Thursday, September 16, 2010
full free access: Self-Diagnosis: A Discursive Systematic Review of the Medical Literature « Journal of Participatory Medicine
Conclusions: The predictive value of self-diagnosis is not the only factor in that medical researchers consider when determining its desirability. Self-diagnosis presents complex challenges to both the doctor and the patient, as it simultaneously threatens medical authority, and strengthens the potential for self-care, compliance and convenience.
Excerpt from paper:
"Methods"....The interest of my work is not on the appraisal of their findings, rather on the positions they defended, for this provides insight into beliefs and rationalizations for enunciated arguments about self-diagnosis, the focus of this paper...."
NEW YORK (GenomeWeb News) – Researchers from the Fred Hutchinson Cancer Research Center in Seattle have won $17.5 million from the National Cancer Institute's Early Detection Research Network in five-year awards toward ongoing coordination of the EDRN, as well as projects centered on colon cancer biomarker discovery and breast and ovarian cancer biomarker validation.........Christopher Li, a member of the public health sciences division, received $2.5 million to lead a clinical epidemiology and validation center for breast and ovarian cancer – one of nine such centers in the US. Li plans to validate breast and ovarian cancer biomarkers with phase III studies, as well as share the center's breast and ovarian cancer tissue repositories with collaborators, said the Hutch...cont'd
Purpose Every year approximately 25% of women diagnosed with breast cancer are younger than 50 years of age, and almost 10% of them have a BRCA mutation. Not all potential carriers are identified by existing criteria for BRCA testing. We estimated the costs and benefits of different BRCA testing criteria for women with breast cancer younger than 50 years.
Conclusion Testing women with TN breast cancers who were younger than 50 years for BRCA mutations is a cost-effective strategy and should be adopted into current guidelines for genetic testing.
American Institute for Cancer Research (AICR): AICR Cancer Research Conference Oct 21/22, Washington, DC
Food, Nutrition, Physical Activity and Cancer
October 21 & 22, 2010 | Capital Hilton Hotel, Washington, DC
Who Should Attend
Basic scientists, clinical investigators, epidemiologists, dietitians, nutritionists, policy makers and other health professionals interested in food, nutrition, physical activity and weight management in relation to cancer.
"...Through a new partnership with the Canadian Institutes of Health Research called the Terry Fox New Frontiers Program, the foundation is giving $9.7 million to institutions and researchers in Ontario including Sunnybrook and Mount Sinai Hospital, $2 million to projects in Quebec and $3.1 million to programs in British Columbia. The funding is aimed at four areas of cancer research: improving ultrasound techniques for radiation therapy, understanding how cancer spreads, exploring genetic aspects of rare cancers and developing new approaches to childhood leukemia....cont'd
Baylor researchers advancing genetic treatment for ovarian cancer - Baylor College of Medicine press release - (microRNA - miR-31)
HOUSTON -- (September 16, 2010) -- As the understanding of the biology of ovarian cancer broadens, there is an increased need to develop treatments that are targeted toward a person's genetic makeup, said a clinician-researcher from Baylor College of Medicine.
"We have not been able to pinpoint exactly what causes ovarian cancer," said Dr. Matthew Anderson, assistant professor of obstetrics and gynecology and a member of the NCI-designated Dan L. Duncan Cancer Center at BCM. "However, we do know that the molecular changes in each ovarian cancer are different and each person's response to treatment is unique."
Anderson said a major research goal is to individualize treatments for each woman, so that clinicians are able to more effectively manage or perhaps even cure ovarian cancer.
That's why Anderson and his team, including Dr. Martin Matzuk, professor of pathology at BCM, and Dr. Preethi Gunaratne, assistant professor of pathology at BCM and assistant professor of biochemistry and biology at the University of Houston, are in the process of developing treatments that target the different types of molecular changes that they have identified as playing a role in ovarian cancer development.
Identifying new genetic signatures
Their work focuses on a class of recently discovered small non-coding RNA transcripts in ovarian cancer called microRNAs. MicroRNAs are tiny messenger molecules that are generated by chromosomes that feed back to inhibit the expression of traditional, protein-coding genes. They have become a hot topic in biology because an individual microRNA can target many hundreds of different genes, making them potentially very powerful as therapeutic or diagnostic targets, Anderson said.
"Genes have many signals and rules that turn them on and off," said Anderson. "MicroRNAs are one kind of signal. When these signals do not get turned on or off appropriately, gene expression is altered, causing changes in cell behavior that we now know can lead to cancer."
Using Next Generation Sequencing, Anderson and his colleagues identified a number of microRNAs, including miR-31, involved in ovarian cancer. In the case of miR-31, decreased levels were found in every ovarian cancer studied, potentially altering the expression of more than 2,200 individual gene products.
Their work has now been published in the American Association of Cancer Research journal Cancer Research. Anderson also received a basic science award from the Society of Gynecologic Oncologists for a presentation at its 41st Annual Meeting on Women's Cancer in March 2010.
Anderson and team hypothesize that a treatment targeting this malfunction could be effective against cancers that are shown to lack miR-31.
"In the lab, we have shown that once miR-31 is turned back on, cancer growth stops and the cells die," said Anderson.
Next step in research
The next question is finding out how miR-31 can be administered safely as a treatment in humans, Anderson said. "The process will start using ovarian cancer models and then move to human trials."
Another important question is how to determine which patients are likely to benefit from these treatments.
"Physicians understand that the same drug does not always work for the same problem in all people," said Anderson. "This is particularly true for cancer. Understanding how and when microRNAs stop cancer growth can help to tell us how this new class of targets can be used for different people and diseases."
"In the future, we particularly want to be able to take a tumor and comprehensively profile the genetic changes that are specific to the ovarian cancer for each women so that we can prospectively determine what treatment works best for each person," said Anderson. "We believe that this approach will generate far superior results than the currently 'one-size-fits-all' approach used to treat this disease."
Partnership for Baylor College of Medicine campaign
Anderson, Matzuk and Gunaratne's project was selected as the main fundraising effort for 2010-2011 by the Partnership for Baylor College of Medicine, the college's primary support group.
The group will focus their community advocacy, educational programs and involvement in fundraising activities on the project.
"Translating this finding into a clinical application is critically important," said Anderson. "The Partnership support will help us to advance this process significantly."
Statement from Commonwealth Fund President Karen Davis: New Census Data on Uninsured Shows Recession Hits Middle-Class Health Care Coverage Hard - The Commonwealth Fund (U.S.)
"....This is not the time to be talking about repealing health reform. It is urgently needed and should be accelerated. The nation cannot afford to ignore the plight of millions of Americans whose health is at risk, and whose health and productivity are key to revitalizing the American economy....."
One of the main reasons why most patients with advanced cancer are not curable with the therapies available is the broad heterogeneity of cancer cells, inherently related to their genomic instability that reflects defects of cell cycle checkpoints and DNA mismatch repair (MMR). The present paper reviews Today's knowledge of MMR. Microsatellite (DNA repetitive sequences) instability (MSI) used as a surrogate marker of MMR defects was associated with a predisposition to somatic mutations of several genes including those involved in the neoplastic transformation and tumor progression. Lynch syndrome is an autosomal dominant cancer predisposition syndrome caused by germ line mutation in genes involved in MMR such as hMLH1 or hMLH2, or less frequently hMLH6 or hPMS2; it is associated with a high risk of intestinal cancer (CRC) and other tumors including endometrial, stomach, kidney and brain (AND ovarian cancer). There is ample preclinical evidence that cells deficient in MMR are resistant to methylating agents and to some antimetabolites, including 5FU, which is the drug used most for the CRC, whereas they are equally sensitive to oxaliplatin and possibly more sensitive to irinotecan. More studies are needed on the importance of MMR for sensitivity to different anticancer regimens and drugs, so this knowledge can guide rational therapy according to the tumor MMR status.
The open-label Phase II study will evaluate the overall response rate of SG2000 in approximately 50 patients with recurrent, resistant or refractory epithelial ovarian, primary peritoneal, or fallopian tube carcinoma. The trial will be conducted at a consortium of four leading southeast U.S. cancer centers, led by Vanderbilt-Ingram Cancer Center, and including Moffitt Cancer Center at the University of South Florida, Winship Cancer Institute at Emory University and Massey Cancer Center at Virginia Commonwealth University.
"We are delighted to have commenced this important trial for SG2000 in platinum-resistant and refractory ovarian cancer. We believe that if SG2000 demonstrates similar activity in this Phase II trial to that demonstrated in vitro and in patients in four separate Phase I trials with more than 60 patients, it has the potential to be an important new therapeutic for women with ovarian cancer," said Marta Ann Crispens, MD, FACOG, Principal Investigator, Vanderbilt University Medical Center....cont'd
Erlotinib added to carboplatin and paclitaxel as first-line treatment of ovarian cancer: A phase II study based on surgical reassessment
BACKGROUND: The purpose of this study was to determine whether adding the anti-epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor erlotinib to carboplatin/paclitaxel improved pathologic complete response (pCR) at reassessment surgery in epithelial ovarian, fallopian tube, or primary peritoneal cancers (OFPC).
CONCLUSIONS: Among unselected patients, erlotinib plus carboplatin-paclitaxel did not improve pCR rates compared with historical experience with carboplatin-paclitaxel alone in patients with stage III-IV OFPC.
"Approximately 23% of unselected cases of breast cancer in the Bahamian population are attributable to a founder mutation in the BRCA1 gene - this is the highest reported mutation prevalence for any country studied to date."
Wednesday, September 15, 2010
Education Network to Advance Clinical Trials | Achieving the highest quality cancer care and research through clinical trials
ENACCT was founded in 2004 with support from the Lance Armstrong Foundation. ENACCT is the only national organization devoted solely to identifying, implementing and evaluating innovative community-centered approaches to cancer clinical trials education.
ENACCT and Howard University Cancer Center Partner for New Program to Help Washington, DC Doctors Connect Cancer Patients to Clinical Trials
Physician Training to Address District’s Low Cancer Clinical Trial Enrollment Rate
Open to Options staff appeared on the show "Speaking Frankly about Cancer with the Cancer Support Community" for their April 2010 Broadcast.
"Enhancing Access to Cancer Clinical Trials" article featured in Community View section.
ENACCT and Community-Campus Partnerships for Health (CCPH) are partners in the federally funded project, Communities as Partners in Cancer Clinical...
Open to Options, funded as a cooperative agreement with the Centers for Disease Control and Prevention, is an innovative pilot project between The...
In 2006, ENACCT launched a unique and ambitious Pilot Education Program (PEP) focused on community engagement and education.
Six free one hour e-learning courses enabling advocates and community leaders, primary care providers, and cancer clinical trial staff (CEU provided...
Training & Resources
This program helps clinical research teams improve recruitment and retention, especially among ethnic and racial minorities.
This program empowers community leaders to spread the message about the importance of cancer clinical trials.
This program helps primary care providers explore their important role to increase clinical trials participation.
Note: see chart for selected cancers (includes ovarian)
Healing Journeys » Cancer as a Turning Point – free conference "Cancer as a Turning Point, From Surviving to Thriving" October
October 9 & 10 - Cancer as a Turning Point, From Surviving to Thriving™
a FREE conference for anyone touched by cancer or other life challenges
San Mateo Performing Arts Center (near San Francisco airport)
www.healingjourneys.org or (800) 423-9882
Health Advisory: Arth-Forth: Unauthorized Herbal Product May Pose Serious Health Risks - Health Canada Advisory 2010-09-15
September 15, 2010
For immediate release
The issue:"Arth-Forth" (pictured below), an unauthorized product promoted as an herbal supplement and distributed by Ka Wing Hong Ltd., was tested by Health Canada and found to contain a steroid prescription drug, dexamethasone, that was not declared on the product's labelling. Prescription drugs should only be taken under the supervision of a healthcare practitioner as they may cause serious side effects.
Who is affected:Consumers who may have bought or used "Arth-Forth," particularly people with gastrointestinal ulcers, Cushing's syndrome, severe heart problems, uncontrolled diabetes, uncontrolled high blood pressure, tuberculosis, severe systemic infections (viral, bacterial, fungal), certain eye disorders, and osteoporosis. Retailers who have this product in stock are also affected.
Educational Events & Programs
NCCN Oncology Case Management Program™ Webinar: An Overview of Gynecologic Malignancies
Friday, September 17, 2010 (On-line)
12:30 PM – 2:00 PM
the issue of universal pharmacare is old and outstanding/outdated (eg. Romanow Commission/others) but governments have not acted primarily due to political 'infighting'
Note: reference to Avastin/breast cancer
Tuesday, September 14, 2010
Access : Hospitalisation for venous thromboembolism in cancer patients and the general population: a population-based cohort study (abstract)
Risk of VTE is higher among cancer patients than in the general population. Predictors of VTE include recency of cancer diagnosis, cancer site, stage and the type of cancer-directed treatment.
Note: in research, full paper is free to view - click on 'pdf'
Purpose: Dichloroacetate (DCA) inhibits pyruvate dehydrogenase kinase (PDK), and thus promotes glucose oxidation over glycolysis and induces apoptotic death of tumor cells. The present study investigated the potential of DCA to increase the antitumor effects of platinum-based compounds against a panel of permanent cell lines, including small cell lung cancer (SCLC), ovarian cancer, and Ewing’s sarcoma in vitro.
Methods: DCA at a concentration of 10 mM was combined with cisplatin, carboplatin, satraplatin, the satraplatin metabolite JM118, oxaliplatin, oxoplatin, and picoplatin, and the cytotoxic activity was evaluated in proliferation tests employing a panel of different cell lines. Additionally, cells were pretreated with DCA and then exposed to the platinum drugs and etoposide, or incubated with cisplatin or etoposide followed by application of DCA, respectively.
Results: DCA 10 mM significantly increased the cytotoxicity of the platinum-based drugs carboplatin, satraplatin, JM118, and oxoplatin, but not cisplatin, picoplatin, and oxaliplatin in vitro. Preincubation of cell lines with DCA 10 mM for three days reduced the antiproliferative activity of platinum-based agents in sequential application, but exposure of cells pretreated with cisplatin or etoposide to DCA resulted in minor sensitization. The inhibitory effect of DCA showed no correlation with sensitization to the platinum compounds.
Conclusion: DCA alone in a concentration that shows low antiproliferative activity is capable of increasing the cytotoxicity of selected platinum compounds upon coincubation, and such combinations may be interesting for clinical application in tumors like SCLC, Ewing’s sarcoma, and ovarian cancer refractory to cisplatin chemotherapy as standard care. The mechanism of this synergistic effect of DCA in combination with specific platinum species remains to be investigated.
abstract: 6-thioguanine selectively kills BRCA2-defective tumors and overcomes PARP inhibitor resistance
"...Altogether, our data show that 6TG efficiently kills BRCA2-defective tumors and suggest that 6TG may be effective in the treatment of advanced tumors that have developed resistance to PARP inhibitors or platinum-based chemotherapy."
Soc Sci Med. 2010 Aug 26
Cancergazing? CA125 and post-treatment surveillance in advanced ovarian cancer.
Centre for Values, Ethics and the Law in Medicine, The University of Sydney, Sydney, NSW, Australia.
AbstractPost-treatment surveillance of advanced ovarian cancer involves regular testing of asymptomatic patients using the CA125 test. This practice is based on a rationale that is not supported by evidence from clinical trials. This paper aims to stimulate critical reflection concerning the effect of investigative tests on clinical decisions and interactions, and the experience of illness, particularly in the context of advanced malignant disease. Drawing on the idea of the "medical gaze", and building on previous health communication research, we present an analysis of in-depth interviews and psychometric tests collected in a prospective study of 20 Australian women with advanced ovarian cancer conducted between 2006 and 2009. We describe the demands placed on patients by the use of the CA125 test, some hazards it creates for decision-making, and some of the test's subjective benefits. It is widely believed that the CA125 test generates anxiety among patients, and the proposed solution is to educate women more about the test. We found no evidence that anxiety was a problem requiring a response over and above existing services. We conclude that the current debate is simplistic and limited. Focussing on patient anxiety does not account for other important effects of post-treatment surveillance, and educating patients about the test is unlikely to mitigate anxiety because testing is part of a wider process by which patients become aware of a disease that - once it has relapsed - will certainly kill them in the near future.
Neoadjuvant chemotherapy in advanced ovarian cancer: What kind of evidence is needed to convince US gynaecological oncologists? Vergote I, Amant F, L
Note: Dr Vergote is one of Europe's top gynecologic cancer researchers; journal correspondence=pay-per-view ($$$)
Neoadjuvant chemotherapy in advanced ovarian cancer: What kind of evidence is needed to convince US gynaecological oncologists?
Vergote I, Amant F, Leunen K.
Access Pharmaceuticals receives $700,000 first order for MuGuard product in North America (oral mucositis)
The Wistar Institute has appointed ovarian cancer researcher José R. Conejo-Garcia, M.D., Ph.D., as associate professor in the Institute’s Immunology Program. | Medical Education
"....Conejo-Garcia’s laboratory program explores an innovative approach to fighting ovarian cancer by exploiting the tumor’s reliance on its “microenvironment,” the collection of neighboring, healthy cells that nourish the tumor and enable it to thrive. In particular, he has developed a “Trojan Horse” method that reprograms white blood cells within the microenvironment – which otherwise have the effect of preventing the spontaneous anti-tumor activity of the immune system – so that they activate immune cells to attack the ovarian tumor...."
Preferred Imaging installs Naviscan Positron Emission Mammography scanner in new Plano facility (PEM)
" PEM (Positron Emission Mammography) scanners are high-resolution breast PET systems that show the location as well as the metabolic phase of a lesion. The metabolic view assists physicians in making the optimal patient care decision by providing an unprecedented ability to distinguish between benign and malignant lesions, what researchers term “specificity.”"
Breast cancer classification algorithm to identify 20 gene signature developed using Microsoft Excel
"....The 10 most highly ranked genes predictive of poor prognosis and those 10 genes most highly predictive of good prognosis established a 20-gene expression based predictor, which was found to perform as well as two other models in the validation group. According to Hassell, "Our algorithm produces prediction models with comparable accuracy to other feature selection techniques while having generally better accessibility and useability for biological research scientists. We've begun using our algorithm to generate gene expression based prediction models of breast cancer cell sensitivity to commonly used anti-cancer therapies"....cont'd
per the media headline, this was not actually a 'study' but a Cochrane Collaboration review of pertinent studies, the Cochrane Collaboration does not perform studies but conducts reviews
Cancer Newsline - CA-125 Change Over Time Shows Promise for Early Detection of Ovarian Cancer - MD Anderson Cancer Center
CA-125 Change Over Time Shows Promise for Early Detection of Ovarian Cancer
Guest(s): Karen Lu, M.D., Robert Bast, M.D.
"Patient Experience -- The sum of all interactions, shaped by an organization's culture, that influence patient perceptions across a continuum of care."
EvidenceUpdates - Bevacizumab (Avastin) increases risk for severe proteinuria in cancer patients including professional commentaries
Monday, September 13, 2010
Inconsistent Labeling of Food Effect for Oral Agents across Therapeutic Areas: Differences between Oncology and Non-Oncology Products — Clinical Cancer Research
Drug labeling patterns with respect to food-drug interactions observed with oncology drugs are in contradiction with fundamental pharmacologic principles, as exemplified in the labeling of non-oncology drugs.
abstract submissions: http://www.geneticalliance.org/conference2011.abstracts
An international consortium has published the largest survey of human genetic variation thus far: a third-generation map that includes data from 11 global populations. The accomplishment will help in the ongoing search for genetic variants associated with complex diseases.
Stretches of DNA sequence tend to be inherited together. Thus, sets of small genetic variations called single nucleotide polymorphisms (SNPs) tend to be grouped. These clusters are called haplotypes. The map of human genetic variation is called a haplotype map, or HapMap.
Previous versions of the HapMap were built on the analysis of DNA collected from 270 volunteers from 4 geographically diverse populations. The first version contained approximately 1 million SNPs. The second-generation map brought that total to more than 3.1 million SNPs.
Over the last few years, researchers conducting genome-wide association studies have relied on data from the HapMap to discover hundreds of common genetic variants associated with complex human diseases, such as cardiovascular disease, diabetes, cancer and many other health conditions. Funding to create the third-generation HapMap was provided by NIH’s National Human Genome Research Institute (NHGRI), National Institute on Deafness and Other Communication Disorders (NIDCD) and the Wellcome Trust.
For the latest version, researchers analyzed about 1.6 million SNPs in a much broader range of samples from around the world. As reported in the September 2, 2010, issue of Nature, the HapMap now includes data from an additional 7 global populations, bringing the total number of volunteers to almost 1,200.
The consortium also carefully sequenced 10 regions totaling about 1 million base pairs in 692 samples. The scientists found that 77% of the SNPs they detected were new. This result shows that many more variants remain to be found, especially rare variants. In addition, the scientists added more than 800 copy-number variants to the resource. These reflect differences in the number of copies of specific DNA regions people harbor.
"The generated HapMap provides an important foundation for studies aiming to find genetic variation related to human diseases," says NHGRI Director Dr. Eric D. Green. "It is now routinely used by researchers as a valuable reference tool in our quest to use genomics for improving human health."Many of the HapMap researchers are also part of the 1000 Genomes Project, an international public-private consortium launched in 2008 to build an even more detailed map of human genetic variation. The scientists are using next-generation DNA sequencing technologies to build a public database with information from the complete genomes of 2,500 people from 27 populations around the world, many of which were studied in the HapMap project. Researchers will be able to use this data to expand their studies of how common and rarer genetic variations contribute to illness.
- Second-Generation Map of Human Genetic Variation:
- International HapMap Project:
Inside Knowledge CampaignCDC, in collaboration with the Department of Health and Human Services' Office on Women's Health, established the Inside Knowledge: Get the Facts About Gynecologic Cancer campaign to raise awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. (A sixth type of gynecologic cancer is the very rare fallopian tube cancer.) When gynecologic cancers are found early, treatment is most effective. It is important for women to pay attention to their bodies and know what is normal for them so they can recognize the warning signs of gynecologic cancers.
Note: the conference fees would exclude most patients, epatients or otherwise
Presented by Ontario Hospital Association
|Course name:||e-Patients: Changing the Health Care System in Real-Time|
|Course duration:||September 21, 2010 - September 21, 2010|
|Location:||Novotel Toronto Centre |
45 The Esplanade
|Download PDF Brochure Register Now|
Dee Edwards Memorial Whisper Walk hope to bring awareness to ovarian cancer Louisville, Kentucky - media
Calgary-based Oncolytics Biotech Inc. recently announced that the Gynecologic Oncology Group (GOG) intends to conduct a randomized Phase II trial of weekly paclitaxel versus weekly paclitaxel with REOLYSIN® in patients with persistent or recurrent ovarian, fallopian tube or primary peritoneal cancer (GOG186H).
Call us toll free: 1-877-769-4829
The American Association for Cancer Research (AACR) and Stand Up To Cancer (SU2C) encourage you to use the AACR-SU2C Clinical Trials Finder, a free and confidential cancer clinical trials matching and referral service. You may start your search online (see below).
How we can help?
The Clinical Trials Finder is designed to help you and your doctor quickly identify studies that match your specific diagnosis, stage and treatment history. New trials are added or updated every day, therefore we encourage you to search for new matches every time you have to make a new treatment decision.
Call AACR's Clinical Trials Navigators toll free at 1-877-769-4829.
If you find a match, we will assign a Clinical Trials Navigator to make sure you are successfully connected with the trials and locations that are most appropriate and convenient.
Hours of operation: 8:30 a.m. to 6:00 p.m. ET, Monday through Friday
Independent Expert Reviews of News Stories: Can a new supplement boost immunity, slow aging? (TA-65)
Our Review SummaryThe story attempts to provide readers with a summary of the results of an early study of how a "natural" product (TA-65) might alter a the truly natural course of aging. Despite some comments from outside experts, overall the story fails to answer many questions and ultimately presents an overly enthusiastic picture of the product.
full free access: 2009 Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma -- Journal of Clinical Pathology (note reference to clear cell ovarian cancer)
Women with hereditary non-polyposis colorectal cancer (HNPCC)/Lynch syndrome have a high risk for endometrial cancer (EC) and frequently present with a gynaecological cancer as their first or sentinel malignancy. Identification of these patients is important given their personal and family risk for synchronous and metachronous tumours. Modalities to detect ECs for the possibility of HNPCC include microsatellite instability assay, immunohistochemistry for DNA mismatch repair proteins, MLH1 promoter hypermethylation assay and mutational analysis of DNA mismatch repair genes. The revised Bethesda guidelines provide screening criteria for HNPCC in colorectal cancers (CRCs). However, there are currently no such screening recommendations for women with endometrial carcinoma. While age and family history are useful screening criteria, their sensitivity has been shown to be low for detection of HNPCC in EC. Expansion of these criteria to include tumour morphology (presence of tumour infiltrating lymphocytes and tumour heterogeneity including dedifferentiated/undifferentiated ECs) and topography (lower uterine segment localisation) as well as presence of synchronous ovarian clear cell carcinomas may significantly enhance the detection of patients with EC at risk for HNPCC. Consideration should be given to incorporating these screening criteria into a revision of the Bethesda guidelines for detecting EC patients at highest risk for HNPCC.
Areas covered in this review:
A systematic literature review of clinical studies published between January 2005 and March 2010 was conducted using search engines, PubMed and MEDLINE with the entry keywords ‘ovarian cancer’ and ‘platinum resistance’. This search revealed 40 clinical trials (1793 patients).
Take home message:
Analysis of recent clinical trials showed that gemcitabine-based combination chemotherapy was associated with the highest antitumor effects in platinum-resistant ovarian cancer patients during the study period.
Even among high-risk groups it is not possible to identify individuals who will go on to develop VTE, and, therefore, thromboprophylaxis is a recommended component of the management of high-risk patients. Ensuring patients receive safe, effective, easily administered antithrombotic therapy both in hospital and post-discharge, for a sufficient length of time, should be central to any strategy to reduce incident or recurrent VTE and minimise the risk of long-term complications.
add your opinions complications , ovarian primary peritoneal cancer risk side effects , venous thromboembolism , VTE
Sunday, September 12, 2010
Search of: ovarian cancer | Open Studies | received from 08/01/2010 to 09/11/2010 - List Results - ClinicalTrials.gov
|Found 16 studies with search of:||ovarian cancer | Open Studies | received from 08/01/2010 to 09/11/2010|
|1||Not yet recruiting||Short Non-coding RNA Biomarkers of Predisposition to Ovarian Cancer |
|2||Recruiting||Consolidation Whole Abdominal Intensity-Modulated Radiation Therapy (IMRT) in Advanced Ovarian Cancer |
|3||Recruiting||Trial of High Dose Topotecan With Carboplatin in Patients With Relapsed Ovarian Carcinoma |
|4||Not yet recruiting||RO4929097 in Treating Patients With Recurrent and/or Metastatic Epithelial Ovarian Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer |
|5||Recruiting||Maintenance Treatment for Ovarian Carcinoma in Remission by an Antiangiogenic Treatment Strategy |
|6||Not yet recruiting||Vinorelbine and Gemcitabine Combination In Platinum Resistant Recurrent Ovarian Cancer |
|7||Not yet recruiting||Saracatinib and Paclitaxel in Platinum-resistant Ovarian Cancer |
|8||Not yet recruiting||Temsirolimus, Carboplatin, and Paclitaxel as First-Line Therapy in Treating Patients With Newly Diagnosed Stage III or Stage IV Clear Cell Ovarian Cancer |
|9||Not yet recruiting||Changes in Performance Status and Symptom Distress in Older Patients With Advanced Ovarian Epithelial Cancer Undergoing Surgery and/or Chemotherapy |
|10||Not yet recruiting||Early Detection of Cancers in Low Resource Countries |
|11||Not yet recruiting||Paclitaxel With or Without Viral Therapy in Treating Patients With Recurrent or Persistent Ovarian Epithelial, Fallopian Tube, or Primary Peritoneal Cancer |
|12||Not yet recruiting||Carboplatin and Pralatrexate in Patients With Recurrent Platinum-Sensitive Ovarian, Fallopian or Primary Peritoneal Cancer |
|13||Recruiting||A Controlled Study of Quality of Life and it's Related Factors Among Gynecological Cancer Survivors |
|14||Recruiting||A Phase I Study of MGAH22 in Patients With Refractory HER2 Positive Cancers |
|15||Recruiting||Predictors of Ovarian Insufficiency in Young Breast Cancer Patients |
|16||Recruiting||Analysis of Two Therapeutic With Cetrotide® in PolyCystic Ovarian (PCO) Women in Assisted Reproductive Technology (ART) |
Search of: ovarian cancer | Open Studies | received from 08/01/2010 to 09/11/2010 - List Results - ClinicalTrials.gov
|Found 16 studies with search of:||ovarian cancer | Open Studies | received from 08/01/2010 to 09/11/2010|
|1||Not yet recruiting|| Short Non-coding RNA Biomarkers of Predisposition to Ovarian Cancer |
|2||Recruiting|| Consolidation Whole Abdominal Intensity-Modulated Radiation Therapy (IMRT) in Advanced Ovarian Cancer |
|3||Recruiting|| Trial of High Dose Topotecan With Carboplatin in Patients With Relapsed Ovarian Carcinoma |
|4||Not yet recruiting|| RO4929097 in Treating Patients With Recurrent and/or Metastatic Epithelial Ovarian Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer |
|5||Recruiting|| Maintenance Treatment for Ovarian Carcinoma in Remission by an Antiangiogenic Treatment Strategy |
|6||Not yet recruiting|| Vinorelbine and Gemcitabine Combination In Platinum Resistant Recurrent Ovarian Cancer |
|7||Not yet recruiting|| Saracatinib and Paclitaxel in Platinum-resistant Ovarian Cancer |
|8||Not yet recruiting|| Temsirolimus, Carboplatin, and Paclitaxel as First-Line Therapy in Treating Patients With Newly Diagnosed Stage III or Stage IV Clear Cell Ovarian Cancer |
|9||Not yet recruiting|| Changes in Performance Status and Symptom Distress in Older Patients With Advanced Ovarian Epithelial Cancer Undergoing Surgery and/or Chemotherapy |
|10||Not yet recruiting|| Early Detection of Cancers in Low Resource Countries |
|11||Not yet recruiting|| Paclitaxel With or Without Viral Therapy in Treating Patients With Recurrent or Persistent Ovarian Epithelial, Fallopian Tube, or Primary Peritoneal Cancer |
|12||Not yet recruiting|| Carboplatin and Pralatrexate in Patients With Recurrent Platinum-Sensitive Ovarian, Fallopian or Primary Peritoneal Cancer |
|13||Recruiting|| A Controlled Study of Quality of Life and it's Related Factors Among Gynecological Cancer Survivors |
|14||Recruiting|| A Phase I Study of MGAH22 in Patients With Refractory HER2 Positive Cancers |
|15||Recruiting|| Predictors of Ovarian Insufficiency in Young Breast Cancer Patients |
|16||Recruiting|| Analysis of Two Therapeutic With Cetrotide® in PolyCystic Ovarian (PCO) Women in Assisted Reproductive Technology (ART) |
Journal of Health Care for the Poor and Underserved - Strength and Courage: The Development of a Native American Cancer Survivor Archive
Note: pay-per-view ($$)
This report describes the first Native American cancer survivor archive and lessons learned from its development. Unusual not only in its holdings, this archive project is distinct as it is led by researchers and community health advocates without professional archival development training.
Plain language summary
Interventions for the treatment of borderline ovarian tumours
Women with borderline (low malignant potential) ovarian tumours do very well after surgery and recurrences may be cured by further surgery. The ideal form of initial surgical treatment for borderline ovarian tumours is controversial. Furthermore, it is not known if additional treatment after surgery reduces the risk of re-appearance of tumours or of death.
In this review, we found six trials which enrolled 340 patients who had undergone surgery for borderline ovarian tumours. These trials compared the number of deaths among women who had various forms of treatment or no additional treatment after surgery. In five of the trials, the women had tumours confined to the ovaries and most were followed up for over 10 years. Only one trial enrolled women with tumours that had spread beyond the ovary, and this trial followed patients up for less than three years, which is not long enough to detect any difference between groups receiving different treatments. None of the trials found any demonstrable benefit from any of the additional forms of treatment. However, all six trials were conducted over 15 years ago and since then platinum-based chemotherapy has become widely used to treat advanced ovarian cancer. However, only one of the trials in our review assessed this more modern type of chemotherapy. Further trials of platinum-based chemotherapy and of less toxic treatments are needed, looking at the benefit of reducing the anxiety and distress of further surgery and treatment for relapse.
One further trial, which recruited 32 women who had borderline ovarian tumours in both ovaries, compared conservative surgery (taking away the most diseased ovary and removing the tumour from the other ovary) with ultra-conservative surgery (removing the tumours without taking away either ovary). Nearly all the women who had ultra-conservative surgery became pregnant compared with half of those who had conservative surgery. Although about two thirds of the women in the trial developed similar tumours again, most women got pregnant before the disease recurred, all had their recurrences treated by further surgery, none developed invasive ovarian cancer nor died of their tumour. This small study suggests that ultra-conservative surgery by an experienced surgeon with careful follow up for recurrence may be recommended for women with bilateral borderline ovarian tumours who still intend to have children but, ideally, this approach should be evaluated in other independent trials. Despite rigorous searches, we did not find any trial directly comparing conservative surgery with radical surgery (surgery to remove all of the female reproductive organs) or comparing keyhole surgery (laparoscopy) with open surgery (laparotomy) for women with borderline ovarian tumours.
In this issue of Science Translational Medicine, Wallin et al. have identified a subset of breast and ovarian cancer cell lines that show synergistic response to the combination of doxorubicin and GDC-0941, a class IA phosphatidylinositol 3-kinase (PI3K) inhibitor. Here, we discuss the potential implications of these data on the clinical development of PI3K pathway inhibitors as cancer therapeutics.
New Strategies in Ovarian Cancer: Uptake and experience of women at high risk of ovarian cancer who are considering risk-reducing salpingo-oophorectomy
This paper reviews factors associated with uptake of risk-reducing salpingo-oophorectomy by women at increased hereditary risk for ovarian cancer, as well as quality of life issues following surgery. Forty one research studies identified through PubMed and PsychInfo met inclusion criteria. Older age, having had children, a family history of ovarian cancer, a personal history of breast cancer, prophylactic mastectomy, and BRCA1/2 mutation carrier status increase the likelihood of undergoing surgery. Psychosocial variables predictive of surgery uptake include greater perceived risk of ovarian cancer and cancer-related anxiety. Most women report satisfaction with their decision to undergo surgery and both lower perceived ovarian cancer risk and less cancer-related anxiety as benefits. Hormonal deprivation is the main disadvantage reported, particularly by premenopausal women who are not on hormonal replacement therapy (HRT). The evidence is mixed regarding satisfaction with the level of information provided prior to surgery, although generally women report receiving insufficient information regarding the pros and cons of HRT. These findings indicate that when designing decision aids, demographic, medical history, and psychosocial variables need to be addressed in order to facilitate quality decision making.
Heredity represents the strongest risk factor for ovarian cancer with disease predisposing mutations identified in 15% of the tumors. With the aim to identify genetic classifiers for hereditary ovarian cancer, we profiled hereditary ovarian cancers linked to the hereditary breast and ovarian cancer (HBOC) syndrome and the hereditary non-polyposis colorectal cancer (HNPCC) (Lynch Syndrome) syndrome. Genome-wide array comparative genomic hybridization was applied to 12 HBOC associated tumors with BRCA1 mutations and 8 HNPCC associated tumors with mismatch repair gene mutations with 24 sporadic ovarian cancers as a control group. Unsupervised cluster analysis identified two distinct subgroups related to genetic complexity. Sporadic and HBOC associated tumors had complex genetic profiles with an average 41% of the genome altered, whereas the mismatch repair defective tumors had stable genetic profiles, with an average 18% of the genome altered. Losses of 4q34, 13q12-q32 and 19p13 were overrepresented in the HBOC subset. Discriminating genes within these regions include BRCA2, FOXO1A and RB1. Gains on chromosomes 17 and 19 characterized the HNPCC tumors, but target genes herein are unknown.
The results indicate that HBOC and HNPCC associated ovarian cancer develop along distinct genetic pathways and genetic profiles can thus be applied to distinguish between different types of hereditary ovarian cancer.