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Thursday, February 03, 2011

MSKCC (Memorial Sloan Kettering) Winter 2011 newsletter Molecular Medicine for Ovarian and Endometrial Cancer - Douglas A Levine



Note: includes reference to PARP inhibitors

Download Article - Update in Gynecologic Oncology, Winter 2011






Using Quality of Life Measures in Breast Cancer Clinical Trials — J. Natl. Cancer Inst. (and all cancers)



"Both the World Health Organization and the U.S. Food and Drug Administration have endorsed quality of life, but they are not always incorporated into trials because of the additional resources needed for data collection."

Cancer Awareness A Must For Women February is Ovarian Cancer month in Australia




abstract: Cancer survival among Latinos and the Hispanic Paradox.



CONCLUSIONS: No evidence of a Hispanic advantage was found in cancer survival. Improvement in mortality follow-up procedures for Latinos, especially for those without a valid social security number, is critical. By considering Hispanics as a whole rather than by subgroup, existing survival disparities are being missed.

abstract: Healthy eating index and ovarian cancer risk. [Cancer Causes Control. 2011] - PubMed result




The evidence for a role of diet on ovarian cancer prevention remains inconclusive.
While many studies have evaluated individual foods and food groups, the evaluation of a comprehensive dietary quality index for predicting cancer risk has received little attention.
This study investigates the association between the Healthy Eating Index (HEI), which reflects adherence to the current USDA Dietary Guidelines for Americans and ovarian cancer risk in a population-based case-control study in New Jersey. A total of 205 cases and 390 controls completed the Block 98.2 food frequency questionnaire (FFQ) in addition to reporting on potential risk factors for ovarian cancer. FFQ data were then utilized to calculate the HEI score, and cup, ounce, gram, or caloric equivalents for the 12 different food groups comprising the index. In multivariate models, the OR for the highest tertile of the HEI score compared with the lowest (reflecting a better diet compared with a worse diet) was 0.90 (95% CI: 0.55-1.47).
There was limited evidence for a statistically significant association between any of the 12 individual food components and ovarian cancer risk. Based on this study's results, neither individual food groups nor dietary quality showed potential for preventing ovarian cancer.

abstract: A non-BRCA1/2 hereditary breast cancer sub-group defined by aCGH profiling of genetically related patients (BRCAx)



Germline mutations in BRCA1 and BRCA2 explain approximately 25% of all familial breast cancers.

Despite intense efforts to find additional high-risk breast cancer genes (BRCAx) using linkage analysis, none have been reported thus far.

Here we explore the hypothesis that BRCAx breast tumors from genetically related patients share a somatic genetic etiology that might be revealed by array comparative genomic hybridization (aCGH) profiling.

As BRCA1 and BRCA2 tumors can be identified on the basis of specific genomic profiles, the same may be true for a subset of BRCAx families. Analyses used aCGH to compare 58 non-BRCA1/2 familial breast tumors (designated BRCAx) to sporadic (non-familiar) controls, BRCA1 and BRCA2 tumors. The selection criteria for BRCAx families included at least three cases of breast cancer diagnosed before the age of 60 in the family, and the absence of ovarian or male breast cancer.

Hierarchical cluster analysis was performed to determine sub-groups within the BRCAx tumor class and family heterogeneity. Analysis of aCGH profiles of BRCAx tumors indicated that they constitute a heterogeneous class, but are distinct from both sporadic and BRCA1/2 tumors. The BRCAx class could be divided into sub-groups. One subgroup was characterized by a gain of chromosome 22. Tumors from family members were classified within the same sub-group in agreement with the hypothesis that tumors from the same family would harbor a similar genetic background. This approach provides a method to target a sub-group of BRCAx families for further linkage analysis studies.

full free acPhase II Trial of Trastuzumab in Women with Advanced or Recurrent, HER2-Positive Endometrial Carcinoma: a Gynecologic Oncology Group Study




abstract: Clear cell carcinoma of the ovary: A report from the first Ovarian Clear Cell Symposium, June 24th, 2010 (plus blogger's commentary)



Blogger's Notes: with the exception of the 2 mutations mentioned, there is nothing new in this abstract;  social media can overcome past issues with patient accrual


OBJECTIVES: Recent literature has highlighted histological types of ovarian carcinoma as distinct diseases, each with unique clinical and molecular features. Historically, the diagnosis of ovarian clear cell carcinoma (CCC) has been of concern to both patients and physicians due to reports that CCC is associated with a worse prognosis than the more common serous type of ovarian carcinoma (HGSC). This review discusses the unique features of ovarian CCC.

METHODS: In June of 2010, a group of researchers and clinicians convened in Vancouver to review and discuss the clinical, pathological, molecular, and treatment-related features of CCC.

RESULTS: CCC is the second most common type of ovarian epithelial cancer, representing 5-25% of ovarian carcinomas. It is characterised by its association with endometriosis, and frequent mutations of ARID1A and PIK3CA. Low-stage CCC appears to have a better outcome than stage matched HGSC, while the opposite is true for high-stage disease, suggesting that the current standard treatments applied to HGSC (high grade serous) are ineffective for CCC.

CONCLUSIONS: Ovarian CCC is highly distinct from HGSC, and a clearer understanding of the basic biology of this disease is needed. Alternative therapies should be explored: irradiation and targeting disease-specific molecular markers should be examined in greater detail. Finally, novel approaches to clinical trial design are needed due to the smaller numbers of patients affected.

abstract: Surgical staging of early stage epithelial ovarian... [Gynecol Oncol. 2011] - PubMed result



Note: positive lymph node findings upgrade staging from early stage to advanced stage; full access is by subscription ($$$)


OBJECTIVES: The objectives of this study were to determine the adequacy of surgical staging performed on surgically treated epithelial ovarian cancer (EOC) patients with apparent early stage disease and to determine if receipt of surgical staging had an influence on survival.
METHODS: Detailed surgical staging information was collected from medical records for 721 patients diagnosed between 1998 and 2000 with EOC. Patients resided in California or New York and were identified through population-based cancer registries.
RESULTSNearly 90% of patients had removal of the omentum and evaluation of bowel serosa and mesentery but only 72% had assessment of retroperitoneal lymph nodes and the majority of patients did not receive biopsies of other peritoneal locations. Only lymph node assessment (as well as node assessment combined with washings and omentectomy) had a statistically significant association with improved survival. The 5-year survival for women with node sampling was 84.2% versus 69.6% for those without this surgical procedure, and patients who did not have lymph node assessment had nearly twice the risk of death as those who did. When patients were stratified by receipt of chemotherapy, lack of node sampling had an effect only on patients who also had no chemotherapy (adjusted HR=2.2, CI=1.0-4.5).
CONCLUSIONS: The results of this population-based study confirm the prognostic importance of surgical staging for women with EOC, and the important role of gynecologic oncologists in treating these patients. Adjuvant chemotherapy does not appear to further improve survival for those women who receive adequate surgical staging.

sanibel island photo (testing android app)



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abstract: Ovarian serous surface papillary borderline tumors form sea anemone-like masses



PURPOSE: To clarify the imaging characteristics of ovarian serous surface papillary borderline tumor (SSPBT), whose prognosis is far better than that of serous surface papillary adenocarcinoma (SSPC).

in research: (miR-335) Running A Cancer Roadblock - Science News breast/ovarian



"The function of miR-335 in controlling whether escaped cancer cells can form a new tumor may also be important in ovarian cancer. Women with ovarian cancer who later had a relapse were more likely to be missing a copy of miR-335 in their original tumors than women who did not relapse, the team found."

in research: (miR-429) Discovery may lead to turning back the clock on ovarian cancer | Science Blog




Imedex: Great Debates & Updates in Gynecologic Malignancies April 9, 2011 New York, New York conference notice