PCPs Want to Deliver Radiology Results to Patients - Diagnostic Imaging

PCPs Want to Deliver Radiology Results to Patients - Diagnostic Imaging

Anonymous Testing of Pathology Specimens for BRCA Mutations in Ashkenazi Jewish Individuals Who Have Cancer - Full Text View - ClinicalTrials.gov

Anonymous Testing of Pathology Specimens for BRCA Mutations in Ashkenazi Jewish Individuals Who Have Cancer - Full Text View - ClinicalTrials.gov

Purpose

The intent of the proposed study is to describe the prevalence of the most common recurring mutations in BRCA1 and BRCA2, blmAsh , and the A636P MSH2 mutation among Ashkenazi Jewish individuals with a variety of cancer diagnoses. If a substantial proportion of these samples contain such mutations, future patients presenting with these diseases may wish to undergo genetic counseling and, if appropriate, formal genetic testing. The benefit from such a process would pertain mainly to the families of these individuals.

Search of: ovarian cancer | Open Studies | Exclude Unknown | Adult | received from 01/01/2013 to 02/01/2013 - List Results - ClinicalTrials.gov

 Blogger's Note: a cursory look indicates some results do not apply

Search of: ovarian cancer | Open Studies | Exclude Unknown | Adult | received from 01/01/2013 to 02/01/2013 - List Results - ClinicalTrials.gov

14 studies found for:    ovarian cancer | Open Studies | Exclude Unknown | Adult | received from 01/01/2013 to 02/01/2013  

Rank	Status	Study

Search of: ovarian cancer | Open Studies | Exclude Unknown | Adult - List Results - ClinicalTrials.gov

Search of: ovarian cancer | Open Studies | Exclude Unknown | Adult - List Results - ClinicalTrials.gov

 484 studies found for:    ovarian cancer | Open Studies | Exclude Unknown | Adult

Search of: ovarian cancer | Open Studies | Adult - List Results - ClinicalTrials.gov

Search of: ovarian cancer | Open Studies | Adult - List Results - ClinicalTrials.gov

606 studies found for:    ovarian cancer | Open Studies | Adult

paywalled: BRCA1 and BRCA2 Mutations in the Ovarian Cancer Population across Race and Ethnicity: Special Reference to Asia

BRCA1 and BRCA2 Mutations in the Ovarian Cancer Population across Race and Ethnicity: Special Reference to Asia.

Objective: To evaluate the prevalence and spectrum of BRCA mutations among ovarian carcinoma patients of different races and ethnicity with special reference to Asia.

Methods: A systematic review of the literature was undertaken to evaluate the prevalence of BRCA mutations among people belonging to different races. The electronic search strategy was developed specifically for the different databases concerned and via cross-referencing.

Results: The frequency of BRCA1 and BRCA2 mutations ranged from 1.1 to 39.7 and from 0 to 13.9, respectively. BRCA1 mutations are more common among ovarian cancer cases than BRCA2 mutations, although the ratio of BRCA1 to BRCA2 varies between populations. The Swedish and Indian populations showed 12 and 7 times as many BRCA1 as BRCA2 mutations, respectively, whilst in a study from Iceland the ratio was 0.5:1. These wide-ranging estimates of the mutation prevalence suggest genetic heterogeneity between different populations.

Conclusion: The ability to identify BRCA1/2 mutations was found to be successful in the clinical management of ovarian cancer. Given the implications for clinical care and for advances in cancer prevention, identifying racial difference in genetic or lifestyle factors, which may modify the cancer risk due to BRCA1/2 mutations, is a high priority for future research.

Table 6 : Beliefs about cancer outcomes – individual items re: BMJ article - Differences in cancer awareness and beliefs

 Table 6.  Beliefs about cancer outcomes – individual items

article: 
 Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival

British Journal of Cancer - Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival[quest]

Blogger's Note:  of relevance - Jan 31st, 2013  -  NICE declined the use of Avastin for ovarian cancer patients in the UK

British Journal of Cancer - Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival

"...International comparisons show wide differences in cancer survival between high-income countries with good cancer registration systems and good access to health care (Berrino et al, 2007; Coleman et al, 2008). The International Cancer Benchmarking Partnership (ICBP) was set up to examine and explain survival differences between Australia, Canada, Denmark, Norway, Sweden and the UK. For cancers of the lung, breast, bowel and ovary diagnosed in 1995–2007, Australia, Canada and Sweden had the highest survival and Denmark and the UK the lowest; Norway had intermediate survival (Coleman et al, 2011)........

"We aimed to examine whether people living in countries with lower cancer survival (UK, Denmark) had lower cancer awareness, more negative beliefs about cancer or more barriers to symptomatic presentation than people in countries with higher cancer survival (Australia, Canada, Sweden)."

* see ovarian cancer referenced material:

Maringe C, Walters S, Butler J, Coleman MP, Hacker N, Hanna L, Mosgaard BJ, Nordin A, Rosen B, Engholm G (2012) Stage at diagnosis and ovarian cancer survival: Evidence from the International Cancer Benchmarking Partnership. Gynecol Oncol 127(1): 75–82 | Article | PubMed |

* see blog post:

 Wednesday, January 30, 2013

Lower awareness isn’t behind the UK’s poorer survival - Cancer Research UK - Science Update blog

Blogger Sandi Pniauskas at Wednesday, January 30, 2013

PLOS ONE: The MDM2 309T>G Polymorphism and Ovarian Cancer Risk: A Meta-Analysis of 1534 Cases and 2211 Controls

PLOS ONE: The MDM2 309T>G Polymorphism and Ovarian Cancer Risk: A Meta-Analysis of 1534 Cases and 2211 Controls

 Conclusions
This meta-analysis provides evidence for the association between MDM2 309 polymorphism and ovarian cancer risk, supporting the hypothesis that MDM2 SNP309 G allele acts as an important ovarian cancer protective factor in Asians but not in Caucasians.

Two-step immunotherapy attacks advanced ovarian cancer (Coukos/Tcells/vaccine)

Two-step immunotherapy attacks advanced ovarian cancer

NHS rationing body refuses drug (Avastin) for women with advanced ovarian cancer | Society | guardian.co.uk

NHS rationing body refuses drug for women with advanced ovarian cancer | Society | guardian.co.uk

Implementing the Affordable Care Act: State Action on 2014 Market Reforms

Implementing the Affordable Care Act: State Action on 2014 Market Reforms: Because states are the primary regulators of health insurance, this issue brief examines new state action on a subset of protections—such as guaranteed access to coverage and a ban on pre existing condition exclusions—that go into effect in 2014.

Just 11 percent of adults, 5 percent of children participate in medical research

Just 11 percent of adults, 5 percent of children participate in medical research

"We Remember" Colorado Ovarian Cancer Alliance - Sad News Announcements

Colorado Ovarian Cancer Alliance - Sad News Announcements

"Please subscribe to our Sad News Announcement List to be notified by email when someone in our community passes away."

How cancer cells rewire their metabolism to survive (glucose/sugar)

How cancer cells rewire their metabolism to survive

 LA JOLLA, Calif., January 31, 2013 – Cancer cells need food to survive and grow. They're very good at getting it, too, even when nutrients are scarce. Many scientists have tried killing cancer cells by taking away their favorite food, a sugar called glucose. Unfortunately, this treatment approach not only fails to work, it backfires—glucose-starved tumors actually get more aggressive.....

VG Life Sciences Reports Positive Results from First Stage of Ovarian Cancer Clinical Trial Using Sorafenib (Nexavar) Combined with Hydroxychloroquine - News Press Release | PharmiWeb.com

VG Life Sciences Reports Positive Results from First Stage of Ovarian Cancer Clinical Trial Using Sorafenib (Nexavar) Combined with Hydroxychloroquine - News Press Release | PharmiWeb.com

Health News - Preclinical study identifies 'master' proto-oncogene that regulates stress-induced ovarian cancer metastasis

Health News - Preclinical study identifies 'master' proto-oncogene that regulates stress-induced ovarian cancer metastasis

Health care is good medicine for Canada's economy

Health care is good medicine for Canada's economy

HIGHLIGHTS

• At over 10 per cent of GDP, the health care industry in Canada is almost the same size as the entire manufacturing sector.
• Governments get more than 21 per cent of all health spending back in the form of tax revenues.
• Overall wages in the health care sector are $59,300 per job, slightly higher than the national average of $57,677.

PR Newswire (http://s.tt/1zcch)

Next-generation CT scanner provides better images with minimal radiation, January 31, 2013 News Release - National Institutes of Health (NIH)

Next-generation CT scanner provides better images with minimal radiation, January 31, 2013 News Release - National Institutes of Health (NIH)

 "The machine recently received approval by the U.S. Food and Drug Administration, but more studies will be needed before it can be adopted for wide clinical use.....

Does neoadjuvant chemotherapy decrease the risk of hospital readmission following debulking surgery?

 Does neoadjuvant chemotherapy decrease the risk of hospital readmission following debulking surgery?

 Highlights

► Elderly patients undergoing either PDS or NACT-IDS have similar oncologic outcomes.
► The risk of readmission within 30 days of surgery is significantly greater among patients undergoing PDS.

Abstract

Objective

To compare primary debulking surgery (PDS) vs. neoadjuvant chemotherapy with interval debulking surgery (NACT-IDS) among elderly patients with ovarian/fallopian tube/primary peritoneal carcinoma.

Methods

Medical records of patients ≥ 70 years old with epithelial ovarian/fallopian tube/primary peritoneal carcinoma between January 2000 and December 2010 were reviewed. Patients were separated by PDS or NACT-IDS. Preoperative characteristics, surgical procedures and postoperative and oncologic outcomes were compared. Surgical procedures were given a complexity score based on a previously published method.

Results

Of 165 patients, 125 (75.8%) underwent PDS and 40 (24.2%) underwent NACT-IDS. Patients undergoing NACT-IDS were more likely to have a pleural effusion (without cytology) and stage 4 disease. Median CA-125 at diagnosis was greater for those undergoing NACT-IDS. The NACT-IDS group was associated with less intraoperative blood loss (250 vs. 400 mL, p = 0.001), a greater chance of achieving no residual disease (40% vs. 16%, p = 0.005) and a shorter hospital length of stay (LOS) (5 vs. 7 days, p < 0.001). PFS (17 vs. 15 months, p = 0.708) and OS (29 vs. 33 months, p = 0.827) were similar between the two groups. Readmission rates within 30 days of surgery were greater in those undergoing PDS (17.6% vs. 2.5%, p = 0.016). After readmission, the median hospital LOS was 6 days (range: 1–41).

Conclusions

Elderly patients undergoing PDS have similar oncologic outcomes when compared to patients undergoing NACT-IDS. The risk of readmission within 30 days of surgery is significantly greater among patients undergoing PDS.

Genetic testing by cancer site: stomach (wide variety of high-risk genetic syndromes eg. BRCA/Lynch...)

Genetic testing by cancer site: stomach. [Cancer J. 2012] - PubMed - NCBI

Abstract

Gastric cancer is a global public health concern, ranking as the fourth leading cause of cancer mortality, with a 5-year survival of only 20%. Approximately 10% of gastric cancers appear to have a familial predisposition, and about half of these can be attributed to hereditary germline mutations. We review the genetic syndromes and current standards for genetic counseling, testing, and medical management for screening and treatment of gastric cancer. Recently, germline mutations in the E-cadherin/CDH1 gene have been identified in families with an autosomal dominant inherited predisposition to gastric cancer of the diffuse type. The cumulative lifetime risk of developing gastric cancer in CDH1 mutation carriers is up to 80%, and women from these families also have an increased risk for developing lobular breast cancer.

Prophylactic gastrectomies are recommended in unaffected CDH1 mutation carriers, because screening endoscopic examinations and blind biopsies have proven inadequate for surveillance. In addition to this syndrome, gastric cancer risk is elevated in Lynch syndrome associated with germline mutations in DNA mismatch repair genes and microsatellite instability, in hereditary breast and ovarian cancer syndrome due to germline BRCA1 and BRCA2 mutations, in familial adenomatous polyposis caused by germline APC mutations, in Li-Fraumeni syndrome due to germline p53 mutations, in Peutz-Jeghers syndrome associated with germline STK11 mutations, and in juvenile polyposis syndrome associated with germline mutations in the SMAD4 and BMPR1A genes.

Guidelines for genetic testing, counseling, and management of individuals with hereditary diffuse gastric cancer are suggested. A raised awareness among the physician and genetic counseling communities regarding these syndromes may allow for increased detection and prevention of gastric cancers in these high-risk individuals.

A Detailed Study of Patients and Tumor Characteristics of Epithelial Ovarian Cancer in Saudi Women

 A Detailed Study of Patients and Tumor Characteristics of Epithelial Ovarian Cancer in Saudi Women

 Abstract

BACKGROUND:

The Saudi population is characterized by high parity and intermarriages that may impact ovarian carcinogenesis. Herein, we analyzed the tumor characteristics and outcomes in Saudi patients with epithelial ovarian cancer (EOC).

METHODS:

Patients with EOC treated at King Faisal Specialist Hospital and Research Center during 1995-2007 were identified retrospectively through a review of their medical records. Patients' and tumor characteristics were collected including age at diagnosis, marital status, parity, histology, stage, treatment rendered, and follow-up data.

RESULTS:

One hundred-ninety-three patients with EOC were identified in this cohort. The mean age of the patients was 55 ± 15 years, the mean ± SD body mass index was 27.0 ± 5.6 kg/m, and the median parity was approximately 7.0. Whereas 4 patients reported a family history of cancer, 164 women reported negative family history; and it was unknown in 27 cases. Tumor distribution by International Federation of Gynecology and Obstetrics stage was the following: 12 patients (6.2%) had stage I disease at diagnosis, 1 patient (0.5%) stage II disease, 130 patients (67.4%) stage III disease, 39 patients (20.2 %) stage IV disease, and that of 11 patients (5.7%) was unknown. Information on residual disease after surgery was available on 98 patients with optimal debulking (<1 cm) achieved in 61 cases. Median progression-free survival from end of chemotherapy to recurrence/progression was 11.9 months (95% confidence interval, 9.4-15.2). Tumor histology, size of residual disease, and stage at diagnosis were significant prognostic factors. The patients' age, body mass index, tumor histology, and grade had no impact on survival.

CONCLUSIONS:

Patients presenting with advanced-stage disease are higher among Saudis than those reported in global literature. Despite high intermarriage rates, reported family history for related cancers was quite low in this cohort. Notably, this is the first study evaluating EOC in Saudi patients.

paywalled: Topotecan and Doxorubicin Combination to Treat Recurrent Ovarian Cancer: The Influence of Drug Exposure Time and Delivery Systems to Achieve Optimum Therapeutic Activity

Topotecan and Doxorubicin Combination to Treat Recurrent Ovarian Cancer: The Influence of Drug Exposure Time and Delivery Systems to Achieve Optimum Therapeutic Activity

Abstract

Purpose: To provide proof-of-concept data to support use of Doxil–liposomal topotecan (Topophore C) combinations to treat ovarian cancer.

Experimental Design: ES-2, OVCAR-3, and SKOV-3 ovarian cancer cell lines were treated with doxorubicin–topotecan combinations by exposing the cells to drugs from 1 to 72 hours. Pharmacokinetic analysis was conducted following administration of liposomal formulations of these drugs alone and in combination. Efficacy assessments were completed in ES-2 and SKOV-3 ovarian cancer models.

Results: On the basis of drug doses capable of achieving 50% reduction in cell viability over 72 hours, doxorubicin–topotecan combinations were additive in SKOV-3 but highly synergistic in ES-2 and OVCAR-3 cells. Favorable drug–drug interactions increased with increased drug exposure time. Topophore C pharmacokinetic remained unaffected when co-administered with Doxil. In the ES-2 model, Doxil at maximum tolerated dose (MTD 7.5 mg/kg) in combination with free topotecan (MTD 15 mg/kg) did not enhance median survival time (MST) over that achieved with topotecan alone. In contrast, MST was increased to 52 days with combination of Topophore C (MTD 2.5 mg/kg) and Doxil (7.5 mg/kg) compared with untreated animals (MST 18 days) or those treated with Topophore C alone (MTD 5 mg/kg, MST 40 days). In the SKOV-3 model, combination treatments showed better therapeutic efficacy than the individual drugs.

Conclusions: Topotecan–doxorubicin combinations produced additive or synergistic effects which were best achieved when the tumor cells were exposed to drugs over extended time. Doxil–Topophore C combinations are therapeutically superior as judged in two ovarian cancer models.

DSMB recommends continuation of CTI’s OPAXIO Phase 3 trial on ovarian cancer

DSMB recommends continuation of CTI’s OPAXIO Phase 3 trial on ovarian cancer

Cell Therapeutics, Inc. (CTI) (NASDAQ and MTA: CTIC) today announced that the Gynecologic Oncology Group (GOG) informed CTI that an independent Data Safety Monitoring Board (DSMB) recommended continuation of the GOG-0212 Phase 3 clinical trial of OPAXIO^TM (paclitaxel poliglumex) as maintenance therapy in ovarian cancer with no changes following a planned interim survival analysis. CTI remains blinded to the interim analysis results. GOG-0212 is the largest maintenance study in this setting, having enrolled approximately 1,000 of the planned 1,100 patients. Enrollment is expected to be completed in 2013.
The trial is being conducted and managed by the GOG, which is one of the National Cancer Institute's (NCI) funded cooperative cancer research groups focused on the study of gynecologic malignancies.
"This is an important milestone for our OPAXIO clinical development program and potentially for women with advanced ovarian cancer," noted Steve Benner , M.D., Chief Medical Officer of CTI. "GOG-0212 seeks to address an important question on the role OPAXIO may play in maintenance therapy for ovarian cancer and potentially other solid tumors." 

Continued on Next page >>

Additional information about GOG-0212 may be found at www.clinicaltrials.gov, study ID NCT00108745 

Redefining Physicians' Role in Assisted Dying — NEJM

Redefining Physicians' Role in Assisted Dying — NEJM

To the Editor:

As two of the original petitioners to bring a Death with Dignity Act before Massachusetts voters, we are pleased that Prokopetz and Lehmann believe “there is a compelling case for legalizing assisted dying,” as they state in their Perspective article (July 12 issue).1 However, we oppose their idea that physicians who agree that assisted dying is sometimes indicated might outsource the actual writing of the prescription to a government agency, presumably because they find that final step “incompatible with the physician's role as healer” (in the words of the statement on the subject by the American Medical Association).2
Laws permitting physician-assisted dying in the United States restrict it to dying patients who cannot be healed and who desire to hasten their deaths because of intractable suffering. In such cases, a physician's overriding ethical obligation should shift from healing to relieving suffering, in accord with the patient's wishes. To outsource that duty at the last minute is a form of abandonment. It also invites the establishment of an intrusive bureaucracy. Physicians should think less about their self-image and more about their patients' needs.