Thursday, June 02, 2011
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Does maternal or paternal inheritance of BRCA mutation affect the age of cancer diagnosis? 2011 ASCO Abstract
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Found 246 documents
abstract #1501: Is hormone replacement therapy (HRT) following risk-reducing salpingo-oophorectomy (RRSO) in BRCA1 (B1)- and BRCA2 (B2)-mutation carriers associated with an increased risk of breast cancer? | 2011 ASCO Annual Meeting Abstracts
University of Pennsylvania School of Medicine - Women with BRCA mutations can take hormone-replacement therapy safely after ovary removal
Women with the BRCA1 or BRCA2 gene mutations, which are linked to a very high risk of breast and ovarian cancer, can safely take hormone-replacement therapy (HRT) to mitigate menopausal symptoms after surgical removal of their ovaries, according to new research from the Perelman School of Medicine at the University of Pennsylvania which will be presented Monday, June 6 during the American Society for Clinical Oncology's annual meeting (Abstract #1501). Results of the prospective study indicated that women with BRCA mutations who had their ovaries removed and took short-term HRT had a decrease in the risk of developing breast cancer...............
Domchek says some of the confusion about the role of HRT in cancer risk elevation comes from the fact that the risks and benefits associated with HRT depend on the population of women studied. In this group of women – who have BRCA1/2 mutations and who have had their ovaries removed while they are quite young – HRT should be discussed and considered an option for treating menopausal symptoms. "People want to make hormone replacement therapy evil, so they can say 'Don't do it,'" she says. "But there isn't one simple answer. The devil is in the details of the studies."
By contrast, Penn researchers and their collaborators in the PROSE consortium have shown definitively that oophorectomy reduces ovarian and breast cancer incidence in these women, and reduces their mortality due to those cancers. But paying attention to the role that hormone depletion following preventive oophorectomy plays in women's future health (blogger's note: eg. cardiovascular) is also important............"
"...PF-01367338 would be developed by Clovis as both a monotherapy and in combination with chemotherapeutic agents for the potential treatment of selected cancer patients.
PF-01367338 is currently in a Phase 1 clinical trial examining the maximum tolerated dose of oral PF-01367338 that can be combined with intravenous platinum chemotherapy in the treatment of solid tumors.
Clovis was founded by former executives of Pharmion Corp., which was acquired by Celgene Corporation in 2008. The company is headquartered in Boulder, Colorado, and has additional offices in San Francisco and London."
For ovarian (epithelial) cancer, the committee recommended:
- Physical exam and review of symptoms: Every three months for two years, followed by increasing intervals
- Pap test: Not indicated
- CA-125: Optional
- Radiographic imaging: Insufficient data to support routine use
- Suspected recurrence: CT and/or PET, plus CA-125
- Physical exam and review of symptoms: Every two to four months for two years, then every six months or annually depending on histology
- Serum tumor markers: Every two to four months for two years, then every six months for sex-cord stromal tumors but no longer indicated for germ-cell tumors
- Radiographic imaging: Generally, not indicated or data lacking to support routine use
- Suspected recurrence: CT and tumor markers
Moreover, a survey of primary care providers showed that respondents believed transition of oncology patients could be improved with individualized patient summaries, guidelines for surveillance, and expedited referral for suspected recurrence, the committee members noted.
"Thus, the provision of up-to-date information and the education of both patients and physicians are mandatory," they wrote.
Point out that this report indicates that there is very little evidence that either routine cytologic procedures or imaging are sufficiently useful to detect ovarian and endometrial cancer recurrence and alter response rates to salvage therapy.
Note that this report suggests that the most effective method to detect recurrences is a taking a thorough history, performing a detailed physical examination, and educating patients about relevant symptoms."
"The article is “Post treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology recommendations: by Ritu Salani, MD, MBA; Floor J. Backes, MD; Michael Fung Kee Fung, MB, BS; Christine H. Holschneider, MD; Lynn P. Parker, MD; Robert E. Bristow, MD, MBA; and Barbara A. Goff, MD (doi: 10.1016/j.ajog.2011.03.008). It will appear in the American Journal of Obstetrics & Gynecology, Volume 204, Issue 6 (June 2011) published by Elsevier."