Monday, February 22, 2016
A Case of Sertoli-Leydig Cell Tumor With Intermediate Differentiation in an Adolescent Female
requires subscription to view (no abstract)
Video
A Case of Sertoli-Leydig Cell Tumor With Intermediate Differentiation in an Adolescent Female
- 1 Division of Pediatric and Adolescent Gynecology, Departments of Obstetrics and Gynecology and Pediatrics, Baylor College of Medicine, Houston, Texas
- 2 Texas Children’s Cancer Center, Texas Children's Hospital, Houston, Texas
- 3 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
- 4 Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas and Division of Pediatric Surgery, Department of Surgery, Texas Children’s Hospital, Houston, Texas
- Available online 17 February 2016
Sunday, February 21, 2016
Safety, Costs, and Efficacy of Rapid Drug Desensitizations to Chemotherapy and Monoclonal Antibodies
abstract
Background
Rapid
drug desensitization (RDD) is used to address hypersensitivity
reactions to chemotherapeutics and monoclonal antibodies, allowing
patients to be treated with optimal pharmacological agents. RDD
protocols are tailored to each individual patient's reaction and needs,
and protect against anaphylaxis, but overall risks, costs, and benefits
have not been determined.
Objective
We investigated the safety, efficacy, costs, and life expectancy of patients in a large population undergoing RDD.
Methods
We
analyzed 2177 RDD procedures performed in 370 patients with cancer,
vasculitis, and hematological and connective tissue diseases who
presented 402 reactions. A subgroup of carboplatin allergic patients
with ovarian cancer treated with RDD was analyzed for costs and life
expectancy and compared with a nonallergic control group.
Results
RDD
allowed all patients to receive safely the full dose of the medication
to which they were reactive. A gradual increase in the fraction of
outpatient desensitizations from 81% to 98% was achieved through risk
stratification. Of the 2177 desensitizations, 93% had no or mild
reactions whereas 7% had moderate to severe reactions, which did not
preclude the completion of the treatment, and there were no deaths.
Overall health costs in the carboplatin allergic group were not higher
than those in the nonallergic group treated with standard of care.
Administration of carboplatin through RDD was as effective as standard
administration with a nonsignificant increase in life expectancy in
desensitized patients as compared with nonallergic, nondesensitized
controls.
Conclusions
RDD is cost effective and safe for allergic patients with cancer and chronic disease to remain on first line therapy.
Key words
- Drug desensitization;
- Chemotherapeutic agents;
- Monoclonal antibodies;
- Carboplatin;
- Drug hypersensitivity;
- Cost;
- Efficacy;
- Safety
Abbreviations used
- HSR, Hypersensitivity reaction;
- MoAbs, Monoclonal antibodies;
- RDD, Rapid drug desensitization
- Funding for this study was provided by Ovations for the Cure.
Sensitivity of ovarian cancer cells to acetaminophen reveals biological pathways that affect patient survival
abstract/open access - pdf (technical/in research)
Abstract
Experimental and epidemiological data support the potential
activity of acetaminophen against ovarian cancer (OVCA). In this study,
we sought to confirm the activity of acetaminophen in OVCA cell lines
and to investigate the molecular basis of response. A total of 16 OVCA
cell lines underwent pretreatment (baseline) genome-wide expression
measurements and were then treated with and analyzed for acetaminophen
sensitivity. Pearson's correlation analysis was performed to identify
genes that were associated with OVCA acetaminophen response. The
identified genes were subjected to pathway analysis, and the expression
of each represented pathway was summarized using principal component
analysis. OVCA acetaminophen response pathways were analyzed in
4 external clinico‑genomic datasets from 820 women for associations with
overall survival from OVCA. Acetaminophen exhibited antiproliferative
activity against all tested OVCA cell lines, with half maximal
inhibitory concentration values ranging from 63.2 to 403 µM. Pearson's
correlation followed by biological pathway analysis identified
13 pathways to be associated with acetaminophen sensitivity (P<0.01).
Associations were observed between patient survival from OVCA and
expression of the following pathways: Development̸angiotensin signaling
via β-arrestin (P=0.04), protein folding and maturation̸angiotensin
system maturation (P=0.02), signal transduction̸c-Jun N-terminal kinase
(JNK) pathway (P=0.03) and androstenedione and testosterone biosynthesis
and metabolism (P=0.02). We confirmed that acetaminophen was active
against OVCA cells in vitro. Furthermore, we identified 4 molecular
signaling pathways associated with acetaminophen response that may also
affect overall survival in women with OVCA, including the JNK pathway,
which has been previously implicated in the mechanism of action of
acetaminophen and is predictive of decreased survival in women with
OVCA.
Communicating genetic test results within the family: Is it lost in translation? (BRCA)
Communicating genetic test results within the family: Is it lost in translation? A survey of relatives in the randomized six-step study
Saturday, February 20, 2016
TNM and Ovary, Fallopian Tube and primary peritoneal carcinoma FIGO 2014 (effective 2017)
TNM and Ovary, Fallopian Tube and primary peritoneal carcinoma FIGO 2014
•
FIGO has published a new classification for ovarian cancer*
•
This classification incorporates cancers of the fallopian tube
and primary peritoneal carcinomas
•
These new cancer staging rules will be incorporated into the
8th Edition of the UICC TNM Classification of MalignantTumours, which is scheduled for release in the Autumn of 2016, with an effective date of January 1, 2017.
•
A comparison of the current TNM for ovary and the new FIGO classification and proposal for the 8th edition follow
The new WHO classification of ovarian, fallopian tube, and primary peritoneal cancer and its clinical implications
abstract
Introduction
Molecular
pathological research has contributed to improving the knowledge of
different subtypes of ovarian cancer. In parallel with the
implementation of the new FIGO staging classification, the WHO
classification was revised. The latter is mainly based on the
histopathological findings and defines the actual type of tumor. It has,
therefore, also an important impact on prognosis and therapy of the
patient.
Materials and methods
The new WHO Classification of Ovarian Cancer published 2014 by Robert Kurman and
co-authors is summarized. The major changes compared to the hitherto
existing classification are presented.
Results
The new
classification eliminates the previous focus of mesothelial origin of
ovarian cancer. Instead, it features a discussion of tubal
carcinogenesis of hereditary and some other high-grade serous
carcinomas. The previously assumed pathogenesis pathway may be correct
for some, but not for all, serous cancers. The new classification was
established to classify ovarian cancer in a more consistent way. The
earlier transitional cell type of ovarian cancer has been removed while
seromucinous tumors have been added as a new entity. The role of some
borderline tumors as one possible step in the progression from benign to
invasive lesions is incorporated. The article summarizes the essential
updates concerning serous, mucinous, seromucinous, endometrioid,
clear-cell, and Brenner tumors.
Conclusion
The new WHO
classification takes into account the recent findings on the origin,
pathogenesis, and prognosis of different ovarian cancer subtypes. The
tubal origin of hereditary and some non-hereditary high-grade serous
cancers is mentioned in contrast to the hitherto theory of mesothelial
origin of tumors. Seromucinous tumors represent a new entity.
2016 Annual Meeting on Women's Cancer® - abstracts/schedule/search function
Blogger's Note: website also includes search function
eg. "lynch syndrome" "brca"
2016 Annual Meeting on Women's Cancer®
Schedule
Mar 19-20 San Diego: The SGO’s 2016 Annual Meeting on Women’s Cancer
Clinical Research Forum at Annual Meeting
The Society of
Gynecologic Oncology’s 2016
Annual Meeting on Women’s Cancer kicks off in less than a month! Register
and book
your housing today for this premier event -- to be held March 19-22, in San
Diego -- and dig in to the latest science and hottest education topics in the industry.
Education Forum VI -- Overcoming Barriers to Clinical
Research: How to Enroll Your Patients Onto Trials in an Academic, Hospital-Based,
or Private PracticeSunday, March 20
4:45 p.m. – 6:00 p.m.
Take an in-depth look at the clinical trials process and focus on overcoming barriers to participation. During this session, you’ll hear about the process from three perspectives: the large academic center, the community hospital, and the patient. Join us for the unique opportunity to hear about the clinical trial process not just from physicians, but also from a patient who went through a trial.
Get details on all the Education Forums offered during the Annual Meeting.
View the complete Schedule of Events.
4:45 p.m. – 6:00 p.m.
Take an in-depth look at the clinical trials process and focus on overcoming barriers to participation. During this session, you’ll hear about the process from three perspectives: the large academic center, the community hospital, and the patient. Join us for the unique opportunity to hear about the clinical trial process not just from physicians, but also from a patient who went through a trial.
Get details on all the Education Forums offered during the Annual Meeting.
View the complete Schedule of Events.
deadline Mar 10th: Scholarships available to e-Patients for palliative care summit
Scholarships available to e-Patients for palliative care summit – Ignite. Inspire. Innovate
The Coalition for Compassionate Care of California (CCCC) is inviting e-Patients to apply for a scholarship to their 8th Annual Summit in Newport Beach, California, on May 12-13, 2016.
The deadline to submit an application is March 10, 2016.
The e-Patient scholarship program is funded by the John and Wauna Harman Foundation, and will cover the full Summit registration fee. Travel and hotel accommodation scholarships will be awarded on an as needed-basis.
Now in its 8th year, the Coalition for Compassionate Care of California Annual Summit is designed for physicians, nurses, social workers, nursing home administrators, chaplains, patients and consumers who are interested in best practices, quality and policy as it pertains to palliative and end-of-life care. In 2016 we are pleased to announce a special pediatric track that will run throughout the event.
This year’s Summit “Ignite. Inspire. Innovate. Taking Palliative Care to the Next Level,” includes the following topics: Palliative care, patient-centered care, advance care planning, managing serious illness for the adult and pediatric populations, end-of-life care, cultural congruency, and Physician Orders for Life-Sustaining Treatment (POLST). Learn more about the Summit at http://ccccsummit.org.
About CCCC
The Coalition for Compassionate Care of California is an interdisciplinary collaborative of thought-leaders from healthcare systems and organizations, government agencies, consumer organizations, and the general public. Our goal is to transform healthcare so that medical care is aligned with individual patient preferences—that people get the care they need and no less, and the care they want and no more. We want to create a community where people have support to explore their wishes for care during a serious illness, express their wishes, and have these wishes honored.Why include e-Patients at the Annual Summit?
Twenty-one–gene recurrence score assay in BRCA-associated versus sporadic breast cancers...
abstract
Twenty-one–gene recurrence score assay in BRCA-associated versus sporadic breast cancers: Differences based on germline mutation status
BACKGROUND
Biological differences between BRCA-associated
breast cancer and sporadic breast cancer may warrant different adjuvant
chemotherapy (ACRx) recommendations despite similar phenotypic
features. A 21-gene expression profile (Oncotype DX) generates a
prognostic recurrence score (RS) that predicts the ACRx benefit in
patients with hormone receptor–positive breast cancer. No reports
describe assay results for BRCA-associated breast cancer.
METHODS
A
review of Memorial Sloan Kettering Cancer Center databases identified
4908 patients with hormone receptor–positive, node-negative breast
cancer who underwent Oncotype DX testing between July 2006 and March
2014. BRCA1/BRCA2 carriers (cases) were identified and
matched (1:2) by age at diagnosis and tumor size to noncarrier
controls. Two-sample nonparametric tests were used to compare the
baseline characteristics, RSs, and risk stratification between BRCA1 and BRCA2 patients. Conditional logistic regression was used to assess these differences by mutational status.
RESULTS
Fifty mutation-associated cases (19 BRCA1 cases and 31 BRCA2 cases) and 100 controls who were well matched for age (P = .9) and tumor size (P = .6) were included. BRCA1 and BRCA2 carriers had similar median RSs (P = .6) and risk category stratification (P = .3). The median RS was higher for cases versus controls (24 vs 16; P < .0001). Risk stratification also differed by mutational status (P
= .0002). Cases had more high-risk disease (28% vs 7%) and
intermediate-risk disease (56% vs 36%) and less low-risk disease (16% vs
57%). Cases were more likely than controls to receive ACRx (74% vs 46%;
P = .002).
CONCLUSIONS
Germline BRCA-associated hormone receptor–positive breast cancer may be associated with intrinsically less favorable biology. Few affected carriers have RS indicating a clear absence of benefit from ACRx. The increased use of ACRx and benefit from ACRx in BRCA carriers may mitigate otherwise inferior outcomes.Dispositional optimism and therapeutic expectations in early-phase oncology trials
abstract
Dispositional optimism refers to generalized outcome expectancies that good things, rather than bad things, will happen;
BACKGROUND
Prior
research has identified unrealistic optimism as a bias that might
impair informed consent among patient-subjects in early-phase oncology
trials. However, optimism is not a unitary construct; it also can be
defined as a general disposition, or what is called dispositional
optimism. The authors assessed whether dispositional optimism would be
related to high expectations for personal therapeutic benefit reported
by patient-subjects in these trials but not to the therapeutic
misconception. The authors also assessed how dispositional optimism
related to unrealistic optimism.
METHODS
Patient-subjects
completed questionnaires designed to measure expectations for
therapeutic benefit, dispositional optimism, unrealistic optimism, and
the therapeutic misconception.
RESULTS
Dispositional
optimism was found to be significantly associated with higher
expectations for personal therapeutic benefit (Spearman rank correlation
coefficient [r], 0.333; P<.0001), but was not associated with the therapeutic misconception (Spearman r, -0.075; P = .329). Dispositional optimism was found to be weakly associated with unrealistic optimism (Spearman r, 0.215; P = .005). On multivariate analysis, both dispositional optimism (P = .02) and unrealistic optimism (P<.0001)
were found to be independently associated with high expectations for
personal therapeutic benefit. Unrealistic optimism (P = .0001), but not dispositional optimism, was found to be independently associated with the therapeutic misconception.
CONCLUSIONS
High expectations for therapeutic benefit among patient-subjects in early-phase oncology trials should not be assumed to result from misunderstanding of specific information regarding the trials. The data from the current study indicate that these expectations are associated with either a dispositionally positive outlook on life or biased expectations concerning specific aspects of trial participation. Not all manifestations of optimism are the same, and different types of optimism likely have different consequences for informed consent in early-phase oncology research.Recommendations for the improvement of bladder cancer quality of care in Canada....
Blogger's Note: this paper is not specific to Lynch syndrome genetics but includes high risk features (eg. microscopic hematuria, prior chemo/radiation) and includes notes concerning surgical interventions (eg. female/ovary...)
open access (pdf):
Recommendations for the improvement of bladder cancer quality of care in Canada: A consensus document reviewed and endorsed by Bladder Cancer Canada (BCC), Canadian Urologic Oncology Group (CUOG), and Canadian Urological Association (CUA), December 2015 | Kassouf | Canadian Urological Association Journal
FDA’s (U.S.) Fast Track Status to Ovarian Cancer Drug TPIV 500 (200)
Oncology Times
Monday, February 8, 2016
FDA’s Fast Track Status to Ovarian Cancer Drug TPIV 500
The U.S.
Food and Drug Administration has granted Fast Track designation to the
multiple-epitope Folate Receptor Alpha Peptide Vaccine (TPIV 200) with
GM-CSF adjuvant for maintenance therapy in patients with
platinum-sensitive advanced ovarian cancer whose disease is stable or
who have had a partial response following completion of standard of care
chemotherapy.
The Fast Track designation, established under the FDA Modernization Act of 1997, is designed to facilitate frequent interactions with the FDA review team to expedite clinical development and submission of a New Drug Application for medicines with the potential to treat serious or life-threatening conditions and address unmet medical needs. The designation permits the drug developer the opportunity to submit sections of an NDA on a rolling basis as data become available, allowing the FDA to review those materials on a rolling basis as well.
The FDA had granted orphan drug designation to TPIV 200 for the same indication late last year.
A Phase II trial for TPIV 200 is being planned, according to a news release from the drug company developing the agent, TapImmune Inc.
The Fast Track designation, established under the FDA Modernization Act of 1997, is designed to facilitate frequent interactions with the FDA review team to expedite clinical development and submission of a New Drug Application for medicines with the potential to treat serious or life-threatening conditions and address unmet medical needs. The designation permits the drug developer the opportunity to submit sections of an NDA on a rolling basis as data become available, allowing the FDA to review those materials on a rolling basis as well.
The FDA had granted orphan drug designation to TPIV 200 for the same indication late last year.
A Phase II trial for TPIV 200 is being planned, according to a news release from the drug company developing the agent, TapImmune Inc.
Ovarian cancer survivors’ quality of life: a systematic review
abstract
Purpose
The assessment of
quality of life (QOL) among ovarian cancer (OC) patients has mainly
focused on the acute phase of treatment. This systematic review examines
studies measuring QOL in patients who survived OC after treatment and
synthesizes results in order to assess QOL and patient-reported outcome
(PRO) data at long-term follow-up.
Methods
Articles published
in English between 1990 to November 2014 were identified with the
databases MEDLINE and PubMed, using the specific keywords “OC survivors”
combined with the terms, “QOL,” “health-related QOL,” and “PROs.” Data
were reviewed for design, time since end of treatment, measurement
tools, and outcomes (categorized in three topics: global QOL compared to
controls, treatment sequelae, and intervention strategies).
Results
The initial search
strategy provided 148 articles of which 31 were considered eligible.
Most studies focused on epithelial OC, and only a few studies
investigated survivors of ovarian germ cell tumor. More than 60
instruments of QOL measures were used in the corpus. Despite the
persistence of psychological and physical symptoms, treatment sequelae,
sexual problems, and fear of recurrence in some survivors, most studies
demonstrated that OC survivors generally have good QOL compared to
healthy women. Studies proposing interventions are lacking.
Conclusions and Implications for Cancer Survivor
OC survivors
experience a wide range of sequelae that may persist for a long time and
negatively impact QOL. Further large-scale research is needed to fully
understand problems that have significant effects on QOL, in order to
develop interventions and treatments suitable for women at need.
Friday, February 19, 2016
Letter to my new oncologist: The Seven Traits of Leadership on the High Seas of Cancer
Cancer Network
Blog | February 18, 2016
I am hoping that you can help me. I just found out that I have cancer and it has spread. I know you’ve heard this before, but the past 2 weeks have been unreal, as if I was in someone else’s body. I am told that the cancer is treatable but it is hard to be hopeful after hearing that horrible word thrown at you like a javelin.
My internist gave me your name and I have an appointment with you tomorrow. I think you should know that I am quite familiar with oncologists.....
How Effective Are Percutaneous Liver-Directed Therapies in Patients with Non-Colorectal Liver Metastases? - PubMed - NCBI
abstract
BACKGROUND:
The purpose of this review is to demonstrate the clinical indications, technical developments, and outcome of liver-directed therapies in interventional oncology of non-colorectal liver metastases.METHODS:
Liver-directed therapies are classified into vascular transarterial techniques such as chemoperfusion (TACP), chemoembolization (TACE), radioembolization (selective internal radiation therapy (SIRT)), and chemosaturation, as well as thermal ablation techniques like microwave ablation (MWA), radiofrequency ablation (RFA), laser-induced thermotherapy (LITT), cryotherapy, and irreversible electroporation (IRE). The authors searched the database PubMed using the following terms: 'image-guided tumor ablation', 'thermal ablation therapies', 'liver metastases of uveal melanoma', 'neuroendocrine carcinoma', 'breast cancer', and 'non-colorectal liver metastases'.RESULTS:
Various combinations of the above-mentioned therapy protocols are possible. In neuroendocrine carcinomas, oligonodular liver metastases are treated successfully via thermal ablation like RFA, LITT, or MWA, and diffuse involvement via TACE or SIRT. Although liver involvement in breast cancer is a systemic disease, non-responding nodular metastases can be controlled via RFA or LITT. In ocular or cutaneous melanoma, thermal ablation is rarely considered as an interventional treatment option, as opposed to TACE, SIRT, or chemosaturation. Rarely liver-directed therapies are used in pancreatic cancer, most likely due to problems such as biliary digestive communications after surgery and the risk of infections. Rare indications for thermal ablation are liver metastases of other primary cancers like non-small cell lung, gastric, and ovarian cancer.CONCLUSION:
Interventional oncological techniques play a role in patients with liver-dominant metastases.
Common cancer treatment side effects
National Cancer Institute
Common side effects caused by cancer treatment include:
- Anemia
- Appetite Loss
- Bleeding and Bruising (Thrombocytopenia)
- Constipation
- Diarrhea
- Edema
- Fatigue
- Hair Loss (Alopecia)
- Infection and Neutropenia
- Lymphedema
- Memory or Concentration Problems
- Mouth and Throat Problems
- Nausea and Vomiting
- Nerve Problems (Peripheral Neuropathy)
- Pain
- Sexual and Fertility Problems (Men)
- Sexual and Fertility Problems (Women)
- Skin and Nail Changes
- Sleep Problems
- Urinary and Bladder Problems
Similar protein expression profiles of ovarian and endometrial high-grade serous carcinomas
Abstract
Background:
Ovarian
and endometrial high-grade serous carcinomas (HGSCs) have similar
clinical and pathological characteristics; however, exhaustive protein
expression profiling of these cancers has yet to be reported.
Methods:
We
performed protein expression profiling on 14 cases of HGSCs (7 ovarian
and 7 endometrial) and 18 endometrioid carcinomas (9 ovarian and 9
endometrial) using iTRAQ-based exhaustive and quantitative protein
analysis.
Results:
We
identified 828 tumour-expressed proteins and evaluated the statistical
similarity of protein expression profiles between ovarian and
endometrial HGSCs using unsupervised hierarchical cluster analysis
(P<0.01).....
Conclusions:
We
demonstrated the statistical similarity of the protein expression
profiles of ovarian and endometrial HGSC beyond the organs. We suggest
that increased IMP2 and MCM2 expression may underlie some of the rapid
HGSC growth observed clinically.
Thursday, February 18, 2016
mini review: The Value of Ultrasound Monitoring of Adnexal Masses for Early Detection of Ovarian Cancer
open access
Front. Oncol., 10 February 2016 | http://dx.doi.org/10.3389/fonc.2016.00025
Division of Gynecologic Oncology, The Permanente Medical Group, Walnut Creek, CA, USA
TABLE OF CONTENTS
Toxicities of Anti-PD-1/PD-L1 Immune Checkpoint Antibodies
Toxicities
Abstract and Introduction
- General Adverse Events of Anti-PD-1/PD-l1 Therapy
- Organ-specific Adverse Events With Single-agent Anti-PD-1/PD-l1 Agents
- Rare Toxicities With Anti-PD-1/PD-L1 Agents
- Combinations of Anti-PD-1/PD-l1 Agents With Other Anticancer Agents
- Anti-PD-1/PD-l1 Therapy in Patients With Pre-existing Autoimmune or Infectious Diseases
- Conclusion
Discussing Cancer Prognosis (audio/text)...and hope vs #'s
Discussing Cancer Prognosis (text)
audio (12.36 min)
The Limitations of ‘How much time do I have left?’
“How much time do I have left?” seems an inadequate way of asking your doctor about prognosis for a number of reasons. First, the question suggests that it can be answered with an absolute number—eg, 1 year—which patients often interpret literally. They feel cheated if they are short-changed, and if they surpass the deadline, they feel as though they are just waiting to die. Statistically, it confounds average and median survival. Survival is commonly measured in terms of median survival, but patients are rarely familiar with the concept of “median,” and understand it to mean “average.” Perhaps more importantly, it does not account for the fundamental statistical principle of range, an essential part of understanding survival curves. Finally, prognosis should be tailored to the individual in order to account for variables such as fitness, comorbidities, newer treatments, and better delivery of care. Prognosis should also offer hope, which an absolute number does not do.....Q & A: Vinay Prasad on the Use of Exaggerated Language in Cancer Research
open access
Vinay Prasad on the Use of Exaggerated Language in Cancer Research, and How It Can Mislead Doctors, Patients, and the Public
(Interview) You recently had a research letter published in JAMA Oncology titled “The Use of Superlatives in Cancer Research,” which essentially demonstrates that the overuse of inflated descriptors of new cancer drugs may lead to misconceptions among readers that certain drugs are more beneficial to patients than they actually are. What led you to investigate this topic, and what were the most surprising findings of your research?......
Personal genomics: Where are we now?
open access
Applied & Translational Genomics
Article outlineWhere are we now?The moment you know…David Bowie (1947–2016)
Peering into the Deep: Characterizing the Internet Search Patterns of Patients with Gyn Cancers
abstract
Cancer patients are increasingly using the Internet to learn about their disease, connect with others undergoing similar treatments and obtain support outside of the clinical encounter. The goal of this project was to explore how patients with gynecological cancers (ovarian, cervical, and endometrial) used the Internet as an information resource and how this influenced their treatment decisions and interactions with their health care specialists. From 2013 to 2014, ovarian, endometrial, and cervical cancer patients attending a comprehensive cancer centre were invited to complete a 24-item paper questionnaire detailing their experiences in searching the Internet. Twenty-eight patients completed survey. The largest portion of participants had an ovarian cancer diagnosis (61 %), followed by endometrial (29 %) and cervical cancer (11 %). Results indicate that the majority (85 %) of patients used the Internet as a resource to learn about their gynecological cancers. Most respondents (89 %) used Google as their search engine, and some used multiple search engines. The most frequently searched topics included treatment information (85 %), management of symptoms/treatment toxicity (59 %), and alternative treatments (37 %). Many patients (74 %) felt that the Internet was a useful tool for understanding their diagnosis; however, 33 % reported that the Internet was somewhat hard to understand. Most (78 %) patients reported that Internet information increased their understanding of their diagnosis, and 56 % felt it did not affect their decision-making. This study highlights how gynecological patients are accessing cancer information online and how physicians may support this within the clinical setting.
Wednesday, February 17, 2016
Recall: Morphine Sulfate 0.5 mg/mL Preservative Free in 0.9 percent Sodium Chloride
Morphine Sulfate 0.5 mg/mL Preservative Free in 0.9 percent Sodium Chloride by by Pharmakon Pharmaceuticals: Recall - Super-potent Product
BACKGROUND: The recalled product was made on February 3, 2016, with an expiration date of March 19, 2016, and labeled with lot E52418EV11C and NDC 45183-0322-78. The recalled product was distributed to two medical facilities – one in Indiana and one in Illinois.
Injecting a patient with super-potent morphine could result in serious consequences including respiratory depression, coma, and death.
Assessing the Eventual Publication of Clinical Trial Abstracts Submitted to a Large Annual Oncology Meeting (ASCO)
Materials and Methods. Abstracts describing clinical trials for
patients with breast, lung, colorectal, ovarian, and prostate
cancer from 2009 to 2011 were identified by using a
comprehensive online database (http://meetinglibrary.asco.
org/abstracts).....
Abstract (requires subscription to view full paper)
Background.
Despite the ethical imperative to
publish clinical trials when human subjects are involved, such data
frequently remain unpublished.
The objectives were to tabulate the rate and
ascertain factors associated with eventual publication of clinical trial
results
reported as abstracts in the Proceedings of the American Society of Clinical Oncology (American Society of Clinical Oncology).
Materials and Methods.
Abstracts describing clinical trials for patients with breast, lung, colorectal, ovarian, and prostate cancer from 2009 to
2011 were identified by using a comprehensive online database (http://meetinglibrary.asco.org/abstracts).
Abstracts included reported results of a treatment or intervention
assessed in a discrete, prospective clinical trial.
Publication status at 4−6 years was determined
by using a standardized search of PubMed. Primary outcomes were the rate
of
publication for abstracts of randomized and
nonrandomized clinical trials. Secondary outcomes included factors
influencing
the publication of results.
Results.
A total of 1,075 abstracts describing
378 randomized and 697 nonrandomized clinical trials were evaluated.
Across all years,
75% of randomized and 54% of nonrandomized
trials were published, with an overall publication rate of 61%.
Data Dump: U.S. Trials Often Fail to Report Results
Medpage Today
Krumholz said his team thought they would find the institutions that were doing well and then disseminate identifiable best practices.
"But we were surprised to find that no one is doing well," he added. "The fact that it's so pervasive suggests it's not about bad individuals, it's about a culture that allows for reporting to be discretionary rather than mandatory."
"This is a human subjects' violation," Krumholz explained. "People have agreed to be part of our studies and we routinely don't report [results]. All studies should be completed and reported, but these in particular, are human studies. These aren't studies that have fallen off the tracks. These are studies that were successfully completed. This should alarm everyone."
The impact of comorbidity on cancer and its treatment
open access
Box 1.
Strategies to Address Comorbidity Among Cancer Patients
- Improving the evidence base from which to make cancer treatment decisions for those with comorbidity
- Improving the measurement of comorbidity among cancer patients
- Improving integration and coordination of care
- Preventing the occurrence of new comorbidities and limiting exacerbations of existing conditions
- Developing better tools for clinicians
- Facilitating skill development for clinicians
- Building research collaborations
Preventing the Occurrence of New Comorbidities and Limiting Exacerbations of Existing Conditions
New comorbidities can emerge during or after cancer treatment, and cancer
treatment can exacerbate underlying conditions. To date, most research
has focused on the management of comorbid conditions among cancer
survivors,[181, 182]
whereas there is very little about the impact of careful management of
comorbidity and polypharmacy in the active treatment phase. For example,
to our knowledge, no study has investigated ideal glycemic control for
diabetic patients undergoing chemotherapy. Furthermore, research has
shown that polypharmacy and adverse drug reactions are important causes
of unplanned hospitalization and higher toxicity rates,[135-138]
yet the studies that have been carried out to date are small and
usually single-institution studies or small series. There remains a
substantial gap in the evidence base regarding the frequency, severity,
and impact of drug-drug interactions and regarding whether intervention
to reduce polypharmacy among cancer patients receiving noncancer
medications and chemotherapy would be helpful.[132, 138, 183-186].....
ACOG, SMFM issue updated guidance on Zika
Contemporary OB/GYN
The complete practice advisory, including clinical algorithms for patient management and links to other resources on Zika infection, can be found at http://www.acog.org/About-ACOG/News-Room/Practice-Advisories/Practice-Advisory-Interim-Guidance-for-Care-of-Obstetric-Patients-During-a-Zika-Virus-Outbreak.
For perspective from Editor-in-Chief Charles J. Lockwood, visit http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/zika-virus-and-microcephaly
Reflections on 2015 - the Oncologist
open access
Reflections on 2015
Bruce A. Chabner
Author Affiliations
Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA-
We close a year of remarkable progress in cancer research and care, and make special note of some important trends that this journal is embracing. On the research front, I first would like to recognize two notable achievements that have changed expectations for the future. The first is clustered regularly interspaced short palindromic repeats (CRISPR) technology, which will allow excision of mutant or defective genes and insertion of a physiological alternative. Put simply, we now have the power to remake human DNA. As an example of its potential, this technology could correct inherited disorders that predispose to cancer, or could insert new genes that resist infection by carcinogenic viruses such as HIV, hepatitis B or C, human papillomavirus, or Epstein-Barr virus. Many other applications to cancer are possible. Second, we have witnessed the vast expansion of immunotherapy with checkpoint inhibitors, and the introduction to trial of a series of complementary immunotherapies (vaccines, other checkpoint inhibitors, T-cell and macrophage activators). In the coming year, we expect to learn much more about how to use these expensive drugs more efficiently, developing biomarkers that predict response, and limiting their use to patients who will benefit.At the same time, we have learned a great deal about targeted therapy and its limitations. Increasingly, we are seeing that tumors are not simple BRAF or ALK mutants but a collection of subclones that emerge down diverse pathways. Treating the drug-resistant tumor will not be a simple task. We have harvested valuable information from sequential biopsy specimens of primary tumor and have learned that drug resistance is polyclonal, complex, and daunting. Plasma DNA may prove a better picture of the diversity of mutations throughout the body than a biopsy specimen from a single site. Other uses of plasma DNA monitoring are appealing. For example, plasma sampling after local treatment may be able to predict who among adjuvant-treatment candidates is likely to recur after local therapy. We will be featuring molecular tumor board papers that aid the reader in interpreting results of these and other molecular assays, and in choosing new treatments based on these findings. Despite the enormity of the problem of resistance, the contribution of targeted therapy has been profound, providing treatment options for otherwise incurable tumors.What about the early trials that fail or lead to equivocal results? These results deserve to see the light of day. I would like to note that our Clinical Trial Results (CTR) section, chaired by Susan Bates and Tito Fojo, continues to provide a much-needed path to publication of early clinical trial results. The failure to publish many valuable trials has awakened the attention of Congress and the National Cancer Institute. There is no reason not to publish these trials, given the support available online from CTR.....
Reviews: Cochrane Gyn, Neuro-oncology and Orphan Cancers
Cochrane
Cochrane
Gynaecological, Neuro-oncology
and Orphan Cancers
Trusted evidence.
Informed decisions.
Better health.
By subtopic:
TROPHOBLASTIC TUMOURS (1)Patients’ views of adverse events in primary and ambulatory care: a systematic review to assess methods and the content of what patients consider to be adverse events (multi-national)
open access:
Patients’ views of adverse events in primary and ambulatory care: a systematic review to assess methods and the content of what patients consider to be adverse events
Cancer statistics, 2016 (U.S.)
open access: Cancer statistics, 2016
Article first published online: 7 JAN 2016
| Ovary | (est. new cases) 22,280 | (est. deaths) | 14,240 |
Abstract
Each
year, the American Cancer Society estimates the numbers of new cancer
cases and deaths that will occur in the United States in the current
year and compiles the most recent data on cancer incidence, mortality,
and survival. Incidence data were collected by the National Cancer
Institute (Surveillance, Epidemiology, and End Results [SEER] Program),
the Centers for Disease Control and Prevention (National Program of
Cancer Registries), and the North American Association of Central Cancer
Registries. Mortality data were collected by the National Center for
Health Statistics. In 2016, 1,685,210 new cancer cases and 595,690
cancer deaths are projected to occur in the United States. Overall
cancer incidence trends (13 oldest SEER registries) are stable in women,
but declining by 3.1% per year in men (from 2009-2012), much of which
is because of recent rapid declines in prostate cancer diagnoses. The
cancer death rate has dropped by 23% since 1991, translating to more
than 1.7 million deaths averted through 2012. Despite this progress,
death rates are increasing for cancers of the liver, pancreas, and
uterine corpus, and cancer is now the leading cause of death in 21
states, primarily due to exceptionally large reductions in death from
heart disease. Among children and adolescents (aged birth-19 years),
brain cancer has surpassed leukemia as the leading cause of cancer death
because of the dramatic therapeutic advances against leukemia.
Accelerating progress against cancer requires both increased national
investment in cancer research and the application of existing cancer
control knowledge across all segments of the population.
CA Cancer J Clin 2016;7–30. © 2015 American Cancer Society.
CA Cancer J Clin 2016;7–30. © 2015 American Cancer Society.
year ended March 2015 financial statements: Ovarian Cancer Canada/CCS OC stats
FYE = financial year end
FYE-31Mar15-Signed.pdf
key items:
Total Revenue: (2015) $4,281,688 - (2014) $4,049,57
(Deficiency) excess of revenue over expenses for the year (2015) ($257,956) - (2014) $72,848
Staff costs
OCC allocates staff costs based on management’s estimate of the amount of time required to fulfill the duties of each position. Total salary and benefits subject to allocation amount to $2,302,812 (2014 - $2,118,616).....
Ovarian cancer statistics (Canadian Cancer Society):
To provide the most current
cancer statistics, researchers use statistical methods to estimate the
number of new cancer cases and deaths until actual data become available.
It is estimated that in 2015:
Incidence and mortality
Incidence is the total number of new cases of cancer. Mortality is the number of deaths due to cancer.It is estimated that in 2015:
- 2,800 Canadian women will be diagnosed with ovarian cancer.
- 1,750 women will die from ovarian cancer in Canada.
Tuesday, February 16, 2016
2016 Ovarian Cancer Australia (flyer) - Feb is OC month in Australia
2016_OCAM_digital flyer_1.pdf
Almost half of women were unable to identify any symptom of ovarian cancer according to Cancer Australia research
Raised Ca125 and ascites: Is this ovarian cancer till proven otherwise? case report/no abstract
(requires subscription to view $$) no abstract nor text
Sorry, you do not have access to this article.
search: ovarian cancer - List Results (no parameters)
clinicaltrials.gov search: lynch syndrome - List Results
Search of: Open Studies | Exclude Unknown | lynch syndrome - List Results - ClinicalTrials.gov
19 studies found for:
Open Studies | Exclude Unknown | lynch syndrome
(Toronto) Universal Screening for Lynch Syndrome in Women With Endometrial & Non-Serous Ovarian Cancer - clinicaltrial.gov
Full Text View
Universal Screening for Lynch Syndrome in Women With Endometrial and Non-Serous Ovarian Cancer (LS2) (Lynch Syndrome 2)
Verified July 2015 by University Health Network, Toronto
Sponsor:
University Health Network, Toronto
Collaborators:
Mount Sinai Hospital, Canada
Sunnybrook Health Sciences Centre
Hamilton Health Sciences Corporation
Ryerson University
University of Toronto
Information provided by (Responsible Party):
University Health Network, Toronto
ClinicalTrials.gov Identifier:
NCT02494791
First received: July 7, 2015
Last updated: NA
Last verified: July 2015
History: No changes posted
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Purpose
This study will maximize identification of women
with Lynch Syndrome using an enhanced screening strategy to identify
those at risk. These women will be referred to genetic counselling for
testing and those found to have Lynch Syndrome will be asked to invite
first degree relatives to participate and undergo genetic testing for
Lynch Syndrome. Screening guidelines and risk reducing surgery options
for participants found to have Lynch Syndrome will be reinforced by the
study and adherence to these guidelines will be assessed annually for
ten years following Lynch Syndrome diagnosis to assess the impact and
cost-effectiveness of this enhanced screening approach.
| Condition | Intervention |
|---|---|
|
Lynch Syndrome Endometrial Neoplasms Ovarian Neoplasms Colorectal Neoplasms |
Behavioral: Questionnaire, Educational Material |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
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