science report: Treating cancer as a chronic disease? (study of clear cell ovarian cancer....)

Treating cancer as a chronic disease?

ScienceDaily (Mar. 29, 2012) — New research from the Technion-Israel Institute of Technology Rappaport Faculty of Medicine and Research Institute and the Rambam Medical Center may lead to the development of new methods for controlling the growth of cancer, and perhaps lead to treatments that will transform cancer from a lethal disease to a chronic, manageable one, similar to AIDS.............

".......For this study, the team took cells from one woman's ovarian clear cell carcinoma and injected them either into or alongside the human stem cell-derived environment. "We noticed very early on, rather strikingly, that the human cancer cells grow more robustly when they are in the teratoma environment compared to any other means in which we grew them, such as in a mouse muscle or under the skin of a mouse," says Skorecki.

The scientists were able to tease out six different kinds of self-renewing cells, based on behavior -- how quickly they grow, how aggressive they are, how they differentiate -- and on their molecular profile. This was a previously unknown finding, that one tumor might have such a diversity of cells with crucial fundamental growth properties. Tzukerman explains that the growth of the cancer cell subpopulations can now be explained by their proximity to the human cell environment.

The researchers cloned and expanded the six distinct cell populations and injected them into the human stem cell teratomas. One key observation is that some cells, which were not self-replicating in any other model, became self-replicating when exposed to the human cells.
Skorecki said that while he wasn't surprised that the human environment affected the growth, he was in fact surprised by the magnitude of the effect: "We've known for years now that cancers are complex organs, but I didn't think the power of the human stem cell environment would be so robust, that it would make such a big difference in how the cells were grown."........

open access: 2011 Progression-free survival in advanced ovarian cancer: a Canadian review and expert panel perspective | Dr A. Oza | Current Oncology (topics: eg chronic disease, 1st line therapy...)

Blogger's Note: may require registration (free); note also list of useful (international) reference papers

                                                                                        


Ovarian cancer is leading cause of gynecologic cancer mortality in Canada. To date, overall survival ( os ) has been the most-used endpoint in oncology trials because of its relevance and objectivity. However, as a result of various factors, including the pattern of sequential salvage (outdated term)  therapies, measurement of os and collection of os data are becoming particularly challenging. Phase ii and iii trials have therefore adopted progression-free survival ( pfs ) as a more convenient surrogate endpoint; however, the clinical significance of pfs remains unclear. This position paper presents discussion topics and findings from a pan-Canadian meeting of experts that set out to

• evaluate the relevance of pfs as a valid endpoint in ovarian cancer;
• reach a Canadian consensus on the relevance of pfs in ovarian cancer; and
• try to address how pfs translates into clinical benefit in ovarian cancer.
  
  
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Recommendations for future investigations include these:

• Ensure that trials are designed to evaluate pfs , os , and other clinically relevant endpoints such as disease-related symptoms or qol .
• Incorporate interim futility analyses intended to stop accrual early when the experimental regimen is not active.
• Stop trials early to declare superiority only when compelling evidence suggests that a new treatment provides benefit for a pre-specified clinically relevant endpoint such as os or symptom relief.
• Importantly, discourage early release of secondary endpoint results when such a release might increase the frequency of crossover to the experimental intervention.

(U.S.) Health Alert: Disease Clusters Spotlight the Need to Protect People from Toxic Chemicals

Note:

1)  search terms of 'ovarian'; 'gynecologic' & 'female reproductive' produced zero results;
2)  states included in report: Arkansas, California, Delaware, Florida, Louisiana, Michigan, Missouri, Montana, North Carolina, Ohio, Pennsylvania, Tennessee, Texas

About NRDC
The Natural Resources Defense Council (NRDC) is an international nonprofit environmental organization with
more than 1.3 million members and online activists.  www.nrdc.org.


Cancer Clusters,
Disease, and the need to Protect
People from Toxic Chemicals
An unusually large number of people sickened by a disease in a certain place and
time is known as a ‘disease cluster’. Clusters of cancer, birth defects, and other
chronic illnesses have sometimes been linked to chemicals or other toxic pollutants
in local communities, although these links can be controversial. There is a need for
better documentation and investigation of disease clusters to identify and address
possible causes. Meanwhile, toxic chemicals should be identified and controlled
through reform of the Toxic Substances Control Act, so these chemicals don’t
pollute communities and sicken people.