Genetics education and resources for social scientists

Genetics vs. Genomics

In popular media and common speech, the words "genetic" and "genomic" are often used interchangeably. However, to a geneticist, these terms have specific meanings. To appreciate the difference, we must first understand something about the structure of genetic material.
Genetic information is stored in the molecule DNA, which consists of a string of chemicals called bases. The order of bases on the string, called the "sequence", determines the meaning of the genetic message. A gene is a specific stretch of bases that provides instructions for making a particular product, such as a piece of a hormone or enzyme. Humans have many thousands of genes, spaced across the entire set of DNA, which is packaged into 23 pairs of chromosomes. However, there are many DNA sequences in-between genes that do not directly encode specific products. Some of these sequences modify the way that genes are expressed. Other sequences do not have a known function.

Read the full story

Ex-Medicare Chief (Don) Berwick Takes Gloves Off - Washington Wire - WSJ

Potentiation of a p53-SLP vaccine by cyclophosphamide in ovarian cancer, a single arm phase II study.

Abstract

The purpose of the current phase II single-arm clinical trial was to evaluate whether pre-treatment with low-dose cyclophosphamide improves immunogenicity of a p53-synthetic long peptide (SLP) vaccine in patients with recurrent ovarian cancer. Ovarian cancer patients with elevated serum levels of CA-125 after primary treatment were immunized four times with the p53-SLP vaccine.........The outcome of this phase II trial warrants new studies on the use of low-dose cyclophosphamide to potentiate the immunogenicity of the p53-SLP vaccine, or other anti-tumor vaccines.

Attitudes of Patients With Gynecological and Breast Cancer Toward Integration of Complementary Medicine in Cancer Care

Conclusion:
Although patients with gynecological malignancies use CAM significantly more than patients with breast cancer, both groups share similar conceptions regarding the active role of their gynecologist oncologists in the process of CAM integration within supportive care and expect CAM consultation to focus on improving their well-being.

Impact of Chemotherapy-Induced Nausea and Vomiting on Quality of Life in Indonesian Patients With Gynecologic Cancer

Conclusions:
Patients reported a negative impact on the QoL of delayed emesis after chemotherapy. Poor prophylaxis of patients’ nausea and vomiting after chemotherapy interferes with patients’ QoL. Medical and behavioral interventions may help to alleviate the negative consequences of chemotherapeutic treatment in patients with gynecologic cancers treated with suboptimal antiemetics.

Intravenous/Intraperitoneal Paclitaxel and Intraperitoneal C... : International Journal of Gynecological Cancer

Objective:
This study aimed to evaluate intravenous (IV)/intraperitoneal (IP) paclitaxel and IP carboplatin (TCipTip therapy) feasibility in epithelial ovarian (EOC), fallopian tube (FTC), or peritoneal carcinoma (PC) patients.


Methods:
From December 2007 to August 2010, 20 women with histologically confirmed stage IC to IV EOC, FTC, or PC.....

Identifying Clinical Improvement in Consolidation Single-Arm Phase 2 Trials in Patients With Ovarian Cancer in Second or Greater Clinical Remission

Abstract

Objective: Estimates of progression-free survival (PFS) from single-arm phase 2 consolidation/maintenance trials for recurrent ovarian cancer are usually interpreted in the context of historical controls. We illustrate how the duration of second-line therapy (SLT), the time on the investigational therapy (IT), and patient enrollment plan can affect efficacy measures from maintenance trials and might result in underpowered studies.

Conclusions:

Designs of nonrandomized consolidation trials that aim to prolong PFS must consider the effect of the duration of SLT on the end point definition and on required sample size. If IT is given concurrently with SLT, and after SLT, then SLT duration must be restricted per protocol eligibility, so that a comparison with historical data from other single-arm phase 2 studies is unbiased. If IT is given after SLT, the duration of SLT should be taken into account in the design stage because it will affect statistical power and sample size.

Phase II Study of Docetaxel Weekly in Combination With Carboplatin Every 3 Weeks as First-Line Chemotherapy in Stage IIB to Stage IV Epithelial Ovarian Cancer

 Objectives: 
The purpose of this study was to assess the response rate, toxicity, progression-free survival, and overall survival in a series of patients with advanced-stage ovarian carcinoma treated with a first-line weekly docetaxel and 3 weekly carboplatin regimen.
 
Conclusions:
The tolerable hematologic toxicity (no need for colony-stimulating factors) and the low rate of neurotoxicity (only grades 1–2) and response rates in line with the standard 3-week paclitaxel-carboplatin regimen for advanced primary ovarian carcinoma after suboptimal cytoreductive surgery make this regimen an interesting alternative in selected patients.

published Oct 2011 - full free access: The Role of Hormonal Therapy in Gynecological Cancers-Curren... : International Journal of Gynecological Cancer

Abstract (and full free access to full paper)

Many gynecological cancers, including epithelial and stromal ovarian cancers; endometrial carcinomas; and some gynecological sarcomas, in particular endometrial stromal sarcomas, express estrogen and/ or progesterone receptors. Hormonal therapy, typically progestogens or tamoxifen, is commonly prescribed to patients with potentially hormone-sensitive recurrent or metastatic gynecological cancers with very variable response rates and clinical benefit reported. Aromatase inhibitors are now widely used to treat postmenopausal women with hormone receptor-positive breast cancers as they have greater activity than tamoxifen and are generally better tolerated. The role of aromatase inhibitors in gynecological cancers is uncertain and has not been well studied, although they do appear to be active. The current evidence to support the use of hormonal therapies including aromatase inhibitors in gynecological cancers is reviewed, and the gaps in our knowledge highlighted.

Loss of ARID1A-Associated Protein Expression is a Frequent Event in Clear Cell and Endometrioid Ovarian Cancers

Abstract

Background: Inactivating somatic mutations in the ARID1A gene are described in a significant fraction of clear cell and endometrioid ovarian cancers leading to loss of the corresponding protein (BAF250a).

Conclusions:

These data confirm that loss of the ARID1A-encoded protein BAF250a is a frequent event in the genesis of clear cell and endometrioid ovarian cancers. Loss of BAF250a was not associated with clinical or epidemiologic characteristics. One explanation for these findings is that inactivation of the chromatin remodeling pathway may be a requisite event in the development of these cancers.

Journal of Clinical Epidemiology : Using short information leaflets as recruitment tools did not improve recruitment: a randomized controlled trial

Objective

To assess if the type of patient information leaflet (PIL) received at an initial invitation to participate in a randomized trial influences the number of patients recruited.

Conclusion

Providing patients with shorter PILs when inviting them to participate in research does not affect the numbers who are subsequently recruited and yields more ineligible patients. Therefore, it is recommended to use the full PIL as a recruitment tool.

Can Canada get on with national pharmacare already? (the politics of cancer/healthcare)

We believe the public’s choice would be health care. With Canadians suffering and, indeed, dying every day from inadequate drug coverage, and with a national pharmaceutical strategy already in place, the lack of action on pharmacare is inexcusable.

BMC Medicine | Abstract/free full text: Septin 9 methylated DNA is a sensitive and specific blood test for colorectal cancer (small study)

The complete article is available as a provisional PDF.

Background
About half of Americans 50 to 75 years old do not follow recommended colorectal cancer (CRC) screening guidelines, leaving 40 million individuals unscreened. A simple blood test would increase
screening compliance, promoting early detection and better patient outcomes. The objective of this study is to demonstrate the performance of an improved sensitivity blood-based Septin 9 (SEPT9) methylated
DNA test for colorectal cancer. Study variables include clinical stage, tumor location and histologic grade.

What Is Distracting Doctors More Than Electronic Devices? - Better Health (in response to NYT article)

Survey Asks Doctors And Patients If Doctor’s Notes Should Be In The EHR (electronic health records)

Survey Reveals Just How Stressed Physicians Really Are - Better Health

in research: Combinations of Resveratrol, Cisplatin and Oxaliplatin Applied to Human Ovarian Cancer Cells

Follow-up with CA125 after primary therapy of advanced ovarian cancer has major implications for treatment outcome and trial performances and should not be routinely performed

Follow-up with CA125 after primary therapy of advanced ovarian cancer: in favor of continuing to prescribe CA125 during follow-up

Quality control in ovarian cancer surgery

If the profession does not institute adequate internal regulation of the quality of ovarian cancer surgery, regulation is likely to be imposed by government.

Correction: ABCB1 (MDR1) Polymorphisms and Progression-Free Survival among Women with Ovarian Cancer following Paclitaxel/Carboplatin Chemotherapy

link to original article:

The authors of this article (Clin Cancer Res 2008;14:5594-601), which was published in the September 1, 2008, issue of Clinical Cancer Research (1), wish to inform the scientific community that the results of the analysis of the ABCB1 3435C>T and 1236C>T SNPs presented were incorrectly reported due to a corrupted analysis file.

Completion of Adjuvant Chemotherapy and Use of Health Services for Older Women (65 yrs+) With Epithelial Ovarian Cancer (SEER data/Medicare)

Results
Among 4,617 patients with untreated ovarian cancer, 1,329 (28.8%) received no chemotherapy, 1,139 (24.7%) received a partial course of chemotherapy, and 2,149 (46.5%) completed chemotherapy.

Conclusion
There is considerable room for improvement in helping older patients with ovarian cancer initiate and complete chemotherapy. The oldest women who completed chemotherapy in this study did not use health services more than younger women did.

Skin Tumors Induced by Sorafenib; Paradoxic RAS–RAF Pathway Activation and Oncogenic Mutations of HRAS, TP53, and TGFBR1

Conclusion:

Sorafenib induces keratinocyte proliferation in vivo and a time- and dose-dependent activation of the MAP kinase pathway in vitro. It is associated with a spectrum of lesions ranging from benign follicular cystic lesions to KA-like SCC. Additional and potentially preexisting somatic genetic events, like UV-induced mutations, might influence the evolution of benign lesions to more proliferative and malignant tumors.

Ovarian cancer drug fail (and that’s the good news?) author/ovarian cancer survivor: Donna Trussell - She the People: - The Washington Post

Getting Doctors And Patients On The Same Team: A Basketball Metaphor For Health Care - Better Health

....But for the business of medicine, it’s all about the zone.... But what happens when the patients change tactics?.....What if the patient’s psyche or medical issues don’t follow the typical playbook?....So the players become confused.....

Loss of ARID1A protein expression occurs as an early event in ovarian clear-cell carcinoma development and frequently coexists with PIK3CA mutations : Modern Pathology

ARID1A is a recently identified tumor suppressor gene that is mutated in ~50% of ovarian clear-cell carcinomas. This mutation is associated with loss of ARID1A protein expression as assessed by immunohistochemistry. The present study aimed at determining the timing of the loss of ARID1A protein expression during the development of ovarian clear-cell carcinoma and assessing its relevance in correlation to PIK3CA gene mutations......

A Prospective Study of Serum 25-Hydroxyvitamin D (vitamin D) Levels, Blood Pressure, and Incident Hypertension in Postmenopausal Women

 authors.....for the Women’s Health Initiative Investigators

In postmenopausal women in this study, serum levels of 25(OH)D were not related to changes in blood pressure, and evidence for an association with lower risk of incident hypertension was weak.

Women of Teal: 4 Years of Blogging -

Thanks to the statistics the Blogger software started keeping in May 2009, I know that my blog has reached far from the Garden State. I have also been read in Germany, Great Britain, Russia, Canada, South Korea, France , the Netherlands, Iran and Australia and I have between 1,500 and 2,200 page views a month.....

Serum HE4 levels are less frequently elevated than CA125 in women with benign gynecologic disorders

Introduction

HE4 is a novel biomarker for ovarian cancer. This study measured HE4 and CA125 levels in women with benign gynecologic disorders.

Serum Levels of the Ovarian Cancer Biomarker HE4 are decreased in Pregnancy and Increase with Age

Objectives:

To establish normal ranges for HE4 serum levels in healthy women.

2013 results to show if bevacizumab (Avastin) prolongs life in ovarian cancer - - media

NEW YORK (Reuters Health) - The coauthor of a study that helped convince the European Commission on Friday to approve bevacizumab (Avastin) as an initial post-surgical treatment for advanced ovarian cancer predicted that some doctors may be reluctant to use the drug until mortality data become available in 2013.......

Amazon.com: Methods of Cancer Diagnosis, Therapy, and Prognosis: Ovarian Cancer..... (published 2010)

Blogger's Note: available on kindle; new, used

Book Description

ISBN-10: 9048129176 | ISBN-13: 978-9048129171 | Publication Date: February 18, 2010 | Edition: 1st Edition

This sixth volume in the series Methods of Cancer Diagnosis, Therapy, and Prognosis discusses Ovarian Cancer, Renal Cancer, Urogenitary Cancer, Urinary Bladder Cancer, Cervical Uterine Cancer, Skin Cancer, Leukemia, Multiple Myeloma and Sarcoma. Both standard and emerging therapies for these cancers, written by expert oncologists/pathologists in this field, are included.

This fully illustrated volume

• Identifies biomarkers based on genetic alterations for clear cell ovarian adenocarcinoma.
• Identifies subgroups of ovarian cancer by using differential gene expression.
• Includes the application of the power-Doppler imaging for distinguishing benign from malignant complex adrenal masses in ovarian cancer.
• Emphasizes the advantage of using cytoreduction surgery for diagnosing advanced ovarian cancer.
• and other cancers/ topics

The technological advances presented in this volume are expected to expedite new discoveries and their translation to clinical practice. The field of oncology will benefit the most from these advanced methods, as a combination of therapies and personalized medicine will improve early detection of these different types of cancer.

Professor Hayat has summarized the problems associated with the complexities of research publications and has been successful in editing a must-read volume for oncologists, cancer researchers,

Follow-up with CA125 after primary therapy of adva... [Ann Oncol. 2011] - PubMed - NCBI

CONCLUSIONS:

Women should be advised not to have routine CA125 measurements, providing they are well and have no symptoms suggesting relapse. In asymptomatic patients with a rising CA125 level, chemotherapy can be delayed. Earlier stopping of maintenance therapy just because of rising CA125 might deny patients continuing benefit from that therapy. Use of CA125 to define progression could result in platinum-sensitive patients being falsely classified as platinum resistant.

Table of Contents — Dec 2011 - 8th International Symposium on Advanced Ovarian Cancer: Optimal Therapy 4 Mar 2011, Valencia Spain

Blogger's Note: abstracts - subscription req'd ($$$) to access full view symposium articles

1. R. C. Bast, Jr Molecular approaches to personalizing management of ovarian cancer Ann Oncol (2011) 22(Suppl 8): viii5-viii15 doi:10.1093/annonc/mdr516 
2. N. Urban Designing early detection programs for ovarian cancer Ann Oncol (2011) 22(Suppl 8): viii6-viii18 doi:10.1093/annonc/mdr472 
3. N. F. Hacker Quality control in ovarian cancer surgery Ann Oncol (2011) 22(Suppl 8): viii19-viii22 doi:10.1093/annonc/mdr517 S. 
4. Kang and S.-Y. Park To predict or not to predict? The dilemma of predicting the risk of suboptimal cytoreduction in ovarian cancer Ann Oncol (2011) 22(Suppl 8): viii23-viii28 doi:10.1093/annonc/mdr530 
5. N. Katsumata Dose-dense therapy is of benefit in primary treatment of ovarian cancer? In favor Ann Oncol (2011) 22(Suppl 8): viii29-viii32 doi:10.1093/annonc/mdr468 
6. M. E. L. van der Burg, I. A. Boere, and P. M. J. J. Berns Dose-dense therapy is of benefit in primary treatment of ovarian cancer: contra Ann Oncol (2011) 22(Suppl 8): viii33-viii39 doi:10.1093/annonc/mdr514 
7. S. Pignata, L. Cannella, D. Leopardo, G. S. Bruni, G. Facchini, and C. Pisano Follow-up with CA125 after primary therapy of advanced ovarian cancer: in favor of continuing to prescribe CA125 during follow-up Ann Oncol (2011) 22(Suppl 8): viii40-viii44 doi:10.1093/annonc/mdr470 
8. G. J. S. Rustin Follow-up with CA125 after primary therapy of advanced ovarian cancer has major implications for treatment outcome and trial performances and should not be routinely performed Ann Oncol (2011) 22(Suppl 8): viii45-viii48 doi:10.1093/annonc/mdr471 
9. E. A. Eisenhauer Optimal assessment of response in ovarian cancer Ann Oncol (2011) 22(Suppl 8): viii49-viii51 doi:10.1093/annonc/mdr467 
10. Michael A. Bookman Update of randomized trials in first-line treatment Ann Oncol (2011) 22(Suppl 8): Viii52-viii60 doi:10.1093/annonc/mdr466 
11. E. Pujade-Lauraine and J. Alexandre Update of randomized trials in recurrent disease Ann Oncol (2011) 22(Suppl 8): viii61-viii64 doi:10.1093/annonc/mdr518 
12. R. A. Burger Antiangiogenic agents should be integrated into the standard treatment for patients with ovarian cancer Ann Oncol (2011) 22(Suppl 8): viii65-viii68 doi:10.1093/annonc/mdr529 
13. M. Markman The use of bevacizumab in the management of ovarian cancer: an argument for single-agent rather than combination therapy Ann Oncol (2011) 22(Suppl 8): viii69-viii71 doi:10.1093/annonc/mdr469 
14. C. Sessa Update on PARP1 inhibitors in ovarian cancer Ann Oncol (2011) 22(Suppl 8): viii72-viii76 doi:10.1093/annonc/mdr528 K. 
15. Bell-McGuinn, J. Konner, W. Tew, and D. R. Spriggs New drugs for ovarian cancer Ann Oncol (2011) 22(Suppl 8): viii77-viii82 doi:10.1093/annonc/mdr531

Gynecologic Oncology : Withdrawal from familial ovarian cancer screening for surgery: Findings from a psychological evaluation study (PsyFOCS)

Highlights

► Previous negative experiences of OC screening might lead women to opt for surgery.
► OC screening may be an interim risk management strategy before opting for surgery.

Gynecologic Oncology : The association between endometriosis and ovarian cancer: A review of histological, genetic and molecular alterations

.... PTEN play a part in the malignant transformation of endometriosis, some studies have revealed TP53 mutations in endometriotic lesions, and mutation of ARID1A (clear cell)

Highlights
► Atypical endometriosis is a transition from benign endometriosis to carcinoma.
► Endometriosis is characterized by genetic instability.
► Oxidative stress, inflammation and hyperestrogenism link endometriosis with cancer.

Gynecologic Oncology : There is no decision to make: Experiences and attitudes toward treatment-focused genetic testing among women diagnosed with ovarian cancer

Highlights

► Women's views regarding genetic testing at diagnosis of ovarian cancer 
► This ‘treatment-focused’ genetic testing is highly acceptable 
► Advantages of genetic testing at diagnosis outweigh the disadvantages

Androgen receptor expression is a biological marker for androgen sensitivity in high grade serous epithelial ovarian cancer

Highlights

► Androgen receptor expression correlates with androgen sensitivity in ovarian cancer.
► Androgen receptor expression decreases with chemotherapy.
► Androgen receptor expression is a biomarker for androgen therapy in ovarian cancer.

Second Malignancies Among Elderly Survivors of Cancer

 Blogger's note: selected text referencing ovarian cancer:

 Ovarian Cancer Survivors

Most ovarian cancer patients present with relatively late stage disease, and thus the overall 5-year survival rate is only 46% [1]. However, in women who survive ≥5 years following ovarian cancer, the risk for developing a second malignancy is high, with a 31% higher risk than in the general population [54]. The cancers most often seen after ovarian cancer are breast, colorectal, and bladder cancer and leukemia [55]. Breast and colon cancer are most often seen after ovarian cancer in younger women, largely because of the prevalence of genetic syndromes, such as BRCA mutation and hereditary nonpolyposis colorectal cancer  (Lynch Syndrome),  that predispose to these tumors and ovarian cancer [27, 29, 55]. Some rare tumors have also been associated with ovarian cancer, including biliary tract cancer and both the ocular and skin variants of malignant melanoma, and are also thought to be a result of genetic syndromes such as BRCA-2 mutation [26, 54, 56].

However, an excess risk for second malignancies has been seen in women diagnosed with primary cancer of the ovary at age 50–69 years as well, and these second cancers appear more likely to be a result of treatment. In particular, the risks for bladder, soft tissue, and bone cancers are substantially higher in women who received radiation, and these risks become most apparent ≥10 years following the initial radiation therapy [54, 57].

The risk with chemotherapy in the development of second cancers is also apparent across all age groups. The risk for the subsequent development of both AML and acute lymphocytic leukemia have been shown to be significantly higher in women following a primary diagnosis of ovarian cancer, even in women aged ≥70 years at the time of their primary diagnosis and in women who did not receive radiation [54]. Historically, this greater risk was attributed to alkylating chemotherapeutic agents, such as melphalan and chlorambucil [32], but these agents have largely fallen out of use in the treatment of ovarian cancer. More recently, platinum-based chemotherapy, which is routinely used in ovarian cancer treatment, has also been associated with a higher late risk for leukemia. This was demonstrated in a large registry case–control study of women who developed leukemia after ovarian cancer. Of note, 71% of patients who developed leukemia were aged ≥60 years at the time of their ovarian cancer diagnosis, whereas 29% were aged ≥70 years [31]......

......Further evidence-based guidelines are needed for early detection and treatment of second malignancies in older adults, and physicians caring for this population should integrate age, health status, projected life expectancy, and patient preferences when deciding upon screening and prevention measures.  

Revisiting the Role of Antiandrogen Strategies in Ovarian Cancer

link to abstract

selected excerpts (in efforts to understand the issues):

Epidemiological Data on Androgens and the Risk for EOC

In women, androgens are mainly synthesized in the adrenal glands, the ovaries, and adipose tissue, and they have an important physiological significance for bone and muscle growth and maintenance as well as cognitive function [1, 5]. There is a growing body of evidence supporting the notion that androgens influence proliferation of the normal ovarian epithelium and are a risk factor for EOC......

First, most clinical trials evaluating the use of androgen blockade for the treatment of EOC have been small, nonrandomized studies involving patients with platinum-resistant disease......
 
Third, most clinical trials assessing anti-AR strategies in EOC have not measured AR expression. The trials that did measure it used IHC, the results of which may not always reflect AR activity in EOC.

Factors Associated with Altered Long-Term Well-Being After Prophylactic Salpingo-Oophorectomy Among Women at Increased Hereditary Risk for Breast and Ovarian Cancer

Blogger's note: full view may require $$$ (subscription)

link to abstract

Year in Review: Gene Patent Case May Head to Supreme Court - Myriad + Mayo/Prometheus Labs

Research Papers What Patients Tell Us about Primary Healthcare Evaluation Instruments: Response Form, Bad Questions and Missing Pieces

 Blogger's Note: there is a bias in this report (demographics of participants), however, an interesting read and in particular the integrity of the participants as per one quote below

sample:

Bad questions

When asked about questions they did not like, respondents consistently stated they did not like assessing processes occurring in the provider's mind or that they did not directly observe or experience. Almost all questionnaires contained such questions.....

Obstetrics/Gynecology articles: The New England Journal of Medicine (2 articles)

SpecialtyObstetrics/Gynecology

original article

Bevacizumab in the Treatment of Ovarian Cancer

December 29, 2011 | R.A. Burger
and Others

Incorporating bevacizumab in a chemotherapy regimen (7.5 mg/kg every 3 weeks for five or six cycles) and then continuing bevacizumab alone for a total of 12 months of treatment extended progression-free survival in advanced and high-risk earlystage ovarian cancer.

Bevacizumab in Ovarian Cancer Treatment

December 29, 2011 | T.J. Perren
and Others

The addition of bevacizumab to chemotherapy (15 mg/kg for six cycles) followed by extended therapy with bevacizumab every 3 weeks for a total of 15 months of treatment improved progression-free survival by 4 months in incompletely resected stage III or IV ovarian cancer.

Recurrent Somatic DICER1 Mutations in Nonepithelial Ovarian Cancers — NEJM

Incorporation of Bevacizumab in the Primary Treatment of Ovarian Cancer — NEJM

Blogger's Note: see also the section 'Media in This Article'

Low-Molecular-Weight Heparin and Mortality in Acutely Ill Medical Patients — NEJM (Lovenox (enoxaparin)

Essential gene profiles in breast, pancreas and ovarian cancer cells

Doctors Are Cautious, Patients Enthusiastic About Sharing Medical Notes - Beth Israel Deaconess Medical Center

Roche's Avastin - Trials And Triumphs (overview/history)

Medical News: ECCO-ESMO: Bevacizumab Safe in 'Real World'

Action Points

---

• Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
  



• Explain that a retrospective study showed a benefit for bevacizumab in patients with recurrent ovarian cancer, similar to benefits seen in prior clinical trials.
  



• Note that the greatest benefit from bevacizumab was seen in platinum-sensitive ovarian cancer and those receiving second- or third-line treatment in combination with chemotherapy.

Medical News: ECCO-ESMO: Spikes in Liver Enzymes Common in Ovarian Cancer Tx (Trabectedin / Yondelis)

Action Points

---

• Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.



• Explain that liver transaminase abnormalities in patients with advanced ovarian cancer who received trabectedin did not impact outcomes, including response rate.



• Note that liver transaminase abnormalities were seen in 63% of patients studied.

Medical News: SABCS: Removing Ovaries May Put Bone Health at Risk - in Meeting Coverage, SABCS (cancer prevention/BRCA)

Blogger's Note: note absence of Lynch Syndrome/female cancer prevention

MedPage Today Action Points

• This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
• The removal of both ovaries, which is often done as a preventive measure in women at high risk of breast cancer, may increase a younger woman's likelihood of low bone mineral density (BMD) and arthritis.
• The prevalence of arthritis was even higher in women who had their ovaries removed before age 45.

Salvage chemotherapy for recurrent or persistent clear cell carcinoma of the ovary: a single-institution experience for a series of 20 patients

Bioidentical hormone therapy: Clarifying the misconceptions

Copy Number Variation Analysis of Matched Ovarian Primary Tumors and Peritoneal Metastasis

Blogger's note: technical

Our study highlights the benefit and importance of performing paired analysis of primary tumors and their metastatic lesions in ovarian cancer. While comparison of primary and metastasis as groups provided insight into cancer development, the matched analysis allowed more specific detection of consistent differences. Indeed advanced disease allows access to not only the primary but also the different metastatic sites. It has been clearly demonstrated that the patients' prognosis relies on tumor residue; therefore it is critical to understand the biology of the metastatic lesions in order to design appropriate new therapeutic approaches. The results presented here should be a step in that direction.

Systematic Immunohistochemistry Screening for Lynch Syndrome in Early Age-of-Onset Colorectal Cancer Patients Undergoing Surgical Resection

This strategy identifies a substantial number of LS patients who would have been missed if genetic testing was based on the Amsterdam II Criteria alone.

Microsatellite Instability in Saliva from Patients with Hereditary Non-polyposis Colon Cancer (Lynch Syndrome) and Siblings Carrying Germline Mismatch Repair Gene Mutations

Saliva testing, a less-invasive procedure than PBL testing, is more sensitive and appears to be a viable alternative for identifying MSI in carriers with MMR mutations.

Two cases of ovarian metastasis of colon cancer

Ovarian tumors were diagnosed as metastasis from colon cancer. Ovarian metastasis of colon cancer is a relatively rare event, but a long-term survival case has been reported by multimodality therapy including surgery.

Treatment-related protein biomarker expression differs between primary and recurrent ovarian carcinomas

Patient-Reported Outcomes in Oncology - Center for Medical Technology Policy - survey feedback deadline Jan 30rh, 2012

On May 24, 2011, the project team presented their recommendations at the ISPOR16th Annual International Meeting.

The EGD is available for public comment. Click the following link to download, PRO EGD Final (35), and visit this survey by January 30, 2012 to provide feedback.

For more information, contact Merianne (Tiglao) Spencer.

link to the document - pdf file:

Recommendations for Incorporating Patient-Reported Outcomes into the Design of Clinical Trials in Adult Oncology

Clinical Care Options - Oncology CME - The Right Care for the Younger Patient: Meeting the Needs of Adolescents and Young Adults With Cancer

Blogger's Note: access is free after registering, slideshow (powerpoint) discusses genetics (eg. BRCA/Lynch Syndrome genes/implications)

Use of Complementary and Alternative Medicine by Cancer Patients at a Montreal Hospital

Conclusion:
Whereas disclosure of natural health products use is occurring, informative CAM discussion is not.

Journal of Ovarian Research | Full text | Nuclear survivin expression is a positive prognostic factor in taxane-platinum-treated ovarian cancer patients

Table 1. Patients characteristics.

Dec 2011: Journal of Ovarian Research Gene Expression and Pathway Analysis of Ovarian Cancer Cells Selected for Resistance to Cisplatin, Paclitaxel, or Doxorubicin

Background

Resistance to current chemotherapeutic agents is a major cause of therapy failure in ovarian cancer patients, but the exact mechanisms leading to the development of drug resistance remain unclear. 

Results

A total of 845 genes (p<0.01) were found altered in at least one drug resistance phenotype when compared to the parental, drug sensitive cell line.......

Conclusions

Ovarian cancer cells develop drug resistance through different pathways depending on the drug used in the generation of chemoresistance. A better understanding of these mechanisms may lead to the development of novel strategies to circumvent the problem of drug resistance.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Medline search: 3,495 articles found for: ALL(whole abdominal radiation ovarian cancer)

http://www.sciencedirect.com/science?_ob=ArticleListURL&_method=tag&_temp=&sort=r&sisrterm=&_ArticleListID=1869327428&view=c&_chunk=0&count=1000&_st=&refsource=&_acct=C000228598&_version=1&_urlVersion=0&_userid=10&md5=c13efc117a7aa8062a05f64363fa4bbf&searchtype=a&originPage=rslt_list

Mucinous Tumors of the Ovary: Diagnostic Challenges at Frozen Section and Clinical Implications

Conclusions

Our study showed a 34% rate of discordance between FS and final diagnosis. Given that 5 cases (7%) were of GI origin, intraoperative assessment of the appendix should be performed in all mucinous ovarian tumors.

Highlights

► We examined 73 consecutive cases of mucinous ovarian tumors that had frozen section (FS) at the time of surgery.
► The rate of discordance between FS and final diagnosis was 34%.
► Consideration of appendiceal tumors is important as 7% of all cancers were found to be gastrointestinal in origin.

A phase I study with an expanded cohort to assess the feasibility of intravenous paclitaxel, intraperitoneal carboplatin and intraperitoneal paclitaxel in patients with untreated ovarian, fallopian tube or primary peritoneal carcinoma: A Gynecologic Oncology Group study

Highlights

► The maximum tolerated dose and feasibility of IV and IP chemotherapy was assessed.
► The dose limiting toxicity rate for Paclitaxel 175 mg/m² IV, carboplatin AUC 6 IP and paclitaxel IP was 35%.

A randomized phase III clinical trial of a combined treatment for cachexia in patients with gynecological cancers: Evaluating the impact on metabolic and inflammatory profiles and quality of life

Objectives

Gynecological neoplastic disease progression is characterized by specific energy metabolism alterations and by symptoms including fatigue, anorexia, nausea, anemia, and immunodepression, which result in a cachexia syndrome and a marked decrease in patient quality of life (QoL). Therapeutic protocols associated with appropriate and effective psychological and social support systems are essential to counteract the symptoms of neoplastic disease in incurable patients.

Highlights

► Progression of gynecological cancers is characterized by specific alterations of energy metabolism and symptoms that impact quality of life.
► We compared a combined versus a single-agent approach for the treatment of advanced gynecological cancer-associated symptoms.
► Multimodal regimen was more effective in improving both immunometabolic alterations and quality of life in advanced gynecologic cancer patients.

Brain Metastases from Epithelial Ovarian Carcinoma: Evaluation of Prognosis and Managements - A Taiwanese Gynecologic Oncology Group (TGOG) Study

Conclusions

However, clinicians should keep alert to the neurological complaints of ovarian cancer patients and the patients might benefit from aggressive multimodal treatments.

Highlights

► The clinical characteristics of brain metastases from epithelial ovarian carcinoma.
► To identify prognostic factors and optimal treatment strategy in these patients.

ScienceDirect - Gynecologic Oncology : Proceedings from the 9th International Conference on Ovarian Cancer

Blogger's note: requires ($$$) subscription to view

Surgical staging and adjuvant chemotherapy in the management of patients with adult granulosa cell tumors of the ovary

Patterns of first recurrence following adjuvant intraperitoneal chemotherapy for stage IIIC ovarian cancer

blogger's note:

Table 2. Site of first recurrence.
Table 3. Pattern of first recurrence

"In conclusion, patients treated with adjuvant IP chemotherapy appear to have a different pattern of disease recurrence than patients treated with IV chemotherapy. The locations of these recurrences reflect the ability of IP chemotherapy to successfully eradicate disease within the anatomic regions of drug distribution.
Recurrent disease outside the abdominal cavity can be anticipated to occur more frequently in the current era of primary IP chemotherapy.
Further efforts should be aimed at improving IP distribution of chemotherapy to areas that may become disease sanctuaries."

Should stage IIIC ovarian cancer be further stratified by intraperitoneal vs. retroperitoneal only disease?: A GOG study

An analysis of patients with bulky advanced stage ovarian, tubal, and peritoneal carcinoma treated with primary debulking surgery (PDS) during an identical time period as the randomized EORTC-NCIC trial of PDS vs neoadjuvant chemotherapy (NACT)

Editorial: Advances in ovarian cancer disease control

"Overall, when one considers the relative mortality to incidence annually, ovarian cancer is the second most lethal among women in the United States. It is estimated that in 2011, there will have been 21,990 new cases diagnosed and 15,460 ovarian cancer deaths [1]. Epithelial ovarian cancers and related malignancies, most predominantly high grade serous tumors, contribute most to this public health care burden [2], and thus will be the focus here. While it is beyond the scope to recognize all recent contributions, the purpose of this editorial is to report on several key advances in disease classification, public health, treatment, detection and prevention and to place these advances in context of pre-existing knowledge......"

Editorial: Primary surgery or neoadjuvant chemotherapy in ovarian cancer: What is the value of comparing apples with oranges?

Incidence and Factors Associated with Synchronous Ovarian and Endometrial Cancer: A Population-Based Case–control Study

Carcinosarcoma of the ovary: A review of the literature

A systematic review evaluating the relationship between Progression free survival and Post Progression survival in advanced ovarian cancer

A study of symptoms described by ovarian cancer survivors

"There was a marked discordance between questionnaire-reported symptoms and those recorded in hospital notes."

Nomogram for predicting 5-year disease-specific mortality after primary surgery for epithelial ovarian cancer

Disparities in the allocation of treatment in advanced ovarian cancer: are there certain patient characteristics associated with nonstandard therapy?

Relationship of Type II Diabetes and Metformin Use to Ovarian Cancer Progression, Survival, and Chemosensitivity

Legal help - Cancer Legal Resource Center

IsMyCancerDifferent? (ismycancerdiff) on Twitter

IsMyCancerDifferent? (ismycancerdiff) on Twitter

JCO Editorial/original article link: Is It Time for (Survivorship Care) Plan B?

Blogger's Note: this study (2) was a breast cancer patient study however the editorial discusses similar efforts in other cancers eg. colorectal

1) Is It Time for (Survivorship Care) Plan B?

2)  Evaluating Survivorship Care Plans: Results of a Randomized, Clinical Trial of Patients With Breast Cancer

Eva Grunfeld et al

AstraZeneca - AstraZeneca updates on olaparib

AstraZeneca updates on olaparib

"AstraZeneca today (December 20th, 2011) announced that its investigational compound olaparib will not progress into Phase III development for the maintenance treatment of serous ovarian cancer."

Medical News: Mixed Results With (Aflibercept) Eyelea in Ovarian Cancer - in Clinical Context, Ovarian Cancer from MedPage Today

Medical News: Mixed Results With Eyelea in Ovarian Cancer - in Clinical Context, Ovarian Cancer from MedPage Today


Action Points  

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• The angiogenesis inhibitor aflibercept led to a decreased need for drainage of malignant ascites in patients with advanced ovarian cancer.



• Aflibercept treatment increased the likelihood of fatal bowel perforations in patients whose disease was progressing

EU (The European Commission) OKs Roche's Avastin for ovarian cancer | Reuters

EU OKs Roche's Avastin for ovarian cancer | Reuters

Canadian researchers close in on vaccine for ovarian cancer - media

Canadian researchers close in on vaccine for ovarian cancer

Special Ovarian Cancer Women at One True Media - (~5,000 views) Montage/video

Special Ovarian Cancer Women at One True Media.

2008-2011 most viewed pages: Ovarian Cancer and Us blog

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Two ways to fight a tumor - The Washington Post (Avastin)

avastin, bevTwo ways to fight a tumor - The Washington Post

Avastin for ovarian cancer slows tumors but fails to prolong life - The Washington Post

Avastin for ovarian cancer slows tumors but fails to prolong life - The Washington Post

A Phase 3 Trial of Bevacizumab in Ovarian Cancer — NEJM

A Phase 3 Trial of Bevacizumab in Ovarian Cancer — NEJM

Incorporation of Bevacizumab (Avastin) in the Primary Treatment of Ovarian Cancer — NEJM

Incorporation of Bevacizumab in the Primary Treatment of Ovarian Cancer — NEJM