Recurrent ovarian cancer: Is there a role for re-treatment with bevacizumab after an initial complete response to a bevacizumab-containing regimen?

Recurrent ovarian cancer: Is there a role for re-treatment with bevacizumab after an initial complete response to a bevacizumab-containing regimen?

Publication year: 2012
Source:Gynecologic Oncology
Georgia A. McCann, Blair Smith, Floor J. Backes, Kellie Rath, Simi Chacko, Ritu Salani, Eric Eisenhauer, Jeffrey Fowler, David Cohn, David O'Malley
Objective To compare the progression free survival (PFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC) who received Bev after Bev (BAB) versus those who were not re-treated with Bev (NOTBev) after initially experiencing a complete response (CR) to a Bev-containing regimen (BCR). Methods We performed a retrospective chart review of patients with EOC that received Bev in either the front-line or recurrent setting. Patients who received additional therapy after achieving a CR to BCR were analyzed. Results 36 patients who had a CR to a BCR were included, 17 who received Bev at the time of their subsequent recurrence versus 19 that did not. More patients in the NOTBev group received Bev as primary therapy (21% vs. 6%, p=0.2), but this was not statistically significant. Patients in the BAB group had significantly higher mean PFS compared to the NOTBev group (20 vs. 6months, p=0.0019). On adjusting for covariates, there was a 78% improvement in their PFS (HR 0.22, p=0.0048). No difference in overall survival was noted between the groups (23 vs. 26months, p=0.7244). Conclusions Re-treatment with Bev after a prior Bev response is associated with a significantly improved PFS. This is the first of such reports in this patient population. The 14-month improvement in PFS strongly supports the re-use of Bev in patients who demonstrate an initial response to Bev. This strategy should be formally tested in future clinical trials and further investigation should include evaluation of predictors of response to Bev therapy.

Highlights

► Comparison of patients who were treated with Bev versus not after CR on Bev. ► The use of Bev after CR on Bev increased the PFS versus no subsequent Bev. ► The use of Bev after CR on Bev did not impact OS versus no subsequent Bev.

The biology of ovarian cancer: new opportunities for translation

The biology of ovarian cancer: new opportunities for translation

Nature Reviews Cancer, Vol. 9, No. 6. (01 June 2009), pp. 415-428, doi:10.1038/nrc2644

Over the past two decades, the 5-year survival for ovarian cancer patients has substantially improved owing to more effective surgery and treatment with empirically optimized combinations of cytotoxic drugs, but the overall cure rate remains approximately 30%. Many investigators think that further empirical trials using combinations of conventional agents are likely to produce only modest incremental improvements in outcome. Given the heterogeneity of this disease, increases in long-term survival might be achieved by translating recent insights at the molecular and cellular levels to personalize individual strategies for treatment and to optimize early detection.
Robert Bast, Bryan Hennessy, Gordon Mills

Humanities aren’t a science. Stop treating them like one. | Literally Psyched, Scientific American Blog Network

.....The tools of mathematical and statistical and scientific analysis are invaluable. But their quantifiable certainty is all too easy to see as the only "real" way of doing things when really, it is but one tool and one approach—and not one that is translatable or applicable to all matters of qualitative phenomena. That's one basic fact we'd do well not to forget."


http://blogs.scientificamerican.com/literally-psyched/2012/08/10/humanities-arent-a-science-stop-treating-them-like-one/


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Individualized care best for lymphedema patients, MU researcher says

http://www.eurekalert.org/pub_releases/2012-08/uom-icb081012.php

Management of a suspicious adnexal mass - PubMed Mobile

http://www.ncbi.nlm.nih.gov/m/pubmed/22876153/

Management of a suspicious adnexal mass: a clinical practice guideline.

Authors

Dodge JE, et al. Show all

Journal

Curr Oncol. 2012 Aug;19(4):e244-e257.

Affiliation

Division of Gynaecologic Oncology, Princess Margaret Hospital, University Health Network, Department of Obstetrics and Gynaecology, Toronto, ON.

Abstract

QUESTIONS: What is the optimal strategy for preoperative identification of the adnexal mass suspicious for ovarian cancer? What is the most appropriate surgical procedure for a woman who presents with an adnexal mass suspicious for malignancy?....

July 18th, 2012: Uncertain Genetic Test Results for Lynch Syndrome - Full Text View - ClinicalTrials.gov

Uncertain Genetic Test Results for Lynch Syndrome - Full Text View - ClinicalTrials.gov

This study is currently recruiting participants.

Verified April 2012 by National Institutes of Health Clinical Center (CC)

First Received on July 18, 2012.   No Changes Posted

Sponsor:	National Human Genome Research Institute (NHGRI)
Information provided by:	National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier:	NCT01646112

  Purpose

Background:

• Individuals have varying tolerances for receiving ambiguous information. However, not much is known about how ambiguous genetic testing information is received. Also, not much is known about how at-risk individuals internalize and process these results. More information is needed about how this information affects a person's life.
• Lynch Syndrome is a genetic condition that carries a high risk of colon cancer and other cancers. Individuals at risk for Lynch Syndrome can have genetic testing for it. The test may confirm a diagnosis and determine actions that can be taken. Results from genetic testing can also affect the perspectives of relatives who might also be affected. However, genetic testing can also produce variants of unknown significance (VUS). VUS are data that may not provide enough information to make decisions. Researchers want to study people who have received a VUS result for genetic testing for Lynch Syndrome.

Objectives:

- To learn more about the impact and experience of receiving a VUS for Lynch Syndrome genetic testing.

Eligibility:

- Individuals at least 18 years of age who have recently had a VUS result on a genetic test for Lynch Syndrome.

Design:

• Participants will be asked to answer demographic questions. They will also have a 45- to 60-minute phone interview.
• During the phone interview, participants will be asked a series of questions about their diagnosis. They will be asked about how they received the result and how they felt right after receiving it. They will also discuss who they have spoken to about the result.