Tuesday, May 25, 2010
Chemoresponse Assay Could Lower Treatment Costs in Ovarian Cancer - ChemoFx
"...In the study, the authors assumed, for the sake of analysis, that the "outcomes are likely no worse when chemoresponse testing is performed than when an empiric choice of regimen is made."
However, if, in currently ongoing studies, the assay helps clinicians choose more effective therapies and thus improve survival, it would be "very attractive from a health economics perspective," say the authors, because the current study has already shown it to be cost effective."
The study was funded by Precision Therapeutics.
Karen Mason: Ovarian Cancer represented on Capitol Hill, Washington DC | Ovarian Cancer National Alliance
"Current treatments are brutal and consist of long “debulking” surgeries followed by months of chemotherapies..... During my nine years of survivorship, I have befriended many women who also had late-stage ovarian cancer. One by one, I have watched most of these women die...."
A genomic and transcriptomic approach for a differential diagnosis between primary and secondary ovarian carcinomas in patients with a previous history of breast cancer.
ABSTRACT:
BACKGROUND: The distinction between primary and secondary ovarian tumors may be challenging for pathologists. The purpose of the present work was to develop genomic and transcriptomic tools to further refine the pathological diagnosis of ovarian tumor after a previous history of breast cancer.
METHODS: Sixteen paired breast-ovary tumors from patients with a former diagnosis of breast cancer were collected.. ... A hierarchical clustering of these samples was performed, combined with a dataset of well-identified primary and secondary ovarian tumors.
RESULTS: In 12 of the 16 paired tumors analyzed, the comparison of genomic profiles confirmed the pathological diagnosis of primary ovarian tumor (n = 5) or metastasis of breast cancer (n = 7). Among four cases with uncertain pathological diagnosis, genomic profiles were clearly distinct between the ovarian and breast tumors in two pairs, thus indicating primary ovarian carcinomas, and showed common patterns in the two others, indicating metastases from breast cancer.
CONCLUSIONS: In patients with ovarian carcinoma and a previous history of breast cancer, SNP array analysis can be used to distinguish primary and secondary ovarian tumors. Transcriptomic analysis may be used when primary breast tissue specimen is not available.
Genetic/Familial high-risk assessment: breast and ... [J Natl Compr Canc Netw. 2010] - PubMed result
Abstract
Overview
All cancers develop as a result of mutations in certain genes, such as those involved in the regulation of cell growth and/or DNA repair,(1,2) but not all of these mutations are inherited from a parent. For example, sporadic mutations can occur in somatic/tumor cells only, and de novo mutations can occur for the first time in a germ cell (i.e., egg or sperm) or in the fertilized egg itself during early embryogenesis. However, family studies have long documented an increased risk for several forms of cancer among first-degree (i.e., parents, siblings, and children) and second-degree relatives (i.e., grandparents, aunts or uncles, grandchildren, and nieces or nephews) of affected individuals. These individuals may have an increased susceptibility to cancer as the result of 1 or more gene mutations present in parental germline cells; cancers developing in these individuals may be classified as hereditary or familial cancers. Hereditary cancers are often characterized by mutations associated with a high probability of cancer development (i.e., a high penetrance genotype), vertical transmission through either mother or father, and an association with other types of tumors.(3,4) They often have an early age of onset and exhibit an autosomal dominant inheritance pattern (i.e., occur when the individual has a mutation in only 1 copy of a gene). Familial cancers share only some features of hereditary cancers. For example, although familial breast cancers occur in a given family more frequently than in the general population, they generally do not exhibit the inheritance patterns or onset age consistent.
Vismodegib, a small-molecule inhibitor of the hedgehog pathway for the treatment of advanced cancers
"Vismodegib is currently undergoing phase II clinical trials for the treatment of advanced BCC, metastatic colorectal cancer, ovarian cancer, MB and other solid tumors. Because of its low toxicity and specificity for the Hh (hedgehog) pathway, this drug has potential advantages compared with conventional chemotherapy, and may also be used in combination treatments. Clinical trials with other Hh inhibitors are also ongoing and their therapeutic potential will need to be compared with vismodegib."
Attitudes Toward Information About Genetic Risk for Cognitive Impairment After Cancer Chemotherapy: Breast Cancer Survivors Compared With Healthy Controls
Conclusion
Results suggest lessened enthusiasm for genetic information that maintains or increases uncertainty about a specific course of action and highlight the importance of including clinically relevant groups in treatment decision-making research that employs hypothetical scenarios. Although women generally believe it is important to receive genetic information, they might benefit from assistance (eg, decision aid) in the difficult task of integrating information about survival and risk for adverse late effects from cancer treatment.
Pegylated Liposomal Doxorubicin and Carboplatin Compared With Paclitaxel and Carboplatin for Patients With Platinum-Sensitive Ovarian Cancer in Late Relapse
Pegylated Liposomal Doxorubicin and Carboplatin Compared With Paclitaxel and Carboplatin for Patients With Platinum-Sensitive Ovarian Cancer in Late Relapse
ABSTRACT
Purpose This randomized, multicenter, phase III noninferiority trial was designed to test the efficacy and safety of the combination of pegylated liposomal doxorubicin (PLD) with carboplatin (CD) compared with standard carboplatin and paclitaxel (CP) in patients with platinum-sensitive relapsed/recurrent ovarian cancer (ROC).
Patients and Methods Patients with histologically proven ovarian cancer with recurrence more than 6 months after first- or second-line platinum and taxane-based therapies were randomly assigned by stratified blocks to CD (carboplatin area under the curve [AUC] 5 plus PLD 30 mg/m2) every 4 weeks or CP (carboplatin AUC 5 plus paclitaxel 175 mg/m2) every 3 weeks for at least 6 cycles. Primary end point was progression-free survival (PFS); secondary end points were toxicity, quality of life, and overall survival.
Results Overall 976 patients were recruited. With median follow-up of 22 months, PFS for the CD arm was statistically superior to the CP arm (hazard ratio, 0.821; 95% CI, 0.72 to 0.94; P = .005); median PFS was 11.3 versus 9.4 months, respectively. Although overall survival data are immature for final analysis, we report here a total of 334 deaths. Overall severe nonhematologic toxicity (36.8% v 28.4%; P < .01) leading to early discontinuation (15% v 6%; P < .001) occurred more frequently in the CP arm. More frequent grade 2 or greater alopecia (83.6% v 7%), hypersensitivity reactions (18.8% v 5.6%), and sensory neuropathy (26.9% v 4.9%) were observed in the CP arm; more hand-foot syndrome (grade 2 to 3, 12.0% v 2.2%), nausea (35.2% v 24.2%), and mucositis (grade 2-3, 13.9% v 7%) in the CD arm.
Conclusion To our knowledge, this trial is the largest in recurrent ovarian cancer and has demonstrated superiority in PFS and better therapeutic index of CD over standard CP.
Abstracts 2010 ASCO Annual Meeting
search terms: "ovarian cancer' (note some duplication/non relevance) The abstracts can be search a variety of ways: eg. gynecologic cancer, brca, etc...
New early screening for ovarian cancer 'promising': study
WASHINGTON — A new screening approach to detect early stage ovarian cancer in post-menopausal women has proven promising, researchers said of results to a study released Thursday.
"More than 70 percent of ovarian cancers are diagnosed when they have already grown to an advanced stage, so identifying a reliable screening test for early-stage disease would be like finding the Holy Grail," said the study's lead author Karen Lu, of the University of Texas' Anderson Cancer Center.
"This study is one step forward in that direction. If confirmed in larger studies, this approach could be a useful and relatively inexpensive tool for detecting ovarian cancer in its early, more curable stages," she said.
The results were presented by the American Society of Clinical Oncology (ASCO) ahead of its annual conference, to be held June 4-8 in Chicago.
The new method uses a mathematical model to assess trends in CA-125 blood test results -- a protein known to rise during the cancer's development -- and a patient's age. The model is then "followed by transvaginal ultrasound and referral to a gynecologic oncologist, if necessary," researchers said.
For up to eight years, the study followed 3,238 post-menopausal women aged 50 to 74 who had no significant family history of breast or ovarian cancer, and the accuracy of using the mathematical model followed by ultrasound was 99.7 percent, indicating few false-positives using the approach, researchers said.
A larger study involving more than 200,000 women is currently underway in Britain, with results expected by 2015.
Society of Gynecologic Oncologists Releases 'Gynecologic Oncology 2010: State of the Subspecialty' Survey Results -- CHICAGO, May 18 /PRNewswire-USNewswire/ --
Highlights from the survey include:
- A movement in the profession to younger-aged practitioners and a larger number of women entering the specialty;
- A shift away from private practice as the primary practice setting into salaried positions and an increase in group or multi-specialty practice from individual practice;
- An increase in the number of medical assistants, nurse practitioners and physician assistants employed in gynecologic oncology practices;
- A continued dedication to providing chemotherapy services to patients regardless of the changes in reimbursement rates, as well as the continuation of enrollment of patients into cooperative studies versus the more revenue neutral or positive industry-sponsored trials;
- The positive effect of caps on non-economic and total damages on the cost of medical liability/malpractice insurance; and the
- An overall willingness of gynecologic oncologists to accept/treat women with a gynecologic cancer without knowledge of insurance coverage and the preponderance of Medicare and Medicaid patients seen in a practice, versus private insurance.
How Does Older Age Influence Oncologists' Cancer Management? - The Oncologist
Reference to ovarian cancer:
10. Eisenhauer EL, Tew WP, Levine DA et al. Response and outcomes in elderly patients with stages IIIC-IV ovarian cancer receiving platinum-taxane
chemotherapy. Gynecol Oncol 2007;106:381–387.
High cumulative incidence of cancer in patients with cardio-renal-anaemia syndrome (chronic kidney disease)
Aims
The combination of chronic kidney disease (CKD), chronic heart failure (HF), and anaemia, the so-called cardio-renal-anaemia syndrome (CRA) is associated with dysregulation of erythropoietin levels and inflammation. Both have been associated with the development of cancer. This study aimed to determine the cumulative incidence of cancer in patients with CRA, as compared with anaemic CKD and control patients.
Expert Comments On Radon Recommendations
Note: this is not 'new' news
"Radon, a radioactive, invisible, odorless gas that comes from the decay of naturally occurring uranium in the earth's soil, can accumulate in enclosed areas, such as underground mines and homes. It is the second leading cause of lung cancer in the United States and the leading cause of lung cancer among people who have never smoked, according to the report."
Impact of caregivers’ unmet needs for supportive care on quality of terminal cancer care delivered and caregiver’s workforce performance
Conclusions
Caregivers’ unmet needs negatively affected both the quality of EOL care they delivered and their workplace performance. More investment in caregiver support and public policies that meet caregiver needs are needed, and hospice use should be encouraged.
Sexual issues in early and late stage cancer: a review
"Few studies have assessed sexuality in the advanced stage of disease. Nevertheless, advanced cancer patients are willing to talk about their sex lives and the impact of the disease on their sexual function."
HighWire Medline Abstract
define: gonadotropin - hormone secreted by the anterior pituitary gland and placenta; stimulates the gonads and controls reproductive activity
Harvard Reproductive Endocrine Sciences Center, Massachusetts General Hospital, Boston, MA 02114, USA.
Isolated gonadotropin-releasing hormone (GnRH) deficiency is a treatable albeit rare form of reproductive failure that has revealed physiological mechanisms controlling human reproduction, but despite substantial progress in discovering pathogenic single-gene defects, most of the genetic basis of GnRH deficiency remains uncharted. Although unbiased genetic investigations of affected families have identified mutations in previously unsuspected genes as causes of this disease in some cases, their application has been severely limited because of the negative effect of GnRH deficiency on fertility; moreover, relatively few of the many candidate genes nominated because of biological plausibility from in vitro or animal model experiments were subsequently validated in patients. With the advent of exciting technological platforms for sequencing, homozygosity mapping, and detection of structural variation at the whole-genome level, human investigations are again assuming the leading role for gene discovery. Using human GnRH deficiency as a paradigm and presenting original data from the screening of numerous candidate genes, we discuss the emerging model of patient-focused clinical genetic research and its complementarities with basic approaches in the near future.
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