Randomized Phase III Clinical Trial Evaluating Weekly Cisplatin for Advanced Epithelial Ovarian Cancer — J. Natl. Cancer Inst.

Thus, increasing dose intensity of cisplatin does not improve PFS or OS compared with standard chemotherapy.

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"

JCO (Special Issue) Overview: Host Factors and Cancer Outcome

"A solitary focus on tumor-related factors may explain some of the
failures of clinical translations of preclinical discoveries, which often
take place in systems (eg, the cell culture) that do not involve host
influences. There is growing evidence that it is necessary to go beyond
the cell into the whole organism to fully understand the biology of
cancer and its treatment. In the clinic, we are constantly reminded that
the cancer cell does not exist in isolation in the controlled environment
that is possible in the laboratory—it exists within a complex host
that interacts with both the cancer cell and the treatments that are used
to target that cancer cell. It is our hope that this special issue of Journal
of Clinical Oncology will stimulate future basic and translational research
that will facilitate the incorporation of these complex tumor,
treatment, and host factor interactions to optimize the care provided
to our patients."

Partners of long-term gynaecologic cancer survivors: Psychiatric morbidity, psychosexual outcomes and supportive care needs (abstract)

Objective

To describe long-term psychological morbidity, unmet supportive care needs, positive changes, sexual outcomes and relationship satisfaction in partners of gynaecologic cancer survivors, as compared with respective survivors.

Method

Self-report measures were administered to a cross-sectional sample of 68 partners recruited via patient survivors.

Conclusion

The majority of partners reported excellent sexual outcomes and little perceived change since the survivors' diagnosis. The association between unmet needs and psychological morbidity suggests a useful target for further intervention. Despite methodological limitations, these data are novel and present a starting point for further investigation to improve outcomes for survivors and partners.

Hospice enrollment for terminally ill patients with gynecologic malignancies: Impact on outcomes and interventions (abstract)

Objective 

To determine survival and interventions for patients with non-curative gynecologic malignancies based on supportive care enrollment.

  
Conclusions
While retrospective reviews evaluating hospice are challenging, our data suggest no detrimental impact on survival for hospice patients. Continued evaluation for patients at the end-of-life is necessary in order to optimize resource utilization.

Germline Genetic Variation, Cancer Outcome, and Pharmacogenetics -- abstract (references Lynch/BRCAs)

ABSTRACT
Studies of the role of germline or inherited genetic variation on cancer outcome can fall into three distinct categories. First, the impact of highly penetrant but lowly prevalent mutations of germline DNA on cancer prognosis has been studied extensively for BRCA1 and BRCA2 mutations as well as mutations related to hereditary nonpolyposis colorectal cancer syndrome (Lynch Syndrome). These mainly modest-sized analyses have produced conflicting results. Although some associations have been observed, they may not be independent of other known clinical or molecular prognostic factors. Second, the impact of germline polymorphisms on cancer prognosis is a burgeoning field of research. However, a deeper understanding of potentially confounding somatic changes and larger multi-institutional, multistage studies may be needed before consistent results are seen. Third, research examining the impact of germline genetic variation on differential treatment response or toxicity (pharmacogenetics) has produced some proof-of-principle results. Putative germline pharmacogenetic predictors of outcome include DPYD polymorphisms and fluorouracil toxicity, UGT1A1 variation and irinotecan toxicity, and CYP2D6 polymorphisms and tamoxifen efficacy, with emerging data on predictors of molecularly targeted or biologic drugs. Here we review data pertaining to these germline outcome and germline toxicity relationships. (full text requires $$/subscription)

Abstract/full acess: Hypertension and hand-foot skin reactions related to VEGFR2 genotype and improved clinical outcome following bevacizumab and sorafenib

Background: Hypertension (HT) and hand-foot skin reactions (HFSR) may be related to the activity of bevacizumab and sorafenib. We hypothesized that these toxicities would correspond to favorable outcome in these drugs, that HT and HFSR would coincide, and that VEGFR2 genotypic variation would be related to toxicity and clinical outcomes.

METHODS
Patients and treatment
The analyses were performed on genomic DNA from 178 patients (143 males and 35 females) with solid tumors who received sorafenib (VEGFR2 inhibitor) and/or bevacizumab (anti-VEGF) with or without other agents....cont'd (excerpt from pdf file)

Conclusions: This study suggests that HT and HFSR may be markers for favorable clinical outcome, HT development may be a marker for HFSR, and VEGFR2 alleles may be related to the development of toxicities during therapy with bevacizumab and/or sorafenib.

Single-port risk-reducing salpingo-oophorectomy with and without hysterectomy: Surgical outcomes and learning curve analysis

OBJECTIVE:
Based on considerable prospective data, risk-reducing salpingo-oophorectomy (RRSO) is one of the most beneficial interventions available to reduce ovarian/breast cancer risk in BRCA carriers and high-risk women. The purpose of this study was to describe the initial surgical outcomes and learning curve analysis associated with laparoendoscopic single-site (LESS) RRSO with and without hysterectomy.

RESULTS:
A total of 58 patients were evaluated; 36 (63%) were BRCA1/2 carriers and 38 (63%) had breast cancer.

"Prospective studies are needed to assess the relative benefits of LESS compared with more conventional minimally invasive approaches."

A Comparison of Quality-of-Life Domains and Clinical Factors in Ovarian Cancer Patients: A Gynecologic Oncology Group Study

CONCLUSION:
Ovarian cancer patients have decreased QOL in physical, functional, and emotional domains; however, they may compensate with increased social support. At the time of diagnosis and treatment, patients' QOL is affected by inherent characteristics. Assessment of treatment outcomes should take into account the effect of these independent variables.

When Reputation Trumps Evidence-based Outcomes :: article

"It’s in the interests of public health to try our best to measure what should guide our health decisions – and to measure what actually does."

Feasibility of extension of platinum-free interval with weekly bolus topotecan and subsequent platinum retreatment outcomes in recurrent ovarian cance

Abstract

PURPOSE: The goal of this study was to evaluate the outcomes and response in a cohort of patients with presumed platinum-sensitive disease who were subsequently retreated with platinum after receiving weekly bolus topotecan at the time of initial recurrence.

Outcomes after conservative treatment of advanced-stage serous borderline tumors of the ovary.

"Eighteen pregnancies (nine spontaneous) were observed in 14 patients."

The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews -- Kirkham et al. 340: c365 -- BMJ

"Of the 42 meta-analyses with a statistically significant result only, eight (19%) became non-significant after adjustment for outcome reporting bias and 11 (26%) would have overestimated the treatment effect by 20% or more."

"Conclusions:
Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane reviews. Individuals conducting systematic reviews need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence...."

MRI in the planning of initial lumpectomy for invasive breast carcinoma: effect on ipsilateral breast tumor recurrence after breast conserving therapy

CONCLUSION: MRI evaluation of invasive carcinoma in the planning of initial lumpectomies was not associated with improved local outcomes after BCS (breast conserving surgery) with RT in this cohort of patients.