Sunday, January 30, 2011
Saturday, January 29, 2011
Lancet (abstract) Retraction: validation of gene signatures that predict the response of breast cancer to neoadjuvant chemotherapy: a substudy of the EORTC 10994/BIG 00-01 clinical trial
Note: full details available to subscribers ($$$)
Comment
Retraction—validation of gene signatures that predict the response of
breast cancer to neoadjuvant chemotherapy: a substudy of the EORTC
10994/BIG 00-01 clinical trial
abstract: Is surgical restaging indicated in apparent stage IA pure ovarian dysgerminoma?
Objective
Conservative surgery followed by platinum-based chemotherapy is considered the standard approach for pure ovarian dysgerminoma (POD), except for correctly staged IA patients. The aim of study was to evaluate the outcome of IA POD patients with incomplete surgical staging in order to define the proper management.Friday, January 28, 2011
abstract: Validation of a Self-Concept Scale for Lynch Syndrome in Different Nationalities (multinational study) Denmark, Sweden, Canada
J Genet Couns. 2011 Jan 26. [Epub ahead of print]
"Learning about hereditary cancer may influence an individual's self-concept, which otherwise represents a complex but stable cognitive structure. Recently, a 20-statement self-concept scale, with subscales related to stigma-vulnerability and bowel symptom-related anxiety, was developed for Lynch syndrome. We compared the performance of this scale in 591 mutation carriers from Denmark, Sweden and Canada. Principal component analysis identified two sets of linked statements-the first related to feeling different, isolated and labeled, and the second to concern and worry about bowel changes. The scale performed consistently in the three countries. Minor differences were identified, with guilt about passing on a defective gene and feelings of losing one's privacy being more pronounced among Canadians, whereas Danes more often expressed worries about cancer. Validation of the Lynch syndrome self-concept scale supports its basic structure, identifies dependence between the statements in the subscales and demonstrates its applicability in different Western populations."
abstract: Hormone replacement therapy and breast cancer
Hormone replacement therapy and breast cancer.
Genesis Prevention Centre, University Hospital of South Manchester, Manchester, M23 9LT, UK, anthony.howell@christie.nhs.uk.
Abstract
There is evidence that hormone replacement therapy (HRT) may both stimulate and inhibit breast cancers, giving rise to a spectrum of activities, which are frequently hard to understand. Here we summarise the evidence for these paradoxical effects and, given the current data, attempt to give an indication where it may or may not be appropriate to prescribe HRT.It is clear that administration of oestrogen-progestin (E-P) and oestrogen alone (E) HRT is sufficient to stimulate the growth of overt breast tumours in women since withdrawal of HRT results in reduction of proliferation of primary tumours and withdrawal responses in metastatic tumours. E-P, E including tibolone are associated with increased local and distant relapse when given after surgery for breast cancer. For women given HRT who do not have breast cancer the only large randomised trial (WHI) of E-P or E versus placebo has produced some expected and also paradoxical results. E-P increases breast cancer risk as previously shown in observational studies. Risk is increased, particularly in women known to be compliant. Conversely, E either has no effect or reduces breast cancer risk consistent with some but not all observational studies. Two observational studies report a decrease or at least no increase in risk when E-P or E are given after oophorectomy in young women with BRCA1/2 mutations. Early oophorectomy increases death rates from cardiovascular and other conditions and there is evidence that this may be reversed by the use of E post-oophorectomy. HRT may thus reduce the risk of breast cancer and other diseases (e.g., cardiovascular) in young women and increase or decrease them in older women.Thursday, January 27, 2011
CCR Clinical Trials at NIH: Clinical Research: results - 22 solid tumor (adult)
The NCI Center for Cancer Research (CCR) conducts more than 150 cancer clinical trials at theNational Institutes of Health (NIH) Clinical Center in Bethesda, Maryland. Cancer clinical trialsthat take place at the NIH Clinical Center are open to patients with cancer, regardless of where they live in the United States.
There are 22 clinical trials at NIH that match your search criteria
*Cancer by type/disease: Solid Tumor (Adult)
*Cancer by type/disease: Solid Tumor (Adult)
Editorial (referencing Lancet article/sleep deprivation): Canadian Journal of Surgery [February 2011]
| Staff surgeon competence E.J. Harvey [full text in PDF] |
| La compétence des chirurgiens en titre E.J. Harvey [full text in PDF] |
Wednesday, January 26, 2011
clinical trial: Internet-based System for Cancer Patients to Self-report Toxicity - Full Text View
Purpose
Cancer patients may develop side effects during treatment, such as nausea, pain, fatigue, diarrhea, constipation, or shortness of breath. These symptoms may be due to the cancer itself, or due to treatments like chemotherapy drugs or radiation therapy. Doctors and nurses often ask patients about their symptoms, because an important part of cancer treatment is to make patients feel as well as possible. If patients do not feel well, the investigators may need to change the way the investigators are treating you or prescribe therapies that will decrease your symptoms. The best way to find out how you are feeling is to ask you directly.
However, during your time between appointments the investigators may not be able to ask you how you are feeling on a regular basis. In addition, even at an appointment, there may be symptoms that the investigators do not have a chance to discuss.
The investigators are interested in developing new ways to ask patients about how they are feeling, using the Internet. A special new website called STAR ("Symptom Tracking and Reporting for Patients") has been developed to help patients record this information, so that their doctors and nurses can review it during clinic appointments. This study is designed to help us see if STAR is a helpful way for us to keep track of information about patients' symptoms and quality of life.
clinical trial: Pathway to Diagnosis of Ovarian Cancer - Full Text View
Purpose
The purpose of this study is to describe the prediagnostic symptoms and the events along the pathway to diagnosis of women with ovarian cancer, referred for first-line chemotherapy.
clinical trial: Primary Tumor Harvest for the Purpose of Possible Use in a Future Clinical Trial in Patients With Ovarian, Fallopian Tube or Primary Peritoneal Cancer
Purpose
The purpose of this research study is to collect tumor samples at the time of surgery and store them for possible use as part of an experimental vaccine study for the participants cancer in the future.
clinical trial: Pancreatic Cancer Genetics ClinicalTrials.gov
Purpose
The aim of this study is to determine the frequency of the three most common BRCA1 and BRCA2 genetic mutations that are commonly found in Ashkenazi Jewish patients with pancreatic cancer. Testing for BRCA1 and BRCA2 mutations in relatives of hereditary pancreatic cancer patients may have a significant impact; allowing for early screening, treatment, and resection of pre-malignant tissue or malignant lesions.
clinical trial: Anonymous Testing of Pathology Specimens for BRCA (and Lynch Syndrome MSH2) Mutations in Ashkenazi Jewish Individuals Who Have Cancer
Purpose
The intent of the proposed study is to describe the prevalence of the most common recurring mutations
in BRCA1 and BRCA2, blmAsh , and the A636P MSH2 (Lynch Syndrome) mutation among Ashkenazi Jewish individuals with a variety of cancer diagnoses. If a substantial proportion of these samples contain such mutations, future patients presenting with these diseases may wish to undergo genetic counseling and, if appropriate, formal genetic testing. The benefit from such a process would pertain mainly to the families of these individuals.
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| Extrahepatic Bile Duct Cancer Gallbladder Cancer Gastric Cancer Lung Cancer Melanoma Non-Hodgkin's Lymphoma Uterine Cancer CORPUS UTERI,ENDOMETRIUM LUNG OVARY |
this week's partial stats - blog views this week ranked by country
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free full access: WHO/PLoS Collection “No Health Without Research”
"It seems astonishing that in the 21st century decisions on health care can still be made without a solid grounding in research evidence. This is true even in clinical research, whether for simple or complex interventions [1], where systematic reviews time and time again conclude that the evidence base is inadequate [2]. It is even more true in the areas of health policy and health systems, where quality research is hampered further by a lack of shared definitions, a lack of consensus on guiding principles, poor capacity (especially in low-resource regions), and methodological challenges [3],[4].
The World Health Report (WHR) for 2012 will be on the theme of “No Health without Research”. This flagship report from WHO will, for the first time in its history, focus on research for better health. The primary target audience of the report will be ministers of health in the WHO member states, and the goal of the report is to provide new ideas, innovative thinking, and pragmatic advice for member states on how to strengthen their own health research systems. The report will have the three following aims.
- To show that research is important for meeting health needs and improving health outcomes;
- To encourage countries to therefore invest more resources in developing and strengthening their national health research systems;
- To argue that countries should not see research as an expense or as an afterthought, but as an investment for a better, healthier future.....cont'd
Thirty-day mortality rate in women with cancer and venous thromboembolism. Findings from the RIETE Registry (abstract)
Note: different adverse events depending on cancer site
FDA review indicates possible association between breast implants and a rare cancer (see Blogger's Notes on this issue)
Blogger's Notes: for background information regarding the long standing health issues concerning breast implants do a 'litigation' search. Past research on
the issue of risk/breast implants (noncancer/cancer issues) includes many
lawsuits, the latter of which were settled by some of the manufacturers without admission of fault (guilt). The past lawsuits (class action suits) were based on the older forms of implants.
Takeda Pharma, Millennium commence (AMG386) TRINOVA-1 Phase III cancer (ovarian) trial
Takeda Pharmaceutical and the Takeda Oncology Company: Millennium, have commenced TRINOVA-1 Phase III clinical trial on anti-cancer agent AMG 386 in Japan
Addition of Bevacizumab to Chemotherapy for Treatment of Solid Tumors: Similar Results but Different Conclusions
Table 1. Randomized Phase III Studies Comparing Chemotherapy With or Without Bevacizumab As First-Line Chemotherapy for Advanced Epithelial Cancers
Tuesday, January 25, 2011
Involving the public in healthcare policy: An update of the research evidence and proposed evaluation framework | RAND
Blogger's Note: worth reading if not, critically, somewhat old news
IAPO calls on WHO member states to involve patients at all levels to meet the health related MDGs (Millennium Development Goals)| A global voice for patients
"To do this effectively, patients must be involved in both the design and delivery of their care."
Cost recovery (handouts) trumps concerns about conflicted interest -- Canadian Medical Association Journal
Although there's widespread variation in the policies that Canadian medical schools have toward pharmaceutical and medical devices industry handouts for medical education and in some cases, seemingly no policies at all, administrators say there is no need for restrictive guidelines ....cont'd
Association Between a Name Change from Palliative to Supportive Care and the Timing of Patient Referrals -- The Oncologist
"....Because of the nature of our institution as a comprehensive cancer center
with a large patient volume, the results might not be generalizable to smaller cancer centers and oncology programs in other areas. However, the findings
of our study regarding a higher overall number of referrals and earlier
referrals in the outpatient setting confirm the findings of our previous
survey study on the attitudes and beliefs of medical oncologists and
midlevel providers regarding the term palliative care. We believe
that these findings and the difference in referral pattern after the
name change are not center specific but rather reflect perceptions
among health care professionals in the U.S. regarding the strong
associations among palliative care, hospice, and end of life."
Conclusion The name change to supportive care was associated with more inpatient referrals and earlier referrals in the outpatient setting. The outpatient setting facilitates earlier access to supportive/palliative care and should be established in more centers.
Contagious Cancer - The Oncologist
Of interest: note reference to organ transplant (not new news but under-recognized??)
"INTRODUCTION
In the cancer clinic, physicians and other oncology caregivers are
occasionally asked whether cancer can ever be passed along from
one individual to another. One example is the wife who asks whether
she could ever "catch" cancer from her husband with prostate cancer.
Although the answer to that one is no, the question of a man "catching"
cancer from a partner with cervical cancer is not unrealistic since
various strains of human papilloma virus are known causes of cervical
cancer as well as penile cancer. Pathogens including certain viruses,
bacteria, and parasites represent major causes of cancer in developing
parts of the world. In fact, an estimated 1.5 million cases per year or
15% of all cancers worldwide can be attributed to infectious
etiologies, mostly due to viral infections...."cont'd
Monday, January 24, 2011
2nd annual event: (call for participants) tHE ART of the Matter - OCATS (Ovarian Cancer Awareness & Treatment in Sask
On Saturday May 21st
OCATS (Ovarian Cancer Awareness & Treatment in Sask) will host its 2nd
Annual “tHE ART of the Matter” art
show, the theme being all things feminine, related to the creativity of feminine,
all matters of interest or important to women – whether as the artist, or as
the subject matter of her work.
The goals
of the event is to honour women and our joy and our struggles, and to create
awareness for gynecologic cancers for all women and men who care about us.
If you are
an artist and would like to participate please let us know by February 15th. Please know that your participation and
support will be very much appreciated by women and their support people who are
dealing with a gynecologic cancer.
If you know an artist please forward this notice on. And if you are just interested in art,
please plan on attending the show!
Thank you,
Darlene Gray
OCATS
Ovarian Cancer Awareness & Treatment in Saskatchewan
Find us on Facebook too!
full free access: 2011 The Risk of Urothelial Bladder Cancer in Lynch syndrome is increased, in particular among MSH2 mutation carriers
| See Box 1 for surveillance recommendations Attached file list to this document: | ||||||
 | ||||||
|
Premature Menopause: The Unexpected Symptoms of Cancer Treatment - Chicago event Feb 2nd (surgical menopoause....)
The Institute for Women’s Health Research is hosting an event with a panel of experts and pre-screening of the documentary on Wednesday, February 2nd in Chicago
Unrealistic optimism appears common in early cancer trials (patient version HOPE ??)
Blogger Comment: patients call optimism also as "HOPE"
Cochrane Collaboration awarded seat on World Health Assembly
(Geneva, Switzerland – January 24, 2011) On
January 24, 2011, the
World Health Organization (WHO) awarded
The Cochrane Collaboration a seat on the World Health Assembly allowing the Collaboration to provide input on WHO health resolutions.
The Cochrane Collaboration was accepted as a Non-Governmental Organization in Official Relations
with the WHO at the WHO’s Executive Board meeting, establishing a partnership with formalized communication
between the two organizations.
You can read more in the official press release announcing this story on www.cochrane.org. It is available in Arabic, Standard Chinese, German, English, French, Russian and Spanish.
call for Nominations - deadline Feb. 11, 2011 Top 25 Women in Healthcare - Modern Healthcare
| Do you know a female executive making a positive difference in the healthcare industry? A leader at the forefront of healthcare reform, policy, education, research or advocacy? A woman who is using her power or abilities to successfully effect change? |
| Nominate her for Modern Healthcare's 4th biennial Top 25 Women in Healthcare recognition program! |
| For entry criteria, submission details and FAQs, visit ModernHealthcare.com/topwomenexecs |
Research and Markets: Ovarian Cancer Therapeutics - Pipeline Assessment and Market Forecasts to 2017
Business
Research and Markets: Ovarian Cancer Therapeutics - Pipeline Assessment
and Market Forecasts to 2017
© Business Wire 2011
2011-01-20 16:11:16 -
OCATS - Ovarian Cancer Awareness & Treatment in Saskatchewan
For Medical Professionals
Because ovarian cancer has no screening tools, blood tests and the symptomsoften are mistaken for other conditions, misdiagnosed and even ignored OCATS has developed an OCATS Physician Guide (available to anyone). This guide
was developed to help medical professionals and women recognize the
symptoms, be aware of symptoms andcombinations of symptoms, the diagnostic tools available to every physician, proper referral practices for women
with the possibility of a gynecologic cancer. We will soon be sending this
guide to every medical clinic and medical
professional in Saskatchewan.
These guides are available in Australia and in the United States.
To view these documents:
OCATS Guide for Medical Professionals
Australia
GP Guide for Australia
CPO Guidelines for Ovarian Cancer, Australian Government
United States
2009.10.1-Symptons document
Sunday, January 23, 2011
Saturday, January 22, 2011
short (very) commentary: EORTC 55971: Does it apply to all patients with advanced state ovarian cancer?
Research Highlights
► Within this randomized trial a statistical benefit was seen with primary
surgery among patients with less than 5 cm of upper abdominal
disease (HR 0.64).
► Across different countries in this study there was significant
heterogeneity of the benefit of primary cytoreductive surgery.
refers to:
EORTC Newsletter Results of the EORTC 55971 trial: Neoadjuvant
chemotherapy followed by interval debulking surgery is not inferior to
primary debulking surgery followed by chemotherapy as a treatment
option for patients with stage IIIC or IV ovarian carcinoma
Comparison of gene expression patterns between avian and human ovarian cancers
abstract: Ovarian cancer patient surveillance after curative-intent initial treatment
Objective
Patient surveillance after potentially curative treatment of ovarian carcinoma has important clinical and financial implications for patients and society. The optimal intensity of surveillance for these patients is unknown. We aimed to document the current follow-up practice patterns of gynecologic oncologists.Methods
We created four idealized vignettes describing patients with stages I–III ovarian cancer. We mailed a custom-designed survey instrument based on the vignettes to the members of the Society of Gynecologic Oncologists (SGO). SGO members were asked, via this instrument, how often they requested 11 discrete follow-up evaluations for their patients for the first 10 postoperative years after treatment with curative intent.Results
We received 283 evaluable responses (30%) from the 943 SGO members and candidate members. The most frequently performed items for each year were office visit, pelvic examination, and serum CA-125 level. Imaging studies such as chest X-ray, abdominal–pelvic CT, chest CT, abdominal–pelvic MRI, and transvaginal ultrasound were rarely recommended. There was marked variation in the frequency of use of most tests. There was a decrease in the frequency of testing over time for all modalities.Conclusion
This dataset provides detailed documentation of the self-reported surveillance practices of highly credentialed experts who manage patients with ovarian cancer in the 21st century. The optimal follow-up strategy remains unknown and controversial. Our survey showed marked variation in surveillance intensity. Identifying the sources of this variation warrants further research.OWHN: Echo: Women's Health Leadership Program Ontario - retreat/training application note deadline dates
Women's Health Leadership Program
Upcoming Women's Health Leadership 101 Retreats:
Retreat Date: March 7 - 9, 2011 ~ Application Deadline: January 26, 2011
Retreat Date: March 23 - 25, 2011 ~
Application Deadline: February 2, 2011
The Ontario Women's Health Network (OWHN) is currently accepting
applications for the upcoming Women's Health Leadership 101 training
retreats scheduled for March 7-9, 2011 and March 23-25, 2011,
respectively, at the Nottawasaga Inn in Alliston. Women's Health
Leadership 101 is the first of three graduated training levels that
make up the Women's Health Leadership Program. This is an ongoing
program and further upcoming retreat dates and information will be
announced in the near future.
The program, funded by Echo: Improving Women's Health in Ontario,
seeks to amplify women's voices in the development of health policy,
research and services.
Women's Health Leadership 101 addresses leadership and sex and
gender based analysis in the context of women's health and health
systems in a participatory and supportive environment. It explores
women's own sense of leadership and application of skills, while
enhancing their leadership skills and community networks.
This program is designed for women who are motivated and
interested in women's health issues and who are already actively
engaged in their communities. The program seeks to recruit women
who are committed to being active in women's health issues in their
communities following the retreat.
More information about the program as well as the application package
is available on the OWHN website at: http://www.owhn.on.ca/Women%27s_Health_Leadership.htm
Women who are interested in applying to participate in the Women's
Health Leadership Program should complete application and return
it to OWHN by the appropriate application deadline date (shown above).
We welcome you to share this email widely.
Please do not hesitate to contact OWHN with questions about the
program or application process.
OWHN: 416-408-4840 or toll-free 1-877-860-4545
email: owhn@owhn.on.ca.
Friday, January 21, 2011
CAM Journals and Databases
IN-CAM website
One of the information resources that we provide on the IN-CAM website is a list of research journals that publish research on CAM and Integrative Health Care. As this field of inquiry continues to develop and expand, this list continues to grow.
CAM Journals and Databases list
Determinants of geographic patterns of diseases: interaction of lactose/lactase status and sunshine exposure - Jnl Med Hypotheses
".........The patterns related to sunshine (Vitamin D) reflect that obtained with national lactase status proportions and also corroborate a literature review. However, correlations are weak to moderate and only ovarian cancer reached conventional statistical significance. Because these comparisons are based on modest number of national data firm conclusions cannot be made....."
abstract: Bleeding events in (Avastin) bevacizumab-treated cancer patients who received full-dose anticoagulation and remained on study
Conclusions:
These data suggest that bevacizumab did not increase the risk of severe bleeding in cancer patients who received
"Diagnosis" - The Woman Who Was Wasting Away - NYTimes.com
Lisa Sanders is the author of “Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis.”
full free access: Preventable adverse drug events and their causes and contributing factors: the analysis of register data — Int J Qual Health Care (patient safety)
"In recent years, the number of patient complaints has also increased, probably because patients are more aware of their rights and more attention has been paid to patient safety [18]. These complaints contain detailed narratives about the case, and these data can be used to understand which factors contribute to errors in health care [1].
The purpose of this study was to evaluate the nature of preventable ADEs based on data from national supervisory authority. In particular, the study focuses on the potential causes and contributing factors of preventable ADEs from the information management point of view.
The study aims to answer the following questions:
1. What are the causes of ADEs, and in which phase of the medication management process are the causes for ADEs present?
2. How does information management affect the origin of ADEs?
3. What are the contributing factors for ADEs in information management?
Expression of TGFß1 and its receptors is associated with biological features of ovarian cancer and sensitivity to paclitaxel/carboplatin
Abstract ....... It is suggested that TGFß1 mRNA expression is an indicator of tumor sensitivity to standard therapy with PTX (Taxol) and CBDCA (Carboplatin), that it can identify biologically aggressive and highly malignant tumors and that it can predict the prognosis of patients with ovarian cancer."
Webinar Series | Ovarian Cancer National Alliance (register/dates/times)
Register for our webinar series online! If you've already registered, you'll be sent a reminder the day before this presentation.
The Webinar Series schedule is as follows:
Tuesday, January 25, 2011 at 2:00pm EST
Are Clinical Trials the Answer?
Dr. Ronnie Alvarez, Professor Ob/Gyn, University of Alabama
Thursday, February 10, 2011 at 1:00pm EST
Young Survivors Rock!
Lindsay Avner, Founder and Executive Director, Bright Pink
Chana Garcia, advocate, blogger and ovarian cancer survivor
Thursday, February 17, 2011 at 1:00pm EST
Ovarian Cancer – What’s Basic? What’s New?
Dr. Robert Coleman, Professor, Department of Gynecologic Oncology, MD Anderson Cancer Center
Wednesday, March 2, 2011 at 1:00pm EST
Getting Involved with Partner Members
Robin Cohen, OCNA Board member and Partner Member
Sue Ellen Moore, OCNA Board member and Partner Member
abstract: Value of FDG PET/CT in Patients with Treated Ovarian Cancer and Raised CA125 Serum Levels
CONCLUSION:
PET/CT was able to detect active disease at relatively low levels of CA125, thereby facilitating the early diagnosis of recurrence or residual disease. Also in patients with low CA125 levels (<30).
magazine: Women’s Health Headlines UT Medical Center’s “Frontiers” Magazine | Tennessee Today
This issue of Frontiers is available in print and online (pdf).
To request a printed copy, contact the UT Graduate School of Medicine at 865-305-9190 or click here.
Hereditary Colorectal Cancer: eMedicine Gastroenterology
Background
Hereditary nonpolyposis colorectal cancer (HNPCC), an autosomal-dominant syndrome, accounts for 2-5% of all colorectal carcinomas. Colorectal cancer in patients with hereditary nonpolyposis colorectal cancer (HNPCC) presents at an earlier age than in the general population and is characterized by an increased risk of other cancers, such as endometrial cancer and, to a lesser extent, cancers of the ovary, stomach, small intestine, hepatobiliary tract, pancreas, upper urinary tract, prostrate, brain, and skin.Table 1. Seven different genes are known to be associated with HNPCC,
and all of them are involved with DNA mismatch repair, identified with
the frequencies below.
| Mismatch Excision Repaired MMR | Chromosome Location | Frequency of HNPCC Cases | ||||||||||||||||||||||||||||||||||||||||||||||||
| MSH2 | 2p16 | 45-50% | ||||||||||||||||||||||||||||||||||||||||||||||||
| MLH1 | 3p22.3/A> | 20% | ||||||||||||||||||||||||||||||||||||||||||||||||
| MSH6 | 2p16 | 10% | ||||||||||||||||||||||||||||||||||||||||||||||||
| PMS2 | 7p22.1 | 1% | ||||||||||||||||||||||||||||||||||||||||||||||||
| PMS1 | 2q32.2 | Rare | ||||||||||||||||||||||||||||||||||||||||||||||||
| MSH3 | 5q14.1 | Rare | ||||||||||||||||||||||||||||||||||||||||||||||||
| EXO1 | 1q43 | Rare | ||||||||||||||||||||||||||||||||||||||||||||||||
| Other genes not yet discovered Table 2. Incidence of different types of cancers between individuals with Lynch syndrome and those in the general population. Table
| 20-25% |
abstract: Health-related quality of life and cancer clinical trials — Therapeutic Advances in Medical Oncology
"The overall outlook for the routine assessment of patient-reported outcomes in clinical trials is assured and, eventually, it is likely to become a standard part of clinical practice. However, there is still a need for a clear method for determining the clinical meaningfulness of changes in scores. The answer will probably come from the greater use of patient-reported outcomes and the consequent growth of experience that is necessary to make such judgements"
Thursday, January 20, 2011
Wednesday, January 19, 2011
Tuesday, January 18, 2011
abstract: Genetic profiles distinguish different types of hereditary ovarian cancer
"The results indicate that HBOC and HNPCC (Lynch Syndrome) associated ovarian cancer develop along distinct genetic pathways and genetic profiles can thus be applied to distinguish between different types of hereditary ovarian cancer."
|
abstract: Clinical predictors of (Avastin) bevacizumab-associated gastrointestinal perforation
Abstract
OBJECTIVES: Bevacizumab is a generally well-tolerated drug, but bevacizumab-associated gastrointestinal perforations (BAP) occur in 0 to 15% of patients with ovarian carcinoma. Our goal was to evaluate the clinical predictors of BAP in order to identify factors, which may preclude patients from receiving treatment.
METHODS: We conducted a review of patients with recurrent epithelial ovarian carcinoma treated with bevacizumab between 2006 and 2009. Demographic and treatment data were collected for statistical analysis.
RESULTS: Eighty-two patients were identified; perforation occurred in 8 (9.76%). Among patients with perforation, a significantly higher incidence of prior bowel surgeries (p=0.0008) and prior bowel obstruction or ileus.
CONCLUSIONS: Predicting BAP remains a challenge. Bowel obstruction or ileus appears to be associated with increased risk of BAP.
METHODS: We conducted a review of patients with recurrent epithelial ovarian carcinoma treated with bevacizumab between 2006 and 2009. Demographic and treatment data were collected for statistical analysis.
RESULTS: Eighty-two patients were identified; perforation occurred in 8 (9.76%). Among patients with perforation, a significantly higher incidence of prior bowel surgeries (p=0.0008) and prior bowel obstruction or ileus.
CONCLUSIONS: Predicting BAP remains a challenge. Bowel obstruction or ileus appears to be associated with increased risk of BAP.
Inequity in access to cancer care: a review of the Canadian literature (abstract)
Cancer Causes Control. 2011 Jan 8. [Epub ahead of print]
Inequity in access to cancer care: a review of the Canadian literature.
Faculty of Medicine, Dalhousie University, 5849 University Ave, Mailbox No. 257, Halifax, NS, B3H 4H7, Canada, andre.maddison@dal.ca.
Abstract
Despite the policy and research attention on ensuring equitable access-equal access for equal need-to health care, research continues to identify inequities in access to cancer services. We conducted a literature review to identify the current state of knowledge about inequity in access to cancer health services in Canada in terms of the continuum of care, disease sites, and dimensions of inequity (e.g., income). We searched MEDLINE, CINAHL, and Embase for studies published between 1990 and 2009. We retrieved 51 studies, which examine inequity in access to cancer services from screening to end-of-life care, for multiple cancer types, and a variety of socioeconomic, geographic, and demographic factors that may cause concern for inequity in Canada. This review demonstrates that income has the most consistent influence on inequity in access to screening, while age and geography are most influential for treatment services and end-of-life care, even after adjusting for patient need. Our review also reports on methods used in the literature and new techniques to explore. Equitable access to cancer care is vitally important in all health systems. Obtaining information on the current status of inequities in access to cancer care is a critical first step toward action.full free access: Absence of microsatellite instability in mucinous carcinomas of the breast (Lynch Syndrome)
Note: some key excerpt; see also Supplemental Tables 1-4
"Microsatellite instability (MSI) is a form of genetic instability that results from defects in DNA mismatch repair. MSI is reported to be rare in unselected breast cancers, however it is a common feature in subsets of colorectal, ovarian and endometrial cancers. In these anatomical sites, MSI-high carcinomas often display a mucinous histology. The aim of this study was to determine whether mucinous carcinomas of the breast would more frequently display MSI-high than invasive ductal carcinomas of no special type (IDC-NSTs). The expression of four MSI markers (i.e. MSH2, MSH6, MLH1 and PMS2) was immunohistochemically assessed in 35 mucinous breast carcinomas and 35 histological grade- and oestrogen receptor (ER) status-matched IDC-NSTs, and in a series of 245 invasive breast cancers...........
........
Subsets of colorectal [24], gastric [31], pancreatic [31], ovarian [32] and endometrial tumours [22,31,33], and particularly those occurring in the hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch syndrome [31], are characterised by microsatellite instability. Interestingly, however, MSI-H appears to be vanishingly rare in breast cancer [21,34]. Likewise, breast cancers displaying an MSI-L status are remarkably rare, whereas in tumours from other anatomical sites, such as colorectal, endometrial or ovarian cancers [27], this phenomenon is not as uncommon. Of note, in some anatomical sites (e.g. colorectal and ovarian), tumours displaying microsatellite instability often display a mucinous histology [32,35,36]. However, the prevalence of MSI in mucinous carcinomas of the breast has not yet been systematically addressed........
...........All 35 pure mucinous carcinomas of the breast analysed were positive for MLH1 and MSH6 as determined by IHC, and 33 out of 35 (94.2%) and 32 out of 34 cases (94.1%) showed expression of MSH2 and PMS2, respectively (Table 2 and Figure 1)............cont'd
Monday, January 17, 2011
Teacher – Learner Contract Gynecologic Surgery Block
Note: question #5 - page 3 (exam while patient under anesthesia)
Cancer Epigenetics - 2010 - CA (includes discussions Lynch Syndrome etc...)
"The term “epigenetics” refers to variability in gene expression, heritable through mitosis and potentially meiosis, without any underlying modification in the actual genetic sequence."
No Gene-Environment Interactions Found in Million Women Study of Breast Cancer 2010 - CA: A Cancer Journal for Clinicians - Wiley Online Library
".....Regarding the question of gene-environment
interactions, lead author Ruth Travis, MD, PhD, adds that “Results from
this study suggest that common genetic and environmental factors
(reproductive and lifestyle factors) act independently on breast cancer
risk, so regardless of common inherited genetic variation, a woman can
still reduce her risk by modifying her lifestyle, for example by
maintaining a healthy body weight and limiting alcohol intake.”
The
absence of interactions means that priorities for risk-reducing
strategies are similar for most women (for example, being based on known
risks associated with lifestyle and reproductive factors) regardless of
the common genetic risk factors for the disease, she says. Dr. Travis
is an epidemiologist, research fellow, and senior scientist in the
cancer epidemiology unit at Oxford University....."
full free access: Poly(ADP-Ribose) polymerase (PARP) inhibitors: Exploiting a synthetic lethal strategy in the clinic - A Cancer Journal for Clinicians - Wiley Online Library
see also:
Table 1. DNA Repair Pathways
(Lynch Syndrome, BRCA 1/2, FANC, ATM, MYH ;
Table 2. PARP Inhibitor Clinical Trials; Other Potential Synthetic Lethal Strategies for PARP Inhibitors.....
Conclusions:
"The synthetic lethal targeting of DNA repair pathways, as exemplified by PARP inhibitors, in cancers bearing HR DNA repair defects is showing considerable potential for delivering selective tumor cell kill while sparing normal cells, and offers a scientifically rational and potentially broad clinical application in oncology.64 Several challenges related to the development of these inhibitors remain, including the identification of robust predictive biomarkers of HR deficiency in cancers. The dissection of the underlying mechanisms of PARP inhibitor resistance and establishment of optimal drug combinations and strategies for chemoprophylaxis with these therapies remain high priorities. It is important to be aware that different PARP inhibitors may have varying potencies on individual members of the PARP superfamily and also affect other targets, resulting in distinct toxicity and efficacy profiles. In the future, it is envisioned that this tumor-specific synthetic lethal strategy with PARP inhibitors may potentially be utilized against cancers with similar molecular defects but diverse anatomical origins.118 Such a paradigm shift in drug discovery may crucially bring us closer to our ultimate goal of personalized medicine."
free full access - Cancer screening in the United States, 2011 - CA: A Cancer Journal for Clinicians - Wiley Online Library
Cancer Screening in the United States, 2011
A Review of Current American Cancer Society Guidelines and Issues in
Cancer Screening
Sunday, January 16, 2011
Free Full-Text - IJMS ( Intl Jnl of Molecular Sciences) Exploring the Immunoproteome for Ovarian Cancer Biomarker Discovery
Published: 14 January 2011
(This article belongs to the Special Issue Cancer Molecules in Ovarian Cancer)
Abstract:
Most
scientific efforts towards early detection of ovarian cancer are
commonly focused on the discovery of tumour-associated antigens (TAA).
Autologous antibodies against TAA, however, may serve as more sensitive
diagnostic markers. They circulate in the blood before TAA and are
usually more abundant than the TAAs themselves as a result of
amplification through the humoral immune response. Accumulating evidence
also suggests that a humoral response already exists during malignant
transformation when aberrant gene expression is translated into
premalignant cellular changes. This article reviews the current
knowledge about autoantibodies against TAA in ovarian cancer and
presents current immunoproteomic approaches for their detection.
full free access: eMJA: When do I know I am cured? Using conditional estimates to provide better information about cancer survival prospects
See also (abstract) reference #7:
Choi M, Fuller CD, Thomas CR Jr, et al. Conditional survival in ovarian cancer: results from the SEER dataset 1988–2001. Gynecol Oncol 2008; 109: 203-209. <PubMed>
Saturday, January 15, 2011
Friday, January 14, 2011
full free text: Targeted Epigenetic Therapies: The Next Frontier? — J. Natl. Cancer Inst. (includes discussion regarding clear cell/ARIDIa mutation
Targeted Epigenetic Therapies: The Next Frontier?
1. Rabiya S. Tuma
When researchers look for mutations associated with cancer, they often expect to come up with alterations in signaling molecules or transcription factors. But an increasing number of the mutations found are in genes that regulate the epigenome—a system that alters DNA structure and regulates gene activity without changing the nucleotide sequence itself.
On Sept. 8, investigators published two independent reports online—one in Science and one in the New England Journal of Medicine—showing that mutations in an epigenetic regulatory gene, ARID1a, were associated with approximately half of the ovarian clear-cell cancers tested.
Randomized Phase III Clinical Trial Evaluating Weekly Cisplatin for Advanced Epithelial Ovarian Cancer
"Thus, increasing dose intensity of cisplatin does not improve PFS or OS compared with standard chemotherapy."
High-grade, chemotherapy-resistant ovarian carcinomas overexpress epithelial cell adhesion molecule (EpCAM) and are highly sensitive to immunotherapy (RNA/IL-2/Adecatumumab)
Abstract
OBJECTIVE: We evaluated the expression of epithelial cell adhesion molecule (EpCAM) and the potential of MT201 (adecatumumab), a human-monoclonal-antibody that targets EpCAM against chemotherapy-resistant ovarian disease.STUDY DESIGN: EpCAM expression was evaluated by real-time polymerase chain reaction and flow cytometry. Sensitivity to MT201 antibody-dependent cell-mediated cytotoxicity (ADCC) and complement-dependent cytotoxicity was tested in 4-hour chromium-release assays. The effect of interleukin-2 on MT201 ADCC was also studied.
RESULTS: High messenger RNA expression by real-time polymerase chain reaction and high EpCAM surface expression by flow cytometry was detected in 71% of ovarian cancers (5 of 7 cell lines). Although these cell lines were highly resistant to complement-dependent cytotoxicity and natural killer-dependent cytotoxicity in vitro (range of killing, 0-7%), EpCAM-positive cell lines showed high sensitivity to MT201 ADCC (range of killing, 27-66%). Incubation with interleukin-2 further increased the cytotoxic activity against EpCAM-positive ovarian cancer cell lines.
CONCLUSION: MT201 may represent a novel, potentially highly effective treatment option for patients with ovarian carcinoma whose body is harboring disease refractory to chemotherapy.
Perspectives 2011: Key to Ovarian Cancer Detection - the Endocrine Society Research Affairs Endocrine News Jan 2011 Dr Lee (Chicago)
Perspective: Dr Lee (Chicago)
"About This Series
For the Bi-Point/Tri-Point perspective series of articles in Endocrine News, the topics, authors, and outside reviewers are selected by The Endocrine
Society’s Research Affairs Core Committee to explore subject areas from different angles. The authors write their articles independently and the drafts are then reviewed by contributing co-editors and by independent experts in the specific topic area.
If you have any comments about this feature, please email
endocrinenews@endo-society.org.
For archived copies of this series on more than 26 topics, please visit the
Endocrine News Web site, www.endo-society.org/endo_news/index.cfm"
2011 (pdf/slides) Screening for Ovarian Cancer - University of Manitoba - Dr Lotocki
Epithelial Ovarian Cancer
Cancer Day for Primary Care
Friday, January 14, 2011
Annual Costs of Cancer Care | Cancer Prevalence and Cost of Care Projections - female/male cancer sites (ncluding ovarian)
Chart: Average Annual Costs of Care
Annualized Mean Net Costs of Care by Age, Gender and Phase of Care (Per Patient). Costs in 2010 US Dollars.
Cancer Prevalence and Cost of Care Projections - Interactive Guide NCI (via WSJ link)
Key Facts
- 18.1 million cancer survivors in 2020, 30% more than 2010
- Costs of cancer care: $157 billion in 2010 dollars
- Growth and aging of the U.S. population is the primary cause
Create Your Own Chart
Graph by Cancer Site and Phase of Cancer(See cost of care or prevalence for cancer site, sex, age and year under various assumptions)
Projection Tables for 2020
National Expenditures for Cancer CareCancer Prevalence
Base Data
Average Annual Costs of CareCancer-Care Costs Could Hit $207 Billion in 2020: NCI Study - Health Blog - WSJ
"....Statistical modeling, of course, depends on the assumptions used by the researchers — so check out the full study to see those details. And here’s an interactive tool that allows you to change some of the assumptions."
Projections of the Cost of Cancer Care in the United States: 2010–2020 — J. Natl. Cancer Inst.
excerpt/also see Table 5 for projection (cost) estimates:
Recent and Projected Incidence
For most of the cancer sites, incidence has been decreasing, and we estimated a negative annual percent change (Table 1) during the period 1996–2005. The largest decreases in men were for lung, stomach, and colorectal cancers, respectively, −2.72, −2.24, and −2.22 annual percent change in age-adjusted rates. More dramatic decreases were observed for women for ovarian and cervical cancer, −4.71 and −3.95, respectively, annual percent change in age-adjusted rates. Incidence of kidney cancer and melanoma has been increasing in both men and women, and incidence of lymphoma and brain cancer has been increasing in women (Table 1). Among the five major cancer sites, the largest decreases in incidence were observed for lung and colorectal cancers in men, −2.72 and −2.22, respectively, annual percent change in age-adjusted incidence rates (Figure 1; Similar figures for more cancer sites are available at http://costprojections.cancer.gov.).
View this table:
Incidence and survival trends used in the incidence and survival trend scenario*
Thursday, January 13, 2011
Wednesday, January 12, 2011
website: FIGO | International Federation of Gynecology and Obstetrics
FIGO - the International Federation of Gynecology and Obstetrics - is the only organisation that brings together professional societies of obstetricians and gynecologists on a global basis. Currently it has member societies in 124 countries or territories.
FIGO has a vision that women of the world achieve the highest possible standards of physical, mental, reproductive and sexual health and wellbeing throughout their lives.
FIGO works with the United Nations Population Fund, The Bill & Melinda Gates Foundation and the Swedish International Development Cooperation Agency, among many other organisations.
Read FIGO in brief for a quick overview.
Visit the Members section to find out more about how to join us.
NCI Cancer Bulletin: (The GOG Rare Tumor Committee)
Comparing First-Line Therapies for Mucinous Ovarian or Fallopian Tube Cancer
Name of the TrialPhase III Study of Carboplatin and Paclitaxel with Versus without Bevacizumab Compared to Oxaliplatin and Capecitabine with Versus without Bevacizumab as First-Line Therapy in Patients with Newly Diagnosed Stage II-IV or Recurrent Stage I Mucinous Epithelial Ovarian or Fallopian Tube Cancer (GOG-0241). See the protocol summary.
Tuesday, January 11, 2011
Shattered Chromosome Can Lead to Cancer - NYTimes.com (reference to bone/breast...cancers + commentary link)
Note: theories/research regarding how cancer develops eg; 'one-hit' theory vs multi-step process of malignancy.
Cell (journal link): Featured Article Free
Massive Genomic Rearrangement Acquired in a Single Catastrophic Event during Cancer Development
Monday, January 10, 2011
Survey: GCF/University of Texas MD Anderson Cancer Center (follow-up for those without a recurrence)
The
Gynecologic Cancer Foundation is cooperating with researchers at The
University of Texas MD Anderson Cancer Center to learn your opinion
about follow-up care after your initial treatment if you have not had a
recurrence of your cancer.
This online survey has been approved by the MD Anderson Institutional Review Board and will take about 15 minutes of your time.
The
Gynecologic Cancer Foundation does not share its mailing list and your
contact information, including your e-mail address, will not be placed
into any other database as a result of your participation in this
survey.
Because cancer treatments continue to improve, the number of women surviving is increasing. Researchers
at MD Anderson are interested in learning about how patients with
gynecologic cancers want to be followed after completing their
treatments and your participation in this survey will assist them.
If you have any questions about the survey, please contact Dr. Matthew Schlumbrecht at MD Anderson at 713-563-4583 or mpschlumbrecht@mdanderson.org.
Instructions and consent information are included in the survey information. To participate, please click here.
Sunday, January 09, 2011
full free access: AHRQ Patient Safety Network - Patient Safety in Primary Care (Canada)
Patient Safety in Primary Care.
Kingston-Riechers J, Ospina M, Jonsson E, Childs P, McLeod L, Maxted JM. Edmondton, AB, Canada: Canadian Patient Safety Institute; 2010. ISBN: 9781926541273.
This report analyzed patient safety in Canadian primary care practice to identify themes, priorities, gaps in research, and opportunities for improvement.
Breasts 'monopolising' cancer spotlight - Australia media report
Note: quotes from a 'plain speaking' physician (and advocate)
Saturday, January 08, 2011
Evidence Updates - Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane Database including professional commentaries
also: see PubMed link (abstract w/o commentary) to abstract
BACKGROUND: Treatment of cancer is increasingly more effective but is associated with short and long term side effects. Oral side effects remain a major source of illness despite the use of a variety of agents to prevent them. One of these side effects is oral mucositis (mouth ulcers).
Friday, January 07, 2011
Wednesday, January 05, 2011
Tuesday, January 04, 2011
Editorial :: The role of Cochrane Review authors in exposing research and publication misconduct - The Cochrane Library
Note: while important the real question is the root of the problem - cause
"At the Joint Colloquium of the Cochrane & Campbell Collaborations in Keystone in October 2010, we ran a workshop about the problems of detecting research misconduct,[1] and had a wonderful discussion with participants. The US Office of Research Integrity defines research misconduct as: "fabrication, falsification, or plagiarism in proposing, performing, or reviewing research, or in reporting research results; fabrication is making up data or results and recording or reporting them; falsification is manipulating research materials, equipment, or processes, or changing or omitting data or results such that the research is not accurately represented in the research record; plagiarism is the appropriation of another person's ideas, processes, results, or words without giving appropriate credit; research misconduct does not include honest error or differences of opinion".[2] The Committee on Publication Ethics (COPE) also outlines publication and research misconduct in its flowcharts for editors, and highlights redundant (duplicate) publication, changes in authorship, undisclosed conflicts of interest, and ethical problems as additional types of misconduct.[3] Cochrane Review authors, as they analyse the entirety of primary research evidence in a specific area, are well placed to identify many of these types of research and publication misconduct. Indeed, Professor Sir Iain Chalmers urged systematic reviewers, not so long ago, to harness their unique opportunity to detect plagiarism.[4].....cont'd
Director's Page - National Cancer Institute - Update to the National Cancer Advisory Board (December 2010) 9 minutes
Also: To view the NCAB Meeting discussions in their entirety, visit http://videocast.nih.gov/launch.asp?16326 (5 hrs and 51 minutes)
abstract: Risk of colorectal and endometrial cancers in EPCAM deletion-positive Lynch syndrome: a cohort study : The Lancet Oncology (multi-national study)
Note: (abstract) study includes 194 mutation carriers with references to pancreatic and duodenal cancers; more information on EPCAM genetics can be found by searching this blog
Duodenal cancer - Wikipedia Duodenal cancer is a cancer in the beginning section of the small intestine. It is relatively rare compared to gastric cancer and colorectal cancer. en.wikipedia.org/wiki/Duodenal_cancer
Uncommon Knowledge: Sorry really isn't enough (apology) - The Boston Globe (breast and ovarian cancer gender comments...)
Note: comments regarding breast and ovarian cancer (gender issues)
"...From an early age, we’re taught to apologize. We’re also taught to accept apologies. In theory, an apology should set things right. But does it...."
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