Still waiting for the world to catch up - Ignace Vergote - Cancer World - including comments on CA-125/biomarkers

"When Ignace Vergote opted to specialise in gynaecological oncology, his country wasn't ready, and he's been waiting for the world to catch up with him ever since....."

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"....The problem is well illustrated by Vergote’s own experience. When asked about the research he is most proud of, Vergote points to an academic study published a year ago in the New England Journal of Medicine, which was independently funded and has already had a global impact. Sponsored by the EORTC, it analysed outcomes in advanced ovarian cancer surgery according to whether the debulking surgery was timed before or during chemotherapy.

“I was very proud of this. But it took us ten years. We had to randomise 720 patients and, because it wasn’t sponsored, people had to be very committed and give their time for free – talking to patients, gaining informed consent, all these things without financial support. It’s very difficult. So I am proud of that.”...

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" He believes that more accurate tumour markers than CA125 need to be found – and his department is working on this problem.

“In 20 years, I think that maybe we will have a marker that will be more specific and good enough for screening. But I think it’s still too early to conclude that we have found it.” " 

 

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

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

Quality of pathology reports for advanced ovarian cancer: Are we missing essential information? An audit of 479 pathology reports from the EORTC-GCG 55971/NCIC-CTG OV13 neoadjuvant trial

2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours

abstract: How to follow-up patients with epithelial ovarian cancer : Current Opinion in Oncology

How to follow-up patients with epithelial ovarian cancer
Miller, Rowan E; Rustin, Gordon JS

Abstract

Purpose of review: Despite optimal primary treatment most patients with advanced epithelial ovarian cancer will relapse. This review discusses the controversy regarding surveillance and the timing of treatment for recurrent disease.

Recent findings: Routine physical examination has a limited role in the detection of recurrent ovarian cancer. PET/computed tomography (CT) has been shown to be useful in detecting small volume disease not apparent on traditional imaging in patients with suspected recurrence based on symptoms and/or rising CA125. The results of PET/CT can alter treatment plans and have particular use in guiding site-directed therapy. The benefits of early detection and systemic treatment of recurrence are now in doubt following the presentation of the MRC/EORTC CA125 surveillance trial. The impact on survival of secondary cytoreductive surgery requires more investigation.

Summary: Uncertainties remain in the surveillance and timing of treatment for relapsed disease. Patients should be informed of these uncertainties and become involved in decisions regarding their follow-up.

abstract: How to follow-up patients with epithelial ovarian cancer.

Abstract

PURPOSE OF REVIEW: Despite optimal primary treatment most patients with advanced epithelial ovarian cancer will relapse. This review discusses the controversy regarding surveillance and the timing of treatment for recurrent disease.
RECENT FINDINGS: Routine physical examination has a limited role in the detection of recurrent ovarian cancer. PET/computed tomography (CT) has been shown to be useful in detecting small volume disease not apparent on traditional imaging in patients with suspected recurrence based on symptoms and/or rising CA125. The results of PET/CT can alter treatment plans and have particular use in guiding site-directed therapy. The benefits of early detection and systemic treatment of recurrence are now in doubt following the presentation of the MRC/EORTC CA125 surveillance trial. The impact on survival of secondary cytoreductive surgery requires more investigation.
SUMMARY: Uncertainties remain in the surveillance and timing of treatment for relapsed disease. Patients should be informed of these uncertainties and become involved in decisions regarding their follow-up.