- This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
- Note that these studies suggest that Asians with various stages of ovarian cancer have improved outcomes versus white patients.
- Be aware that inability to adjust for socioeconomic factors limits the ability to conclude what mediates the perceived benefit of Asian race.
Thursday, March 14, 2013
Low-molecular-weight or Unfractionated Heparin in Venous Thromboembolism: The Influence of Renal Function
Abstract
Conclusions In comparison with low-molecular-weight heparin (LMWH), initial therapy with unfractionated heparin was associated with a higher mortality and higher rate of fatal pulmonary embolism in patients with creatinine clearance levels >60 mL/min or <30 mL/min, but not in those with levels between 30 and 60 mL/min.
UK: Advances in Gynaecological Oncology Surgery
Abstract
Latest
surgical advances in the field of gynaecological oncology, a
sub-specialty of gynaecology, are reviewed in this chapter. The surgery
is mainly practised in cancer centres by board-certified gynaecologists,
and requires a 2–3 year period of additional training in gynaecological
oncology. Surgical treatment of gynaecological malignancies has
progressed in two directions: reduction of the invasiveness of the
surgery and expansion of the number and type of procedures performed.
Gynaecological oncology focuses on the pelvis to the upper abdomen and
the thorax to target (all visible disease) the last cancer cell in women
with advanced ovarian cancer. Minimal-access surgery has evolved to
include any operation by laparoscopy. It uses fewer ports (single-port
surgery), and robotic assistance improves the comfort of the surgeon.
The concept of fertility-sparing surgery for women with cervical cancer
is now supported by mature data. The indication and the aggressiveness
of the exenterative surgery are also broader than originally
recommended. The ideal timing of surgery is under investigation in
several areas, mainly in women with ovarian and cervical cancer. The aim
is to reduce morbidity and mortality of surgical procedures while
maintaining the survival outcome.
Ureteroscopic management of upper tract urothelial carcinoma (UTUC) in patients with Lynch Syndrome (hereditary nonpolyposis colorectal cancer syndrome
Abstract
CONCLUSIONS:
Patients with LS who develop UTUC present at younger ages and appear to be more likely to have bilateral UT disease over their lifetimes vs sporadic UTUC patients. Ureteroscopic laser ablation offers a good renal preservation rate with reasonable cancer control in patients willing to undergo endoscopic surveillance. Development of new bladder tumours is common.Dispelling the Many Myths About Clinical Trials
Press Release
"In the video accompanying this article, University of Kentucky researchers, along with clinical trial participants, explain how clinical trials are designed, approved, monitored and regulated by a large body of knowledgeable experts. They give an overview of myths such as "participants are treated as guinea pigs" or "a single researcher is in charge of each experiment" and reveal the facts about modern clinical research.
For more information on participating in clinical trials, visit: www.ccts.uky.edu, www.ukclinicalresearch.com or www.researchmatch.org/about.
UW Medicine Online News -UW Medicine researchers develop diagnostic tool to detect genetic abnormalities in tumors
UW Medicine Online News
"Because UW-OncoPlex is primarily a clinical tool, the focus is on actionable driver mutations. As a result, the UW-OncoPlex panel studies genes with mutations known to cause cancer variants for which a highly effective therapies are currently available. As of January 2013, the UW-OncoPlex panel includes 194 genes. This number will increase on a rolling basis, as the system easily scales up to accommodate new targets."
"Diseases targeted and treated with UW-OncoPlex at SCCA currently include:
Melanoma
Lung cancer
Leukemia
Sarcoma"
Advanced gene sequencing test helps clinicians treat cancer
Blogger's Note: no specific mention of ovarian cancer
Media
"The University of Washington and Seattle Cancer Care Alliance (SCCA) partnered to launch UW-OncoPlex - an advanced gene sequencing test to help clinicians treat cancer. The new diagnostic tool is a significant milestone in the development of precision medicine and empowers doctors to predict which treatment therapies will be most effective for an individual patient's cancer......
RETRACTED: In vitro anti-tumour and cyto-selective effects of coumarin-3-carboxylic acid and three of its hydroxylated derivatives, along with their silver-based complexes, using human epithelial carcinoma cell lines - Corrected Proof
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Authors.
RETRACTED: Novel target genes responsive to the anti-growth activity of triptolide in endometrial and ovarian cancer cells - Corrected Proof
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief. The Editor in Chief has serious doubts about the handling and publication of data associated with the four panels represented in Figure 4.
RETRACTED: Ca2+/calmodulin-dependent protein kinase IV expression in epithelial ovarian cancer - Corrected Proof
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Authors. Errors were identified in the original data which have affected several figure panels in the article.
Ovarian Cancer: Asians Have Survival Advantage
Medpage
Action Points
Clinical Oncology News - Targeted Therapy: Not All Mutations Are Created Equal
Blogger's Note: requires registration (free)
Clinical Oncology News
Future Challenges
As investigators embrace a personalized medicine approach to cancer care, they can glean a fuller picture of what aberrations drive cancer and how to combat them.
“We can characterize the patient, tumor and tumor environment in a way we’ve never been able to do before,” Dr. Mills said.
However, there are still major challenges in this area. Even after identifying relevant aberrations and useful biomarkers, the scope of this knowledge remains limited.
“For patients with a particular biomarker, only subpopulations benefit and the responses are usually short,” Dr. Mills said. “I think that’s one of the things we forget to emphasize—we’re seeing remarkable steps forward, but they’re usually measured in months, not years and certainly not in cures.”
Dr. Markman stressed, “We need to dramatically change the paradigm for drug development. The idea that we should continue to do clinical trials to help a few we don’t understand is not sustainable or rational and it’s got to stop. This strategy costs tens of millions of dollars per trial to give a benefit of a few weeks, maybe months.”
He added: “The future of research is looking at individual patients, collecting data in these patients worldwide, making info available to doctors and insurers, and figuring out how to do this quickly and less expensively. Although there’s been lots of talk of change, I’ve seen no action yet.”
Editorial: Inadequate Treatment of Ovarian Cancer - NYTimes.com
Blogger's Note: this is a second article as an Editorial (March 13th) on ovarian cancer from the NY Times in reference to the original article (March 11) (Widespread Flaws Found in Ovarian Cancer Treatment)
Editorial
"....Lack of experience with ovarian cancer among many doctors may be a factor in poor treatment. But even patients treated by surgeons with 10 or more ovarian-cancer patients a year, or in hospitals with 20 or more such patients a year, received the recommended therapy only about half the time...."
Bevacizumab-induced perforation of the gastrointestinal tract: clinical and radiographic findings in 11 patients - Springer
Abstract
Methods
A computerized
search identified 11 patients with GI complications of bevacizumab
therapy on abdominal CT (n = 11) and fluoroscopic GI contrast studies
(n = 4) who met our study criteria (including five patients with ovarian
cancer, five with colon cancer, and one with cervical cancer). The
medical records and imaging studies were reviewed to determine the
clinical and radiographic findings in these patients.
Conclusion
Abdominal CT and
fluoroscopic GI contrast studies are useful imaging tests for the
diagnosis of potentially life-threatening GI perforation as a
complication of bevacizumab therapy. When GI perforation is detected on
abdominal imaging studies, treatment with bevacizumab should immediately
be discontinued.
Spirituality May Boost Outcomes in Ovarian Cancer
Medpage
........."Spirituality is an important psychosocial resource that positively influences quality of life," Thaker noted, adding that "less is known about the role of positive stress buffers, such as spirituality and cytokines, in tumor angiogenesis and inflammation in ovarian cancer patients."
She also noted that patient's spirituality was defined as "an individual's sense of peace, purpose, and connection to others, and beliefs about the meaning of life." These beliefs and feelings are important for patients at the time of diagnosis and at the end of life by offering comfort, hope, improved quality of life, and meaning, she explained....
A review of iniparib in ovarian cancer (BSI-201)
abstract
Introduction: Patients with metastatic ovarian cancer continue to experience high recurrence rates and significant morbidity from standard treatments. There is a great need for efficacious tumor-specific agents in ovarian cancer. Iniparib (BSI-201) is a targeted drug currently under investigation.
Areas covered:
The authors identified the mechanistic and clinical data available on
the role of iniparib in ovarian cancer. Iniparib was initially thought
to act via the poly-ADP ribose polymerase 1 (PARP-1) pathway, but recent
studies have shown only nonspecific interactions between the drug and
PARP proteins.
Analysis of Early Hypertension and Clinical Outcome With Bevacizumab: Results From Seven Phase III Studies
Blogger's Note: the Oncologist is subscriber-based ($$$); this study did not include ovarian cancer so the results may or may not be applicable
Abstract
Background. Hypertension
is associated with antivascular endothelial growth factor treatment, but
the clinical implications of hypertension
are uncertain. To assess the prognostic and
predictive value of bevacizumab-related hypertension, a comprehensive
analysis
of whether hypertension and efficacy outcomes are
associated was conducted on seven company-sponsored placebo-controlled
phase
III studies of bevacizumab.
Methods. Patient-specific
data were available from 6,486 patients with metastatic colorectal,
breast, non-small cell lung, pancreatic,
and renal cell cancers.
Statistical Identification of Predictors for Paclitaxel-induced Peripheral Neuropathy in Patients with Breast or Gynaecological Cancer
Abstract
Aim: The aim of this study was to identify
predictors for paclitaxel-induced peripheral neuropathy (PIPN).
Patients and Methods:
We conducted a retrospective analysis of 227
patients who had been treated with paclitaxel at a single institution
between
January 2008 and July 2011. At the time of
chemotherapy completion, the severity of PIPN was graded on a scale of
0-5, in
accordance with the National Cancer Institute
Common Terminology Criteria for Adverse Events v4.0.
Multivariate-ordered logistic
regression analysis was employed to examine the
relationship between various predictive factors and the occurrence of
PIPN.
Results: Diabetes mellitus [odds ratio (OR)=0.070],
age (OR=1.991), co-administration of neurotropin (OR=3.654),
co-administration
of opioids (OR=0.312), co-administration of vitamin
B12 (OR=2.554), co-administration of antidepressant (OR=4.754) and
co-administration
of gabapentinoids (OR=14.620), were significantly
associated with reduction of or less serious PIPN.
Conclusion: Our study
indicates that PIPN may be alleviated by
co-administration of opioids.
Wednesday, March 13, 2013
Canada health centre enhance Sunnybrook (Toronto) e-record with online service | Articles | Asia Pactific
Canada health centre enhance e-record with online service
Sunnybrook Health Science Centre, Canada has recently deployed new software for online appointment scheduling and online consultation assessment questionnaires, adding up to MyChart—its personal health record (PHR).
“The benefits go beyond providing a complete patient profile through a single platform,” said Sarina Cheng, Director, Information and Telecommunication Services & eHealth Strategies at Sunnybrook. “We expect the online service will decrease a clinician’s administrative workload and shorten the time it takes for a patient to book an appointment and complete an assessment.”
The new software will enhance the medical experience of over 8,800 Sunnybrook family practice patients, who have been leveraging MyChart for over six years.......
Proven non-carriers in BRCA families have an earlier age of onset of breast cancer
Conclusion
The age at diagnosis of breast cancer in non-carriers in BRCA mutation families is younger than expected, yielding an increased risk in the fifth decade. This effect is most evident in BRCA1
families. If our results are confirmed by others, this could affect the
advice given on breast cancer screening to proven non-carriers between
the age of 40 and 50 in such families.
Background
Risk estimates for proven non-carriers in BRCA
mutation families are inconsistent for breast cancer and lacking for
ovarian cancer. We aimed to assess the age-related risks for breast and
ovarian cancer for proven non-carriers in these families.
Borderline tumours of the ovary: A cohort study of the Arbeitsgmeinschaft Gynäkologische Onkologie (AGO) Study Group
Abstract
Background
Borderline
ovarian tumours (BOTs) are recognised as a unique entity of ovarian
tumours that do not exert infiltrative destructive growth or stromal
invasion. Prognosis of BOT is much better compared to the more common
invasive epithelial ovarian cancer. Information regarding prognostic
factors is inconclusive and no prospective studies exist that evaluate
therapeutic strategies. We therefore started a retrospective–prospective
cohort study to better understand BOT and identify scenarios in which
future studies could be developed.
Differentiating Stage 1 epithelial ovarian cancer from benign ovarian tumours using a combination of tumour markers HE4, CA125, and CEA and patient’s age
abstract
Highlights
- •
- Distinguishing stage 1 ovarian cancer from benign adnexal masses is difficult
- •
- Usefulness of HE4 and other biomarkers for diagnosis is debated
- •
- Our model using biomarkers and patient’s age will help identify malignancies
Abstract
Objective
Evaluating
the presence of possible malignant disease in women with ovarian masses
relies on medical imaging and serum marker findings. This study
considers the role of serum Human Epididymal Protein 4 (HE4) antigen in
combination with other serum markers to more effectively estimate the
risk of malignancy in patients with isolated pelvic masses.
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