Medscape: Targeting the Epigenome in Ovarian Cancer: Abstract and Introduction

Targeting the Epigenome in Ovarian Cancer: Abstract and Introduction

From Future Oncology

Targeting the Epigenome in Ovarian Cancer

Susan K Murphy

Authors and Disclosures

Posted: 03/28/2012; Future Oncology. 2012;8(2):151-164. © 2012 Future Medicine Ltd.

• Abstract and Introduction
• Ovarian Cancer
• Treatment
• Potential for Epigenetic Therapies
• Epigenome Characterization & Clinical Utility
• Progress in Using Epigenetic Therapies
• Current Limitations of Epigenetic Therapy
• Conclusion
• Future Perspective

• References

abstract: Radiation Oncology Quality: Aggressiveness of Cancer Care Near the End of Life

Radiation Oncology Quality: Aggressiveness of Cancer Care Near the End of Life


Purpose
Quality in cancer care is an issue that has come to the forefront over the past decade. Although the American Society of Clinical Oncology has developed extensive quality metrics and goals, such as limiting chemotherapy being provided within the last 14 days of a patient's life, there are no similar quality metrics, and few data, in the field of radiation oncology.


Methods
In this study, morbidity and mortality records from 2008 to 2011 were reviewed for patients at Indiana University who received radiation therapy (RT) within 30 days of death; 63 patients met those criteria.


Results
Analysis showed that 22.2% of patients had Karnofsky Performance Status Scale scores >80, whereas 66.7% of patients had scores < 60. Just over half of patients (52%) were still on treatment at death, and more than half of patients (54%) had completed less than half of their original RT plans. Six patients had their final treatments on the days of their deaths, and another 43 patients had their last treatments within 10 days of death. Forty-eight percent of patients received RT for less than one-fifth of their final month of life and 21% for more than half of their last month alive.


Conclusions
These data are valuable in ongoing discussions of RT use at the end of life, especially as related to hospice underutilization.

short abstract: Gynecological cancer: True progress in ovarian cancer or just the tip of the iceberg?

Blogger's Note:  requires subscription to view full text ($$$)

 Gynecological cancer: True progress in ovarian cancer or just the tip of the iceberg?

Lisa Hutchinson

"Abstract

Development of malignant ascites is common in patients with ovarian cancer, and few therapeutic options exist for women with ascites whose tumors become resistant to chemotherapy. Furthermore, in such patients symptom palliation options are limited, and the few available treatments are unpleasant and can result in the need for paracentesis."

When a Decision Must Be Made: Role of Computer Modeling in Clinical Cancer Research

Every day, multidisciplinary oncology teams make dozens of treatment decisions that may have a tremendous impact on a patient's survival and quality of life. Made with the best of intentions, these decisions are informed by basic science and clinical research findings, clinical experience, and health policy. All too often, results from the gold standard of clinical trial research, a randomized controlled trial (RCT), that fit the specific details of the patient's situation are not available to guide these decisions...........

abstract: Cost-effectiveness of combination versus sequential docetaxel and carboplatin for the treatment of platinum-sensitive, recurrent ovarian cancer

CONCLUSIONS:

Combined weekly cDC (concurrent docetaxel and carboplatin) appeared to be cost-effective compared with sDC (sequential docetaxel and carboplatin ) as treatment strategy for patients with platinum-sensitive ovarian cancer, even when accounting for slightly lower QoL during treatment.

Oncology STAT on IP chemo & dense dose regime | Cancer Survivors Network (discusses Avastin, Taxol, (Japanese study), clear cell, IP....)

Ovarian Cancer—New Thinking on Old Regimens

2011 Feb 23, Nelson Teng

full access: abstract/pdf file: Management of menopause-associated vasomotor symptoms: Current treatment options, challenges and future directions

Uncertainty in Assessing Value of Oncology Treatments -- The Oncologist

abstract:
Patients, clinicians, payers, and policymakers face an environment of significant evidentiary uncertainty as they attempt to achieve maximum value, or the greatest level of benefit possible at a given level of cost in their respective health care decisions. This is particularly true in the area of oncology, for which published evidence from clinical trials is often incongruent with real-world patient care, and a substantial portion of clinical use is for off-label indications that have not been systematically evaluated.
It is this uncertainty in the knowledge of the clinical harms and benefits associated with oncology treatments that prevents postregulatory decision makers from making accurate assessments of the value of these treatments. Because of the incentives inherent in the clinical research enterprise, randomized control trials (RCTs) are designed for the specific purpose of regulatory approval and maximizing market penetration.
The pursuit of these goals results in RCT study designs that achieve maximal internal validity at the expense of generalizability to diverse real-world patient populations that may have significant comorbidities and other clinically mitigating factors.
As such, systematic reviews for the purposes of coverage and treatment decisions often find relevant and high-quality evidence to be limited or nonexistent. For a number of reasons, including frequent off-label use of medications and the expedited approval process for cancer drugs by the U.S. Food and Drug Administration, this situation is exacerbated in the area of oncology.....

"Until scientific advancements in treatment occur, significant gaps in real-world evidence will be pervasive in the area of oncology. This situation has negative consequences for a variety of players in health care, from patients and physicians to payers and policymakers. Addressing these gaps would result in better decisions that improve patient outcomes and reduce unnecessary costs."

Impact of the Cost of Cancer Treatment: An Internet-Based Survey -- Markman et al (U.S.)

Note: ovarian cancer patients were not included in this study
Conclusion: This survey suggests that a substantial proportion of patients and their families experience considerable distress associated with the cost of cancer care delivery. Furthermore, these costs affect the decision of patients with cancer to receive recommended treatment. This is a particularly serious issue for individuals with a modest annual income.

Advanced ovarian carcinoma: Does a high-dose short-duration schedule of paclitaxel trump prolonged low-dose therapy? - Cancer Network

Note: This is a good discussion debating pros/cons (requires registration to view/free) - some excerpts from article:

Point / Counterpoint

uTube - Bradley J. Monk, MD, University of California Irvine talks about early stage ovarian cancer including clear cell SGO

Note: the title on this video is wrong

The potential benefit of 6 vs. 3 cycles of chemotherapy in subsets of women with early-stage high-risk epithelial ovarian cancer: An exploratory analysis of a Gynecologic Oncology Group study

Abstract Objectives A prior clinical trial on early-stage high risk ovarian cancer showed a lower recurrence rate in those treated with six vs. three cycles of chemotherapy. We proposed to identify subsets of patients who may benefit from more cycles of chemotherapy.

videos: The Chemotherapy Foundation Symposium

Note: there are some key videos (free to view) from a variety of subjects

Meeting Archives

Chemotherapy Foundation Symposium XXVI
November 4 -8, 2008
Marriott Marquis Hotel , New York , NY

Innovative Cancer Therapy for Tomorrow

A Revision Of The EU Clinical Trials Directive Supported By European Cancer Organization

"Certain groups of patients have been particularly hard hit: children, patients with rare cancers, patients who would profit greatly from international trials that optimise already existing treatments and which, therefore, do not find commercial sponsorship, and elderly patients with other health problems, including secondary cancers due to earlier treatments."

full free access: Targeting the EGF Receptor for Ovarian Cancer Therapy

Note: numerous different treatments are discussed