Wiki:
Cyclophosphamide (INN, trade names Endoxan, Cytoxan, Neosar, Procytox, Revimmune), also known as cytophosphane,[1] is a nitrogen mustard alkylating agent,[2] from the oxazophorines group
~~~~~~~~~~~~~~~
Clinical Oncology News
Thursday, March 21, 2013
Clinical Oncology News - Vogl, NY: Cyclophosphamide Prices Skyrocket
Wiki:
Cyclophosphamide (INN, trade names Endoxan, Cytoxan, Neosar, Procytox, Revimmune), also known as cytophosphane,[1] is a nitrogen mustard alkylating agent,[2] from the oxazophorines group
Clinical Oncology News
Clinical Oncology News - Pathogenesis of Serous Cancers Tied to Fallopian Tubes
article
commentary:
" In summary, the report by Reitsma et al provides additional support for the role of the fallopian tube in the pathogenesis of serous “ovarian” cancer. Further studies will be needed to determine the rate of malignancies after identification of STIC lesions, and the implications on screening and risk reduction strategies."
open access: Epigenetic therapy: use of agents targeting deacetylation and methylat
open access
| Published: | 21 March 2013 |
|---|
Abstract:
The emergence of epigenetic mechanisms as key regulators of gene expression has led to dramatic advances in understanding cancer biology. Driven by complex layers that include aberrant DNA methylation and histone modification, epigenetic aberrations have emerged as critical processes that disrupt cellular machinery and homeostasis. Recent discoveries have already translated into successful clinical trials and improved patient care, with several agents approved for hematologic disease and others undergoing study. As the field matures, substantial challenges persist that will require resolution. These include the need to decipher more fully the interplay between the epigenetic and genetic machinery, patient selection and improving treatment efficacy in solid tumors, and optimizing combination therapies to counteract chemoresistance and minimize adverse effects. Here, we review recent progress in epigenetic treatments and consider their implications for future cancer therapy.....
Safety and treatment patterns of angiogenesis inhibitors in patients with advanced renal cell (kidney) carcinoma in Spain - adverse effects
Blogger's Note: may be of interest to all cancer patients who are undergoing treatments of sorafenib, temsirdimus, sunitinib and/or in combination with Avastin
abstract
tech: The Old Reader (for those who were using Google Reader)
Blogger's Note: with the demise of Google Reader (to be shutdown July 1st) The Old Reader is a good alternative with similar formatting to Google Reader
The Old Reader
media: Hormone Pills in Menopause May Carry Gallstone Side Effects - MedicineNet
media
"...If hormone therapy is necessary, skin patches or gels may cause fewer side effects than pills or tablets, she added.
"Unfortunately there are no large clinical trials comparing transdermal and oral therapies, and such trials will probably never be conducted," Liu wrote.....
open access: Menopausal hormone therapy and risk of cholecystectomy: a prospective study based on the French E3N cohort
cmaj
Background: Studies in the United States and
the United Kingdom have reported an in -
creased risk of cholecystectomy among wo men
exposed to menopausal hormone therapy, but
with substantial heterogeneity between types
of hormone treatments. We evaluated the risk
of cholecystectomy (gallbladder) associated with different
regimens of menopausal hormone therapy in a
large prospective cohort study.
".... We did not observe any increased risk of cholecystectomy
associated with transdermal estrogen use,
which is in partial agreement with a weaker association
with transdermal compared with oral estrogen
use reported in the Million Women Study.9"......
Interpretation: The risk of cholecystectomy was
increased among women exposed to oral
estrogen menopausal hormone therapy, especially
oral regimens without a progestagen. (estrogen alone)
Complicated gallstone disease should be added
to the list of potential adverse events to be
considered when balancing the benefits and
risks associated with menopausal hormone
therapy
Blogger's Note: not available paid subscription required
"See related commentary by Liu at www.cmaj.ca/lookup/doi/10.1503/cmaj.130004"
Genetics May Be Tied to Breast Cancer Risk in Unexpected Ways - MedicineNet
media
"...."Currently, three drugs can be used to prevent breast cancer in women who are at extremely high risk for the disease," study co-author Dr. Seema Khan, said in a journal release. "However, these drugs prevent only breast cancers that are sensitive to hormones, commonly referred to as estrogen receptor-positive breast cancers. They do not prevent breast cancers that are insensitive to hormones, or estrogen receptor-negative breast cancers."
"We should not expose women at risk for hormone-insensitive breast cancer to the side effects of preventive medications that we know will not work for them," added Khan, who is co-leader of the Breast Cancer Program at Northwestern University, in Chicago. "Moreover, if we knew who these women were, we could focus on them in terms of designing new studies to find a solution for preventing hormone-insensitive cancer."....
open access: Decade After WHI Experts Agree
Received May 31, 2012; accepted May 31, 2012
"This year marks the 10th anniversary of the 2002 presentation of
the results of the Women's Health Initiative (WHI) hormone trials.
Amidst the debate that ensued, the one consistent theme was that ‘‘even
the experts don't agree.’’ Much has been learned and is still being unraveled regarding the safety and efficacy of hormone therapy from previous and ongoing studies. In response to the many women and clinicians seeking answers, our goal is to reassure both symptomatic women and their providers that experts do indeed agree on key points regarding the safety and role of hormone therapy in menopause
management based on the scientific evidence of the last 10 years. We believe that women deserve to know the facts that can inform their decision to use or not to use hormone therapy.
OVERVIEW
Systemic hormone therapy is an acceptable option for relatively young
(up to age 59 or within 10 years of menopause) and healthy women who are bothered by moderate to severe menopausal symptoms. Individualization is key in the decision to use hormone therapy. Consideration should be given to the woman's quality-of-life priorities
as well as her personal risk factors such as age, time since menopause,
and her risk of blood clots, heart disease, stroke, and breast cancer......
Wednesday, March 20, 2013
Oncology Case Reports - Occult transitional cell carcinoma and Lynch syndrome incidentally revealed after laparoscopic hysterectomy and cystoscopy during staging for endometrial cancer
open access
Highlights
►
Lynch syndrome involves many rare cancers, such as urothelial
carcinoma (ureter, kidney, renal pelvis).
► The case describes incidental urothelial carcinoma associated with Lynch syndrome.
► Clinical suspicion of rare cancers must be maintained in certain patients.
► The case describes incidental urothelial carcinoma associated with Lynch syndrome.
► Clinical suspicion of rare cancers must be maintained in certain patients.
Introduction
Cystoscopy can be performed during hysterectomy for many reasons, especially for suspicion of urologic injury (Ribeiro et al., 1999).
Though it is debated whether routine cystoscopy should be performed at
every hysterectomy, especially with regard to cost-effectiveness,
routine cystoscopy is still commonly performed.
Although
not cost-effective in the general population, another potential use of
routine cystoscopy is to evaluate for non-iatrogenic ureteral
abnormalities. Additionally, some surgeons at large academic
institutions take advantage of universal or selective post-operative
cystoscopy as an opportunity to teach trainees this important surgical
skill. At the time of hysterectomy, most urologic findings (e.g.
hematuria or lack of ureteral efflux) are due to bladder and/or ureteral
injuries. Many of these findings are due to idiopathic and
self-resolving causes (Wilson and Merkur, 2008).
However, urologic findings in certain gynecologic oncology patients
should raise concern about the possibility of synchronous malignancies.
For instance, Lynch syndrome (hereditary non-polyposis colorectal
cancer, HNPCC) is a rare but significant risk factor for ureteral
transitional cell carcinoma (TCC). Whereas there have been reports of
intraoperatively-found incidental lymphoepithelial ureteral carcinomas (Ma et al., 2008),
a Pubmed search using the terms “transitional cell carcinoma” (or
ureteral tumor), “incidental” and “hysterectomy” revealed no prior
reports of incidentally-found ureteral TCCs associated with and leading
to the diagnosis of Lynch syndrome........
open access: Case Reports - Destructive T10 vertebral lesion leads to diagnosis of metastatic ovarian cancer
Open access:
Highlights
►
Ovarian cancer presents as thoracic vertebral lesion in the absence of
gross abdominal disease
► Bilateral salpingo-oophorectomy with surgical resection of vertebral lesion leaves patient with no clinical evidence of disease
► Ovarian cancer can present as vertebral metastases in the absence of pelvic or abdominal metastatic disease
► Bilateral salpingo-oophorectomy with surgical resection of vertebral lesion leaves patient with no clinical evidence of disease
► Ovarian cancer can present as vertebral metastases in the absence of pelvic or abdominal metastatic disease
open access: Casee Reports - Hypercalcemia in a child with juvenile granulosa cell tumor of ovary/review of the literature
open access
Highlights
►
Hypercalcemia is an extremely rare paraneoplastic syndrome in children.
► Small cell carcinoma is the commonest ovarian tumor associated with hypercalcemia.
► Small cell carcinoma must be ruled out because of poor prognosis.
► We report the only third case of JGCT associated with paraneoplastic hypercalcemia.
► Small cell carcinoma is the commonest ovarian tumor associated with hypercalcemia.
► Small cell carcinoma must be ruled out because of poor prognosis.
► We report the only third case of JGCT associated with paraneoplastic hypercalcemia.
open access: Vitamin D: Pharmacokinetics and Safety When Used in Conjunction with the Pharmaceutical Drugs Used in Cancer Patients
Free Full-Text
Abstract:
Vitamin D has reported anti-cancer and anti-inflammatory properties modulated through gene transcription and non-genomic signaling cascades. The purpose of this review was to summarize the available research on interactions and pharmacokinetics between vitamin D and the pharmaceutical drugs used in patients with cancer. Hypercalcemia was the most frequently reported side effect that occurred in high dose calcitriol. The half-life of 25(OH)D3 and/or 1,25(OH)2D3 was found to be impacted by cimetidine; rosuvastatin; prednisone and possibly some chemotherapy drugs. No unusual adverse effects in cancer patients; beyond what is expected from high dose 1,25(OH)2D3 supplementation, were revealed through this review. While sufficient evidence is lacking, supplementation with 1,25(OH)2D3 during chemotherapy appears to have a low risk of interaction. Further interactions with vitamin D3 have not been studied.
Involvement of pelvic inflammation-related mismatch repair abnormalities and microsatellite instability in the malignant transformation of ovarian endometriosis (MLH1/MSH2)
Abstract
"Inflammation in the ovary, including ovulation and pelvic inflammatory disease, has been proposed to play a role in the pathogenesis of ovarian cancer. Endometriotic lesions trigger a local inflammatory reaction and have been reported to be associated with an increased risk of epithelial ovarian cancer. However, the precise molecular mechanisms of ovarian cancer arising from endometriosis are still to be elucidated.
Development of Therapeutic Combinations Targeting Major Cancer Signaling Pathways
Development of Therapeutic Combinations Targeting Major Cancer Signaling Pathways
"Signaling networks play key homeostatic
processes in living organisms but are commonly hijacked in oncogenesis.
Prominent
examples include genetically altered receptor
tyrosine kinases and dysregulated intracellular signaling molecules. The
discovery
and development of targeted therapies against such
oncogenic proteins has imparted clinical benefit. Nevertheless, concerns
remain about the limited single-agent efficacy and
narrow therapeutic indices of many of these antitumor agents. Moreover,
Which Symptoms Come First? Exploration of Temporal Relationships Between Cancer-Related Symptoms over an 18-Month Period
Abstract
BACKGROUND:
Anxiety, depression, insomnia, fatigue, and pain are frequently reported by cancer patients. These symptoms are highly interrelated. However, few prospective studies have documented the sequence with which symptoms occur during cancer care.PURPOSE:
This longitudinal study explored the temporal relationships between anxiety, depression, insomnia, fatigue, and pain over an 18-month period in a large population-based sample of nonmetastatic cancer patients (N = 828), using structural equation modeling.METHODS:
The patients completed a battery of self-report scales at baseline and 2, 6, 10, 14, and 18 months later.RESULTS:
The relationships between the same symptom at two consecutive assessments showed the highest coefficients (β = 0.29 to 0.78; all ps ≤ 0.05). Cross-loading parameters (β = 0.06 to 0.19; ps ≤ 0.05) revealed that fatigue frequently predicted subsequent depression, insomnia, and pain, whereas anxiety predicted insomnia.CONCLUSIONS:
Fatigue and anxiety appear to constitute important risk factors of other cancer-related symptoms and should be managed appropriately early during the cancer care trajectory.message from Healthline (also posted in comments section)
Hi,
Healthline is interested in contributing a guest post to ovariancancerandus.blogspot.com. We would be open to contributing any blog that would be of interest to your readers. Healthline bloggers have been featured on a variety of sites including: Washington Times: http://communities.washingtontimes.com/neighborhood/tango-mind-and-emotion/2012/aug/10/how-healthy-choices-easy/ Natural News: http://www.naturalnews.com/036515_diabetes_strawberries_prevention.html Patch.com: http://strongsville.patch.com/blog_posts/where-and-what-to-eat-in-cleveland-to-beat-the-winter-blues Please let me know if you have any questions. Thank you in advance for your consideration. Warm Regards, Tracy on Impact of beta blocker medication in patients with platinum sensitive recurrent ovarian cancer- a combined analysis of 2 prospective multicenter trials by the AGO Study Group, NCIC-CTG and EORTC-GCG
open access: Colorectal and Other Cancer Risks for Carriers and Noncarriers From Families With a DNA Mismatch Repair Gene Mutation: A Prospective Cohort Study (Canada/U.S./Australia)
Blogger's Note/Opinion: previously posted in abstract form, now open access; also discusses breast cancer in Lynch Syndrome and pancreatic cancer; the lack of pancreatic screening/advocacy in this particularly deadly cancer has not changed in decades and the philosophy remains
JCO
"An unanticipated finding of our study is the confirmation of an
increased risk for cancers of the breast and pancreas for MMR gene
mutation carriers. Although risk of pancreatic cancer has been investigated in Lynch syndrome,29-33 the evidence was inconsistent. The study showing evidence for an association was that of Kastrinos et al,34 which recently showed an increased risk of pancreatic cancer in Lynch syndrome (hazard ratio, 8.6; 95% CI, 4.5 to 15.7). This result is consistent with our finding (test for difference, P .79). However, given
the limited evidence for efficacy of screening for pancreatic cancers,35
expert opinion has not yet advocated pancreatic cancer screening in
the context of Lynch syndrome."
Acrylamide Hemoglobin Adduct Levels and Ovarian Cancer Risk
Abstract
Background:
Acrylamide is a probable human carcinogen formed during cooking of starchy foods. Two large prospective cohort studies of dietary acrylamide intake and ovarian cancer risk observed a positive association, although two other studies reported no association.
Conclusions: We observed no evidence that acrylamide exposure as measured by adducts to hemoglobin is associated with an increased risk
of ovarian cancer.
Impact: Our finding indicates that acrylamide intake may not increase risk of ovarian cancer.Cancer Epidemiol Biomarkers Prev; 1–8. ©2013 AACR.
Factors associated with improved toxicity and tolerability of intraperitoneal chemotherapy in advanced-stage epithelial ovarian cancers
Abstract
OBJECTIVE:
To evaluate the toxicity and tolerability of the Intraperitoneal/Intravenous (IP/IV) regimen utilized at Moffitt Cancer Center and to compare our findings with the IP, Gynecologic Oncology Group (GOG) study 172.STUDY DESIGN:
Using the Moffitt database, we evaluated the outcomes of patients who underwent primary optimal cytoreduction for stage IIC-IV, epithelial ovarian, tubal, and peritoneal carcinoma followed by the intent to treat with IP/IV chemotherapy. NCI CTCAE v3.0 was used to grade adverse events.RESULTS:
We identified 69 patients meeting our inclusion criteria from 2006 - 2011. The most frequent grade 3/4 toxicities were neutropenia (48%), gastrointestinal (9%), metabolic (9%), and infection (5%). Remaining toxicities occurred in < 5% of patients. Patients received a greater number of cycles compared to GOG 172 (4.28 vs. 3.66, respectively, p = 0.0088).CONCLUSION:
Through the use of supportive care and the preemptive management of established side effects, the associated toxicities and tolerability of IP chemotherapy appear improved.
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