing involves making sense of one's death in the context of one's life...."
Choice of Starting Dose for Molecularly Targeted Agents Evaluated in First-in-Human Phase I Cancer Clinical Trials
Purpose: One tenth of the lethal dose to 10% of mice is one of the conventional parameters used to derive a safe starting dose in phase I trials of cytotoxic agents. There is no consensus on which preclinical models and parameters should define the starting dose for molecularly targeted agents.
Note: no mention of cost
"NEW YORK — Medical lab operator Quest Diagnostics Inc. said Monday it is selling the OVA1 blood test, which aims to better assess a woman's likelihood for ovarian cancer.
The OVA1 test, which was approved by the Food and Drug Administration in September, will be sold through Quest, based in Madison, N.J. The test was developed in collaboration with molecular diagnostics company Vermillion Inc....OVA1 is used as a pre-surgical evaluation of a woman's ovarian mass for cancer. It allows physicians to assess, before a planned surgery, the likelihood that a woman's ovarian mass is malignant. The test allows physicians to direct the patient to a specialist more quickly, the company said.....
Nektar Reports Positive Phase 2 Clinical Data From First Stage Of NKTR-102 Study In Women With Platinum-Resistant Ovarian Cancer - Quick Facts
Note: warning on stats in article
"The Phase 2 study has now completed enrollment with a total of 71 patients treated. The study is ongoing. Full data are expected to be presented at a major scientific conference in 2010."
"Archexin is a first in class, potent inhibitor of Akt protein kinase in the treatment of cancer. Akt regulates signal processes of cell proliferation and survival, angiogenesis, and drug resistance in cancer. Archexin is being developed to treat solid tumors and has FDA Orphan drug designation for RCC, pancreatic, stomach, glioblastoma, and ovarian cancers. Archexin is in Phase II clinical development for pancreatic cancer as lead indication."
For those interested 2/2010 (3) job postings: Recruiter positions (Calgary/Edmonton/Vancouver)
Sunday, March 07, 2010
Efficacy of intranasal fentanyl spray versus other opioids for breakthrough pain in cancer; Current Medical Research and Opinion
Objective: To compare the efficacy of intranasal fentanyl spray (INFS), oral transmucosal fentanyl citrate (OTFC), fentanyl buccal tablet (FBT) and oral morphine (OM) for the treatment of breakthrough cancer pain (BTCP).
Conclusion: Based on currently available evidence, INFS is expected to provide the greatest improvement in the treatment of BTCP. Due to its slow onset to effect OM cannot be considered an efficacious treatment for BTCP.
The BEAT ovarian cancer campaign is the first to engage GPs, women and ovarian cancer charities around the world. It has as its centre piece an easy to remember acronym:
B for bloating that is persistent and doesn't come and go;
E for eating less and feeling fuller;
A for abdominal pain; and
T for telling your GP.
Note: plain english, many topics
"Hello, I am Avril Morrison and I run this website “Understanding Cancer”. I’m a scientist and I write about cancer research and cancer information on the web."
UK Patient Education site: VEGF How can we stop the blood supply to cancer cells? « Understanding Cancer
Note: the UK is very good at plain english and often and as best possible uncomplicates the technical language
repost: Combination therapy: intermittent Sorafenib with (Avastin) bevacizumab yields activity and decreased toxicity.
Definitions of VEGF on the Web:
* Vascular endothelial growth factor (VEGF) is a chemical signal produced by cells that stimulates the growth of new blood vessels. ...
* Stimulates the growth of blood vessels.
* A protein that is secreted by oxygen-deprived cells, such as cancerous cells. VEGF stimulates new blood vessel formation, or angiogenesis, by binding to specific receptors on nearby blood vessels, encouraging new blood vessels to form.
* A protein that binds to receptors on epithelial cells and promotes their growth, stimulates angiogenesis, and increases permeability of the ...
* Substances produced by diseased tissues or rapidly growing tissues which play an important role in the formation of abnormal blood vessels and ...
* VEGF promotes venous, venule, artery, arteriole and capillary health by providing the essential cofactors for repairing and restoring damaged vessels.
abstract: From the endometrium physiology to a comprehensive strategy for the discovery of ovarian cancer biomarkers
"After literature review, we could classify the molecules involved in ovulation and menstruation pathways in three main categories: proteases, proteases inhibitors and cell-surface protectors. Strikingly, all validated biomarkers for ovarian cancers belong to at least one of these categories."
"New data indicate that there is marked variability in the intensity of patient surveillance after curative-intent treatment for ovarian cancer. The results were released here on March 6 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO)....The authors said that their study is the first to describe the self-reported practice of experienced clinicians who treat ovarian cancer patients.."
Search of: avastin + chemo + ovarian + Texas = 3 open trials
Search of: avastin + chemo + - 14 open clinical trials listed - ClinicalTrials.gov
Note: must register to access (free):
Review individual CME programs on Ovarian Cancer related topics:
* Beyond Chemotherapy: Current and Future Molecular-Targeted Therapy in Ovarian Cancer
* Managing Ovarian Cancer Recurrence: Coupling Novel Therapeutics With Optimal Treatment Decisions
* Optimizing Treatment Choices in Ovarian Cancer
On the development of a decision support intervention for mothers undergoing BRCA1/2 cancer genetic testing regarding communicating test results....
On the development of a decision support intervention for mothers undergoing BRCA1/2 cancer genetic testing regarding communicating test results to their children
ConclusionsEven 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.
A case of Peutz-Jeghers syndrome with breast cancer, bilateral sex cord tumor with annular tubules, and adenoma malignum caused by STK11 gene mutation.
Clements A, Robison K, Granai C, Steinhoff MM, Scalia-Wilbur J, Moore RG.
Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, RI, USA.
BACKGROUND: Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant disorder, and women with this syndrome are at an increased risk of developing intestinal and extraintestinal malignancies including breast and gynecologic malignancies. This case report presents a patient with PJS with a concomitant breast cancer, bilateral stromal tumors with annular tubules of the ovaries, and adenoma malignum of the cervix.
A Recipe for Proteomics Diagnostic Test Development: The OVA1 Test, from Biomarker Discovery to FDA Clearance
Note: partial document
Note: sign on with password (free)
This website has many good reference sources for ovarian cancer including links to the research - a compilation of information/clinical trial results/discussions amongst researchers/physicians. Most of these papers are available freely from many different sources and have been posted on this blog as well.
try a search for 'ovarian cancer':
E-Updates in Ovarian Cancer
Contemporary Management of and Future Directions in Ovarian Cancer
Saturday, March 06, 2010
Gynecologic Oncology Group (GOG) Notifies CTI That Continuation of GOG-212 Pivotal Trial of OPAXIO Maintenance Therapy... -- SEATTLE, March 4 /PRNewswire-FirstCall/ --
Gynecologic Oncology Group (GOG) Notifies CTI That Continuation of GOG-212 Pivotal Trial of OPAXIO Maintenance Therapy in Front Line Ovarian Cancer Remains High Priority
GOG-218 Bevacizumab Results Do Not Influence Importance of GOG-212
SEATTLE, March 4 /PRNewswire-FirstCall/ -- Cell Therapeutics, Inc. ("CTI") (Nasdaq and MTA: CTIC) announced today that CTI received a statement on March 1, 2010 from the Gynecologic Oncology Group (GOG) leadership that the phase III GOG-212 clinical trial of CTI's OPAXIO™ used as maintenance therapy for ovarian cancer remains a high priority and enrollment will continue. The GOG made the statement to clarify that the recent results of the GOG-218 clinical trial bevacizumab in maintenance therapy for ovarian cancer has not influenced the importance of completing the GOG-212 clinical trial. The Gynecologic Oncology Group (GOG) is one of the National Cancer Institute's (NCI) funded cooperative cancer research groups. The GOG is a multidisciplinary cooperative clinical trial research group focused on the study of gynecologic malignancies. The GOG is conducting phase III trials in ovarian cancer and other gynecologic cancers and has established standard treatments for these diseases in the U.S.
GOG leadership noted that, "GOG-218 and GOG-212 differ in the type of patients under study. It is important to note that some of the patients who completed the initial 6 cycles of chemotherapy in GOG-218 had clinical evidence of persistent tumor and where randomized to either placebo (no treatment) or bevacizumab. Thus a subset of GOG-218 patients received no therapy, despite the presence of persistent tumor. This is not the typical setting of using maintenance or consolidation therapy and it is not the setting for patients enrolled in GOG-212. In GOG-212, only patients who have achieved a complete clinical response are considered candidates for enrollment in the trial."
"Reliance upon the data from GOG-218 to establish the "standard of care" must take into consideration the actual treatment effect (i.e. duration of benefit), the cost of the treatment, and the associated toxicity... [in GOG-212] the toxicity of the intervention may have less associated mortality and the incremental cost-effectiveness ratio may be more acceptable to patients and the health care economists. Thus the GOG has no intention to discontinue enrollment in GOG 212 as they feel that the study is addressing a different scientific question and the primary outcome study goal is survival, not progression free survival, an outcome of greater importance to both physicians and patients," the statement added.
The Data Monitoring Committee is scheduled to conduct an interim analysis of overall survival when 130 events are recorded among patients in the no maintenance treatment arm. The statistical analysis plan utilizes pre-specified boundaries for early stopping for success. Based on current enrollment and study duration, the interim analysis could be conducted as early as 2011. If successful, the Company could utilize those results to form the basis of its New Drug Application for OPAXIO.
About Cell Therapeutics, Inc.
Headquartered in Seattle, CTI is a biopharmaceutical company committed to developing an integrated portfolio of oncology products aimed at making cancer more treatable. For additional information, please visit www.celltherapeutics.com.
This press release includes forward-looking statements that involve a number of risks and uncertainties, the outcome of which could materially and/or adversely affect actual future results and the trading price of the securities of CTI. Specifically, the risks and uncertainties that could affect the development of pixantrone include risks associated with preclinical and clinical developments in the biopharmaceutical industry in general, and with pixantrone in particular, including, without limitation, the potential failure of OPAXIO to prove safe and effective for the use as maintenance therapy in ovarian cancer as determined by the FDA, the risk that the GOG could decide to discontinue enrollment in the future, CTI's ability to continue to raise capital as needed to fund its operations, competitive factors, technological developments, costs of developing, producing and selling pixantrone, and the risk factors listed or described from time to time in CTI's filings with the Securities and Exchange Commission including, without limitation, CTI's most recent filings on Forms 10-K, 10-Q and 8-K. Except as may be required by law, CTI does not intend to update or alter its forward-looking statements whether as a result of new information, future events, or otherwise.
"Full data are expected to be reported at the American Society of Clinical Oncology meeting in Chicago in June."
Note: early trial closure
Rapid Development of Hypertension and Proteinuria with Cediranib, an Oral Vascular Endothelial Growth Factor Receptor Inhibitor -- Robinson et al. 5 (3): 477 -- Clinical Journal of the American Society of Nephrology
Conclusions: Cediranib induced a rapid but variable rise in BP within 3 days of initiation in most patients. Proteinuria was common and also developed rapidly. The rapid development of hypertension suggests that acute inhibition of VEGF-dependent vasodilation might explain the BP rise with VEGF inhibitors. Clinicians must be vigilant in early detection and management of toxicities of this expanding drug class, especially in older patients.
Note: obtain copies of all reports including blood work (CA125...) surgical and pathology reports You may want to ask your doctor these questions before your treatment begins: * What is the stage of my disease? Has the cancer spread from the ovaries? If so, to where? * What are my treatment choices? Do you recommend intraperitoneal chemotherapy for me? Why? * Would a clinical trial be appropriate for me? * Will I need more than one kind of treatment? * What are the expected benefits of each kind of treatment? * What are the risks and possible side effects of each treatment? What can we do to control side effects? Will they go away after treatment ends? * What can I do to prepare for treatment? * Will I need to stay in the hospital? If so, for how long? * What is the treatment likely to cost? Will my insurance cover the cost? * How will treatment affect my normal activities? * Will treatment cause me to go through an early menopause? * Will I be able to get pregnant and have children after treatment? * How often should I have checkups after treatment?
Impact of F-18 fluorodeoxyglucose positron emission tomography-computed tomography on oncologic patient management: British Columbia (abstract)
"..The results of the PET-CT study resulted in a change in treatment decision in 49.8% of the studies and resulted in improved decision making in 83.2% of the studies."
The Cross Cancer Institute (Alberta) Multidisciplinary Summer Studentship in Palliative and Supportive Care in Oncology: Teaching students to see through patients eyes
The Cross Cancer Institute Multidisciplinary Summer Studentship in Palliative and Supportive Care in Oncology: Teaching students to see through patients' eyes.
Association between frequency and intensity of recreational physical activity and epithelial ovarian cancer risk by age period-abstract
"In conclusion, strenuous recreational activity early in life may increase the risk of ovarian cancer, whereas more recent recreational activity may reduce the risk."
About Lynch Syndrome Lynch syndrome refers to individuals with hereditary predisposition to colorectal cancer (CRC) and other malignancies as a result of an inherited mutation in a specific type of gene known as a mismatch repair (MMR) gene. Lynch syndrome includes those with an existing cancer as well as those who have not developed cancer. * Also referred to as hereditary nonpolyposis colorectal cancer (HNPCC) * Autosomal dominant inheritance pattern (50% risk to offspring to inherit the gene mutation) * The lifetime risk for CRC in individuals with Lynch syndrome reported in the literature ranges from approximately 20-80%, dependent upon: o Gene involved o Sex of the individual o Population studied * Mean age of onset of CRC is approximately 45 years * Increased risk for other malignancies including: endometrial, ovarian, urinary tract, gastric, small bowel, pancreatic, and sebaceous skin tumors
abstract: College of Physicians & Surgeons (NY, USA): Views of Discrimination among Individuals Confronting Genetic Disease
"Discrimination can be subjective, and take various forms. Searches for only objective evidence of it may be inherently difficult. Providers need to be aware of, and prepared to address, subtle and indirect discrimination; ambiguities, confusion and potential limitations concerning current legislation; and needs for education about these laws. Policies are needed to prevent discrimination in life, long-term care, and disability insurance, not covered by GINA."
Perceptions of High-Risk Care and Barriers to Care Among Women at Risk for Hereditary Breast and Ovarian Cancer following Genetic Counseling....
Perceptions of High-Risk Care and Barriers to Care Among Women at Risk for Hereditary Breast and Ovarian Cancer following Genetic Counseling in the Community Setting
english translation: more women had a hard time deciding on surgery for breast cancer than for ovarian cancer
"...Close to a quarter of participants reported difficulty deciding whether or not to undergo risk-reducing mastectomy while 10% noted difficulty deciding for or against bilateral salpingo-oophorectomy...."
Friday, March 05, 2010
"The side effect of persistent alopecia is suffered by about 3 per cent of patients who take Taxotere with other chemotherapy drugs, according to the manufacturer's own studies. It has been clearly listed on the product monograph since December, 2006, says Laurent-Didier Jacobs, vice-president of medical affairs for Sanofi-aventis Canada. (A different study suggests the incidence of persistent alopecia could be as high as 6 per cent.)"
Jan Geißler - We, the patients - Cover Story Cancer World - Education & knowledge through people & facts
+ 3 comments
Radiation recall dermatitis triggered by multi-targeted tyrosine kinase inhibitors: sunitinib and sorafenib
Note: other treatments such as Gemzar/Gemcitabine have been noted in radiation recall
Int J Radiat Oncol Biol Phys. 2010 Mar
Jaffray DA, Lindsay PE, Brock KK, Deasy JO, Tomé WA.
Princess Margaret Hospital, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada. email@example.com
The actual distribution of radiation dose accumulated in normal tissues over the complete course of radiation therapy is, in general, poorly quantified.
Differences in the patient anatomy between planning and treatment can occur gradually (e.g., tumor regression, resolution of edema) or relatively rapidly (e.g., bladder filling, breathing motion) and these undermine the accuracy of the planned dose distribution. Current efforts to maximize the therapeutic ratio require models that relate the true accumulated dose to clinical outcome. The needed accuracy can only be achieved through the development of robust methods that track the accumulation of dose within the various tissues in the body. Specific needs include the development of segmentation methods, tissue-mapping algorithms, uncertainty estimation, optimal schedules for image-based monitoring, and the development of informatics tools to support subsequent analysis. These developments will not only improve radiation outcomes modeling but will address the technical demands of the adaptive radiotherapy paradigm.
The next 5 years need to see academia and industry bring these tools into the hands of the clinician and the clinical scientist.
Molecular Profiling Uncovers a p53-Associated Role for MicroRNA-31 in Inhibiting the Proliferation of Serous Ovarian Carcinomas and Other Cancers
Note: miR-31 (rna/genome/gene)
"Our findings reveal that loss of miR-31 is associated with defects in the p53 pathway and functions in serous ovarian cancer and other cancers, suggesting that patients with cancers deficient in p53 activity might benefit from therapeutic delivery of miR-31."
CONCLUSIONS: Antibodies to p53 are detected in the sera of 42% of patients with advanced serous ovarian cancer.
Impact: Although their utility as a preoperative diagnostic biomarker, beyond CA 125 and HE4, is limited, p53-AAb are prognostic for improved overall survival.
Cancer Epidemiol Biomarkers Prev
Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH)
Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial.
INTERPRETATION: Initial antihypertensive treatment with benazepril plus amlodipine should be considered in preference to benazepril plus hydrochlorothiazide since it slows progression of nephropathy to a greater extent.
Prospective Multicenter Cohort Study to Refine Management Recommendations for Women at Elevated Familial Risk of Breast Cancer: The EVA Trial.
CONCLUSION: In women at elevated familial risk, quality-assured MRI screening shifts the distribution of screen-detected breast cancers toward the preinvasive stage. In women undergoing quality-assured MRI annually, neither mammography, nor annual or half-yearly ultrasound or CBE will add to the cancer yield achieved by MRI alone.
CONCLUSIONS: In postmenopausal women with osteoporosis, lasofoxifene at a dose of 0.5 mg per day was associated with reduced risks of nonvertebral and vertebral fractures, ER-positive breast cancer, coronary heart disease, and stroke but an increased risk of venous thromboembolic events. (ClinicalTrials.gov number, NCT00141323.) 2010 Massachusetts Medical Society"
The clinicopathological characteristics of ‘triple-negative’ epithelial ovarian cancer -- JCO (China)
Note: other cell types of ovarian cancer were also compared in this study
"Conclusions: A novel (new) subtype of ovarian carcinoma, which is negative for ER, PR and HER2 expression, has been identified; this specific ovarian subtype tends to have aggressive characteristics and a poor prognosis, which is similar to triple-negative breast cancer in most respects. TNEOC should be considered in future investigations of informative classification of ovarian cancer."
Motivation and Autonomy in Counseling, Psychotherapy, and Behavior Change: A Look at Theory and Practice - abstract
U.S. FDA Recalls Flavor Enhancer Because of Salmonella Risk - in Public Health & Policy, Public Health from MedPage Today
Products on the recall list -- which can be found at http://www.accessdata.fda.gov/scripts/HVPCP/ -- include Earth Island's Sweet and Sour Tofu, T. Marzetti's Southwest Ranch Veggie Dip, Trader Joe's Creamy Ranch Dressing and Dip, and Hawaiian brand potato chips.
Summary and conclusions The challenges and recommendations outlined in this paper are informed by clinical trials of behavioral interventions in the context of HIV-infected populations. Although the specific nature of this trial may restrict the generalizability of the recommendations to other populations, illnesses, trial designs and intervention modalities, the general concepts are likely applicable across settings and are consistent with the limited literature on this topic.8,13 For example, there is a documented need to address expectations, motivations, and barriers to clinical trial participation across gender, race and ethnicity.12,13,16,17 The few sources that address these issues often do so in the context of engagement in treatment rather than clinical trials,18,19 and while there may be some attention to the needs of special populations such as homeless persons,20 this literature typically fails to consider issues unique to a research setting such as altruism and desire for financial incentives.17 Without effective techniques to maximize adherence to innovative health promotion interventions, investigators will struggle to compile empirical evidence of the intervention’s efficacy and eventual effectiveness.
abstract: Comparison of peritoneal carcinomatosis scoring methods in predicting resectability and prognosis in advanced ovarian cancer (no stats)
Note: no stats
Thursday, March 04, 2010
"As we learn more about the many kinds of mutations that are associated with genomic disease, so we can evaluate and model the ways that they interact to cause a phenotype."