abstract: Validating the Impact of a Molecular Subtype in Ovarian Cancer on Outcomes – A Study of the OVCAD Consortium - Pils - Cancer Science - Wiley Online Library

Validating the Impact of a Molecular Subtype in Ovarian Cancer on Outcomes – A Study of the OVCAD Consortium - Pils - Cancer Science -

Abstract

The majority of patients with epithelial ovarian cancer (EOC) is diagnosed at advanced stage and has a poor prognosis. A small proportion of these patients though will survive while others die very quickly. Clinicopathological factors do not allow precise identification of these subgroups. Thus we have validated a molecular subclassification as new prognostic factor in EOC.

One hundred ninety-four patients with stage II to IV EOC were characterized by whole-genome expression profiling of tumor tissues and classified using a published 112 gene-set, derived from a FIGO stage directed supervised classification approach.

The 194 tumor samples were classified into two subclasses of 95 (subclass 1) and 99 (subclass 2) tumors, grouping all 9 FIGO II tumors in subclass 1 (p=0.001). Subclass 2 (54% of advanced stage tumors) correlated significantly with peritoneal carcinomatosis and non-optimal debulking. Patients with subclass 2 tumors had a worse overall survival in both histological subtypes both, univariate (HRs 3.17 (serous) and 17.11 (non-serous), p≤0.001) and in models corrected for relevant clinicopathologic parameters (HRs 2.87 (serous) and 12.42 (non-serous), p≤0.023). Significance analysis of microarrays revealed 2,082 genes differentially expressed in advanced grade serous tumors of both subclasses and the focal adhesion pathway as the most deregulated pathway.

In this validation study we showed that in advanced-stage serous ovarian cancer two approximately equally large molecular subtypes exist, independent from classical clinocopathological parameters presenting with highly different whole genome expression profiles and an impressively different overall survival. Similar results were obtained in a small cohort of patients with non-serous tumors.

Does Estrogen-Only HRT Decrease Breast Cancer Risk? Nationally Recognized Endocrinologist Dr. Marina Johnson Weighs In

Does Estrogen-Only HRT Decrease Breast Cancer Risk? Nationally Recognized Endocrinologist Dr. Marina Johnson Weighs In

"....So here's Dr. Johnson's take-home message: "You don't need to delay starting HRT if you choose natural estradiol and progesterone over synthetic estrogens and progestins. Don't endure symptoms like hot flashes, insomnia, anxiety, depression, sexual dysfunction, mental confusion, and weight gain. Start HRT within 10 years of menopause for the most protection against Heart Disease, Alzheimer's and Osteoporosis.
"Avoid the increased heart attacks and strokes seen in WHI by choosing topical estrogen in the form of patches, gels, creams and mists that are available at any drug store. Pharmaceutical natural hormones (also called bioidentical hormones) are superior to compounded bioidentical hormones because they are required to meet higher standards for quality control and efficacy."

Read more in Dr. Johnson's book, "Outliving Your Ovaries: An Endocrinologist Weighs The Risks And Rewards Of Treating Menopause With Hormone Replacement Therapy" (http://www.outlivingyourovaries.com) (Eyesong Publishing, February 2011), which is available in paperback, e-book and can be shipped internationally. Use coupon code BZCWJDM5 for $5 off of the retail price with purchase at http://www.buydrmarinajohnsonbook.com.
Dr. Marina Johnson, a pharmacist and UCLA/USC-trained physician, is board-certified in Endocrinology and Internal Medicine.

Current Drug Shortages: Etoposide solution for injection (updated)

Current Drug Shortages: Etoposide solution for injection (updated):

Bedford Laboratories has 100mg/5ml available in limited quantities. Once this supply is depleted, the next estimated release dates are unknown. All other presentations are out os stock and the company cannot estimate a release date. Production is pending as capacity permits. Availability of products is updated on the Bedford Laboratories website. Etoposide Injection 20 mg/mL; 5 mL; 53776 vials in stock; approximately 45000 vials will be in warehouse by the 3rd week of this month.

Doctor and Patient: Learning From Other Patients - NYTimes.com

Doctor and Patient: Learning From Other Patients - NYTimes.com

CMAJ: Young women with breast cancer genes face tough choices (8th part of a series in genetic testing - see links)

CMAJ: Young women with breast cancer genes face tough choices

Editor’s note: Eighth of a multipart series on genetic testing.

Part 1: Separating hype from reality in the era of the affordable genome (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4143).
Part 2: Popping the genetics bubble (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4142).
Part 3: Who should hold the keys to your DNA? (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4141).
Part 4: A race-based detour to personalized medicine (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4133).
Part 5: Race and genetics in the doctor’s office (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4134).
Part 6: Predisposed to risk but not change (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4157).
Part 7: Unhealthy behaviours influenced by genes and environment (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4162).

abstract: Shorter telomere length is associated with increased ovarian cancer risk in both familial and sporadic cases.

Shorter telomere length is associated with increased ovarian cancer risk in both familial and sporadic cases.:

J Med Genet. 2012 Apr 6;

Abstract

Background
Alterations in telomere maintenance mechanisms leading to short telomeres underlie different genetic disorders of ageing and cancer predisposition syndromes. It is known that short telomeres and subsequent genomic instability contribute to malignant transformation, and it is therefore likely that people with shorter telomeres are at higher risk for different types of cancer. Recently, the authors demonstrated that the genes BRCA1 and BRCA2 are modifiers of telomere length (TL) in familial breast cancer. The present study analysed TL in peripheral blood leucocytes of hereditary and sporadic ovarian cancer cases, as well as in female controls, to evaluate whether TL contributes to ovarian cancer risk.

Methods
TL was measured by quantitative PCR in 178 sporadic and 168 hereditary ovarian cases (46 BRCA1, 12 BRCA2, and 110 BRCAX) and compared to TL in 267 controls.

Results
Both sporadic and hereditary cases showed significantly shorter age adjusted TLs than controls. Unconditional logistic regression analysis revealed an association between TL and ovarian cancer risk with a significant interaction with age (p<0.001). Risk was higher in younger women and progressively decreased with age, with the highest OR observed in women under 30 years of age.

Conclusion
These findings indicate that TL could be a risk factor for early onset ovarian cancer.

abstract: Assumptions of Expected Benefits in Randomized Phase III Trials Evaluating Systemic Treatments for Cancer

Assumptions of Expected Benefits in Randomized Phase III Trials Evaluating Systemic Treatments for Cancer

Background In designing phase III randomized clinical trials (RCTs), the expected magnitude of the benefit of the experimental therapy (δ) determines the number of patients required and the number of person-years of follow-up. We conducted a systematic review to evaluate how reliably δ approximates the observed benefit (B) in RCTs that evaluated cancer treatment. 

Conclusions Investigators consistently make overly optimistic assumptions regarding treatment benefits when designing RCTs. Attempts to reduce the number of negative RCTs should focus on more realistic estimations of δ. Increased use of interim analyses, certain adaptive trial designs, and better biological characterization of patients are potential ways of mitigating this problem.

book review: Do bioethics really matter? : Malignant: Medical Ethicists Confront Cancer - The Lancet

Do bioethics really matter? : The Lancet

Stem Cell Network Blog: 35 reasons to like stem cells - images and art/voting open on FB "Cells I See"

Blogger's Note: the FB art/images are fabulous - take a look/vote if you wish

Stem Cell Network Blog: 35 reasons to like stem cells

April 12, 2012

35 reasons to like stem cells

by Lisa Willemse

2010 Cells I See winner: The Beauty of Pluripotency by Kamal Garcha

For the past four years, the Stem Cell Network has held a small image/art contest, known as Cells I See. You may have viewed announcements of the winners in previous blog posts. The contest, by and large, was a quiet affair, known only to a few who weren't part of the Network's annual scientific conference -- where the entries were displayed and conference attendees selected the winner via blind judging.

We were content to keep it this way, until we realized that we were, in essence, hiding some of the most incredible stem cell images we've ever seen. Prompted by interest from the Ontario Science Centre, we installed a small exhibit in their museum and the response was incredible. Most people had no idea what stem cells looked like and were amazed at their beauty and complexity. The overriding message was that people are interested not just in the science of stem cells, but in stem cell images and art.

In response, Cells I See has gone social -- we've opened up the 2012 voting to the world. Anyone with a Facebook profile can participate by "liking" any of the 35 entries in this year's contest. Of course, we invite you to share it with your friends and colleagues as well -- the images are breathtaking, displaying a range of cell types, colours and patterns.
But don't take my word for it, go see them for yourself.

abstract: Preoperative assessment of peritoneal carcinomatosis: intraindividual comparison of 18F-FDG PET/CT and MRI

Preoperative assessment of peritoneal carcinomatosis: intraindividual comparison of 18F-FDG PET/CT and MRI:

Conclusion  

With high diagnostic accuracy for PC of both, MRI and PET/CT, PET/CT provides better diagnostic accuracy and especially better NPV.

open access: A Pilot study of the Sharing Risk Information Tool (ShaRIT) for Families with Hereditary Breast and Ovarian Cancer Syndrome - study of 19 BRCA carriers

A Pilot study of the Sharing Risk Information Tool (ShaRIT) for Families with Hereditary Breast and Ovarian Cancer Syndrome 

 ".....ShaRIT strives to ease the “burden of the messenger” and decrease the possibility of mis-communicating and misinterpreting
important medical information to their relatives."