Thursday, October 11, 2012
blog - Where Canada Might Lead The World – The Fourth Canadian Science Policy Conference
Where Canada Might Lead The World – The Fourth Canadian Science Policy Conference:
Later this year the fourth Canadian Science Policy Conference (CSPC) will take place in Alberta, Calgary. I attended the first conference in 2009, when it was held in Toronto. I found it quite valuable, and not being Canadian, I think that says something. In the three years since the first conference, the number of presenters and panels has grown consistently, and I think the conference provides an important convening function for the nation’s researchers and practitioners interested in science policy. I wish we had something like it in the United States. The closest think I can think of is the Forum on Science and Technology Policy put on by the organization formerly called the American Association for the Advancement of Science. For too long it has struck me as too focused on budget and what goes on in Washington to engage with science and technology policy issues in the way that the CSPC is trying to do. I think some of this can be credited to the independent nature of the Canadian effort.....
not yet recruiting: Accelerating Gastrointestinal Recovery after ovarian cancer surgery - Full Text View - ClinicalTrials.gov
Accelerating Gastrointestinal Recovery - Full Text View - ClinicalTrials.gov
Purpose
This
study is designed to determine whether an oral perioperative medication
(alvimopan--a selective mu antagonist) improves bowel recovery over
placebo after surgery for ovarian cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Ovarian Cancer Fallopian Tube Cancer Primary Peritoneal Cancer |
Drug: Alvimopan Drug: Placebo |
Phase 3 |
Evaluation of HE4, CA125, risk of ovarian malignancy algorithm (ROMA) and risk of malignancy index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass
ScienceDirect.com - Gynecologic Oncology - Evaluation of HE4, CA125, risk of ovarian malignancy algorithm (ROMA) and risk of malignancy index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass
Highlights
►
HE4 performs equivalent to CA125 in stratifying women with a pelvic
mass.
► ROMA is valuable as a first line marker for referring high risk patients to tertiary centers.
► ROMA is as good as the ultrasound dependent RMI in differentiating pelvic masses.
► ROMA is valuable as a first line marker for referring high risk patients to tertiary centers.
► ROMA is as good as the ultrasound dependent RMI in differentiating pelvic masses.
Abstract
Objective
Diagnostic
factors are needed to improve the currently used serum CA125 and risk
of malignancy index (RMI) in differentiating ovarian cancer (OC) from
other pelvic masses, thereby achieving precise and fast referral to a
tertiary center and correct selection for further diagnostics. The aim
was to evaluate serum Human Epididymis protein 4 (HE4) and the risk of
ovarian malignancy algorithm (ROMA) for these purposes.
Methods
Serum
from 1218 patients in the prospective ongoing pelvic mass study was
collected prior to diagnosis. The HE4 and CA125 data were registered and
evaluated separately and combined in ROMA and compared to RMI.
Results
809
benign tumors, 79 borderline ovarian tumors, 252 OC (64 early and 188
late stage), 9 non-epithelial ovarian tumors and 69 non-ovarian cancers
were evaluated. Differentiating between OC and benign disease the
specificity was 62.2 (CA125), 63.2 (HE4), 76.5 (ROMA) and 81.5 (RMI) at a
set sensitivity of 94.4 which corresponds to RMI = 200. The areas under
the curve (AUC) were 0.854 (CA125), 0.864 (HE4), 0,897 (ROMA) and 0.905
(RMI) for benign vs. early stage OC. For premenopausal benign vs. OC
AUC were 0.925 (CA125), 0.905 (HE4), 0.909 (ROMA) and 0.945 (RMI).
Conclusion
HE4
and ROMA helps differentiating OC from other pelvic masses, even in
early stage OC. ROMA performs equally well as the ultrasound depending
RMI and might be valuable as a first line biomarker for selecting high
risk patients for referral to a tertiary center and further diagnostics.
Further improvements of HE4 and ROMA in differentiating pelvic masses
are still needed, especially regarding premenopausal women.
Highlights
►
HE4 performs equivalent to CA125 in stratifying women with a pelvic
mass.
► ROMA is valuable as a first line marker for referring high risk patients to tertiary centers.
► ROMA is as good as the ultrasound dependent RMI in differentiating pelvic masses.
► ROMA is valuable as a first line marker for referring high risk patients to tertiary centers.
► ROMA is as good as the ultrasound dependent RMI in differentiating pelvic masses.
Gynecologic Oncology - Impact of beta blockers on epithelial ovarian cancer survival
Gynecologic Oncology - Impact of beta blockers on epithelial ovarian cancer survival
Highlights
►
We predict that beta blocker use correlates with improved outcome in
ovarian cancer.
► We retrospectively evaluated the association between beta blocker use and survival.
► Beta blocker use was associated with improved progression-free and overall survival and was an independent positive prognostic factor.
► We retrospectively evaluated the association between beta blocker use and survival.
► Beta blocker use was associated with improved progression-free and overall survival and was an independent positive prognostic factor.
Abstract
Objective
Stress
may promote ovarian cancer progression through mechanisms including
autonomic nervous system mediators such as norepinephrine and
epinephrine. Beta blockers, used to treat hypertension, block production
of these adrenergic hormones, and have been associated with prolonged
survival in several malignancies. We sought to determine the association
between beta blocker use and epithelial ovarian cancer (EOC) disease
progression and survival.
Methods
We
performed an institutional retrospective review of patients with EOC
treated between 1996 and 2006. Patients underwent cytoreductive surgery
followed by platinum-based chemotherapy. Women were considered beta
blocker users if these medications were documented on at least two
records more than 6 months apart. Statistical tests included Fisher's
exact, Kaplan–Meier, and Cox regression analyses.
Results
248
met inclusion criteria. 68 patients used antihypertensives, and 23 used
beta blockers. Median progression-free survival for beta blocker users
was 27 months, compared with 17 months for non-users (p = 0.05).
Similarly, overall disease-specific survival was longer for beta
blocker users (56 months) compared with non-users (48 months, p = 0.02,
hazard ratio = 0.56). Multivariate analysis identified beta blocker use
as an independent positive prognostic factor, after controlling for
age, stage, grade, and cytoreduction status (p = 0.03). Overall
survival remained longer for beta blocker users (56 months) when
compared with hypertensive patients on other medications (34 months) and
patients without hypertension (51 months) (p = 0.007).
Conclusions
In
this cohort of patients with EOC, beta blocker use was associated with a
54% reduced chance of death compared with that of non-users.
Highlights
►
We predict that beta blocker use correlates with improved outcome in
ovarian cancer.
► We retrospectively evaluated the association between beta blocker use and survival.
► Beta blocker use was associated with improved progression-free and overall survival and was an independent positive prognostic factor.
► We retrospectively evaluated the association between beta blocker use and survival.
► Beta blocker use was associated with improved progression-free and overall survival and was an independent positive prognostic factor.
Factors Influencing the Number of Pelvic and Para-Aortic Lymph Nodes Removed in Surgical Treatment of Endometrial and Ovarian Cancer
Factors Influencing the Number of Pelvic and Para-Aortic Lym... : International Journal of Gynecological Cancer
Conclusions: Age and BMI are independently associated with higher LN counts during LN dissection in ovarian cancer. The present study results may be important when using LN counts as a surrogate for adequate lymphadenectomy.
The Kronos Early Estrogen Prevention Study » KEEPS: Publications
The Kronos Early Estrogen Prevention Study » KEEPS: Publications
Publications
Abstracts & Manuscripts
Below are abstracts and manuscripts about the Kronos Early Estrogen Prevention Study (KEEPS). Click on the links (PDF or HTML format) to view the full abstract or manuscript.KEEPS Abstracts
KEEPS Manuscripts
KEEPS Ancillary Studies
KEEPS Ancillary Abstracts
KEEPS Ancillary Manuscripts
Wednesday, October 10, 2012
Tuesday, October 09, 2012
A multicenter, randomized trial of flat dosing versus intrapatient dose escalation of single-agent carboplatin as first-line chemotherapy for advanced ovarian cancer: an SGCTG (SCOTROC 4) and ANZGOG study on behalf of GCIG.
A multicenter, randomized trial of flat dosing versus intrapatient dose escalation of single-agent carboplatin as first-line chemotherapy for advanced ovarian cancer: an SGCTG (SCOTROC 4) and ANZGOG study on behalf of GCIG.
Conclusions
Intrapatient dose escalation of carboplatin based on nadir blood counts is feasible and safe. However, it provided no improvement in PFS or OS compared with flat dosing. Baseline neutrophils over-ride nadir counts in prognostic significance. These data may have wider implications particularly in respect of the management of chemotherapy-induced neutropenia.
A Phase II, Randomized, Placebo-Controlled Study of Vismodegib as Maintenance Therapy in Patients with Ovarian Cancer in Second or Third Complete Remission.
A Phase II, Randomized, Placebo-Controlled Study of Vismodegib as Maintenance Therapy in Patients with Ovarian Cancer in Second or Third Complete Remission.
Abstract
Abstract PURPOSE: Hedgehog (Hh) pathway inhibition has been suggested as a potential maintenance treatment approach in ovarian cancer through disruption of tumor-stromal interactions. Vismodegib is an orally available Hh pathway inhibitor with clinical activity in advanced basal cell carcinoma and medulloblastoma. This phase II, randomized, double-blind, placebo-controlled trial was designed to provide a preliminary estimate of efficacy in patients with ovarian cancer in second or third complete remission (CR).EXPERIMENTAL DESIGN:
Patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in second or third CR were randomized 1:1 to vismodegib (GDC-0449; 150 mg daily) or placebo 3-14 weeks after completing chemotherapy. Treatment continued until radiographic progression or toxicity. The primary endpoint was investigator-assessed progression-free survival (PFS).RESULTS:
One hundred four patients were randomized to vismodegib (n=52) or placebo (n=52); median PFS was 7.5 months and 5.8 months, respectively (hazard ratio [HR] 0.79 [95% CI, 0.46-1.35]). The HR was 0.66 (95% CI, 0.36-1.20) for second CR patients (n=84) and 1.79 (95% CI, 0.50-6.48) for third CR patients (n=20). The most common adverse events (AEs) in the vismodegib arm were dysgeusia/ageusia, muscle spasms, and alopecia. Grade 3/4 AEs occurred in 12 patients (23.1%) with vismodegib and six (11.5%) with placebo. Hh expression was detected in 13.5% of archival tissues.CONCLUSIONS:
In this study the sought magnitude of increase in PFS was not achieved for vismodegib maintenance versus placebo in patients with ovarian cancer in second or third CR. The frequency of Hh ligand expression was lower than expected.Plasma concentrations of the vitamin E-binding protein afamin are associated with overall and progression-free survival and platinum sensitivity in serous ovarian cancer – A study by the OVCAD consortium
Plasma concentrations of the vitamin E-binding protein afamin are associated with overall and progression-free survival and platinum sensitivity in serous ovarian cancer – A study by the OVCAD consortium
Abstract
Objective
Comparative
proteomics identified the plasma protein afamin (link to google search for 'afamin') as potential biomarker
for ovarian cancer (OC). Significantly decreased afamin plasma
concentrations in pre-therapeutic OC patients reconstituted to control
values after successful tumor surgery. This study evaluates the
association of afamin with survival and response to therapy in serous OC
patients within the OVCAD consortium project.
Conclusion
These data indicate that afamin is associated with therapy response and survival rate in advanced OC patients.
Highlights
►
The plasma protein afamin is evaluated as prognostic tumor marker for
ovarian cancer
► Afamin plasma concentrations are associated with response to therapy and survival
► Afamin may therefore serve as therapy monitoring for estimation of disease progression
► Afamin plasma concentrations are associated with response to therapy and survival
► Afamin may therefore serve as therapy monitoring for estimation of disease progression
(Lynch Syndrome) Frequency of mutations in mismatch repair genes in a population-based study of women with ovarian cancer : British Journal of Cancer
Access : Frequency of mutations in mismatch repair genes in a population-based study of women with ovarian cancer : British Journal of Cancer
Frequency of mutations in mismatch repair genes in a population-based study of women with ovarian cancer
Abstract
Background:
Mutations
in genes for (Lynch Syndrome) hereditary non-polyposis colorectal cancer (HNPCC) in
ovarian cancer patients remains poorly defined. We sought to estimate
the frequency and characteristics of HNPCC gene mutations in a
population-based sample of women with epithelial ovarian cancer.
Methods:
The
analysis included 1893 women with epithelial ovarian cancer ascertained
from three population-based studies. Full-germline DNA sequencing of
the coding regions was performed on three HNPCC genes, MLH1, MSH2 and
MSH6. Collection of demographic, clinical and family history information
was attempted in all women.
Results:
Nine
clearly pathogenic mutations were identified, including five in MSH6,
two each in MLH1 and MSH2. In addition, 28 unique predicted pathogenic
missense variants were identified in 55 patients. Pathogenic mutation
carriers had an earlier mean age at diagnosis of ovarian cancer,
overrepresentation of cancers with non-serous histologies and a higher
number of relatives with HNPCC-related cancers.
Conclusions:
Our findings suggest that fewer than 1%
of women with ovarian cancer harbour a germline mutation in the HNPCC
genes, with overrepresentation of MSH6 mutations. This represents a
lower-range estimate due to the large number of predicted pathogenic
variants in which pathogenicity could not definitively be determined.
Identification of mismatch repair gene mutations has the potential to
impact screening and treatment decisions in these women.
Full Paper Patterns of genomic loss of heterozygosity predict homologous recombination repair defects in epithelial ovarian cancer
Full Paper
Patterns of genomic loss of heterozygosity predict homologous
recombination repair defects in epithelial ovarian cancer
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