repost: Bevacizumab toxicities and their management in ovarian cancer - abstract

Gynecol Oncol. 2010 Apr 1. [Epub ahead of print]

Bevacizumab toxicities and their management in ovarian cancer.

Randall LM, Monk BJ.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine, 101 The City Dr. South, Bldg 56 Room 264, 101 The City Dr., Orange, CA 92868, USA.

Abstract

OBJECTIVES: The purpose of this review is to discuss the side effect profile of bevacizumab, to discuss proposed mechanisms of these toxicities, and to provide suggestions for management of adverse events.

METHODS: A search of MEDLINE and ASCO and SGO abstract databases of articles published between January 1970 and August 2009 addressing the toxicity of bevacizumab in solid tumors was conducted. Reporting was limited to best available evidence including any available phase III studies and ovarian cancer phase II studies. Original publications addressing underlying mechanisms of bevacizumab toxicities were included.

RESULTS: Extensive experience with bevacizumab has proven the agent to be generally well tolerated, with an adverse event profile distinct from traditional cytotoxic chemotherapy and likely peculiar to its novel mechanism of action. The most common bevacizumab-attributable adverse event, hypertension, can be medically-managed, but more serious adverse events such as bowel perforation require drug discontinuation.

CONCLUSIONS: Current best evidence supports the use of bevacizumab in selected patients, and safe administration of bevacizumab requires an understanding of the management of adverse events attributable to its use.

Ovarian cancer: the duplicity of CA125 measurement. abstract

Ovarian cancer: the duplicity of CA125 measurement.

Nat Rev Clin Oncol. 2010 Apr 6. [Epub ahead of print]

Karam AK, Karlan BY.

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology at the David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS 24-130, Los Angeles, CA 90095, USA.

Abstract

Since it was first described in 1981, CA125 has held an important role in monitoring patients with ovarian cancer. CA125 is elevated in 80% of patients with epithelial ovarian cancer at initial diagnosis and correlates well with response to therapy. CA125 monitoring is used for the follow up of patients with epithelial ovarian cancer, and elevations in CA125 measurements often antedate any signs, symptoms or radiographic evidence of disease by several months.

Unfortunately, data favoring early therapeutic intervention for recurrent ovarian cancer is lacking, especially in patients with isolated CA125 elevations.

In asymptomatic patients, elevations in CA125 have been associated with considerable anxiety and deterioration in quality of life without any significant gains in survival.

Patients with ovarian cancer should, therefore, be counseled regarding the advantages and shortcomings of intensive CA125 testing.

While some patients may benefit from early detection of recurrent disease and be candidates for secondary cytoreductive surgery, others may choose to delay therapy until they develop symptoms of disease recurrence.

The results of a clinical trial suggest that withholding treatment in the event of isolated rising CA125 levels will not negatively impact these patients overall survival, highlighting the need for improved salvage therapies for recurrent ovarian cancer

David Silver to lead Warren Hospital effort to create new Women's Institute | - lehighvalleylive.com

New study confirms HRT helps ward off colon cancer | Reuters

 Note: this issue of a protective effect was known at the time the original WHI study information was published but also received very little attention

 New study confirms HRT helps ward off colon cancer

Fri Apr 9, 2010 5:19pm EDT

NEW YORK (Reuters Health) - Hormone replacement therapy (HRT) cuts a woman's risk of developing colon cancer, new research confirms.

Health

Millions of women stopped taking HRT when a Women's Health Initiative study showed in 2002 that the hormones raised the risk of stroke, heart disease and breast cancer.
But the Women's Health Initiative had also found that HRT protected against colon cancer. Some studies have also suggested that oral contraceptives might reduce the risk of the disease, while the fact that women are at lower risk of colon cancer than men also hints at a hormonal role in disease risk.
To investigate ties between HRT and colon cancer further, Dr. Millie D. Long of the University of North Carolina at Chapel Hill and her colleagues matched 443 women diagnosed between 2001 and 2006 with distal large bowel cancer (meaning tumors at the far end of the colon and the rectum) to 405 healthy control women. The average age of the study participants was around 63.
Long's team found that women who had ever used HRT were at half the risk of this type of colon cancer compared to women who'd never used hormone replacement, and the longer a woman was on HRT, the lower the risk.
For example, women who used hormones for less than four years cut their colon cancer risk by about one-quarter; four to eight years of HRT cut risk by a third; nine to 14 years of use halved risk; and 15 years or more of HRT reduced risk by two-thirds. The effects were the same for African-American women and white women.
However, there was no relationship between oral contraceptive use and colon cancer risk, the study team reports in the American Journal of Gastroenterology.
Long-term hormone therapy is no longer recommended for postmenopausal women, Long and her team note, although it is still sometimes prescribed on a short-term basis to help women with menopausal symptoms such as hot flashes. The major drop off in distal large bowel cancer in recent years could have been related to widespread use of HRT, the researchers say.
More research is needed to determine if HRT's protective effects persist after women stop taking hormones, the researchers add, or whether there might be a "rebound" effect with more pre-cancerous polyps developing after a woman halts
HRT.
"It may become important in the future to tailor timing of women's colorectal screening based on cessation of hormonal therapy," Long and her colleagues conclude.

SOURCE: The American Journal of Gastroenterology, online March 30, 2010.

Patented Genes - 60 Minutes - CBS News

North Carolina Man Denied Free Screening for Suspected Male Breast Cancer - ABC News

Gyn Congress 2010 Webcast - Novel Therapies (2) additonal videos free access

Session V: Ovarian Cancer III: Novel Therapies

* Emerging options in antiangiogenic targeted therapy for ovarian cancer
Andrew Clamp, MD, PhD

* Targeted therapy for ovarian cancer: Beyond angiogenesis
Stanley B. Kaye, MD

Gyn Congress 2010 Webcast Case-based approaches Recurrence (4) additional presentations/free access

Session IV: Ovarian Cancer II: A Case-Based Approach to Recurrence

* Interactive clinical case: non surgical Management of platinum sensitive ovarian cancer
Andreas du Bois, MD

* Interactive clinical case: Considerations for the management of a partially platinum sensitive relapse (6-12 months)
Bradley J. Monk, MD

* Interactive clinical case: Management of platinum resistant/refractory ovarian cancer
Eric Pujade-Lauraine, MD, PhD

* Keynote Lecture: Changing standards of care: The role of CA125 in the management of Ovarian Cancer
Gordon J.S. Rustin, MD, FRCP

Gyn Congress 2010 Webcasts (4) free online videos Surgery,systemic therapies,serous carcinomas

*State of the art surgical strategies in ovarian cancer: How to do it?
*State of the art surgical strategies in ovarian cancer: When to do it?
*Interactive clinical case: First-line systemic therapies for ovarian cancer
*Definition and characterization of low-grade and high-grade ovarian serous carcinomas

About consumer participation | Cochrane Consumer Network

Note: "prioritise topics for new reviews"
In response to a request from the Cochrane Network, ovarian cancer women/caregivers were asked to respond to a survey regarding priortisation. This was done, in part, through the ACOR Ovarian Cancer group (http://www.acor.org). A large response was received and the Cochrane Network responded in a positive manner.

 

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"No one will own the problem" Departing oncologist cites frustration - Dr. Lizabeth Brydon Saskatchewan

"No one will own the problem and it is a problem," Brydon said. "The fact of my leaving puts more pressure on it. I realize by doing this I have created a crisis, but we've given them two drop-dead dates saying, 'We're closing our office here because we can't cope.' "

Young Adult Cancer Canada . Community . Profiles Amy young adult with ovarian cancer