Improving cancer control in Canada through knowledge translation: from in-the-field projects to policy initiatives in a new standing section in Current Oncology

Improving cancer control in Canada through knowledge translation: from in-the-field projects to policy initiatives in a new standing section in Current Oncology

abstract: High scores on the Edmonton Symptom Assessment Scale identify patients with self-defined high symptom burden.

High scores on the Edmonton Symptom Assessment Scale identify patients with self-defined high symptom burden.

Abstract:

The terms symptom burden and symptom distress are frequently seen in palliative care literature yet are used in multiple ways ranging from addition of symptom scores to more in-depth assessments of interference in function. Patient input to date has had little role in these varied definitions yet previous reviews have suggested the importance of such input. This mixed qualitative and quantitative prospective study was conducted to seek patient input into the definition of 'symptom burden' and to correlate burden self-ranked scores with symptom scores on the Edmonton Symptom Assessment Scale (ESAS).

Results suggest that patients with advanced disease followed by palliative care providers are a group with a high level of self-defined burden. Further, any patient rating one or more symptoms on the ESAS ≥7 is at high risk of self-defined burden and likely to be experiencing significant impact on physical, emotional and social functioning. Further work should look at which aspects of symptom management best promote a lessening of perceived burden.

Medscape: Colonoscopy No Help in Finding Melena Source - in Gastroenterology, General Gastroenterology

 Wiki: Melena

Medical News: Colonoscopy No Help in Finding Melena Source - in Gastroenterology, General Gastroenterology

"Colonoscopy had a lower-than-expected yield when used after a negative upper endoscopy in stable patients with melena, researchers found.
The procedure diagnosed a suspected source of the bleeding in just 4.8% of patients with melena in a retrospective case-control study by Jason P. Etzel, MD, of Oregon Health and Science University, Portland, and colleagues......

Medscape: (Avastin) Bevacizumab: First-Line Therapy in Ovarian Cancer?: Evidence for First-Line Therapy Dr's Markman, Burger, Swenterton

Bevacizumab: First-Line Therapy in Ovarian Cancer?: Evidence for First-Line Therapy

Editor’s Note:
 
Two phase 3 trials published in the New England Journal of Medicine on December 29, 2011, found bevacizumab to be active as first-line therapy in advanced ovarian cancer. Although both trials showed an increase in progression-free survival [PFS], not enough time has elapsed to determine whether the drug extends overall survival. Furthermore, it is unclear whether bevacizumab in ovarian cancer is best used as first-line or second-line therapy. Recently, Drs. Robert Burger and Kenneth Swenerton participated in a Medscape virtual debate via email to address this question: "Should bevacizumab be used as first-line therapy in patients with advanced ovarian cancer?" Dr. Maurie Markman served as moderator. What follows is their conversation......

how to.....follow Ovarian Cancer and Us via email alerts (many options)

 Ovarian Cancer and Us - Blogger's Note:  

 Looks hard but is not - using this post as an example or you can just use the email link or others on the blog, lots of options for those interested:

                     ~~~~~~~~~~~~~~~~

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abstract: Preoperative PET/CT in early-stage breast cancer (including ovarian cancer primary/metastases)

Preoperative PET/CT in early-stage breast cancer

Abstract

Background: The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer. 

Patients and methods: A total of 103 consecutive patients with newly diagnosed operable breast cancer with tumors ≥2 cm were independently examined preoperatively with conventional assessment (mammography, breast/axillary ultrasound, chest X-ray and blood samples) and PET/CT with no prior knowledge of the other. 

Results: PET/CT identified a primary tumor in all but three patients (97%). PET/CT solely detected distant metastases (ovary, bones and lung) in 6 patients and new primary cancers (ovary, lung) in another two patients, as well as 12 cases of extra-axillary lymph node involvement. In 15 patients (15%), extra-axillary malignancy was detected by PET/CT only, leading to an upgrade of initial staging in 14% (14/103) and ultimately a modification of planned treatment in 8% (8/103) of patients. 

Conclusions: PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases and other occult primary cancers. Preoperative ¹⁸F-fluorodeoxyglucose–PET/CT has a substantial impact on initial staging and on clinical management in patients with early-stage breast cancer with tumors ≥2 cm.

Aspirin and cancer risk: a quantitative review to 2011

Aspirin and cancer risk: a quantitative review to 2011:

Background:
Aspirin has been associated to a reduced risk of colorectal and possibly of a few other common cancers.

Methods:
To provide an up-to-date quantification of this association, we conducted a meta-analysis of all observational studies on aspirin and 12 selected cancer sites published up to September 2011.

Results:
Regular aspirin is associated with a statistically significant reduced risk of colorectal cancer and of other digestive tract cancers, for squamous cell esophageal cancer, for esophageal and gastric cardia adenocarcinoma,, for gastric cancer), with somewhat stronger reductions in risk in case–control than in cohort studies. Modest inverse associations were also observed for breast and prostate cancer, while lung cancer was significantly reduced in case–control studiesbut not in cohort ones. No meaningful overall associations were observed for cancers of the pancreas, endometrium, ovary, bladder, and kidney.

Conclusions:
Observational studies indicate a beneficial role of aspirin on colorectal and other digestive tract cancers; modest risk reductions were also observed for breast and prostate cancer. Results are, however, heterogeneous across studies and dose–risk and duration–risk relationships are still unclear.

2011 Dec open access: Nuclear Medicine and Radiation Therapy - 18FDG-PET/CT Definition of Clinical Target Volume for Robotic Stereotactic Body Radiosurgery Treatment of Metastatic Gynecologic Malignancies

Blogger's Note: investigative research; study of 27 gyn patients of whom 15 were ovarian cancer patients

18FDG-PET/CT Definition of Clinical Target Volume for Robotic Stereotactic Body Radiosurgery Treatment of Metastatic Gynecologic Malignancies

 "As stereotactic body radiosurgery for abdominopelvic sites
of metastatic gynecologic cancers becomes more mainstream,
accumulated 18F-FDG PET and CT data will better guide treating
physician target contouring. Future research directions by our group
will study better radiosurgical target delineation, as modified by the
extent of respiratory motion, by four-dimensional (4D)-CT scanners
or by single 18F-FDG PET-magnetic resonance imaging (PET/MRI)
scanners."

23andMe Founder Discusses Genetics and Healthcare | News | The Harvard Crimson

23andMe Founder Discusses Genetics and Healthcare | News | The Harvard Crimson

A prospective multicenter (phase IIIb) trialstudy of Treosulfan in elderly patients with recurrent ovarian cancer: results of a planned safety analysis

A prospective multicenter study of treosulfan in elderly patients with recurrent ovarian cancer: results of a planned safety analysis

This open-label multicenter phase-IIIb trial was conducted at 47 German institutions; the first 25 patients analyzed in this safety analysis were recruited in 10 centers.

Background  

Treosulfan, an alkylating agent, has demonstrated activity in recurrent ovarian carcinoma. It is equieffective as oral (p.o.) and intravenous (i.v.) formulation. To explore the preference and compliance of elderly patients regarding p.o. or i.v. treosulfan for the treatment of relapsed ovarian carcinoma, women aged 65 years or older were included in this prospective multicenter study. Since elderly patients usually have several concomitant diseases and experience more treatment toxicity, an interim safety analysis was planned and performed after 25 patients finished therapy to assess the tolerability of the treatment regimens.


Table 1 - 6 

• Patient characteristics
• Concomitant diseases
• Treatment delivery
• Reasons for early therapy discontinuation [less than 12 cycles (i.v.) or 12 months of therapy 
• Non-hematological toxicities: highest grade per patient (in alphabetic order)
• Hematological toxicities: highest grade per patient

"Altogether 16 serious adverse events (SAE) were documented for nine patients. The predominant reason for SAE-reporting was hospitalization (14 reports). Death was the matter for the remaining 2 SAEs. An additional patient was hospitalized due to progressive disease and died in hospital. In all 3 cases, death was concerned as not related to study medication and progress of the underlying malignant tumor was stated as cause of death."

"In summary, the observed toxicities were in the same range as reported in previous studies with significantly younger patients and less comorbidity or with old women having received fewer previous lines of chemotherapy.

There were no unexpected hematological or non-hematological toxicities. Based on this safety analysis, treosulfan proved to be a safe and tolerable therapeutic option in elderly, heavily pretreated patients and the next step of study recruitment was initiated. Of note, the majority of patients in the interim safety population chose i.v. treosulfan over the oral application. Detailed analysis after completion of the trial will hopefully yield new insight into therapy preference and compliance of elderly patients with recurrent ovarian cancer."

Conflict of interest  The trial was supported by Medac GmbH.

Selected abstracts submitted to the Fourth International Symposium on Hereditary Breast and Ovarian Cancer 2012| Authors | Current Oncology

Selected abstracts submitted to the Fourth International Symposium on Hereditary Breast and Ovarian Cancer | Authors | Current Oncology

Emerging Therapies for Ovarian Cancer - Chemotherapy Advisor

Emerging Therapies for Ovarian Cancer - Chemotherapy Advisor

Bevacizumab
Other Antiangiogenesis Agents
Poly(ADP-ribose) Polymerase Inhibitors
Other Novel Agents in Ovarian Cancer



 
printer-friendly (view all on one page): link

Phase I Stereotactic Body Radiation for Metastatic or Recurrent Platinum-Resistant Ovarian Cancer - Full Text View - ClinicalTrials.gov

Phase I Stereotactic Body Radiation for Metastatic or Recurrent Platinum-Resistant Ovarian Cancer - Full Text View - ClinicalTrials.gov

Phase I Stereotactic Body Radiation for Metastatic or Recurrent Platinum-Resistant Ovarian Cancer

This study is currently recruiting participants.

Verified April 2012 by Stanford University

First Received on December 13, 2011.   Last Updated on April 18, 2012   History of Changes

Sponsor:	Stanford University
Information provided by (Responsible Party):	Stanford University
ClinicalTrials.gov Identifier:	NCT01494012

  Purpose

This phase I trial studies the side effects and the best dose of stereotactic body radiation therapy (SBRT) in treating patients with metastatic or recurrent ovarian cancer or primary peritoneal cancer. SBRT may be able to send x-rays directly to the tumor and cause less damage to normal tissue.

FDA (U.S.) Safety Alert > Morphine Sulfate Injection USP, 4 mg/mL (C-II), 1 mL fill in 2.5 mL Carpuject by Hospira, Inc: Recall - May Contain More Than Intended Fill Volume

Safety Alerts for Human Medical Products > Morphine Sulfate Injection USP, 4 mg/mL (C-II), 1 mL fill in 2.5 mL Carpuject by Hospira, Inc: Recall - May Contain More Than Intended Fill Volume


[Posted 04/18/2012]
AUDIENCE: Risk Manager, Pain Management
ISSUE: Customer report of two Carpujects syringes containing more than the 1 mL labeled fill volume. Opioid pain medications such as morphine have life-threatening consequences if overdosed. Those consequences can include respiratory depression (slowed breathing or suspension of breathing), and low blood pressure.
BACKGROUND: The affected product is a prefilled glass cartridge for use with the Carpuject Syringe system. The affected lot number is 10830LL, with an expiration date of April 1, 2013. Morphine Sulfate Carpujects 4 mg/mL are packaged in Slim-Pak tamper detection packages with each box containing 10 Carpujects (NDC 0409-1258-30).
The affected lot was distributed in January 2012. It was initially distributed to wholesalers and a limited number of hospitals in Arizona, Colorado, Hawaii, Illinois, Indiana, Michigan, Minnesota, Ohio, Texas and Virginia.
RECOMMENDATION: Anyone with an existing inventory of affected product should stop use and distribution and quarantine the product immediately and call Stericycle at 1-888-912-7088 to arrange for the return of the product.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

• Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
• Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

abstract + links/podcast: Prevention of Pegfilgrastim-Induced Bone Pain: A Phase III Double-Blind Placebo-Controlled Randomized Clinical Trial of the University of Rochester Cancer Center Clinical Community Oncology Program Research Base

Prevention of Pegfilgrastim-Induced Bone Pain: A Phase III Double-Blind Placebo-Controlled Randomized Clinical Trial of the University of Rochester Cancer Center Clinical Community Oncology Program Research Base

Conclusion 

Our phase III randomized placebo-controlled clinical trial demonstrated that naproxen at a dose of 500 mg twice per day is effective in reducing the incidence and severity of pegfilgrastim-induced bone pain.

Footnotes

• See accompanying editorial doi: 10.1200/JCO.2011.41.3146 and article doi: 10.1200/JCO.2011.39.2381;
  •  listen to the podcast by Dr Von Hoenn at www.jco.org/podcasts

Seth's Blog: Bandits and philanthropists

Bandits and philanthropists:

The web is minting both, in quantity.

Bandits want something for nothing. They take. They take free content where they can find it. They fight for anonymity, for less community involvement. They want more than their fair share, and they walk past the busker, because they can hear him playing real good, for free.

The spammer is a bandit, stealing your attention because he can get away with it, and leaving nothing in return.

Philanthropists see a platform for giving. They support the tip jar. They argue for community standards and yes, for taxes that are more fair to the community. They support artists online, and when they can, they buy the book.

The artist who creates a video that touches you, or an infographic that informs you--she's giving more than she gets, leaving the community better than it was before she got there.

Both types have been around forever, of course. But the web magnifies the edges. It's easier than ever to be a free rider, to make your world smaller and to take. And easier than ever to be a big time contributor, even if you don't have any money. You can contribute your links or your attention or your energy...

The fascinating thing for me is how much more successful and happy the philanthropists are. It turns out that when you make the world smaller, you get to keep more of what you've got, but you end up earning a lot less (respect, connections, revenue) at the same time.

Canadian breast implant cohort: Extended follow-up of cancer incidence

Blogger's Note: prior Canadian patient-led lawsuits failed
                                 ~~~~~~~~~~~~~~~~~

Canadian breast implant cohort: Extended follow-up of cancer incidence:

Abstract

Cosmetic breast implants are not associated with increased breast cancer incidence, but variations of risk according to implant characteristics are still poorly understood. As well, the assessment of cancer risk for sites other than breast needs to be clarified. The purpose of this study was to fill these research gaps. This study presents an extended analysis of 10 more years of follow-up of a large Canadian cohort of women who received either cosmetic breast implants (n=24,558) or other cosmetic surgery (15,893). Over 70% of the implant cohort was followed for over 20 years. Cancer incidence among implant women was compared to those of controls using multivariate Poisson models and the general female population using the Standardized Incidence Ratios (SIRs). Women with breast implants had reduced rates of breast and endometrial cancers compared with other surgery women. Subglandular implants were associated to a reduced rate of breast cancer compared to submuscular implants (Incidence Rate Ratio (IRR) = 0.78, 95% CI= 0.63-0.96) and this reduction persisted over time. We observed a 7-fold increased rate (IRR = 7.36, 95% CI= 1.86-29.12) of breast cancer in the first five years after the date of surgery for polyurethane-coated subglandular implant women but this IRR decreased progressively over time (p value for trend = 0.02). We also observed no increased risk of rarer forms of cancer among augmented women. A reduction in breast cancer incidence was observed for women with subglandular implants relative to women with submuscular implants. Possible increase of breast cancer incidence shortly after breast augmentation with polyurethane implants needs to be verified.

FDA (U.S.) Press Announcements > U.S. Marshals seize ultrasound gel product at a New Jersey company

Press Announcements > U.S. Marshals seize ultrasound gel product at a New Jersey company

 FDA NEWS RELEASE
For Immediate Release: April 18, 2012
Media Inquires: Sarah Clark-Lynn, 301-796-9110, sarah.clark-lynn@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA
U.S. Marshals seize ultrasound gel product at a New Jersey companyProduct samples revealed bacterial contamination

JCO Editorial (re: Ontario/Pritchard et al) [18F]Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography in Breast Cancer: When… and When Not?

[18F]Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography in Breast Cancer: When… and When Not?

"....It has taken a relatively long time to generate the data needed to guide appropriate use of FDG PET/CT for breast cancer for all phases of the disease. The task is still not quite complete but is propelled by studies such as Pritchard et al.⁶ We hope that the approach for directing new imaging procedures into clinical practice will continue to improve and be ready when the next imaging breakthrough emerges."

"Diagnostic imaging plays an important role in the care of patients with breast cancer and is used for breast cancer detection, diagnosis, staging, and therapeutic response evaluation.¹ Advances in imaging technology, especially relatively newer technologies such as magnetic resonance imaging (MRI) and positron emission tomography without or with integrated computed tomography (PET or PET/CT) provide powerful diagnostic tools, but also generate questions and controversy regarding where and when to use these new modalities. Early studies of new imaging approaches most often come from centers that are scientifically invested in the development of the technology. Typically, small and highly selected patient populations are evaluated, and these preliminary studies often indicate excellent diagnostic performance. Later on, when large multicenter trials are performed with more clinically representative patient populations, the new test invariably performs less well. Nevertheless, the excitement surrounding early results from a new imaging technology and the increasing public access to these early results fuel the desire by patients for access to new forms of diagnostic imaging. Physicians and patients share the wish for diagnostic certainty in excluding cancer spread at the time of diagnosis and may reason that a purely diagnostic procedure, even if untested, can do no harm. These factors, combined with the challenge and expense of carrying out larger scale diagnostic imaging trials, can lead to the early adoption of new imaging studies into clinical practice, often before their performance and optimal use have been fully determined. However, ......."

abstract: Prospective Study of 2-[18F]Fluorodeoxyglucose Positron Emission Tomography in the Assessment of Regional Nodal Spread of Disease in Patients With Breast Cancer: An Ontario Clinical Oncology Group Study

Prospective Study of 2-[18F]Fluorodeoxyglucose Positron Emission Tomography in the Assessment of Regional Nodal Spread of Disease in Patients With Breast Cancer: An Ontario Clinical Oncology Group Study

 Purpose 2-[¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET) is potentially useful in assessing lymph nodes and detecting distant metastases in women with primary breast cancer.


Conclusion
FDG-PET is not sufficiently sensitive to detect positive axillary lymph nodes, nor is it sufficiently specific to appropriately identify distant metastases. However, the very high positive predictive value (96%) suggests that PET when positive is indicative of disease in axillary nodes, which may influence surgical care.

JCO: Palliative Sedation: When and How? Commentary including references

 Blogger's Note: 
“Not everything that can be counted counts and not everything that counts can be counted.” Albert Einstein

                                           ~~~~~~~~~~~~~~
Commentary (on Maltoni et al):  Palliative Sedation: When and How?

REFERENCES

1. ↵
   1. Yennurajalingam S,
   2. Urbauer DL,
   3. Casper KL,
   4. et al.

   Impact of a palliative care consultation team on cancer-related symptoms in advanced cancer patients referred to an outpatient supportive care clinic. J Pain Symptom Manage, [epub ahead of print on August 24, 2010].
2. ↵
   1. Elsayem A,
   2. Curry E III,
   3. Boohene J,
   4. et al.

   (2009) Use of palliative sedation for intractable symptoms in the palliative care unit of a comprehensive cancer center. Support Care Cancer 17:53–59.
3. ↵
   1. Maltoni M,
   2. Scarpi E,
   3. Rosati M,
   4. et al.

   (2012) Palliative sedation in end-of-life care and survival: A systematic review. J Clin Oncol 30:1378–1383.
4. ↵
   1. Hui D,
   2. Elsayem A,
   3. De la Cruz M,
   4. et al.

   (2010) Availability and integration of palliative care at US cancer centers. JAMA 303:1054–1061.
5. ↵
   1. Bush SH,
   2. Bruera E

   (2009) The assessment and management of delirium in cancer patients. Oncologist 14:1039–1049.
6. ↵
   1. Delgado-Guay MO,
   2. Parsons HA,
   3. Li Z,
   4. et al.

   (2009) Symptom distress, interventions, and outcomes of intensive care unit cancer patients referred to a palliative care consult team. Cancer 115:437–445.

abstract: Postoperative venous thromboembolism predicts survival in cancer patients

Postoperative venous thromboembolism predicts survi... [Ann Surg. 2012]

OBJECTIVES:

To determine whether a postoperative venous thromboembolism (VTE) is associated with a worse prognosis and/or a more advanced cancer stage and to evaluate the association between a postoperative VTE and cancer-specific survival when known prognostic factors, such as age, stage, cancer type, and type of surgery, are controlled.

CONCLUSIONS:

Postoperative VTE in oncology patients with limited disease and a complete surgical resection is associated with an inferior cancer survival. A postoperative VTE remains a poor prognostic factor, even when controlling for age, stage, cancer type, and surgical procedure further supporting an independent link between hypercoagulability and cancer survival.

JNCI J Natl Cancer Inst - audio/podcast - JNCI PODCAST News Summaries for Issue 9 The Efficacy of Cancer Vaccines - Dr. Jeffrey Schlom talks about therapeutic cancer vaccines

Blogger's Note: comments in interview include references to prostate, FAP (genetics/colorectal cancer) & high risk ovarian/breast; note also comments regarding the use of cancer vaccines in early stage cancers

JNCI PODCAST

The Efficacy of Cancer Vaccines- Dr. Jeffrey Schlom talks about therapeutic cancer vaccines

abstract: If patient-reported outcome measures are considered key health-care quality indicators, who is excluded from participation? - Health Expectations

If patient-reported outcome measures are considered key health-care quality indicators, who is excluded from participation?  - Health Expectations 
 

Abstract

Patient-reported outcome measures have received increasing attention with regard to ensuring quality improvement across the health service. However, there is a risk that people with disabilities and low literacy are systematically excluded from the development of these measures as well as their application in clinical practice. This editorial highlights some of these risks and the potential consequences of exclusion for these groups.

Oncology Times - Friday, April 13, 2012 SGO Restructures to Incorporate a 501(c)(6)

Oncology Times

Friday, April 13, 2012

SGO Restructures to Incorporate a 501(c)(6)

A Evaluation of Metformin, Targeting Cancer Stem Cells for the Prevention of Relapse in Patients With Stage IIC/III/IV Ovarian, Fallopian Tube, and Primary Peritoneal Cancer - Full Text View - ClinicalTrials.gov

A Evaluation of Metformin, Targeting Cancer Stem Cells for the Prevention of Relapse in Patients With Stage IIC/III/IV Ovarian, Fallopian Tube, and Primary Peritoneal Cancer - Full Text View - ClinicalTrials.gov

A Evaluation of Metformin, Targeting Cancer Stem Cells for the Prevention of Relapse in Patients With Stage IIC/III/IV Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

This study is currently recruiting participants.

Verified March 2012 by University of Michigan Cancer Center

First Received on March 30, 2012.   Last Updated on April 16, 2012   History of Changes

Sponsor:	University of Michigan Cancer Center
Information provided by (Responsible Party):	Ronald Buckanovich, University of Michigan Cancer Center
ClinicalTrials.gov Identifier:	NCT01579812

  Purpose

The primary objective of this study is to determine if metformin administered as the time of traditional adjuvant chemotherapy to women with advanced ovarian, primary peritoneal or fallopian tube cancer will improve recurrence-free survival at 18 months compared to controls.

Acetyl-L-Carnitine Hydrochloride in Preventing Peripheral Neuropathy in Patients With Recurrent Ovarian Epithelial Cancer, Primary Peritoneal Cavi - GOGty Cancer, or Fallopian Tube Cancer Undergoing Chemotherapy - Full Text View - ClinicalTrials.gov

 WebMd:  ACETYL - L - CARNITINE (including other names)

                            ~~~~~~~~~~~~~~~~~~~~

This study is not yet open for participant recruitment.

Verified April 2012 by National Cancer Institute (NCI)

First Received on December 14, 2011.   Last Updated on April 17, 2012   History of Changes

Acetyl-L-Carnitine Hydrochloride in Preventing Peripheral Neuropathy in Patients With Recurrent Ovarian Epithelial Cancer, Primary Peritoneal Cavity Cancer, or Fallopian Tube Cancer Undergoing Chemotherapy - Full Text View - ClinicalTrials.gov

Purpose

RATIONALE: Acetyl-L-carnitine hydrochloride may prevent or lessen peripheral neuropathy caused by chemotherapy. It is not yet known whether acetyl-L-carnitine hydrochloride is more effective compared to a placebo in preventing peripheral neuropathy caused by chemotherapy.

PURPOSE: This randomized phase III trial studies how well acetyl-L-carnitine hydrochloride works compared to a placebo in preventing peripheral neuropathy in patients with recurrent ovarian epithelial cancer, primary peritoneal cancer, or fallopian tube cancer undergoing chemotherapy.

Does “Cancer” – The Word – Properly Explain “Cancer” – the Disease?

Does “Cancer” – The Word – Properly Explain “Cancer” – the Disease?:
by Jonathan Klein, MD
Often times, after explaining a diagnosis and treatment plan to a patient, physicians hear some variation on “my brother/sister/parent/friend/co-worker had cancer and received radiation/surgery/phase I clinical trial medication. Why am I not receiving this?” The answer may revolve around the idea that different cancers, even different cancers arising from the same part of the body, can be wildly different in biology, treatment, and prognosis. We obviously want to ensure that patients understand their options so that they can make informed decisions about their own care, but couldn’t the medical community do a better job of conveying this concept to the public even before people end up in our clinics?

We use the catch-all term “cancer” to refer to diseases within the body arising from uncontrollably dividing cells. It is a term familiar to everyone, and a diagnosis of cancer is a useful shorthand – it’s concise, easy to understand, and conveys a sense of seriousness around what lies ahead. But beyond that initial purpose, it’s largely insufficient.

Potentially Dangerous Complementary and Alternative Medicine (CAM) Use by Ovarian Cancer Patients | Abstract

Potentially Dangerous Complementary and Alternative Medicine (CAM) Use by Ovarian Cancer Patients

Abstract

Objective: 

The use of complementary or alternative medicine (CAM) has increased greatly over the last decade. Although many CAM activities are unlikely to increase a patient's risk for adverse events with conventional treatment for cancer, this is not necessarily true of ingestible CAM treatments such as herbal remedies, teas, and other supplements. This study surveyed women with ovarian cancer in order to evaluate the use of herbs and supplements that might place them at increased risk at the time of their surgery for ovarian cancer.  

Methods: 

A total of 219 women with ovarian cancer, who had received care from one of two participating oncology practices, were surveyed. 

Results: 

Of the women who reported having had surgery to treat their ovarian cancer (n=209), 65 (31%) reporting using one or more herbs or supplements that have been hypothesized to increase their risk for adverse outcomes. In almost all cases the risks associated with these substances were elevated risks for excessive bleeding.  

Conclusions: 

The use of herbs and supplements that might increase risks associated with excessive bleeding during gynecologic cancer surgery is common. Further research is needed to better understand the risks associated with use of herbs and supplements among women approaching surgery

. (J GYNECOL SURG 28:1)

Medscape: New Map of Breast Cancer Identifies 10 Disease Subtypes

Blogger's Note: references Oncotype DX and MammaPrint

New Map of Breast Cancer Identifies 10 Disease Subtypes

Oncofertility Education Modules: A presentation by Dr. Hananel Holzer

Oncofertility Education Modules: A presentation by Dr. Hananel Holzer:


Resident Module – Fertility#1
Resident Module – Fertility#2a
Resident Module – Fertility#2b

Resident Module – Fertility#3


by Monisha Sudarshan, MD
As one walks into Dr.Holzer’s office, his passion and love for helping patients with fertility issues is clear. Among the many honors and thank you notes, sits a small decorative baby carriage with the words engraved “Doctors are known to heal, you are known to create miracles”. Dr. Holzer is the Medical Director of the MUHC (McGill University Health Centre) Reproductive Centre and one of the pioneers in oncofertility. In fertility management, he describes every couple as a “new story” however, oncofertility presents its own unique challenges and complexities for the patient and physician population. Dr.Holzer advises his patients that the first and foremost importance is to fight the cancer; fertility represents an important aspect but is not the primary priority. One of his goals is also to educate and bring awareness to cancer physicians and residents about the options of fertility preservation for the younger oncology population and is working on creating easy, timely access for referral of these patients to expert centers. Continuing his educational endeavour, he has designed expert teaching modules targeted for resident education in oncology and fertility and to spark interest in this interesting and rapidly growing field. Modules begin with basic physiological changes with chemotherapy and radiotherapy, progress to current options in fertility preservation and the experience at the McGill University Health Center. Continue to stay tuned for more knowledge on this important and stimulating topic within oncology.

Clinical Performance Allocation April 2012 report - CIHI

Clinical Performance Allocation

• Access and Wait Times
• Quality of Care and Outcomes
• Integration and Continuity of Care
• Indicators
  • Health
  • Performance
• Health Funding

Where the Oldest Die Now - NYTimes.com

Where the Oldest Die Now - NYTimes.com

".... But if people are being shuttled from home to hospital to nursing home (and possibly around again) during their last days and weeks, that’s nothing to celebrate. “Site-of-death data only tells you where you are at time of death, but nothing about the transitions leading to that point,” Dr. Teno said....."

Leading Provider of Doctor-Formulated Nutritional Supplements Gets America Moving in a Healthy... -- POTOMAC, Md., April 18, 2012 /PRNewswire/ --

Leading Provider of Doctor-Formulated Nutritional Supplements Gets America Moving in a Healthy... -- POTOMAC, Md., April 18, 2012 /PRNewswire/ --

Opinion: Data to Knowledge to Action (pizza? lost friend? genomics.....)

Opinion: Data to Knowledge to Action:

Pizza on Tuesday within 2 miles of home?  There is a search for that.  Find a long lost high school friend or an out of print book? There are searches for that.  Correlating genomic information with proteomics data, patient information, and drug trial results?  You’re on your own.  It is ironic and lamentable that internet queries can get you information on so many things, yet the scientific data that are crucial to finding cures for numerous diseases are often buried in an unusable format on a hard drive in somebody’s garage.

press release: Problems in cancer care are not uncommon

 Blogger's Opinion: although this article focuses on breast cancer, there is of course a common theme, attention is deserved for those with less common/rare cancers as the dichotomies in care (access, research, outcomes.....) should be obvious

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Problems in cancer care are not uncommon

Public release date: 17-Apr-2012

Difficulties occur more often in communication than in medical care

Cancer care is increasingly complex, and as many as one in five cancer patients may experience "breakdowns" in their care, according to a new study in the Journal of Clinical Oncology. Such breakdowns include communication problems between patients and their care providers, as well as more traditional medical errors; both types of problems can create significant harms. In the study, communication problems outnumbered problems with medical care.

Kathleen Mazor, EdD, Assistant Director of the Meyers Primary Care Institute, in Worcester, MA, led the study, with researchers from the University of Washington, Group Health, and Kaiser Permanente. Their study was a project of the Cancer Research Network's Cancer Communication Research Center. They found that problematic events led to varied consequences, such as additional medical care, delayed recovery, emotional distress, and persistent damage to the relationship between patients and their doctors.

"For me, the take-home message is it's critical for us to listen to patients as we try to improve care," Dr. Mazor said. "The patients we spoke with were generous, articulate, and thoughtful in recounting their experiences, and were glad to share their stories because they wanted to make a difference. We also heard a lot of stories about physicians, nurses, and others who really helped make things better—in the aftermath of a problem or even in the absence of a problem."

Examining actions patients took following a breakdown, the research team found that only 13 percent formally reported the problem, choosing instead to focus on their health and their future. Nearly all patients indicated that the problem spurred them to take positive steps in their health care behaviors, such as asking more questions or researching symptoms and treatments. However, 10 percent of patients reported they became more hesitant to seek care. 

The study used telephone interviews rather than medical-chart documentation to understand how patients perceived their care experiences.

"It's vital that we hear directly from the patients," noted study co-author Sarah M. Greene, MPH. "The communication problems probably wouldn't have appeared in their medical record. But to the patient, they are as significant as a clinical adverse event, like a wrong dose of chemotherapy." Ms. Greene is a research associate at Group Health Research Institute in Seattle.

Both patients and clinicians need new ways to provide negative and positive feedback about cancer care, according to the authors, and these systems should include some patient and clinician education. Additionally, the study team noted that patients' perceptions of problems may differ from clinicians' perspectives, so educating clinicians is equally critical. The health systems in this study are currently exploring strategies to encourage both patients and clinicians to openly communicate about their care experiences and expectations.

This study "reminds us that substantial work is needed to optimize breast cancer care and, most importantly, communication," Jeffrey Peppercorn, MD, MPH, of Duke University Medical Center, wrote in an accompanying editorial.

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The National Cancer Institute funded the study.
Dr. Mazor's and Ms. Greene's co-authors were Douglas Roblin, PhD, and Josephine Calvi, MPH, of Kaiser Permanente Georgia, in Atlanta; Kathryn Horner, MPH, of Group Health Research Institute; Celeste Lemay, RN, and Cassandra Firneno, BS, of Meyers Primary Care Institute, in Worcester, Massachusetts; and Thomas H. Gallagher, MD, an affiliate investigator at Group Health Research Institute who is based at the University of Washington School of Medicine's Department of Medicine.

Journal of Clinical Oncology The Journal of Clinical Oncology serves its readers as the single most credible, authoritative resource for disseminating significant clinical oncology research. In print and in electronic format, JCO strives to publish the highest quality articles dedicated to clinical research. Original Reports remain the focus of JCO, but this scientific communication is enhanced by appropriately selected Editorials, Commentaries, Reviews, and other work that relate to the care of patients with cancer. For more information, see http://jco.ascopubs.org/
 
HMO Research Network The HMO Research Network is a consortium of 19 health care delivery organizations with both defined patient populations and formal, recognized research capabilities. The Network's vision is to be the research partner of choice for those seeking to shape health and health care delivery. For more information, see http://www.hmoresearchnetwork.org
 
Meyers Primary Care Institute The Meyers Primary Care Institute was established in 1996 as a joint venture of Fallon Clinic (now Reliant Medical Group), Fallon Community Health Plan, and the University of Massachusetts Medical School. The Institute's mission is to promote primary care practice through innovative research and educational initiatives. For more information, see http://www.umassmed.edu/meyers/index.aspx
Kaiser Permanente Georgia's Center for Health Research Kaiser Permanente Georgia's Center for Health Research conducts professionally independent, public domain research and disseminates its findings in the scholarly literature and scientific community. For more information, see http://www.kpchr.org/research/public/default.aspx
 
Group Health Research Institute Group Health Research Institute is the research arm of Seattle-based Group Health Cooperative, a consumer-governed, nonprofit health care system. Founded in 1947, Group Health Cooperative coordinates health care and coverage. Group Health Research Institute changed its name from Group Health Center for Health Studies in 2009. Since 1983, the Institute has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding. For more information, see http://www.grouphealthresearch.org
 
UW Medicine The UW Medicine health system includes Harborview Medical Center, Northwest Hospital & Medical Center, Valley Medical Center, UW Medical Center, UW Neighborhood Clinics, UW Physicians, UW School of Medicine, and Airlift Northwest. UW Medicine also shares in the ownership and governance of Children's University Medical Group and Seattle Cancer Care Alliance, a partnership among UW Medicine, Fred Hutchinson Cancer Research Center, and Seattle Children's. UW Medicine has major academic and service affiliations with Seattle Children's, Fred Hutchinson Cancer Research Center, the Veteran's Affairs Puget Sound Health Care System in Seattle, and the VA Hospital in Boise, Idaho. The UW School of Medicine is the top public institution for biomedical research in funding received from the National Institutes of Health. For more information about UW Medicine, visit http://uwmedicine.washington.edu.

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abstract: [Clinical aspects of familial ovarian cancer - current status and issues in Japan] (focus on brca)

Blogger's Note: the [ ] indicates translated version


[Clinical aspects of familial ovarian cancer - current status and issues in Japan]

Abstract
Familial ovarian cancer occurs as part of two genetically distinct syndromes: hereditary breast and ovarian cancer(HBOC) and hereditary nonpolyposis colorectal cancer(HNPCC) (Lynch Syndrome) .

HBOC caused by inherited mutations of BRCA1/2 and HNPCC caused by mismatch-repair genes are considered responsible for about 65 to 75% and 10 to 15% of familial ovarian cancers, respectively. Germline mutations of BRCA1 are considered responsible for about 50% of ovarian cancer families and 80% of breast-ovarian cancer families. BRCA2 mutations are less common than BRCA1 mutations in ovarian cancer families. A high proportion of serous adenocarcinomas at an advanced stage has been reported with BRCA-related ovarian cancers in several studies. It is controversial whether BRCA-related ovarian cancer patients carry a better prognosis despite the aggressive tumor-pathological characteristics of their disease, compared to sporadic cases. However, a good therapeutic response may be attributable to platinum-based chemotherapy. Recently in Japan, gene testing of BRCA1/2 has been available as a routine clinical test for diagnosing ovarian cancer families. Because the mutation spectrum of BRCA1/2 in Japanese was different from that of non-Ashkenazi individuals, the clinical application of BRCA1/2 gene testing for Japanese has been advocated. Approximately 1-5% of ovarian cancer pa-tients in Japan are thought to have a family history of breast and/or ovarian cancer. The prevalence of deleterious mutations of BRCA1/2 in Japanese was reportedly significantly higher than that of non-Ashkenazi individuals despite the low frequency of familial cases in Japan. Although the age at diagnosis of ovarian cancers with BRCA1/2 mutation in the United States was earlier than those of the sporadic cases, there were no differences among Japanese. These results suggest that clinical and genetic aspects of BRCA-related ovarian cancer of the Japanese are different from those of Caucasians.

A serious issue in this field is how the results will lead to a basis for the clinical application of a cancer prevention strategy targeting BRCA mutation carriers in Japanese.

Progress against cancer in the Netherlands since the late 1980s: An epidemiological evaluation.

Progress against cancer in the Netherlands since the late 1980s: An epidemiological evaluation.:

Progress against cancer through prevention and treatment is often measured by survival statistics only instead of analyzing trends in incidence, survival and mortality simultaneously because of interactive influences. This study combines these parameters of major cancers to provide an overview of the progress achieved in the Netherlands since 1989 and to establish in which areas action is needed. The population-based Netherlands Cancer Registry and Statistics Netherlands provided incidence, 5-year relative survival and mortality of 23 major cancer types. Incidence, survival and mortality changes were calculated as the estimated annual percentage change. Optimal progress was defined as decreasing incidence and/or improving survival accompanied by declining mortality, and deterioration as increasing incidence and/or deteriorating survival accompanied by increasing mortality rates. Optimal progress was observed in 12 of 19 cancer types among males: laryngeal, lung, stomach, gallbladder, colon, rectal, bladder, prostate and thyroid cancer, leukemia, Hodgkin and non-Hodgkin lymphoma. Among females, optimal progress was observed in 12 of 21 cancers: stomach, gallbladder, colon, rectal, breast, cervical, uterus, ovarian and thyroid cancer, leukemia, Hodgkin and non-Hodgkin lymphoma. Deterioration occurred in three cancer types among males: skin melanoma, esophageal and kidney cancer, and among females six cancer types: skin melanoma, oral cavity, pharyngeal, esophageal, pancreatic and lung cancer. Our conceptual framework limits misinterpretations from separate trends and generates a more balanced discussion on progress.

open access: Causes and imaging features of false positives and false negatives on 18F-PET/CT in oncologic imaging

fulltext.pdf (application/pdf Object)

press release: Consumer Activity on Social Media Sites Dwarfs That of Healthcare Companies, Finds New PwC Study on Social Media in Healthcare

Consumer Activity on Social Media Sites Dwarfs That of Healthcare Companies, Finds New PwC Study on Social Media in Healthcare

NEW YORK, April 17, 2012 /PRNewswire/ -- Social media is changing the nature of healthcare interaction, and health organizations that ignore this virtual environment may be missing opportunities to engage consumers, according to a new report by the Health Research Institute (HRI) at PwC US entitled, "Social media likes healthcare: From marketing to social business." The report found that social media activity by hospitals, health insurers and pharmaceutical companies is miniscule compared to the activity on community sites......

The consumer survey found:

• One-third of consumers now use social media sites such as Facebook, Twitter, YouTube and online forums for health-related matters, including seeking medical information, tracking and sharing symptoms, and broadcasting how they feel about doctors, drugs, treatments, medical devices and health plans.
• Four in 10 consumers say they have used social media to find health-related consumer reviews (e.g. of treatments or physicians); one in three have sought information related to other patients' experiences with their disease; one in four have "posted" about their health experience; and one in five have joined a health forum or community.
• When asked how information found through social media would affect their health decisions, 45 percent of consumers said it would affect their decision to get a second opinion; 41 percent said it would affect their choice of a specific doctor, hospital or medical facility; 34 percent said it would affect their decision about taking a certain medication; and 32 percent said it would affect their choice of a health insurance plan.
• While 72 percent of consumers said they would appreciate assistance in scheduling doctor appointments through social media channels, nearly half said they would expect a response within a few hours.
• As is the case more broadly, young adults are leading the social media healthcare charge. More than 80 percent of individuals between the ages of 18 and 24 said they were likely to share health information through social media channels and nearly 90 percent said they would trust information they found there. By comparison, less than half (45 percent) of individuals between the ages of 45 and 64 said they were likely to share health information via social media.

Diffusion-weighted Imaging Study in Cancer of the Ovary - Full Text View - ClinicalTrials.gov

Diffusion-weighted Imaging Study in Cancer of the Ovary - Full Text View - ClinicalTrials.gov

Diffusion-weighted Imaging Study in Cancer of the Ovary (DISCOVAR)

This study is not yet open for participant recruitment.

Verified March 2012 by Institute of Cancer Research, United Kingdom

First Received on November 18, 2011.   Last Updated on March 30, 2012   History of Changes

Sponsor:	Institute of Cancer Research, United Kingdom
Collaborators:	Cancer Research UK Royal Marsden NHS Foundation Trust Cambridge University Hospitals NHS Foundation Trust Imperial College Healthcare NHS Trust Northumbria Healthcare NHS Foundation Trust
Information provided by (Responsible Party):	NdeSouza, Institute of Cancer Research, United Kingdom
ClinicalTrials.gov Identifier:	NCT01505829

  Purpose

This project seeks to develop a quantitative imaging biomarker for evaluating and monitoring treatment response in ovarian cancer metastases and assess its potential in monitoring treatment response. This will involve standardising DW-MRI for the abdomen and pelvis across multiple centres and platforms, assessing reproducibility of the measurement in patients planned for neoadjuvant chemotherapy and assessing its utility as an early response biomarker in patients with platinum-sensitive relapse due to receive therapy with carboplatin. Scanning measurements will be correlated with histopathological markers in tumour samples in order to link the biomarker with response mechanisms.

Condition
Ovarian Cancer Peritoneal Metastases

Study Type:	Observational
Study Design:	Observational Model: Cohort Time Perspective: Prospective
Official Title:	Assessing Treatment Response of Peritoneal Metastases in Ovarian Cancer Using Diffusion Weighted Magnetic Resonance Imaging.

financial news: ImmunoGen Says IND For Anticancer Compound IMGN853 Is Now Active

ImmunoGen Says IND For Anticancer Compound IMGN853 Is Now Active


(RTTNews.com) - ImmunoGen, Inc. (IMGN) announced that the Investigational New Drug, or IND, application for its IMGN853 product candidate is now active. IMGN853 is a potential new therapeutic for ovarian cancer, non-small cell lung cancer and other epithelial malignancies which over-express folate receptor 1, or FOLR1.
The company expects Phase I evaluation of IMGN853 to commence in the middle of 2012.....

Pinterest: Lynch Syndrome

Lynch Syndrome

Health Imaging: Uptick in colorectal cancer among under-50 crowd poses questions for researchers (Lynch Syndrome....)

Uptick in colorectal cancer among under-50 crowd poses questions for researchers

 ....Whatever the cause, the rate of colorectal cancer in young adults has increased to the point where nearly 10 percent of new diagnoses are in patients younger than 50. Most of these patients were diagnosed in their forties, but the disease has been found in patients in their twenties and thirties.......Another troubling recent finding is that when colorectal cancers are diagnosed in younger patients, they are more likely to be at an advanced stage of the disease. A study published Feb. 13 online in Archives of Internal Medicine found 63 percent of colon cancers and 57 percent of rectal cancers are stage III or IV at diagnosis......“The important thing for radiologists would be the notion that certain individuals, because of their age, may be denied radiology procedures by insurance companies,” she said.......

open access: What do surgical trainees think about patient safety culture, and is this different from their consultants?

What do surgical trainees think about patient safety culture, and is this different from their consultants?

Abstract

Introduction Little is known about the patient safety culture within surgical departments in UK hospitals. What has been done to date is to survey only permanent senior staff opinion of the safety culture in their institution. This study surveyed both consultant and trainee views on perceived patient safety and compared the results between these two groups. 

Material and methods The previously validated Team Work and Safety Climate Questionnaire was configured in Survey Monkey format and sent to all surgical trainees and consultant surgeons in the South West Strategic Health Authority. Two reminders were sent to achieve as high a return rate as possible. 

Results Two hundred and ninety-six replies were received. Forty-four percent of trainees and 30% of consultants responded to the survey. Consultants consistently rated a higher safety culture than surgical trainees. Only 2.9% of trainees believe their patient safety concerns would be acted upon by hospital management. There is notable variation in perceived patient safety culture between hospitals. 

Conclusion This study has suggested that the patient safety culture in hospitals, within a Strategic Health Authority, is variable and sub-optimal when viewed by surgical trainees and their consultants. This study also provides some evidence that the perception of patient safety in an organization varies according to clinical experience. As trainees deliver a great deal of clinical care, surveys of safety culture should include this group. As perceived patient safety culture is correlated to clinical outcomes, validated safety surveys might form part of the assessment of a hospital's performance, along with outcome and patient satisfaction.

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Introduction

Medical errors are a major cause of mortality and morbidity. The National Patient Safety Agency (NPSA) estimates that 10% of all hospital admissions suffer an adverse event defined as a medical error that results in harm to the patient. One percent of all admissions die as a result of an adverse event. In practice this means that in England and Wales 300,000 adverse events and 30,000 deaths are recorded every year. This figure of 30,000 deaths a year is a greater number of deaths than the combined annual mortality from colorectal, prostate and breast cancer.¹ Even these striking figures may be underestimating the extent of the problem because recent studies in the surgical literature² indicate the adverse event rate could even be as high as 20%...........

Cancer Prevention Research: Does Vitamin E Prevent or Promote Cancer?

Abstract

The cancer preventive activity of vitamin E has been suggested by many epidemiologic studies. However, several recent large-scale human trials with α-tocopherol, the most commonly recognized and used form of vitamin E, failed to show a cancer preventive effect. The recently finished follow-up of the Selenium and Vitamin E Cancer Prevention Trial (SELECT) even showed higher prostate cancer incidence in subjects who took α-tocopherol supplementation. The scientific community and the general public are faced with a question: “Does vitamin E prevent or promote cancer?” Our recent results in animal models have shown the cancer preventive activity of γ- and δ-tocopherols as well as a naturally occurring mixture of tocopherols, and the lack of cancer preventive activity by α-tocopherol. On the basis of these results as well as information from the literature, we suggest that vitamin E, as ingested in the diet or in supplements that are rich in γ- and δ-tocopherols, is cancer preventive; whereas supplementation with high doses of α-tocopherol is not. Cancer Prev Res; 1–5. ©2012 AACR.

open access: PLoS ONE: Proteins from Avastin® (bevacizumab) Show Tyrosine Nitrations for which the Consequences Are Completely Unclear

PLoS ONE: Proteins from Avastin® (bevacizumab) Show Tyrosine Nitrations for which the Consequences Are Completely Unclear

"......A major finding indicating pathogenetic or toxic properties of nitrated proteins was presented recently: assembly of alpha-synuclein and fibrinogen were deteriorated by nitration of only a small fraction of proteins [25], [32]. As for fibrinogen, nitration is accelerating the rate of fibrin clot formation [33]. It cannot be ruled out, therefore, that nitration of Avastin® may lead to side effects based upon probable disturbed protein-protein interactions as aggregations that in turn may lead to a series of complications as listed in the drug information sheet.
As to the underlying cause of tyrosine nitration it remains open, whether it can be considered as a post-translational modification of the immunoglobulin Avastin® or technical in nature, or both [34]-[38].
Taken together, it remains unclear if the observed nitrations and other PMs detected on Avastin® may be responsible for different biological or pharmacotoxicological properties and effects. Quantification of nitrations and their presence in several batches of the product has to be taken into considerations on probable toxicity as well, but corresponding in vivo analyses based upon these findings should be carried out by the manufacturers to probably save this protein drug that may have strong potential in tumor therapy."

media: Merck’s $1 billion deal includes phase 3 ovarian cancer therapeutic (Vintafolide/Endocyte)

Merck’s $1 billion deal includes phase 3 ovarian cancer therapeutic

 Merck (NYSE:MRK) has forged a deal with a biopharmaceutical company for its phase 3 platinum-resistant ovarian cancer treatment and nonsmall cell lung cancer in mid-stage development in a deal valued at up to $1 billion... Under the terms of the deal, Merck, through a subsidiary, will get worldwide rights to develop and commercialize vintafolide for ovarian cancer that’s resistant to platinum-based chemotherapy treatment. Endocyte (NASDAQ:ECYT), the Indiana-based cancer therapeutics developer, will receive a $120 million up-front payment and is eligible for milestone payments of up to $880 million if it achieves certain development, regulatory and commercialization milestones for vintafolide for a total of six cancer indications, according to a company statement......

"...The clinical trials for both maladies will also use etarfolatide, a noninvasive companion diagnostic imaging agent that is used to identify folate receptor positive tumor cells.....