Quest Diagnostics: OVA1™

"Clinical proof
The OVA1 test was validated using a blood sample from 269 women, 72 of whom had a pathology-determined malignancy. When pre-surgical assessment was combined with results from the OVA1 test, the following results were concluded:^[1]

• Sensitivity for malignancy increased by 20% from 72% to 92% In all women, and as high as 96%in postmenopausal women,
• Approximately 70% of the malignancies missed by pre-surgical assessment alone were identified by OVA1
• A high negative predictive value (NPV-93%) strengthened the prediction that cancer is absent
• NPV was similar in pre- and postmenopausal women."

Medicare Establishes Reimbursement Coverage for Vermillion's OVA1(TM) Test

Sorafenib in combination with carboplatin and paclitaxel as neoadjuvant chemotherapy in patients with advanced ovarian cancer.

RESULTS: .....Four patients were enrolled. After preoperative treatment and cytoreductive surgery, all patients were excluded from protocol due to severe toxicities. Three patients had life threatening events (cardiac output failure, myocardial infarction, anastomotic leak); two patients had primary progressive disease.
CONCLUSION: The addition of sorafenib to carboplatin/paclitaxel chemotherapy was not feasible within this neoadjuvant regimen in primary advanced ovarian cancer. Although the occurrence of serious adverse events might have emerged at random, a detrimental effect of preoperative study medication could not be denied. Further evaluations of sorafenib in ovarian cancer are warranted.

What are the core elements of oncology spiritual care programs?

health alert: Roche and Biogen Idec have suspended trials of Ocrelizumab treatment in patients with rheumatoid arthritis due to safety concerns

abstract/free full text: MicroRNA profiling of BRCA1/2 mutation-carrying and non-mutation-carrying high-grade serous carcinomas of ovary

CONCLUSIONS/SIGNIFICANCE: High grade serous ovarian carcinomas with and without BRCA1/2 abnormalities demonstrate very similar miRNA expression profiles. High grade serous carcinomas as a group exhibit significant miRNA dysregulation in comparison to tubal epithelium and the levels of miR-34c and miR-422b appear to be prognostically important. full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2749450/?tool=pubmed

abstract: Administration of cisplatin in three patients with carboplatin hypersensitivity: is skin testing useful?

In Research: Gene Expression Profile for Predicting Survival in Advanced-Stage Serous Ovarian Cancer Across Two Independent Datasets (Japan)

In Research: 

Introduction:
Patients with advanced-stage ovarian cancer generally undergo primary debulking surgery followed by platinum/taxane-based chemotherapy. Although postoperative introduction of taxane drug has improved the 5-year survival rate for advanced-stage ovarian cancer..... Clinicopathological characteristics, such as debulking status after primary surgery, are clinically considered important indicators of prognosis. However, recurrence after optimal debulking surgery occurs in some patients, while disease-free status after incomplete surgery is maintained in others......Therefore, these clinicopathological factors alone are insufficient for predicting prognosis and elucidating the pathological mechanisms of disease progression or recurrence. Molecular biology approaches can be used to identify new prognosis-related profiles leading to elucidation of pathological issues of advanced-stage serous ovarian cancer.

Meanwhile, there are no microarray kits for clinical diagnosis and management in patients with ovarian cancer yet."

OICR Advances Development of Two Investigational Cancer Innovations - press release

TORONTO -- 03/12/10 -- The Ontario Institute for Cancer Research (OICR) today announced a significant investment toward the development of two new promising cancer therapies. The recipients of the awards are:

Sunnybrook Health Sciences Centre, for Kullervo Hynynen's low-cost focused ultrasound system. This system can find and destroy tumors without surgery, increasing quality of life and lowering the cost of treatment for patients with inoperable bone and liver cancer. Hynynen will use the investment from OICR to develop a complete prototype and perform pre-clinical testing of the new system.

OncoTek Drug Delivery Inc., for Joseph Elliot's preclinical development of PoLi-PTX, an intraperitoneal ovarian cancer therapy invented by Drs. Christine Allen and Micheline Piquette-Miller at the University of Toronto, which would deliver localized cancer killing agents to the abdominal cavity with fewer side effects than traditional systemic chemotherapy.

"Both these therapies promise to provide patients and physicians with new tools to treat cancer that are less expensive or more effective than traditional treatments while vastly improving patients' quality of life," said Dr. Tom Hudson, President and Scientific Director of OICR. "This investment will help to make both therapies a reality."...cont'd

Phase 2 study of canfosfamide in combination with pegylated liposomal doxorubicin in platinum and paclitaxel refractory or resistant epithelial ovarian cancer

Abstract/full free pdf: published March 11, 2010


Patients:
Women who were at least 18 years old with recurrent, histologically confirmed epithelial ovarian, primary peritoneal, or fallopian tube cancer; measurable disease as defined
by RECIST; had received at least 1 but fewer than 4 prior platinum-containing chemotherapy regimens; at least 1 prior paclitaxel-containing regimen; and considered platinum refractory or resistant disease according to the standard GOG criteria (had progressed during or had persistent disease after completion of platinum-based therapy or had a platinum-free interval of < 6 months) were enrolled. There were no additional limits to lines of therapy.

Difficulty Accepting a Terminal Prognosis Linked with Depression, Anxiety, and Suffering -- A Cancer Journal for Clinicians

Note: VERY SENSITIVE TOPIC Dissenting Opinion
Not all clinicians agree with the foregoing interpretations of these findings. "I've certainly seen people who denied dying up to their last breath and somehow never accepted it," Dr. Holland tells CA. "Were they more upset? I'm not sure."
She cautioned against allowing the findings by Dr. Thompson and colleagues to set a tone in which nonaccepting patients are viewed as dysfunctional. Death is as individualized as is life, she argues, invoking Sir William Osler, who said "Basically, people die as they have lived."

Search of: lynch syndrome | Open Studies - List Results - ClinicalTrials.gov

Note: variety of different types of studies/locations

Approaches to Phase 1 Clinical Trial Design Focused on Safety, Efficiency, and Selected Patient Populations: A Report from the Clinical Trial Design Task Force of the National Cancer Institute Investigational Drug Steering Committee — Clinical Cancer Research

Abstract: Approaches to Phase 1 Clinical Trial Design Focused on Safety, Efficiency, and Selected Patient Populations: A Report from the Clinical Trial Design Task Force of the National Cancer Institute Investigational Drug Steering Committee — Clinical Cancer Research Steering Committee 1. S. Percy Ivy1, 2. Lillian L. Siu2, 3. Elizabeth Garrett-Mayer3 and 4. Larry Rubinstein1 + Author Affiliations 1. Authors' Affiliations:1Investigational Drug Branch and Biometrics Research Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland; 2Princess Margaret Hospital, Toronto, Canada; and 3Medical University of South Carolina, Charleston, South Carolina 1. Corresponding Author: S. Percy Ivy, Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, 6130 Executive Blvd, Suite 7131, Rockville, MD 20852. Phone: 301-496-1196; Fax: 301-402-0428; E-mail: ivyp@ctep.nci.nih.gov.

Abstract The goals and objectives of phase 1 clinical trials are changing to include further evaluation of endpoints such as molecular targeted effects, in addition to dose-toxicity profile of the investigational agent. Because of these changes in focus, the National Cancer Institute and Investigational Drug Steering Committee's Task Force on Clinical Trial Design met to evaluate the most efficient ways to design and implement early clinical trials with novel therapeutics. Clinical approaches discussed included the conventional 3 + 3 cohort expansion phase 1 design, multi-institutional phase 1 studies, accelerated titration designs, continual reassessment methods, the study of specific target patient populations, and phase 0 studies. Each of these approaches uniquely contributes to some aspect of the phase 1 study, with all focused on dose and schedule determination, patient safety, and limited patient exposure to ineffective doses of investigational agent. The benefit of labor-intensive generation of preliminary biomarker evidence of target inhibition, as well as the value of molecular profiling of the study population, is considered. New drug development is expensive and the failure rate remains high. By identifying patient populations expected to respond to the study agent and tailoring the treatment with a novel drug, investigators will be one step closer to personalizing cancer treatment. The “fail early and fast” approach is acceptable if the appropriate patient population is evaluated in the phase 1 trial. The approaches outlined in this overview address the merits, advantages, disadvantages, and obstacles encountered during first in human studies. Clin Cancer Res; 16(6); 1726–36

Medical News: FDA Reassures on Osteoporosis Drugs - in Endocrinology, Osteoporosis (confused yet?)

FDA Reassures on Osteoporosis Drugs

By John Gever, Senior Editor, MedPage Today Published: March 10, 2010 Reviewed by Zalman S. Agus, MD; Emeritus Professor University of Pennsylvania School of Medicine.

"Bisphosphonate drugs for osteoporosis do not seem to increase the risk of femoral fractures, the FDA announced Wednesday, though the agency will continue to evaluate that possibility. Even as the FDA was making its announcement in Washington, orthopedic surgeons gathered in New Orleans were hearing news of a study showing an eventual decline in bone quality among patients who took bisphosphonates for more than four years. The FDA issued its statement as a result of case reports suggesting that "atypical" subtrochanteric femur fractures were occurring at higher-than-expected rates in women taking bisphosphonate drugs for osteoporosis....."

Breast cancer susceptibility variants alter risks in familial disease -- Latif et al. 47 (2): 126 -- Journal of Medical Genetics

"Conclusions:
This study confirms that susceptibility variants in FGFR2, TOX3 and MAP3K1 and on chromosome 8q are all associated with increased risk of cancer in individuals with a family history of breast cancer, whereas CASP8 is protective in this context. The level of risk is dependent on the strength of the family history and the presence of a BRCA1/2 mutation and contributes to the understanding of the use of these variants in clinical risk prediction."

Medicare Establishes Reimbursement Coverage for Vermillion's OVA1(TM) Test - financial news

"FREMONT, Calif., March 12, 2010 /PRNewswire via COMTEX/ -- Vermillion, Inc. (Pink Sheets: VRML) today announced that Medicare will cover OVA1(TM), a test to help assess the likelihood that an ovarian mass is benign or malignant. Highmark Medicare Services is the CMS contractor that will process Medicare claims for OVA1. Yesterday Highmark announced its decision to cover this new service....."

financial news: short excerpts/overview from article: Avastin- UPDATE 3-Roche's Avastin fails in prostate cancer study (see comments ovarian)

UPDATE 3-Roche's Avastin fails in prostate cancer study
Fri Mar 12, 2010 6:35am EST


* Treatment doesn't prolong life in late stage patients prostate cancer patients (combination therapy phase 111)

* Some adverse effects seen, already noted in other trials

* Follows recent ovarian cancer success and gastric failure

By Martin de Sa'Pinto and Ben Hirschler

"ZURICH/LONDON, March 12 (Reuters) - Roche Holding AG's (ROG.VX) Avastin did not help men with late stage prostate cancer live longer in a clinical trial, marking another setback for the Swiss group as it tries to extend use of the blockbuster drug into new areas.

The miss in prostrate cancer, announced on Friday, follows similar disappointment last month with Avastin in gastric cancer but success in ovarian cancer. (note: GOG trials prior blog postings)

Determine Your Risk | Check Your Genes

breast/ovarian

Hereditary Breast and Ovarian Cancer | Cancer.Net

Hereditary Breast and Ovarian Cancer | Cancer.Net

NO abstract:CA-125 Monitoring in Ovarian Cancer: Patient Survey Responses to the Results of the MRC/EORTC CA-125 Surveillance Trial

article is pay per view

Future Oncology - abstract: Müllerian Inhibiting Substance/anti-Müllerian hormone: a potential therapeutic agent for human ovarian and other cancers

Future Oncology-full text: DNA methylation-based fecal biomarkers for the noninvasive screening of GI cancers

"The next obvious question is “Are we there yet?”

Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners' Oral Contraception Study -- Hannaford et al. 340: c927 -- BMJ

Objective: To see if the mortality risk among women who have used oral contraceptives differs from that of never users.
Design: Prospective cohort study started in 1968 with mortality data supplied by participating general practitioners, National Health Service central registries, or both.
Setting: 1400 general practices throughout the United Kingdom.
Participants: 46 112 women observed for up to 39 years, resulting in 378 006 woman years of observation among never users of oral contraception and 819 175 among ever users.
Results:
....1747 deaths occurred in never users of oral contraception and 2864 in ever users. Compared with never users, ever users of oral contraception had a significantly lower rate of death from any cause (adjusted relative risk 0.88, 95% confidence interval 0.82 to 0.93). They also had significantly lower rates of death from all cancers; large bowel/rectum, uterine body, and ovarian cancer; main gynaecological cancers combined; all circulatory disease; ischaemic heart disease; and all other diseases...cont'd

National Osteoporosis Foundation - new article of interest on Bisphosphonates

click on the title to view the pdf file:

"Special Concerns About Bisphosphonates"

Patient Advocate Programs at the ASCO Annual Meeting deadline is Apr 28thth

Reduced Registration Rate for Patient Advocates (for non-exhibitors)

If you represent a patient advocacy organization, you may be eligible for the discounted patient advocate registration rate of $255 per person on or before April 28, 2010, and $330 per person beginning April 29, 2010. Up to two representatives per organization may register at this discounted rate. The discounted registration rate for patient advocates is reserved exclusively for advocates who work or volunteer for not-for-profit patient advocacy organizations that provide programs, services, and support for people with cancer. People that register under this category may be asked to provide a curriculum vitae or resume, outlining their advocacy roles and experience. Please download a patient advocate registration form if you are a patient advocate and meet the registration criteria.

Post-Traumatic Stress Disorder and Cancer

Radiation Therapy for Brain Cancer: Facts About Brain Cancer

ASTRO has just completed a new section on radiation therapy for brain metastases.
We’d love any feedback from patient educators or patients on how we can make it better.
http://www.rtanswers.com/treatmentinformation/cancertypes/brainmets/index.aspx

Katherine Egan Bennett
Director of Communications
American Society for Radiation Oncology

703-839-7330
703-839-7331 fax
http://www.astro.org
http://www.rtanswers.org

When treatment ends, patients with cancer combat challenges - STLtoday.com

"Many patients find themselves asking: What now?

"When you lose the security of knowing that you're acting toward curing your cancer, it's really scary," said Barbara Platzer, 72, of Chesterfield, who finished treatments for ovarian cancer three years ago. "Every time I'd go for chemotherapy, I'd have a doctor looking at me and doing lab tests where I'd see that my (cancer antigen-125) numbers were improving. And that made me feel secure, like I had control over what was happening. I felt like we were actively killing the cancer.""

Mar 2010 abstract: Incidence and management of (Avastin) bevacizumab-associated gastrointestinal perforations in patients with recurrent ovarian carcinoma

METHODS: We identified all patients who received bevacizumab off protocol from August 2004-August 2008. We examined their medical records for reports of confirmed GI perforation, associated clinicopathological factors, treatment, and outcomes. RESULTS: Six (4%) of 160 patients with ovarian carcinoma who had been treated with bevacizumab developed GI perforation.

The Soy - Breast Cancer Controversy - Cancerwise | Cancer blog from M. D. Anderson Cancer Center

"These studies provide further information that regular dietary soy as part of a normal diet is probably safe and, in fact, may be beneficial for women with breast cancer. These studies, as well as others, create a growing body of evidence that the current advice that all soy foods should be removed from the diet of a woman diagnosed with breast cancer is probably untrue.
The role of non-dietary soy products such as soy supplements, powders or pills and the use of heavily processed soy items such as soy cheese, soy hot dogs or soy turkey remain unclear and should be avoided.
As the research to date is observational in nature, future randomized trials are needed to verify if a beneficial effect truly exists for the use of dietary soy."

Study Questions Benefits of Elective Removal of Ovaries During Hysterectomy

Note: this is not new news but has been reported over the past few years

PHILADELPHIA -- March 10, 2010 -- An article published in the March/April issue of The Journal of Minimally Invasive Gynecology suggests that bilateral oophorectomy may do more harm than good.

Deficiency of knowledge of genetics and genetic tests among general practitioners, gynecologists, and pediatricians: A global problem

Conclusion: The overall knowledge levels of genetics in many nongeneticist health care providers show clear deficiencies. This is in line with reports from other countries, showing that these deficiencies are a global problem.

The Missing Voice of Patients in Drug-Safety Reporting - New England Journal of Medicine

The Missing Voice of Patients in Drug-Safety Reporting

Posted by NEJM • March 10th, 2010 • Printer-friendly

Ethan Basch, M.D.
A patient wants to know about symptoms she may have from a prescription drug she is taking. Consulting the label’s “Adverse Reactions” section, she finds a wealth of data. Little does she realize that this information, largely collected during clinical trials, is based almost entirely on clinicians’ impressions of patients’ symptoms — not on patients’ own firsthand reports of their experiences with the drug.
The current drug-labeling practice for adverse events is based on the implicit assumption that an accurate portrait of patients’ subjective experiences can be provided by clinicians’ documentation alone. Yet a substantial body of evidence contradicts this assumption, showing that clinicians systematically downgrade the severity of patients’ symptoms, that patients’ self-reports frequently capture side effects that clinicians miss, and that clinicians’ failure to note these symptoms results in the occurrence of preventable adverse events.^{1,2...continued}

video: Dr Maurie Markman - Is BRCA1 the Link Between Infertility and Breast/Ovarian Cancer?

Note: Medscape requires registration (free)

References: Citation: Oktay K, Kim JY, Barad D, et al. Association of BRCA1 mutations with occult primary ovarian insufficiency: a possible explanation for the link between infertility and breast/ovarian cancer risks. J Clin Oncol. 2009;28:240-244. Available at: http://www.medscape.com/medline/abstract/19996028.

In research: Scientists identify microRNA as possible cause of chemotherapy resistance

Public release date: 10-Mar-2010  AACR conference

Scientists identify microRNA as possible cause of chemotherapy resistance

DEAD SEA, Jordan — Scientists may have uncovered a mechanism for resistance to paclitaxel in ovarian cancer, microRNA-31, suggesting a possible therapeutic target for overcoming chemotherapy resistance.
Mohamed K. Hassan, Ph.D., a postdoctoral fellow at Hokkaido University in Japan, completed the research as a collaborative study with his colleagues when he was a professional assistant in South Valley University in Egypt. Results of this study were presented at the second AACR Dead Sea International Conference on Advances in Cancer Research: From the Laboratory to the Clinic, held March 7-10, 2010.

"MicroRNAs do not code protein, but they regulate other proteins' expression," said Hassan. "So identifying any microRNA as responsible for chemoresistance is, in fact, introducing a real reason for the mechanism."

Ovarian cancer is typically responsive to chemotherapy with paclitaxel, but sometimes cancer cell lines become resistant, which renders chemotherapy useless. Hassan's research team analyzed a set of microRNAs and identified microRNA-31 as being responsible for this chemoresistance. MicroRNA-31 regulates the protein IFITM-1.
"We need to further verify this observation in clinical ovarian cancer samples and find a way to inhibit this target protein to improve the effect of paclitaxel and prevent the risk of recurrence," he said.

full free access: Journal of Hematology & Oncology - Ovarian cancer immunotherapy: opportunities, progresses and challenges

"Abstract

Due to the low survival rates from invasive ovarian cancer, new effective treatment modalities are urgently needed. Compelling evidence indicates that the immune response against ovarian cancer may play an important role in controlling this disease. We herein summarize multiple immune-based strategies that have been proposed and tested for potential therapeutic benefit against advanced stage ovarian cancer.(see tables 2 & 3)

CDC Features - Genetic Testing for Hereditary Colorectal Cancer

Note: the EGAPP group published several papers in 2009
(EGAPP supplementary evidence review DNA testing strategies aimed at reducing morbidity and mortality in Lynch Syndrome; Methods of the EGAPP Working Group Lynch Syndrome;  Recommendations EGAPP Working Group testing strategies to reduce morbidity and mortality in Lynch Syndrome)

Also: search this blog for 'EGAPP'  for additional references such as:

Saturday, June 27, 2009

Center for Genomics and Public Health - EGAPP - What is EGAPP?

"The EGAPP Working Group concluded that all people with a new diagnosis of colorectal cancer should be offered counseling and educational materials about genetic testing for Lynch syndrome. 
The EGAPP™ Working Group is an independent, non-governmental panel of scientists and health care experts from universities, industry, clinical practice, insurance companies, and public health who review available research and evidence to make recommendations about the use of genetic tests."

YouTube - The Faces of Medical Errors...From Tears to Transparency (Helen Haskell/Patient Safety)

news item: Helping doctors cope (after medical errors)

Lynch Syndrome Associated Breast Cancers: Clinicopathologic Characteristics of a Case Series from the Colon Cancer Family Registry Clinical Cancer Research

Purpose: The recognition of breast cancer as a spectrum tumor in Lynch syndrome remains controversial. The aim of this study was to explore features of breast cancers arising in Lynch syndrome families.

(Breast cancers were reviewed by one pathologist. Tumor sections were stained for MLH1, PMS2, MSH2, and MSH6, and underwent microsatellite instability testing)  

Conclusions: MMR deficiency was identified in 51% of breast cancers arising in known mutation carriers. Breast cancer therefore may represent a valid tissue option for the detection of MMR deficiency in which spectrum tumors are lacking.

Nano & Me - Home - UK plain english user friendly website to understanding basics of nanotechnology

UK: Public Engagement with Research benefits researchers and provides a major contribution to society

Defective mismatch repair, microsatellite mutation bias, and variability in clinical cancer phenotype

Cancer Res. 2010 Jan 15

Shah SN, Hile SE, Eckert KA.
Department of Pathology, Gittlen Cancer Research Foundation, Pennsylvania State University College of Medicine, Hershey, Pennsylvania

Microsatellite instability is associated with 10% to 15% of colorectal, endometrial, ovarian, and gastric cancers, and has long been used as a diagnostic tool for (Lynch Syndrome) hereditary nonpolyposis colorectal carcinoma-related cancers.
Tumor-specific length alterations within microsatellites are generally accepted to be a consequence of strand slippage events during DNA replication, which are uncorrected due to a defective postreplication mismatch repair (MMR) system.
Mutations arising within microsatellites associated with critical target genes are believed to play a causative role in the evolution of MMR-defective tumors.
In this review, we summarize current evidence of mutational biases within microsatellites arising as a consequence of intrinsic DNA sequence effects as well as variation in MMR efficiency.
Microsatellite mutational biases are generally not considered during clinical testing; however, we suggest that such biases may be clinically significant as a factor contributing to phenotypic variation among microsatellite instability-positive tumors.

Comparison of treatment received versus long-standing guidelines for stage III colon and stage II/III rectal cancer patients diagnosed in Alberta, Sas

Comparison of treatment received versus long-standing guidelines for stage III colon and stage II/III rectal cancer patients diagnosed in Alberta, Saskatchewan, and Manitoba in 2004

CONCLUSION: The percentage of patients receiving guideline-recommended treatment is low. Reasons for lack of adherence to guidelines need to be addressed.

High weight associated with risk of colorectal tumors without microsatellite instability

Note: the microsatellite test (MSS = stable; MSI-L = low; MSI-H = high) is a blood test and has also been studied in ovarian cancers

"Recent body mass index (people over 30 kg/m2 or more, the cut off for obesity) was positively associated with overall risk of colorectal cancer for men and women combined. It was also associated with risk of MS-stable and MSI-low colorectal tumors, but not with the risk of MSI-high tumors."

A High Proportion of DNA Variants of BRCA1 and BRCA2 Is Associated with Aberrant Splicing in Breast/Ovarian Cancer Patients

Conclusions: An important fraction of DNA variants of BRCA1/2 presents splicing aberrations that may represent a relevant disease-causing mechanism in HBOC.

Medical News: ACS Stats Find Gains in War on Cancer

Note: short news report "The data cover 1970 (the year before President Nixon declared a "War on Cancer") through 2006."

abstract: Phase I trial of ATRA-IV and depakote in patients with advanced solid tumor malignancies

Phase I trial of ATRA-IV and Depakote in patients with advanced solid tumor malignancies.
David KA, Mongan NP, Smith C, Gudas LJ, Nanus DM.
Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College - New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA.

Retinoic acid derivatives have shown their greatest benefit in acute promyelocytic leukemia, but have also demonstrated pre-clinical anti-cancer effects in some solid tumors. Histone deacetylase inhibitors, by upregulating gene expression, are able to limit cancer cell proliferation and induce apoptosis. The combination of all-trans retinoic acid (ATRA) and the histone deacetylase inhibitor valproic acid has been previously studied in hematologic malignancies. We conducted a phase I two-step dose escalation trial of the liposomal ATRA analog ATRA-IV and divalproex sodium (Depakote((R))) in nine patients with advanced solid tumors refractory to prior therapy. Side effects attributed to therapy had a severity

Gynecological Pathology - Sunnybrook Health Sciences Centre (Odette Cancer Centre) Toronto

NCI : People Continue to Trust Physicians, Despite Increasing Health Information Online

"According to a recent NCI survey, the public’s trust in their physicians has continued to rise in spite of the fact that people report turning to the Internet first for their health information needs. In contrast, trust in the Internet and other more traditional sources such as television has been on the decline. The survey also showed a consistent increase in the number of Americans who communicate with their doctors through e-mail. A letter about the findings from staff who oversee NCI’s Health Information National Trends Survey (HINTS) appeared March 4 in the New England Journal of Medicine.

NCI U.S. - NCI Recovery Act Web Site Features Comparative Effectiveness Research and ACTNOW Trial Details

NCI’s Recovery Act Web site also features a list of the clinical trials supported by NCI’s Accelerating Clinical Trials of Novel Oncologic PathWays (ACTNOW) initiative. The ACTNOW trials are high-priority, early-phase clinical trials of new cancer treatments being studied on an accelerated timeline in a variety of cancer types. The accelerated timeline is intended to shorten the time between drug discovery and approval and safe use of these treatments by cancer patients. The trials include a significant number of correlative studies, including studies of biologic and imaging tests.

The Web page lists the ACTNOW trials by cancer type and contains links to descriptions of the trials, including the objectives, patient enrollment criteria, and current trial locations.

NCI:The Heart: An Unintended Victim of Some Targeted Cancer Therapies

Breast Cancer Screening: How to Guide Black, White, and Asian Patients: Case Scenarios

• Case Scenarios 

• Background
• US Disparities in Breast Cancer: Statistics
• What Explains the Disparity in Breast Cancer Rates and Risks Between Black and White Women in the United States?
• Strategies to Minimize Disparities and Improve Care
• Summary
• Case Response

news: Colorado's Online News Leader - Making sure those with breast cancer get help (and ovarian cancer COCA)

"The BWRC Fund has also helped expand cancer education programs across the state. Survivors Teaching Students, a program sponsored by the Colorado Ovarian Cancer Alliance (COCA), brings ovarian cancer survivors into the lives of medical students with the goal of helping them become more sensitive to the symptoms of and risk factors for ovarian cancer.

"The majority of ovarian cancer cases are not diagnosed until the disease is advanced and women's survival is compromised, so the key to treatment is early diagnosis," said Lucy Trujillo, COCA executive director and ovarian cancer survivor."

press release: Special Session Highlights Late-Breaking Abstracts -- CHICAGO, March 8

"Range of gynecologic oncology research is as impressive as pace" "These abstracts are indicative of the high-quality research being conducted in our sub-specialties," said Dr. David G. Mutch, president of the SGO. "It is very encouraging to see the frequency with which important results are becoming available and we are thrilled to be able to showcase these studies at our Annual Meeting, where our colleagues from across the country and the world can evaluate the findings and learn about the latest approaches."

new and updated website: The Cochrane Collaboration

Webcast: Clinical Trials and Translational Research - info on NCI's clinical trials/public meetings

The Clinical Trials and Translational Research Advisory Committee (CTAC) meets three times annually to provide strategic advice regarding NCI’s clinical trials and translational research portfolio and processes. In order to make this dialogue transparent and available to the public these meetings will be webcast at http://videocast.nih.gov/. The next meeting is scheduled for Wednesday, March 10th from 8a to 3:30pm. We encourage you to tune in and learn more. This meeting will include: · A report from the Operational Efficiency Working Group on how to make the clinical research process more efficient · An update from the NCI Director · An update on Comparative Effectiveness Research (CER) funding and a future vision for CER and Cancer · Information about the new NCI Cancer Human Biobank or caHUB A full agenda is available at http://deainfo.nci.nih.gov/advisory/ctac/0310/agenda.pdf. Shannon K. Bell, MSW Director, Office of Advocacy Relations, NCI Bldg 31 Rm 10A28, 301-451-3393 Key info about NCI: http://www.cancer.gov/aboutNCI/servingpeople

financial news: references Tarceva

"Tarceva Trials
There will also be data in ovarian cancer in the first half of 2011, Meacham said."

Two studies hope to test the benefits of vitamin D once and for all - The Globe and Mail

1-2-year Surveillance Intervals Reduce Risk of Colorectal Cancer in Families with Lynch Syndrome.

CONCLUSIONS: With surveillance intervals of 1-2 years, members of families with Lynch Syndrome have a lower risk of developing CRC than with surveillance intervals of 2-3 years. Because of the low risk of CRC in non-Lynch Syndrome families, a less-intensive surveillance protocol can be recommended.

What "best practice" could be in Palliative Care

"Overall, 34 organizations were identified, 7 international organisations, and 27 organisations operating on the national level in four different countries (Australia, Canada, UK and United States).....Indeed, the consistency of end-of-life choices with the patient's wishes, as well as completion and meaningfulness at the end of life is given only a minor relevance."

full access: Journal of Ovarian Research BRCA1/2 genetic background-based therapeutic tailoring of human ovarian cancer : hope or reality?

Conclusion:
All together these findings introduce a provocative novel scenario where BRCA1/2 carcinogenetic process in the hereditary setting produces novel opportunities for pharmacological intervention. Apart novel drugs like PARP inhibitors, these findings may allow a different and more rational approach for the treatment of BRCA1/2 related ovarian tumors by currently available drugs.

Outcomes of Fertility-Sparing Surgery for Stage I Epithelial Ovarian Cancer: A Proposal for Patient Selection -- abstract

Conclusion: Our data confirm that fertility-sparing surgery is a safe treatment for stage IA patients with favorable histology and suggest that stage IA patients with clear cell histology and stage IC patients with favorable histology can be candidates for fertility-sparing surgery followed by adjuvant chemotherapy.

full access: The Prognostic Value of BRCA1 mRNA Expression Levels Following Neoadjuvant Chemotherapy in Breast Cancer

Background A fraction of sporadic breast cancers has low BRCA1 expression. BRCA1 mutation carriers are more likely to achieve a pathological complete response with DNA-damage-based chemotherapy compared to non-mutation carriers. Furthermore, sporadic ovarian cancer patients with low levels of BRCA1 mRNA have longer survival following platinum-based chemotherapy than patients with high levels of BRCA1 mRNA. Conclusions/Significance We provide evidence for a major role for BRCA1 mRNA expression as a marker of time to progression and overall survival in sporadic breast cancers treated with anthracycline-based chemotherapy. These findings can be useful for customizing chemotherapy

The Prognostic Value of BRCA1 mRNA Expression Leve... [PLoS One. 2010] - PubMed result

CONCLUSIONS/SIGNIFICANCE: We provide evidence for a major role for BRCA1 mRNA expression as a marker of time to progression and overall survival in sporadic breast cancers treated with anthracycline-based chemotherapy. These findings can be useful for customizing chemotherapy.

OVA1: A New Test to See If Ovarian Masses Are Cancerous - WSJ.com

Note: details on proteins included, public commentaries

news: Ontario now paying for (Oncotype DX test) breast cancer test + clinical trials

Note: selected cases (Oncotype DX test)

Body mass index and risk of ovarian cancer (abstract)

full access: The Art of Oncology series: Healing by Cancer

"....This story illustrates one of many ways of healing. Healing is always possible, even when cure is beyond reach, even when physical pain cannot be relieved. Healing, in this sense, involves restoring a sense of sacredness and wholeness that no living experience, including terminal disease, can take away. Healing involves making sense of one's death in the context of one's life...."

Choice of Starting Dose for Molecularly Targeted Agents Evaluated in First-in-Human Phase I Cancer Clinical Trials

Purpose: One tenth of the lethal dose to 10% of mice is one of the conventional parameters used to derive a safe starting dose in phase I trials of cytotoxic agents. There is no consensus on which preclinical models and parameters should define the starting dose for molecularly targeted agents.

press release: Quest Diagnostics to offer new ovarian cancer test OVA1

Note: no mention of cost

"NEW YORK — Medical lab operator Quest Diagnostics Inc. said Monday it is selling the OVA1 blood test, which aims to better assess a woman's likelihood for ovarian cancer.

The OVA1 test, which was approved by the Food and Drug Administration in September, will be sold through Quest, based in Madison, N.J. The test was developed in collaboration with molecular diagnostics company Vermillion Inc....OVA1 is used as a pre-surgical evaluation of a woman's ovarian mass for cancer. It allows physicians to assess, before a planned surgery, the likelihood that a woman's ovarian mass is malignant. The test allows physicians to direct the patient to a specialist more quickly, the company said.....

Donna Trussell - News Flash: Your Diet May -- or May Not -- Beat Cancer -- Politics Daily

Nektar Reports Positive Phase 2 Clinical Data From First Stage Of NKTR-102 Study In Women With Platinum-Resistant Ovarian Cancer - Quick Facts

Note: warning on stats in article

"The Phase 2 study has now completed enrollment with a total of 71 patients treated. The study is ongoing. Full data are expected to be presented at a major scientific conference in 2010."

Rexahn Pharma financial news: Japanese Patent for Anti-cancer Compound Archexin (R)

"Archexin is a first in class, potent inhibitor of Akt protein kinase in the treatment of cancer. Akt regulates signal processes of cell proliferation and survival, angiogenesis, and drug resistance in cancer. Archexin is being developed to treat solid tumors and has FDA Orphan drug designation for RCC, pancreatic, stomach, glioblastoma, and ovarian cancers. Archexin is in Phase II clinical development for pancreatic cancer as lead indication."

Connecting the dots between online self-screening-tests and pharma funding - Gary Schwitzer's HealthNewsReview Blog

Does Vitamin D lower heart risk? Depends on which news story you read! - Gary Schwitzer's HealthNewsReview Blog

Job posting (3) The Underwear Affair (fight cancers below the waist)

For those interested 2/2010 (3) job postings: Recruiter positions (Calgary/Edmonton/Vancouver)

Efficacy of intranasal fentanyl spray versus other opioids for breakthrough pain in cancer; Current Medical Research and Opinion

Objective: To compare the efficacy of intranasal fentanyl spray (INFS), oral transmucosal fentanyl citrate (OTFC), fentanyl buccal tablet (FBT) and oral morphine (OM) for the treatment of breakthrough cancer pain (BTCP).

Conclusion: Based on currently available evidence, INFS is expected to provide the greatest improvement in the treatment of BTCP. Due to its slow onset to effect OM cannot be considered an efficacious treatment for BTCP.

UK - Ovacome :BEAT ovarian cancer with Ovacome

The BEAT ovarian cancer campaign is the first to engage GPs, women and ovarian cancer charities around the world. It has as its centre piece an easy to remember acronym:

B for bloating that is persistent and doesn't come and go;
E for eating less and feeling fuller;
A for abdominal pain; and
T for telling your GP.

UK site: Understanding Cancer

Note: plain english, many topics

"Hello, I am Avril Morrison and I run this website “Understanding Cancer”. I’m a scientist and I write about cancer research and cancer information on the web."

UK Patient Education site: VEGF How can we stop the blood supply to cancer cells? « Understanding Cancer

Note: the UK is very good at plain english and often and as best possible uncomplicates the technical language

repost: Combination therapy: intermittent Sorafenib with (Avastin) bevacizumab yields activity and decreased toxicity.

VEGF in ovarian cancer from ResearchVEGF.com - Genentech website

define:VEGF

Definitions of VEGF on the Web:

* Vascular endothelial growth factor (VEGF) is a chemical signal produced by cells that stimulates the growth of new blood vessels. ...
en.wikipedia.org/wiki/VEGF

* Stimulates the growth of blood vessels.
www.vibrantskinspa.com/ingredients.asp

* A protein that is secreted by oxygen-deprived cells, such as cancerous cells. VEGF stimulates new blood vessel formation, or angiogenesis, by binding to specific receptors on nearby blood vessels, encouraging new blood vessels to form.
www.alnylam.com/Global/glossary.php

* A protein that binds to receptors on epithelial cells and promotes their growth, stimulates angiogenesis, and increases permeability of the ...
linkinghub.elsevier.com/retrieve/pii/S1546144003000231

* Substances produced by diseased tissues or rapidly growing tissues which play an important role in the formation of abnormal blood vessels and ...
www.uhn.ca/Focus_of_Care/KNC/DKJ_Eye_Centre/glossary.asp

* VEGF promotes venous, venule, artery, arteriole and capillary health by providing the essential cofactors for repairing and restoring damaged vessels.
www.bioproducts.co.nz/Default.asp

Avastin Healthcare Professionals Reimbursement Information - Avastin (Genentech website)

abstract: From the endometrium physiology to a comprehensive strategy for the discovery of ovarian cancer biomarkers

"After literature review, we could classify the molecules involved in ovulation and menstruation pathways in three main categories: proteases, proteases inhibitors and cell-surface protectors. Strikingly, all validated biomarkers for ovarian cancers belong to at least one of these categories."

UK News :: Cancer 'code' is cracked

Note: no specific details on the 'pill' but note comment rearding low dose therapy

Patient Surveillance After Ovarian Cancer Treatment Is Variable: Presented at SSO (article)

"New data indicate that there is marked variability in the intensity of patient surveillance after curative-intent treatment for ovarian cancer. The results were released here on March 6 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO)....The authors said that their study is the first to describe the self-reported practice of experienced clinicians who treat ovarian cancer patients.."

2009 search ASCO abstracts: Gynecologic Cancer : Ovarian Cancer - ASCO

Search of: avastin chemo | Open Studies | ovarian | texas - List Results - ClinicalTrials.gov

Search of: avastin + chemo + ovarian + Texas = 3 open trials

Search of: avastin chemo | Open Studies | ovarian - List Results - ClinicalTrials.gov

Search of: avastin + chemo + - 14 open clinical trials listed - ClinicalTrials.gov

Clinical Care Options Oncology - Ovarian Cancer

Note: must register to access (free):

Review individual CME programs on Ovarian Cancer related topics:

* Beyond Chemotherapy: Current and Future Molecular-Targeted Therapy in Ovarian Cancer

* Managing Ovarian Cancer Recurrence: Coupling Novel Therapeutics With Optimal Treatment Decisions

* Optimizing Treatment Choices in Ovarian Cancer

Erythropoietic stimulating agents; Expert Opinion

On the development of a decision support intervention for mothers undergoing BRCA1/2 cancer genetic testing regarding communicating test results....

On the development of a decision support intervention for mothers undergoing BRCA1/2 cancer genetic testing regarding communicating test results to their children

Health-related direct-to-consumer genetic testing: a review of companies’ policies with regard to genetic testing in minors

Primary care providers’ willingness to recommend BRCA1/2 testing to adolescents

worth repeating: Understanding the problem of inadequately staging early ovarian cancer

Conclusions

Even in a randomised trial in which comprehensive surgical staging was strongly advised in the study protocol the majority of patients (66%) were incompletely staged. Factors relating to a lack of surgical skills attributed most to the number of incompletely staged patients, but insufficient knowledge of the tumour behaviour and routes of spread of ovarian cancer also contributed substantially to this problem. Multicentre trials recruiting patients from many institutes with small volume contribution to the study, run the risk of inadequate adherence to the study protocol.

Peutz-Jeghers syndrome with breast cancer/gyn cancer...

A case of Peutz-Jeghers syndrome with breast cancer, bilateral sex cord tumor with annular tubules, and adenoma malignum caused by STK11 gene mutation.

Clements A, Robison K, Granai C, Steinhoff MM, Scalia-Wilbur J, Moore RG.

Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, RI, USA.

BACKGROUND: Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant disorder, and women with this syndrome are at an increased risk of developing intestinal and extraintestinal malignancies including breast and gynecologic malignancies. This case report presents a patient with PJS with a concomitant breast cancer, bilateral stromal tumors with annular tubules of the ovaries, and adenoma malignum of the cervix.

A Recipe for Proteomics Diagnostic Test Development: The OVA1 Test, from Biomarker Discovery to FDA Clearance

Note: partial document

Cancer Network site

Note: sign on with password (free)
This website has many good reference sources for ovarian cancer including links to the research - a compilation of information/clinical trial results/discussions amongst researchers/physicians. Most of these papers are available freely from many different sources and have been posted on this blog as well.

try a search for 'ovarian cancer':
example today:

E-Updates in Ovarian Cancer
Contemporary Management of and Future Directions in Ovarian Cancer

Gynecologic Oncology Group (GOG) Notifies CTI That Continuation of GOG-212 Pivotal Trial of OPAXIO Maintenance Therapy... -- SEATTLE, March 4 /PRNewswire-FirstCall/ --

Gynecologic Oncology Group (GOG) Notifies CTI That Continuation of GOG-212 Pivotal Trial of OPAXIO Maintenance Therapy in Front Line Ovarian Cancer Remains High Priority

GOG-218 Bevacizumab Results Do Not Influence Importance of GOG-212

SEATTLE, March 4 /PRNewswire-FirstCall/ -- Cell Therapeutics, Inc. ("CTI") (Nasdaq and MTA: CTIC) announced today that CTI received a statement on March 1, 2010 from the Gynecologic Oncology Group (GOG) leadership that the phase III GOG-212 clinical trial of CTI's OPAXIO™ used as maintenance therapy for ovarian cancer remains a high priority and enrollment will continue. The GOG made the statement to clarify that the recent results of the GOG-218 clinical trial bevacizumab in maintenance therapy for ovarian cancer has not influenced the importance of completing the GOG-212 clinical trial. The Gynecologic Oncology Group (GOG) is one of the National Cancer Institute's (NCI) funded cooperative cancer research groups. The GOG is a multidisciplinary cooperative clinical trial research group focused on the study of gynecologic malignancies. The GOG is conducting phase III trials in ovarian cancer and other gynecologic cancers and has established standard treatments for these diseases in the U.S.

GOG leadership noted that, "GOG-218 and GOG-212 differ in the type of patients under study. It is important to note that some of the patients who completed the initial 6 cycles of chemotherapy in GOG-218 had clinical evidence of persistent tumor and where randomized to either placebo (no treatment) or bevacizumab. Thus a subset of GOG-218 patients received no therapy, despite the presence of persistent tumor. This is not the typical setting of using maintenance or consolidation therapy and it is not the setting for patients enrolled in GOG-212. In GOG-212, only patients who have achieved a complete clinical response are considered candidates for enrollment in the trial."

"Reliance upon the data from GOG-218 to establish the "standard of care" must take into consideration the actual treatment effect (i.e. duration of benefit), the cost of the treatment, and the associated toxicity... [in GOG-212] the toxicity of the intervention may have less associated mortality and the incremental cost-effectiveness ratio may be more acceptable to patients and the health care economists. Thus the GOG has no intention to discontinue enrollment in GOG 212 as they feel that the study is addressing a different scientific question and the primary outcome study goal is survival, not progression free survival, an outcome of greater importance to both physicians and patients," the statement added.

The Data Monitoring Committee is scheduled to conduct an interim analysis of overall survival when 130 events are recorded among patients in the no maintenance treatment arm. The statistical analysis plan utilizes pre-specified boundaries for early stopping for success. Based on current enrollment and study duration, the interim analysis could be conducted as early as 2011. If successful, the Company could utilize those results to form the basis of its New Drug Application for OPAXIO.

About Cell Therapeutics, Inc.

Headquartered in Seattle, CTI is a biopharmaceutical company committed to developing an integrated portfolio of oncology products aimed at making cancer more treatable. For additional information, please visit www.celltherapeutics.com.

This press release includes forward-looking statements that involve a number of risks and uncertainties, the outcome of which could materially and/or adversely affect actual future results and the trading price of the securities of CTI. Specifically, the risks and uncertainties that could affect the development of pixantrone include risks associated with preclinical and clinical developments in the biopharmaceutical industry in general, and with pixantrone in particular, including, without limitation, the potential failure of OPAXIO to prove safe and effective for the use as maintenance therapy in ovarian cancer as determined by the FDA, the risk that the GOG could decide to discontinue enrollment in the future, CTI's ability to continue to raise capital as needed to fund its operations, competitive factors, technological developments, costs of developing, producing and selling pixantrone, and the risk factors listed or described from time to time in CTI's filings with the Securities and Exchange Commission including, without limitation, CTI's most recent filings on Forms 10-K, 10-Q and 8-K. Except as may be required by law, CTI does not intend to update or alter its forward-looking statements whether as a result of new information, future events, or otherwise.

Medical News: (Avastin) Bevacizumab Slows Ovarian Cancer Progression - Medscape article

"Full data are expected to be reported at the American Society of Clinical Oncology meeting in Chicago in June."

Cancer Biology & Therapy MicroRNAs and cancer therapy: The next wave or here to stay?

Phase I trial of ATRA-IV and depakote in patients with advanced solid tumor malignancies

Note: early trial closure

abstract: What psychological and behaviour changes are initiated by 'expert patient' training and what training techniques are most helpful?

Rapid Development of Hypertension and Proteinuria with Cediranib, an Oral Vascular Endothelial Growth Factor Receptor Inhibitor -- Robinson et al. 5 (3): 477 -- Clinical Journal of the American Society of Nephrology

Conclusions: Cediranib induced a rapid but variable rise in BP within 3 days of initiation in most patients. Proteinuria was common and also developed rapidly. The rapid development of hypertension suggests that acute inhibition of VEGF-dependent vasodilation might explain the BP rise with VEGF inhibitors. Clinicians must be vigilant in early detection and management of toxicities of this expanding drug class, especially in older patients.

What You Need To Know About™ Ovarian Cancer - National Cancer Institute

Note: obtain copies of all reports including blood work (CA125...) surgical and pathology reports You may want to ask your doctor these questions before your treatment begins: * What is the stage of my disease? Has the cancer spread from the ovaries? If so, to where? * What are my treatment choices? Do you recommend intraperitoneal chemotherapy for me? Why? * Would a clinical trial be appropriate for me? * Will I need more than one kind of treatment? * What are the expected benefits of each kind of treatment? * What are the risks and possible side effects of each treatment? What can we do to control side effects? Will they go away after treatment ends? * What can I do to prepare for treatment? * Will I need to stay in the hospital? If so, for how long? * What is the treatment likely to cost? Will my insurance cover the cost? * How will treatment affect my normal activities? * Will treatment cause me to go through an early menopause? * Will I be able to get pregnant and have children after treatment? * How often should I have checkups after treatment?

Story Power: (Dennis Quaid/actor)The Secret Weapon : Journal of Patient Safety

Impact of F-18 fluorodeoxyglucose positron emission tomography-computed tomography on oncologic patient management: British Columbia (abstract)

"..The results of the PET-CT study resulted in a change in treatment decision in 49.8% of the studies and resulted in improved decision making in 83.2% of the studies."

The Cross Cancer Institute (Alberta) Multidisciplinary Summer Studentship in Palliative and Supportive Care in Oncology: Teaching students to see through patients eyes

The Cross Cancer Institute Multidisciplinary Summer Studentship in Palliative and Supportive Care in Oncology: Teaching students to see through patients' eyes.

Association between frequency and intensity of recreational physical activity and epithelial ovarian cancer risk by age period-abstract

"In conclusion, strenuous recreational activity early in life may increase the risk of ovarian cancer, whereas more recent recreational activity may reduce the risk."

Amazon.com: Positive Results: Making the Best Decisions When You're at High Risk for Breast or Ovarian Cancer (9781591027768): Joi L. Morris, Ora K. Gordon: Books

repost: Genomics|Genetic Testing|EGAPP Recommendations|Lynch Syndrome

About Lynch Syndrome Lynch syndrome refers to individuals with hereditary predisposition to colorectal cancer (CRC) and other malignancies as a result of an inherited mutation in a specific type of gene known as a mismatch repair (MMR) gene. Lynch syndrome includes those with an existing cancer as well as those who have not developed cancer. * Also referred to as hereditary nonpolyposis colorectal cancer (HNPCC) * Autosomal dominant inheritance pattern (50% risk to offspring to inherit the gene mutation) * The lifetime risk for CRC in individuals with Lynch syndrome reported in the literature ranges from approximately 20-80%, dependent upon: o Gene involved o Sex of the individual o Population studied * Mean age of onset of CRC is approximately 45 years * Increased risk for other malignancies including: endometrial, ovarian, urinary tract, gastric, small bowel, pancreatic, and sebaceous skin tumors

Kidney Stent - website

The Information on this site will give you a good understanding of various aspects of this essential organ, including its...
# Anatomy
# Functions
# Diseases
# Treatments...

Lawsuit attacks patent giving company control over genetic test for cancer risk - washingtonpost.com (BRCA)

Primary Care Providers’ Responses to Patient-Generated Family History

abstract: College of Physicians & Surgeons (NY, USA): Views of Discrimination among Individuals Confronting Genetic Disease

"Discrimination can be subjective, and take various forms. Searches for only objective evidence of it may be inherently difficult. Providers need to be aware of, and prepared to address, subtle and indirect discrimination; ambiguities, confusion and potential limitations concerning current legislation; and needs for education about these laws. Policies are needed to prevent discrimination in life, long-term care, and disability insurance, not covered by GINA."

Perceptions of High-Risk Care and Barriers to Care Among Women at Risk for Hereditary Breast and Ovarian Cancer following Genetic Counseling....

Perceptions of High-Risk Care and Barriers to Care Among Women at Risk for Hereditary Breast and Ovarian Cancer following Genetic Counseling in the Community Setting

english translation: more women had a hard time deciding on surgery for breast cancer than for ovarian cancer

"...Close to a quarter of participants reported difficulty deciding whether or not to undergo risk-reducing mastectomy while 10% noted difficulty deciding for or against bilateral salpingo-oophorectomy...."

E-Commerce News: Law: Putting a Patent on Human Genes

Taxotere: Women who took chemo drug say they weren't warned of permanent hair loss

"The side effect of persistent alopecia is suffered by about 3 per cent of patients who take Taxotere with other chemotherapy drugs, according to the manufacturer's own studies. It has been clearly listed on the product monograph since December, 2006, says Laurent-Didier Jacobs, vice-president of medical affairs for Sanofi-aventis Canada. (A different study suggests the incidence of persistent alopecia could be as high as 6 per cent.)"

Jan Geißler - We, the patients - Cover Story Cancer World - Education & knowledge through people & facts

+ 3 comments

Radiation recall dermatitis triggered by multi-targeted tyrosine kinase inhibitors: sunitinib and sorafenib

Note: other treatments such as Gemzar/Gemcitabine have been noted in radiation recall

Accurate accumulation of dose for improved understanding of radiation effects in normal tissue

Int J Radiat Oncol Biol Phys. 2010 Mar

Jaffray DA, Lindsay PE, Brock KK, Deasy JO, Tomé WA.
Princess Margaret Hospital, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada. david.jaffray@rmp.uhn.on.ca

Abstract:
The actual distribution of radiation dose accumulated in normal tissues over the complete course of radiation therapy is, in general, poorly quantified.  
Differences in the patient anatomy between planning and treatment can occur gradually (e.g., tumor regression, resolution of edema) or relatively rapidly (e.g., bladder filling, breathing motion) and these undermine the accuracy of the planned dose distribution. Current efforts to maximize the therapeutic ratio require models that relate the true accumulated dose to clinical outcome. The needed accuracy can only be achieved through the development of robust methods that track the accumulation of dose within the various tissues in the body. Specific needs include the development of segmentation methods, tissue-mapping algorithms, uncertainty estimation, optimal schedules for image-based monitoring, and the development of informatics tools to support subsequent analysis. These developments will not only improve radiation outcomes modeling but will address the technical demands of the adaptive radiotherapy paradigm.
The next 5 years need to see academia and industry bring these tools into the hands of the clinician and the clinical scientist.

Molecular Profiling Uncovers a p53-Associated Role for MicroRNA-31 in Inhibiting the Proliferation of Serous Ovarian Carcinomas and Other Cancers

Note: miR-31 (rna/genome/gene)

"Our findings reveal that loss of miR-31 is associated with defects in the p53 pathway and functions in serous ovarian cancer and other cancers, suggesting that patients with cancers deficient in p53 activity might benefit from therapeutic delivery of miR-31."

p53 Autoantibodies as Potential Detection and Prognostic Biomarkers in Serous Ovarian Cancer

CONCLUSIONS: Antibodies to p53 are detected in the sera of 42% of patients with advanced serous ovarian cancer.
Impact: Although their utility as a preoperative diagnostic biomarker, beyond CA 125 and HE4, is limited, p53-AAb are prognostic for improved overall survival.
Cancer Epidemiol Biomarkers Prev

Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH)

Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial.

INTERPRETATION: Initial antihypertensive treatment with benazepril plus amlodipine should be considered in preference to benazepril plus hydrochlorothiazide since it slows progression of nephropathy to a greater extent.
FUNDING: Novartis

Prospective Multicenter Cohort Study to Refine Management Recommendations for Women at Elevated Familial Risk of Breast Cancer: The EVA Trial.

CONCLUSION: In women at elevated familial risk, quality-assured MRI screening shifts the distribution of screen-detected breast cancers toward the preinvasive stage. In women undergoing quality-assured MRI annually, neither mammography, nor annual or half-yearly ultrasound or CBE will add to the cancer yield achieved by MRI alone.

Lasofoxifene in postmenopausal women with osteoporsis

CONCLUSIONS: In postmenopausal women with osteoporosis, lasofoxifene at a dose of 0.5 mg per day was associated with reduced risks of nonvertebral and vertebral fractures, ER-positive breast cancer, coronary heart disease, and stroke but an increased risk of venous thromboembolic events. (ClinicalTrials.gov number, NCT00141323.) 2010 Massachusetts Medical Society"

Long-Term Use of Bisphosphosphonates in Osteoporosis Jnl Clin Endocrinol Metabolism

The clinicopathological characteristics of ‘triple-negative’ epithelial ovarian cancer -- JCO (China)

Note: other cell types of ovarian cancer were also compared in this study

"Conclusions: A novel (new) subtype of ovarian carcinoma, which is negative for ER, PR and HER2 expression, has been identified; this specific ovarian subtype tends to have aggressive characteristics and a poor prognosis, which is similar to triple-negative breast cancer in most respects. TNEOC should be considered in future investigations of informative classification of ovarian cancer."

Motivation and Autonomy in Counseling, Psychotherapy, and Behavior Change: A Look at Theory and Practice - abstract

U.S. FDA Recalls Flavor Enhancer Because of Salmonella Risk - in Public Health & Policy, Public Health from MedPage Today

Products on the recall list -- which can be found at http://www.accessdata.fda.gov/scripts/HVPCP/ -- include Earth Island's Sweet and Sour Tofu, T. Marzetti's Southwest Ranch Veggie Dip, Trader Joe's Creamy Ranch Dressing and Dip, and Hawaiian brand potato chips.

full access: Challenges with engaging participants in behavioral intervention research

Summary and conclusions The challenges and recommendations outlined in this paper are informed by clinical trials of behavioral interventions in the context of HIV-infected populations. Although the specific nature of this trial may restrict the generalizability of the recommendations to other populations, illnesses, trial designs and intervention modalities, the general concepts are likely applicable across settings and are consistent with the limited literature on this topic.8,13 For example, there is a documented need to address expectations, motivations, and barriers to clinical trial participation across gender, race and ethnicity.12,13,16,17 The few sources that address these issues often do so in the context of engagement in treatment rather than clinical trials,18,19 and while there may be some attention to the needs of special populations such as homeless persons,20 this literature typically fails to consider issues unique to a research setting such as altruism and desire for financial incentives.17 Without effective techniques to maximize adherence to innovative health promotion interventions, investigators will struggle to compile empirical evidence of the intervention’s efficacy and eventual effectiveness.

Journal of Open Access Journal of Clinical Trials

Note: this journal began in 2009 (free access)

abstract: Comparison of peritoneal carcinomatosis scoring methods in predicting resectability and prognosis in advanced ovarian cancer (no stats)

Note: no stats

BioMed Central Blog : Calculating genetic risk from multiple loci

"As we learn more about the many kinds of mutations that are associated with genomic disease, so we can evaluate and model the ways that they interact to cause a phenotype."

Obstetrics/Gynecology Residents' Knowledge of Hereditary Breast and Ovarian Cancer and Lynch Syndrome.

"Although there have been many studies regarding physicians' knowledge of hereditary cancer syndromes, very little information exists regarding medical residents' knowledge of hereditary cancer syndromes. Obstetrics/gynecology residents completed a test which evaluated their knowledge of hereditary breast and ovarian cancer and Lynch syndrome.

Endocyte Announces DSMB Supports Continuation of Phase 2 PRECEDENT Study - EC145 combo

"The PRECEDENT study is a randomized phase 2 clinical trial comparing the company's drug EC145 in combination with pegylated liposomal doxorubicin (PLD/Doxil(R)) to PLD alone for women with platinum-resistant ovarian cancer."

Gynecologic Oncology Group (GOG) Notifies CTI That Continuation of GOG-212 Pivotal Trial of OPAXIO Maintenance Therapy in Front Line Ovarian Cancer Remains High Priority - MarketWatch

press release

March 4, 2010, 1:30 a.m. EST
Gynecologic Oncology Group (GOG) Notifies CTI That Continuation of GOG-212 Pivotal Trial of OPAXIO Maintenance Therapy in Front Line Ovarian Cancer Remains High Priority
GOG-218 Bevacizumab Results Do Not Influence Importance of GOG-212

SEATTLE, March 4, 2010 /PRNewswire via COMTEX/ -- Cell Therapeutics, Inc. ("CTI") (Nasdaq and MTA: CTIC) announced today that CTI received a statement on March 1, 2010 from the Gynecologic Oncology Group (GOG) leadership that the phase III GOG-212 clinical trial of CTI's OPAXIO(TM) used as maintenance therapy for ovarian cancer remains a high priority and enrollment will continue. The GOG made the statement to clarify that the recent results of the GOG-218 clinical trial bevacizumab in maintenance therapy for ovarian cancer has not influenced the importance of completing the GOG-212 clinical trial.

Patients should be "unafraid" to seek second opinion: Canadian news item

Patients who question medical test results or diagnoses from their doctors should be "unafraid" to ask for a second opinion, because mistakes, although uncommon, can be made, according to the Canadian Medical Association.

Tell It Slant: History, Memory, and Imagination in the Healing Writing Workshop - Traumatology

Randomized phase II trial of paclitaxel plus carboplatin therapy versus irinotecan plus cisplatin therapy as first-line chemotherapy for clear cell ad

"INTRODUCTION: Paclitaxel plus carboplatin (TC) is generally considered to be the "gold standard" regimen for treatment of epithelial ovarian carcinomas. Little data are available, however, on the use of this regimen in patients with clear cell adenocarcinoma of the ovary (CCC). ...Randomized phase II trial of paclitaxel plus carboplatin therapy versus irinotecan plus cisplatin therapy as first-line chemotherapy for clear cell adenocarcinoma of the ovary: a JGOG study.

Progression-free survival (PFS) showed no significant difference between the 2 treatment groups. Because there were more patients with large residual disease in the CPT-P arm, we performed a subset analysis by removing those patients, and then compared the PFS with that of patients without residual disease or with residual disease less than 2 cm.

The PFS tended to be longer in the CPT-P group, although the difference was not statistically significant.

CONCLUSIONS: A phase III randomized trial is required to elucidate the effectiveness of CPT-P combination chemotherapy for CCC."

Volunteers sought for cancer study in Oklahoma (ovarian cancer)

U.S. - FDA approves a risk evaluation and mitigation strategy (REMS) to ensure the safe use of Erythropoiesis-Stimulating Agents (ESAs)"

Washington, DC: Cancer Survivorship Research: Mapping the New Challenges NOTE THE DEADLINE

NOTE: Application deadline April 9th, 2009
Survivor Advocate Research Program Now Open! (2/22/10)
The Survivor Advocate program provides travel scholarships for 20 advocates to attend the conference, learn first-hand about key research in cancer survivorship, and to interact with other advocate leaders and survivorship researchers.

Program participants will be selected on the basis of their research advocacy experience and the potential impact conference attendance will have on their future advocacy work. Priority will be given to applicants who have not participated in the program previously.

Conference registration fees, as well as hotel and transportation costs will be covered for Survivor Advocate program participants who are selected. In addition, food expenses incurred outside of conference meals will be reimbursed"....cont'd

What Questions Should I Ask My Doctor?: Questions to ask about radiation safety

2010 abstract:Restless legs syndrome and its relationship with anxiety, depression, and quality of life in cancer patients undergoing chemotherapy.

"The prevalence of RLS in patients undergoing chemotherapy is 18.3%, about double of that expected in the general population. The occurrence of RLS is much more frequent in female patients and with longer-term chemotherapy."

Restless Legs Syndrome Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS)

What causes restless legs syndrome?

In most cases, the cause of RLS is unknown (referred to as idiopathic). A family history of the condition is seen in approximately 50 percent of such cases, suggesting a genetic form of the disorder. People with familial RLS tend to be younger when symptoms start and have a slower progression of the condition.

In other cases, RLS appears to be related to the following factors or conditions, although researchers do not yet know if these factors actually cause RLS.

Differentiating between Peripheral Neuropathy, Leg Cramps, and Restless Legs Syndrome | Foot Pain Center

High prevalence of restless legs syndrome in cancer patients undergoing chemotherapy: ASCO abstract

Efficacy of Annual Colonoscopic Surveillance in Individuals With Hereditary Nonpolyposis Colorectal Cancer (Lynch Syndrome) - MS status

Note: MS - microsatellite status
  
Methods:In a prospective, multicenter cohort study, 1126 individuals underwent 3474 colonoscopies. We considered individuals from 3 groups of HNPCC families: those with a pathogenic germline mutation in a mismatch repair gene (MUT group), those without a mutation but with microsatellite instability (MSI group), and those who fufilled the Amsterdam criteria without microsatellite instability (MSS group).

Conclusions:
Annual colonoscopic surveillance is recommended for individuals with HNPCC. Less intense surveillance might be appropriate for MSS families.

Risk assessment, genetic testing, and management of Lynch syndrome-abstract

"...Genetic test results, when conclusive, can guide management for patients and their families. However, indeterminate test results may provide false reassurance to patients who should be managed as being at higher-than-average risk...."

Distribution of second primary malignancies suggests a bidirectional effect between breast and endometrial cancer: a population-based study - abstract

Note: the study included Tamoxifen use; risks of other cancers including ovarian (% risk)

Hereditary Ovarian Cancer: Molecular Genetics, Pathology, Management, and Heterogeneity

Future Prospects: DNA Variants Modify HBOC and LS (Lynch Syndome) Cancer Risk:
What does the future hold with respect to molecular genetics and cancer control in hereditary cancer, inclusive of HBOC and Lynch syndrome?

This projection relates to the truism that cancer-causing mutations do not act in a vacuum, since they are likely to be impacted by additional low-penetrant modifier genes in concert with myriad environmental events.

PLoS ONE: An Epigenetic Signature in Peripheral Blood Predicts Active Ovarian Cancer

Note: in research; included all major subtypes of epithelial ovarian cancer (see table 1)

full access: PLoS ONE: The Prognostic Value of BRCA1 mRNA Expression Levels Following Neoadjuvant Chemotherapy in Breast Cancer

Background:
A fraction of sporadic breast cancers has low BRCA1 expression. BRCA1 mutation carriers are more likely to achieve a pathological complete response with DNA-damage-based chemotherapy compared to non-mutation carriers. Furthermore, sporadic ovarian cancer patients with low levels of BRCA1 mRNA have longer survival following platinum-based chemotherapy than patients with high levels of BRCA1 mRNA.
Conclusions/Significance:
We provide evidence for a major role for BRCA1 mRNA expression as a marker of time to progression and overall survival in sporadic breast cancers treated with anthracycline-based chemotherapy. These findings can be useful for customizing chemotherapy.

Prognostic Factors for Stage I Ovarian Carcinoma

All patients who died of disease were stage IC

Administrative Outcomes Five Years after Opening an Acute Palliative Care Unit at a Comprehensive Cancer Center.

"Purpose:.....In keeping with targets set at the unit's opening, our primary hypotheses were that outpatient admissions, admissions for symptom control, and discharges home would increase over the study period; secondary hypotheses were that length of stay and inpatient death rate would decrease.....Results: There were 1748 admissions during the study period: the median age was 64, 54% were women, and the most common cancer sites were gastrointestinal (24%), lung (20%), and gynecologic (13%)....Conclusion: Setting and adhering to administrative targets for an APCU is possible with appropriate admission criteria, adequate community resources, and education of patients, families and health professionals regarding the model of care."

Prevalence of BRCA2 and CDKN2a mutations in German familial pancreatic cancer families.

Ovarian Intestinal Type Mucinous Borderline Tumors: Are We Ready for a Nomenclature Change?

"At a National Cancer Institute-sponsored workshop it was proposed that the borderline category of ovarian intestinal-type mucinous tumors (OInMTs) could be eliminated if the apparent benign behavior of these tumors could be confirmed.....Caution dictates retaining the current nomenclature to ensure the follow-up of patients affected by this disease until uncertainty regarding the extent of sampling needed to exclude the presence of carcinoma is resolved."

Study on cancer incidence through the Cancer Registry Program in 11 Cities and Counties, China (1988-2002 cancer registries data)

"The leading cancer sites were lung, stomach, liver, esophagus, breast, colon, rectum, pancreas, bladder and leukemia. The sixteen key cancers accounted for 85.56% of all the cancer cases. The crude incidence rate of all cancers had been significantly increased from 1988 to 2002. Among them, prostate ranked the fastest growing one followed by cancers of the gallbladder, breast, colon, ovarian, lymphoma, bladder, pancreas, rectum, lung, leukemia and liver. The one that had reduced the most was cervix uteri, followed by esophagus, stomach and nasopharynx."

Building a better understanding of the intracellular tyrosine kinase PTK6 - BRK by BRK.

"PTK6 expression is also increased in a number of other epithelial tumors, including ovarian and colon cancer."

Seromic profiling of ovarian and pancreatic cancer- abstract

Three New Technologies for Beating Breast Cancer - Women's Health Online

* Intensity Modulated Radiation Therapy (IMRT)
* DyNeMo (analyzes networks of proteins in cancer cells)
* Automated Breast Volume Scanner (ABVS)

Breast Cancer - Women's Health Online

"Genes that can predict which breast cancer patients will respond to the anti-cancer drug paclitaxel have been identified by an international team of scientists.
They analyzed 829 genes in breast cancer cells and pinpointed 6 that had an impact on whether the drug was effective, BBC News reported.

Hormones, Hypertension and Headaches- Women's Health Online

Taxol (Paclitaxel) Drug Information: Uses, Side Effects, Drug Interactions and Warnings at RxList

definition: Neuromotor: A term that describes a process involving both nerves and muscles Note the terms: neurotoxicity/neuromotor/neurosensory (relating to restless leg syndrome, neuropathy as examples)

Cochrane Review: Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in patients with

Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in patients with gynaecological malignancies.

CONCLUSIONS: Placement of retroperitoneal tube drains has no benefit in prevention of lymphocyst formation after pelvic lymphadenectomy in patients with gynaecological malignancies. When the pelvic peritoneum is left open, the tube drain placement is associated with a higher risk of short and long-term symptomatic lymphocyst formation.

The Associated Press: AstraZeneca shuffles, eliminates Del. R&D jobs

"While continuing research on cancer and infection drugs and therapies for cardiovascular, gastrointestinal, respiratory, inflammatory and neurological conditions, AstraZeneca said it will cease disease-specific research on drugs to treat thrombosis, acid reflux disease, ovarian and bladder cancers, systemic scleroderma, schizophrenia, bipolar disorder, depression, anxiety, and hepatitis C."

Study finds delay in referrals for older women with ovarian cancer - UK

Supercomputer to benefit Rice, Medical Center | Houston & Texas News | Chron.com - Houston Chronicle

"As part of this effort Kim Worley, a Baylor geneticist, said the college has sequenced the DNA in the healthy cells of 50 patients, and the DNA in tumor cells of these same patients with ovarian cancer......But Baylor doesn't want to just store the information, it wants to cross reference each of these 100 DNA sequences with the originally sequenced version of human DNA to see which gene mutations might contribute to ovarian cancer...."

news item: Fish oil supplements may bring PCB compounds: Study

IAPO: Patient Involvement in Health Policy, Systems and Delivery | A global voice for patients

Why is Patient Involvement in Health Policy Important? Healthcare policy decisions, at whatever level they are made, will ultimately affect patients' lives. Therefore patients have a moral and ethical right to play a meaningful role in developing healthcare policies.

IAPO press release: A Call from IAPO’s 4th Global Patients Congress on Strengthening Healthcare Systems Globally | A global voice for patients

"Patients call for greater support for meaningful involvement in healthcare decision making as a means to ensure equitable distribution of limited health resources

London, United Kingdom, 1 March 2010 – Patient advocates have called for more meaningful engagement in healthcare design and delivery at the International Alliance of Patients’ Organizations (IAPO) 4th Global Patients Congress in Istanbul, Turkey."

Cancer Research Center of Hawaiii: Cancer: Thriving and Surviving

The Cancer Research Center of Hawaii and Stanford School of Medicine are conducting a study testing a new online workshop for people who have survived cancer. 

9 minute video: YouTube - The Story Of Human Rights

UMCCC Gynecologic Oncology Patient Handbook: When to Call a Doctor or Nurse

Opaxio (XYOTAX) - New FDA Date for Cell Therapeutics: media item

Note: Lots of unanswered questions

"....Meantime, Cell Therapeutics also disclosed another setback for its experimental cancer drug Opaxio. The Gynecologic Oncology Group (GOG) turned down Cell Therapeutics' request to conduct an interim analysis of the phase III study of Opaxio in patients with advanced ovarian cancer,

news story: As hospital probe widens, are pathologists overworked?

science news item: Dietary factors influence ovarian cancer survival rates

In Research (abstract): Plasma cell-free DNA in ovarian cancer. Aparna A. Kamat. 2010; Cancer - Wiley InterScience

Avastin Treatment Overview for Healthcare Professionals - Avastin

Genentech's website: note section on serious side effects

FAQ: ClinicalTrials.gov - What is "Expanded Access"?

Answer:

Expanded access is a means by which manufacturers make investigational new drugs available, under certain circumstances, to treat a patient(s) with a serious disease or condition who cannot participate in a controlled clinical trial....cont'd

Abstract: A link between mir-100 and FRAP1/mTOR in clear cell ovarian cancer

Although miRNAs have been implicated as oncogenes and tumor suppressors in a variety of human cancers, functional roles for individual miRNAs have not been described in clear cell ovarian carcinoma..... We performed deep sequencing to comprehensively profile miRNA expression in 10 human clear cell ovarian cancer cell lines compared with normal ovarian surface epithelial cultures and discovered 54 miRNAs that were aberrantly expressed.....Our experiments have revealed strong candidate miRNAs and their target genes that may contribute to the pathogenesis of clear cell ovarian cancer, thereby highlighting alternative therapeutic strategies for the treatment of this deadly cancer.

Australia news item: Most women don't know ovarian cancer symptoms

Louise Bayne, Chief Executive of Ovacome said: "In the last 20 years, there has been a transformation in the way ovarian cancer is treated - but public awareness of the symptoms has not kept up with this medical progress.

"Women are becoming more aware of other common female cancers and how to spot them - but ovarian cancer has been left behind."

DNA Testing Centres of Canada - Get Your DNA Tested - 100% Free Consultation

Ontario Appoints Investigators For Essex County Hospitals

The UK Cochrane Centre is pleased to announce that we will broadcast the plenary sessions from the Annual Meeting of UK and Ireland-based Contributors to The Cochrane Collaboration live on the internet on Tuesday and Wednesday of this week (details of the speakers are below). The broadcasts will be free to view at www.cochrane.tv. The site does not require a login or any special software. We will also make recordings of the sessions available later.

We are doing this in an effort to improve access to the sessions and we apologise in advance if technical problems mean that it does not work well. However, please be assured that we will be working hard to resolve any problems that arise during the broadcasts.

First plenary from 13.00 to 14.00 GMT on March 2 2010

Chair: Jane Noyes
Director of the Centre for Health-Related Research at Bangor University

The importance of The Cochrane Collaboration.
Tony Jewell, Chief Medical Officer, Welsh Assembly Government

Sense about science
Tracey Brown, Managing Director, Sense About Science

Hunting for snarks: The challenge of getting evidence into guidelines
Fergus Macbeth, Director of the Centre for Clinical Practice, National Institute for Health and Clinical Excellence

Second plenary from 13.30 to 15.00 GMT on March 3 2010

Chair: Julian Higgins
Co-Editor, Cochrane Handbook for Systematic Reviews of Interventions

Addressing reporting bias
Jonathan Sterne, Department of Social Medicine, University of Bristol
Co-Convenor, Bias Methods Group

The risk of bias tool
Doug Altman, Director, Centre for Statistics in Medicine; Co-Convenor, Bias Methods Group

Summary of findings tables
Phil Wiffen, Operations and Training Director, UK Cochrane Centre

Including non-randomized studies
Barney Reeves, Bristol Heart Institute, University of Bristol; Co-Convenor, Non-randomised Studies Methods Group

Incorporating economics
Miranda Mugford, School of Medicine, Health Policy and Practice, University of East Anglia; Chair of Convenors, Campbell and Cochrane Economics Methods Group

The role of qualitative evidence
Jane Noyes, Noreen Edwards Chair in Nursing Research; Director of the Centre for Health-Related Research, Bangor University; Co-Convenor, Qualitative Methods Research Group

How can we improve the quality of reviews?
David Tovey, Editor in Chief, The Cochrane Library 

Pathways to the diagnosis of ovarian cancer in the UK: a cohort study in primary care. J Barrett. 2010; BJOG: An International Journal of Obstetrics & Gynaecology - Wiley InterScience

Correspondence: Defining the surgical management of suspected early-stage ovarian cancer by estimating patient numbers through alternative management

Correspondence: Defining the surgical management of suspected early-stage ovarian cancer by estimating patient numbers through alternative management strategies

refers to original article (abstract):

Defining the surgical management of suspected early-stage ovarian cancer by estimating patient numbers through alternative management strategies

full access:Gynaecological oncology Impact of bowel obstruction at the time of initial presentation in women with ovarian cancer

"This is a small, single institution, retrospective study. The limitations imposed by these attributes have to be borne in mind when interpreting or using the findings of this study."

full access: Surgical training in gastrointestinal procedures within a UK gynaecological oncology subspecialty programme

"Table 4 also includes comparison with the published literature of gynaecological oncologists performing colorectal procedures on women with gynaecological cancers and of colorectal surgeons performing colorectal procedures on women with primary colorectal problems........Previous publications from various countries, including the USA, Australia, Japan, France, Italy, South Africa, Singapore, China and Turkey, show similar rates of performance of gastrointestinal procedures in the management of gynaecological malignancies with similar complication rates."

Recovery Act Funding at NCI - NCI (30 new)

Note: see website for list

Clinical Trials Supported by Accelerating Clinical Trials of Novel Oncologic PathWays (ACTNOW) Initiative

ACTNOW is an early-phase clinical trial program designed to help shorten the time it takes to move new cancer treatments from the discovery phase, to drug development, and, ultimately, to approval and safe use by cancer patients.

The table below lists the ACTNOW trials by cancer type, and contains links to descriptions of the drugs being studied, the trial objectives, patient enrollment criteria, and locations where patients receive treatment. Investigators interested in collaborating on these trials can contact the Study Chair listed on the trial description.

Is the subject of this story going to kill you or cure you? - Gary Schwitzer's HealthNewsReview Blog

Note: see website for the link

Is the subject of this story going to kill you or cure you?
By Gary Schwitzer on February 26, 2010 9:20 AM

There's now a website that actually tracks The Daily Mail of London to categorize its stories as either "kill or cure" stories. The site quotes British physician-author Ben Goldacre: "The Daily Mail, as you know, is engaged in a philosophical project of mythic proportions: for many years now it has diligently been sifting through all the inanimate objects in the world, soberly dividing them into the ones which either cause - or cure - cancer."

Visitors to the site can vote on the stories.

HealthNewsReview.org: Bitter Melon Extract May Slow, Stop Breast Cancer

HealthNewsReview.org | Independent Expert Reviews of News Stories | Holding Health and Medical Journalism Accountable

BBC News - Gene test aid to cancer treatment

"Starting with 829 genes in breast cancer cells, the team whittled down the possibilities to six genes which had an impact on whether a drug worked."

full free access: Clinical relevance of extent of extreme drug resistance in epithelial ovarian carcinoma (repost from Jan 2010)

Note: also note reference materials included in this paper

Patient Advocate Foundation: Co-Pay Relief Patient Center - Home

Patient Advocate Foundation Underinsured Application

Patients and their Families - Patient Safety (Canada)

Note: Selection of different articles

full access: Is no news good news? Inconclusive genetic test results in BRCA1 and BRCA2 from patients and professionals' perspectives

Choice of Management of Southern Chinese BRCA Mutation Carriers.

Research Advocacy Network - Advancing Patient-Focused Research

Now accepting nominations for the Focus on Research class for 2010

Advocates would you like to:

* Have a greater understanding of concepts in oncology research?
* Be able to relate these concepts to specific research results?
* Be more effective in understanding and communicating research results that will change how cancer is treated?

Complete the nomination form today to participate in the Focus on Research class for 2010.
Deadline for receipt of nomination forms to participate in the course is March 25, 2010.

Nomination/Application form:
https://www.surveymonkey.com/s.aspx?sm=lJwbeo8%2f5DVgtGmGhpLHFrbeSxow21GN0tVx5Xoro6c%3d&

INQUIRIES
Questions concerning the Focus on Research program should be addressed to Research Advocacy Network, Elda Railey email: erailey@researchadvocacy.org or by voice message on the Research Advocacy Network central number at 877.276.2187.

Bioethics Forum - Choosing Paternalism?

Note: 2007

"....The article described the case of a 39-year-old patient with ovarian cancer that had metastasized to her liver. She was asked to decide whether to undergo a novel chemotherapy regimen about which five oncologists disagreed. When she asked her doctor what she should do he said he didn’t know, that she would have to make the decision based on her own values. The patient, “bald, tumor-ridden and exhausted from chemotherapy was reeling. ‘I’m not a doctor!’ she shouted, ‘I’m a criminal defense lawyer! How am I supposed to know?’” The story illustrates the frustration, anxiety, and loneliness of being a “modern patient” attempting to cope with medical uncertainty."

Prediagnosis Food Patterns Are Associated with Length of Survival from Epithelial Ovarian Cancer.

Cochrane Menstrual Disorders and Subfertility Group: Clomiphene citrate for unexplained subfertility in women

Plain English Summary: "Clomiphene citrate for unexplained subfertility in women Clomiphene citrate is a fertility drug that can increase the number of eggs released for possible fertilisation. It is used by women who do not ovulate regularly and by some who do but still have not become pregnant. Clomiphene citrate does not appear to increase the chance of pregnancy in women who ovulate regularly but have failed to conceive after more than a year of unprotected intercourse and so are considered to be subfertile. An associated risk of treatment with clomiphene citrate is a 10% chance of multiple pregnancy. The results of this review of trials should be used with caution due to the heterogeneity between some of the studies."

Management of drainage for malignant ascites in gynaecological cancer

Authors' conclusions:
Since no relevant studies were identified, we are unable to make recommendations regarding the management of drains for malignant ascites in women with gynaecological cancer. Large, multi-centre RCTs are required to evaluate the efficacy and safety of the management of ascitic drains when in situ and their impact on QOL.

Some people just won’t take death for an answer

e-patients blog: "We often talk here about empowered patients’ struggles to get – or even create – the care they need. Usually we’re talking about it in a medical sense. But as far too many people know, sometimes there are other obstacles. Laurie Todd is, to me, an outstanding example of someone who wouldn’t take death for an answer – neither from doctors....."

CK7, CK20, CDX2 and MUC2 Immunohistochemical Staining Used To Distinguish Metastatic Colorectal Carcinoma Involving Ovary from Primary Ovarian Mucinous Adenocarcinoma

Objective: Colorectal adenocarcinoma, the most common tumor that metastasizes to the ovary, is often difficult to distinguish from primary ovarian mucinous adenocarcinoma (POMA). Obtaining the correct diagnosis is difficult but crucial to treatment and prognosis.

new book: Editor's comment (Jason Marsh) "The Compassionate Instinct": Uncovering the New Science of Human Goodness

"Taken together, this research challenges some long-held notions about human nature, revealing that the good in us is just as intrinsic to our species as the bad. Empathy, gratitude, compassion, altruism, fairness, trust, and cooperation, once thought to be aberrations from the tooth-and-claw natural order of things, are actually core features of primate evolution.
For too long a view of humans has prevailed that assumes we are wired to compete, to act aggressively, to pursue unbridled self-interest. These are no doubt facets of human nature, but they represent only half of the story.
"The Compassionate Instinct" reveals another story, one that places goodness at the center of human nature. The book doesn't deny the existence of the violence and selfishness we see in the world around us. But it offers scientific evidence that another world is possible."

full free access: (McGill University) Assessing the accuracy of an inter-institutional automated patient-specific health problem list

full access: Association of shared decision-making with type of breast cancer surgery

press release: Precision Therapeutics- Chemosensitivity/Resistance Assay Included as Part of the NCCN Principles of Chemotherapy - MarketWatch

Note: as per just published NCCN guidelines 2/2010 Ovarian Cancer section (read the guidelines for further explanation) http://www.nccn.org

Laboratory Product News: Manhattan Scientifics Acquires Exclusive Rights to Nanomedicine Technology for Early Cancer Detection and Treatment

"Manhattan Scientifics Inc. (OTCBB: MHTX), a nanomedicine technology transfer and commercialization pioneer, today announced completion of its agreement to acquire all commercial rights to the body of work of nuclear physicist Edward R. Flynn, PhD and his company, Senior Scientific LLC. The breakthrough technology focuses on the emerging field of nanomedicine, with an emphasis on the early detection and localization of cancer and other diseases, and providing image-guided therapy for treatment."Financial details of the agreement were not disclosed. Early detection of cancer can be critical to effective treatment. For example,

Genomics - Funding 2010 CDC and NIH New Genomics Funding Opportunity Announcement

Systematic evidence reviews will examine the validity and utility of various health-related genomic tests (e.g., DNA, RNA, and proteomic tests; family health history tools; other health-related genomic services), including information on contextual factors and ethical, legal, and social issues. These evidence reviews will be conducted using the methods developed by the Evaluation of Genomic Applications in Practice and Prevention (EGAPP™) Working GroupExternal Web Site Icon and CDC. Some of these reviews will be used by the EGAPP™ Working Group to make recommendation statements on the use of the genomic tests and other services.

The center will collaborate with CDC to develop brief evidence summaries (topic briefs) on the validity and utility of selected genomic applications and related issues.

Evidence reviews and topic briefs, along with recommendation statements and other resources, will be made publicly available in an online knowledge repository. This repository is being developed by NOPHG, NIH’s National Cancer InstituteExternal Web Site Icon, and the National Center for Biotechnology InformationExternal Web Site Icon of the National Library of MedicineExternal Web Site Icon and will be released later this year.

EvidenceUpdates: Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial

Note: includes commentaries

CBC News - Health - Hospitals aim to resterilize, cut waste

Hospitals can resterilize some devices for reuse and cut waste: researchers

Northwestern Memorial's Integrative Oncology Program aims to ease pain and help patients manage cancer

The European Medicines Agency is in Overall Agreement with OncoGenex Pharmaceuticals' Development Plan for OGX-011 - financial news

"Since increased clusterin production is observed in many human cancers, including prostate, non-small cell lung, breast, ovarian, bladder, renal, pancreatic, anaplastic large cell lymphoma and colon cancers and melanoma, OGX-011 may have broad market potential to treat many cancer indications and disease stages."

California health insurers subpoenaed in rate probe | Reuters

updated (annual) February 2010: NCCN Clinical Practice Guidelines in Oncology

Note: the NCCN website requires registration/password but is free. It is an excellent resource for ovarian cancer(s) as well as genetic syndrome guidelines.

Page 4 indicates changes over prior guidelines.

Genentech Announces Positive Results of Avastin Phase III Study in Women with Advanced Ovarian Cancer

In the three-arm study, known as Gynecologic Oncology Group (GOG) 0218, women with newly diagnosed advanced ovarian cancer who already had surgery to remove as much of the tumor as possible were randomized to receive one of the following:

-- Arm 1: Placebo in combination with carboplatin and paclitaxel chemotherapy followed by placebo alone, for a total of up to 15 months of therapy

-- Arm 2: Avastin in combination with carboplatin and paclitaxel chemotherapy followed by placebo alone, for a total of up to 15 months of therapy

-- Arm 3: Avastin in combination with carboplatin and paclitaxel chemotherapy followed by the maintenance use of Avastin alone, for a total of up to 15 months of therapy.

The study showed that women who continued maintenance use of Avastin alone, after receiving Avastin in combination with chemotherapy (Arm 3), lived longer without the disease worsening compared to those who received chemotherapy alone. Women who received Avastin in combination with chemotherapy, but did not continue maintenance use of Avastin alone (Arm 2), did not live longer without the disease worsening compared to chemotherapy alone.

Ontario, Canada: Hospitals: Public consultations needed - Welland Tribune - Ontario, CA

"It's up to a lobby group to bring democracy to discussions about changes to Ontario's hospitals.

That's because the provincial government refuses to do so, said Ontario Health Coalition executive director Natalie Mehra. Despite repeated requests to the Ministry of Health, asking that its public Rural and Northern Health Care Panel hold public consultations, Mehra said the government has "refused to hold public consultations."

She said the government's panel will only be consulting with select organizations including Ontario Hospital Association, the Ontario Medical Association, Registered Nurses Association of Ontario and an emergency medical service organization.

"There's not a single patient group, no municipality, no seniors group, or advocacy groups, or public interest groups, nobody," she said in an interview Tuesday....."

Myriad press release: New Study Finds 41% of Patients at Community Oncology Practices Were at Risk for Hereditary Breast/Ovarian Cancer

Ovarian cancer survival rates up - ABC News (Australian Broadcasting Corporation)

Avastin performs in ovarian cancer trial - news item

Medical News: Minimally Invasive Surgery Takes Toll on MDs,

Outcomes after conservative treatment of advanced-stage serous borderline tumors of the ovary.

"Eighteen pregnancies (nine spontaneous) were observed in 14 patients."

Aberrant expression of p27(Kip1)-interacting cell-cycle regulatory proteins in ovarian clear cell carcinomas and their precursors with special consideration of two distinct multistage clear cell carcinogenetic pathways.

"These data suggest that accumulated alterations of p27(Kip1)-interacting proteins may accelerate the development of CCAs regardless of their carcinogenetic pathways, but that tumor cells in the CCAF-associated pathway appear to show slower cell-cycle progression than those in the endometriosis-associated pathway, possibly accounting for the distinct clinicopathological features of the two CCA subtypes."

full access: DNA Methylation Profiles of Ovarian Epithelial Carcinoma Tumors and Cell Lines

Table 1

Histology and clinical characteristics of primary ovarian tumors. (serous, endometrioid, clear cell - CA125 levels, menopausal status,patient age)

Background

Epithelial ovarian carcinoma is a significant cause of cancer mortality in women worldwide and in the United States. Epithelial ovarian cancer comprises several histological subtypes, each with distinct clinical and molecular characteristics. The natural history of this heterogeneous disease, including the cell types of origin, is poorly understood.

Occult ovarian cancers identified at risk-reducing salpingo-oophorectomy in a prospective cohort of BRCA1/2 mutation carriers.

"An unacceptably high proportion of pathologic examinations did not adequately examine ovaries and fallopian tubes obtained at RRSO."

2009 Safety of Bevacizumab in Advanced Ovarian and Müllerian Cancers: A Review: Bevacizumab (Avastin) and Ovarian Cancer

"To date, several investigators (Table 1) have explored bevacizumab as a single agent or in combination with metronomic chemotherapy in the management of advanced ovarian cancer. All studies to date with bevacizumab as a single agent or in combination with chemotherapy have shown promising responses...."

abstract: Combined oral cyclophosphamide and bevacizumab in heavily pre-treated ovarian cancer (Spain)

Conclusions: Combined bevacizumab and metronomic oral cyclophosphamide is a safe and effective regimen for heavily pre-treated ovarian cancer patients. Further research is needed on predictive factors to screen for those patients who will benefit from anti-angiogenic therapy.

2008 Phase II clinical trial of bevacizumab and low-dose metronomic oral cyclophosphamide in recurrent ovarian cancer: a trial of the California, Chic

Phase II clinical trial of bevacizumab and low-dose metronomic oral cyclophosphamide in recurrent ovarian cancer: a trial of the California, Chicago, and Princess Margaret Hospital phase II consortia.

Bevacizumab and Low-Dose Cyclophosphamide in Treating Patients With Recurrent Ovarian Epithelial or Primary Peritoneal Cancer - Full Text View - ClinicalTrials.gov

Bevacizumab and Low-Dose Cyclophosphamide in Treating Patients With Recurrent Ovarian Epithelial or Primary Peritoneal Cancer
This study has been completed.
First Received: November 4, 2003 Last Updated: February 6, 2009

Sponsor: California Cancer Consortium
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00072566

(2005) Bevacizumab (Avastin) combined with low-dose chemotherapy slows ovarian cancer (Cyclophosphamide )

full access: PLoS ONE: An Optimized Pentaplex PCR for Detecting DNA Mismatch Repair-Deficient Colorectal Cancers (LynchSyndrome)

Note: technical paper