Monday, October 11, 2010
ESMO - ICON 7 - Avastin Shows Promise For Ovarian Cancer Treatment
Further evidence that Avastin improved progression free survival in women with ovarian cancer was presented by researchers at the European Society of Medical Oncology (ESMO) congress in Milan, Italy. A new Phase III Avastin (ICON7) trial showed again that women with chemotherapy-naïve ovarian cancer had better progression free survival compared to women only on chemotherapy. A chemotherapy-naïve patient is one who has never received chemotherapy.
ICON7 is the second Phase III clinical trial on Avastin for ovarian cancer treatment. It compared chemotherapy-naïve women on Avastin plus chemotherapy versus similar patients on just chemotherapy. PFS (progression free survival) was approximately 27% better among those in the Avastin group; this corresponded to a 21% drop in the chances of cancer progression to death, the investigators explained. GOG0218, the first Phase III pivotal Avastin trial, had demonstrated earlier this year that Avastin plus chemotherapy and then alone gave ovarian cancer patients a 54% higher chance of progression free survival compared to women on chemotherapy alone.The Avastin dosage was smaller in the ICON7 trial, which also lasted less time....cont'd
full free access: A review and characterization of the various perceptions of quality cancer care - Jnl Cancer
"...Patient Perspectives
Thirteen studies reported patient perceptions of quality cancer care from >9000 patients (Table 1).
Five of those 13 studies enrolled exclusively patients with breast
cancer (N = 1039), whereas 1 study enrolled only patients with
colorectal cancer (N = 1067). Four studies included 6905 patients with
any cancer or with 1 of several kinds of cancer.
When information was difficult to obtain, trust was limited, or care was not well coordinated, patients experienced reduced quality of care.
When information was difficult to obtain, trust was limited, or care was not well coordinated, patients experienced reduced quality of care.
Patient characteristics associated with unfavorable perceptions of care quality
Three
studies identified patient and clinical characteristics that were
associated with unfavorable perceptions of quality care. These
characteristics included factors related to health status, type of
treatment, living conditions, and sociodemographic characteristics of
the patients, including age, income level, ethnicity, and language
spoken (Table 3)....."
Adding topotecan to standard treatment for ovarian cancer does not improve progression-free survival
Blogger's Note: discussions/research have been made in the past regarding triple therapies (irrespective of types of therapies) with most resulting, if not all, leading to increased toxicities/no survival advantage
"...Adding topotecan to carboplatin plus paclitaxel, the standard treatment for ovarian cancer, does not improve progression-free survival in patients and leads to greater toxicity, according to a study published online October 11 in the Journal of the National Cancer Institute.
Cisplatin plus paclitaxel, and carboplatin plus paclitaxel, are the most widely accepted first-line regimens for advanced epithelial ovarian cancer. Still, most women relapse and die from their disease. One possible solution is to add a third agent, such as topotecan, which has activity in the treatment of recurrent disease. However, combining topotecan with carboplatin plus paclitaxel as a triplet therapy is problematic because of bone marrow toxicity. So, to integrate topotecan into the standard regimen researchers tested cisplatin plus topotecan followed by carboplatin plus paclitaxel.
The phase III randomized study included 819 women aged 28-78 with newly-diagnosed stage IIB or more advanced ovarian cancer. The study was led by Paul Hoskins, M.D., of the British Columbia Cancer Agency in Vancouver and colleagues from three other groups: the NCIC Clinical Trials Group at Queen's University in Kingston, Canada, the European Organization for Research and Treatment of Cancer – Gynecologic Cancer Group, European Union, and the Grupo Espańol de Investigación en Cáncer de Ovario in Spain.
The women in the study were from Canada and Europe, and were randomly assigned to one of two study groups: the first arm received cisplatin and topotecan, followed by carboplatin and paclitaxel; the second arm received only carboplatin and paclitaxel...."
Physical symptoms prevalent no matter what stage of cancer including remission
"....The study of 405 patients was reported in the Oct. 11, 2010, issue of the Archives of Internal Medicine. Numerous physical symptoms, rather than just a few, were prevalent in patients with cancer and this prevalence did not diminish after completion of therapy. "We found that regardless of where they are in the course of their diseases, many individuals with cancer have a high symptom burden," said Kurt Kroenke, M.D...."cont'd
abstract/full free access: Improving the interpretation of quality of life evidence in meta-analyses: the application of minimal important difference units
Abstract:
Systematic reviews of randomized trials that include measurements of health-related quality of life potentially provide critical information for patient and clinicians facing challenging health care decisions. When, as is most often the case, individual randomized trials use different measurement instruments for the same construct (such as physical or emotional function), authors typically report differences between intervention and control in standard deviation units (so-called "standardized mean difference" or "effect size"). This approach has statistical limitations (it is influenced by the heterogeneity of the population) and is non-intuitive for decision makers. We suggest an alternative approach: reporting results in minimal important difference units (the smallest difference patients experience as important). This approach provides a potential solution to both the statistical and interpretational problems of existing methods.
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