abstract JCO: At What Cost Does a Potential Survival Advantage of Bevacizumab Make Sense for the Primary Treatment of Ovarian Cancer? A Cost-Effectiveness Analysis

Abstract

Purpose 

To determine whether the addition of bevacizumab to paclitaxel and carboplatin for the primary treatment of advanced ovarian cancer can be cost effective.

 Conclusion:

  The addition of bevacizumab to standard chemotherapy in patients with advanced ovarian cancer is not cost effective. Treatment with maintenance bevacizumab leads to improved PFS but is associated with both direct and indirect costs. The cost effectiveness of bevacizumab in the adjuvant treatment of ovarian cancer is primarily dependent on drug costs.

JCO Editorial + abstract/podcast: Bevacizumab (Avastin) for Advanced Breast Cancer: All Tied Up With a RIBBON? (the Ribbon-1 trial)

Editorial: Bevacizumab for Advanced Breast Cancer: All Tied Up With a RIBBON?

• Harold J. Burstein

JCO published online on March 7, 2011; DOI:10.1200/JCO.2010.33.2684.

• [PDF]
• [JCO Podcast]
• Breast Cancer RIBBON-1: Randomized, Double-Blind, Placebo-Controlled, Phase III Trial of Chemotherapy With or Without Bevacizumab for First-Line Treatment of Human Epidermal Growth Factor Receptor 2–Negative, Locally Recurrent or Metastatic Breast Cancer

JCO published online on March 7, 2011; DOI:10.1200/JCO.2010.28.0982.

• [Abstract]
• [JCO Podcast]

JCO March 7. 2011: Editorial Big Costs for Little Gain in Ovarian Cancer

Editorial: Big Costs for Little Gain in Ovarian Cancer

• Martee L. Hensley

JCO published online on March 7, 2011; DOI:10.1200/JCO.2010.34.0489.

• [PDF]
• [JCO Podcast]

Ohio State study: Targeted ovarian cancer therapy not cost-effective (Bevacizumab/Avastin)

Note: read the whole article
 ------------------------------------------------------------------------------------
Ohio State study: Targeted ovarian cancer therapy not cost-effective

COLUMBUS, Ohio – An analysis conducted by Ohio State University cancer researchers has found that adding the targeted therapy bevacizumab to the treatment of patients with advanced ovarian cancer is not cost effective.

The findings comparing the relative value of various clinical strategies will be published online March 7 in the Journal of Clinical Oncology (see blog)................ cont'd

"Although a discussion regarding cost-effectiveness of a potentially life-extending intervention invariably suggests the rationing of limited health care resources, the intent of this study was to provide a framework with which to evaluate the pending results of a clinical trial of three different interventions for ovarian cancer, said Cohn."............... cont'd

video - Treating Urogynocolgy

call for papers: Measuring Consumer Involvement in Health and Social Care: Dividing fact from fiction | Cochrane Consumer Network

Centre for Clinical Epidemiology & Evaluation - Research Links - Mon Mar 7, 2011 British Columbia

Medical News: SGO: Ovarian Ca Patients Shortchanged by Medicare - in Meeting Coverage, SGO from MedPage Today

Action Points  

---

• Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
• Explain that an analysis of NCI and Medicare databases found that less than 40% of patients over age 65 with advanced ovarian cancer received care that measures up to national standards.
• Note that this study found demographic factors -- including race, marital status, geographic location, and socioeconomic status -- affected whether patients over 65 received optimal treatment.

(Pixantrone ) Cell Therapeutics Inc Announces Meeting with FDA Officials - NASDAQ:CTIC | Galaxy Stocks

(social media) Patient health sites might be delivering bad medicine :: March 1, 2011 ... American Medical News

Editorial - Human gene patents limit access to care :: March 7, 2011 ... American Medical News

still recruiting: Quality of Life Associated With a Low-Risk Screening Program for Ovarian Cancer - Full Text View - ClinicalTrials.gov

Purpose

The goal of this research study is to learn more about how women feel about an ovarian cancer screening program that involves getting a blood test to measure CA 125 levels. This includes finding out about women's quality of life and whether they are concerned or worried about their risk of developing cancer. This study also seeks to find out whether elevated CA 125 levels affect participants in terms of cancer worries or concerns.

Therapeutic Targeting of Stress Factors in Ovarian Cancer Patients - Full Text View - ClinicalTrials.gov

Note Exclusion criteria: 
Exclusion Criteria:    a. Patients who receive neoadjuvant chemotherapy for their ovarian, primary peritoneal, or fallopian tube cancer are excluded....

Purpose

This research is looking at the effect of biobehavioral factors such as stress and whether these factors alter how the body responds to chemotherapy, one of the purposes of this study is to determine if the addition of a beta-blocker such as Propranolol (Inderal) is tolerable when given with chemotherapy in the treatment of newly diagnosed ovarian, fallopian tube, or primary peritoneal cancer. An additional purpose of the study is to understand if behavioral factors such as depression and anxiety can alter different blood markers that affect tumor vascularity. The Investigator wishes to determine whether the use of beta-blocker drugs such as Inderal, might alter these behavioral factors by drawing blood prior to and after the administration of Inderal as well as giving behavioral questionaires at different time points. Beta-blockers are commonly used for the treatment of hypertension, protection of the heart after a heart attack, and irregularities in heartbeats. Altering these factors might boost the immune system and affect other areas of cancer biology, thereby allowing the chemotherapy to be more effective. The significance of this research is that it may help improve our treatments of this disease in the future.

ABT-888 With Cyclophosphamide in Refractory BRCA-Positive Ovarian, Primary Peritoneal or Ovarian High-Grade Serous Carcinoma, Fallopian Tube Cancer, Triple-Negative Breast Cancer, and Low-Grade Non-Hodgkin's Lymphoma - Full Text View - ClinicalTrials.gov

10-year analysis of the ATAC trial: wrong conclusion? : The Lancet Oncology

"The 10-year analysis of the Arimidex, Tamoxifen, Alone or in Combination (ATAC) trial1 continues to show a difference in its primary endpoint of disease-free survival, which favours anastrozole as adjuvant treatment for postmenopausal women with hormone-responsive breast cancer. Ultimately, however, clinical trials have two aims: either to show improvement in survival, or in its quality.
Anastrozole has failed to meet these criteria when compared with tamoxifen."

SGO Annual Meeting on Women's Cancer

scroll down page to pdf file: Final Program

Caris Life Sciences to Present on Biomarker Expression at the Society of Gynecologic Oncologists 2011 Annual Meeting on Women's Cancer

Incidence and mortality in epithelial ovarian cancer by family history of any cancer - 2011

define: sororal
Of or pertaining to a sister; Related through someone's sister

Abstract
BACKGROUND:

Practically all data on familial risk in ovarian and other cancers are based on incident cancer, whereas familiality in cancer mortality is largely unknown. If fatal forms of cancer are a highly familial subtype, then familial risk for mortality may exceed that of incidence, which is relevant for clinical decision making and counseling.

METHODS:

Ovarian cancer patients in the nationwide Swedish Family Cancer Database were classified according to fatal and nonfatal (incident) family history. Familial risks for incident and fatal ovarian cancer were calculated for offspring based on their parental or sibling family history of any cancer using standardized incidence ratios (SIRs) for incidence and standardized mortality ratios (SMRs) for mortality. Offspring without family history were referents.

RESULTS:

The database included 24,757 mothers and 8138 daughters with ovarian cancer. When a mother had ovarian cancer, the SIR for incident ovarian cancer in daughters was 2.69, and when a sister had ovarian cancer it was 3.49. The SMRs for fatal cancer by fatal cancer in probands were 3.39 and 5.80, respectively. For fatal serous cancers among siblings, the SMR was 6.16, compared with 10.01 for the endometrioid type. Ovarian cancer was associated with maternal (SIR, 1.22; SMR, 1.56) and sororal breast cancer (SIR, 1.27). Another discordant association was between ovarian and paternal prostate cancer (SIR, 1.12; SMR, 1.66).

CONCLUSIONS:

Fatal familial risks were higher for concordant ovarian, ovarian-breast, and ovarian-prostate cancers than the corresponding incident risks. This may suggest that highly fatal subtypes exist for these cancers, calling for genetic dissection. Cancer 2011

Postmenopausal hormone use and incident ovarian cancer: Associations differ by regimen- Intl Journal of Cancer

"......Neither current nor former E + P use was associated with ovarian cancer risk (RR 1.08, 95% CI 0.86–1.35; RR 1.08, 95% CI 0.68–1.71, respectively, per 5-year increment). These findings suggest that progestins may mitigate some of the detrimental effects of estrogen on the ovarian epithelium."

Blog: Under Pressure: The Abyss (PRD Pelvic Radiation Disease) one woman's journey

Timing of administration of bevacizumab (Avastin) chemotherapy affects wound healing after chest wall port placement - Cancer

Definition: dehiscence - Separation of wound edges.

Abstract
BACKGROUND:

The authors investigated how the timing of administration of bevacizumab, a targeted vascular endothelial growth factor-inhibiting chemotherapeutic agent, affected the risk of wound healing in patients undergoing chest wall port placement.

CONCLUSIONS:

The risk of a wound dehiscence requiring chest wall port explant in patients treated with bevacizumab was inversely proportional to the interval between bevacizumab administration and port placement, with significantly higher risk seen when the interval is less than 14 days.

March 2011 (Cancer) The use of recombinant erythropoietin for the treatment of chemotherapy-induced anemia in patients with ovarian cancer does not affect progression-free or overall survival

Abstract
BACKGROUND.

Studies have suggested that erythropoietin-stimulating agents (ESAs) may affect progression-free survival (PFS) and overall survival (OS) in a variety of cancer types. Because this finding had not been explored previously in ovarian or primary peritoneal carcinoma, the authors of this report analyzed their ovarian cancer population to determine whether ESA treatment for chemotherapy-induced anemia affected PFS or OS.

CONCLUSIONS.

The current results indicated that there was no difference in cancer-related PFS or OS with use of ESA in this cohort of women treated for ovarian cancer.

Paper: Analysis of Quality of Life in Cancer Patients by Structural Equation Model (technical)

Note: see Table 1 for criteria/index of variables

Expression Compilation of Several Putative Cancer Stem Cell Markers by Primary Ovarian Carcinoma Open Access

Note: see Table 1 for cell types/stage included in study

".......None of the stem cell markers was expressed by all patients’ cells. No correlation with tumor type was demonstrated. The complexity of expression challenges the isolation of cancer stem cell."

Cancer Forums and News by PhD's

abstract (+references) Challenges Related to Developing Serum-Based Biomarkers for Early Ovarian Cancer Detection — Cancer Prev Res

 Challenges Related to Developing Serum-Based Biomarkers for Early Ovarian Cancer Detection

In this issue of the journal, Cramer and colleagues and Zhu and colleagues report carefully designed phase 3 assessments of candidate ovarian cancer screening biomarkers. The main conclusion is that CA-125 remains the “best of a bad lot”; the new candidates have fallen short of expectations. We review factors impeding the development of an effective ovarian cancer screening strategy, highlight the requirements related to validating proposed screening biomarkers, and emphasize the risks from premature clinical applications of unvalidated tests, all underscoring the need for new research strategies. Cancer Prev Res; 4(3); 303–6. ©2011 AACR.

Perspective on Cramer et al., p. 365

Zhu et al., p. 375

Related articles

Research Article: Ovarian Cancer Biomarker Performance in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Specimens Cancer Prev Res March 2011 4:365-374; doi:10.1158/1940-6207.CAPR-10-0195
• Abstract
Research Article: A Framework for Evaluating Biomarkers for Early Detection: Validation of Biomarker Panels for Ovarian Cancer Cancer Prev Res March 2011 4:375-383; doi:10.1158/1940-6207.CAPR-10-0193
• Abstract

(full free access) Cell - Hallmarks of Cancer: The Next Generation - references to ovarian cancer

update with patient/consumer/public responses: Patients With Unrealistic Expectations - NYTimes.com

Genetics Company Myriad May Shift From Patents To Proprietary Data | Intellectual Property Watch

media: (mother is ovarian cancer survivor) Patrick Dempsey puts on his car racing leathers for cancer charity event at Miami Speedway | Mail Online

Business Line : Companies News : Strides gets EU nod to market ovarian cancer drug (generic Carboplatin)

Mutation deep within an intron of MSH2 causes Lynch syndrome

".......... thus highlighting the need for more extensive sequencing approaches in families where routine procedures fail to find a mutation."

CHSPR - University of British Columbia: 2011 Health Policy Conference BOOMERANGST: Myths and Realities about health care for an aging population (Lewis/Berwick quote...)

Note:  1) includes influence of cancer/aging/demographics 2)  referenced via Hsien Seow presentation: "Inbalance. Not by chance. (Don Berwick quote: every system is perfectly designed to produce exactly the results it gets.  A systematic issue.) We have a system that provide PC only when patients are “dying” or at EOL. – actively dying." ...................................................................... Day 1: February 22, 2011

8:30 am -- Welcome from the co-chairs

Patricia Baird, University of British Columbia

Audio

Slides

9:00 am -- Opening Plenary: Myths and Realities about demographics

	Jay Olshansky, University of Illinois	Audio	Slides
	Alan Cassels, University of Victoria	Audio	Slides

11:00 am -- Session I: Will aging bankrupt the health care system?

	Michael Wolfson, University of Ottawa	Audio	Slides
	Stephen Duckett, University of Alberta	Audio	Slides

12:00 pm -- Lunch Presentation

Audio

Slides

1:15 pm -- Session II: Is it possible (or sensible) to differentiate health and social care?

	John Sloan, University of British Columbia	Audio	Slides
	Jon Glasby, University of Birmingham	Audio	Slides
	Vasanthi Srinivasan, Ontario Health Systems Strategy Division	Audio	Slides

2:45 pm -- Session III: Aging in (what) place?

	Carole Estabrooks, Canada Research Chair in Knowledge Translation	Audio	Slides
	Tine Rostgaard, Danish National Institute of Social Research	Audio	Slides
	Neena Chappell, Department of Sociology at the University of Victoria	Audio	Slides

Day 2: February 23, 2011

8:30 am -- Session IV: Whose death is it anyway?

	Hsien Seow, Cancer Care Ontario Research Chair	Audio	Slides
	Dr. Michael Dolan, Internal Medicine Physician	Audio	Slides
	Hon. Sharon Carstairs, P.C., Liberal Senate Forum	Audio

10:30 am -- Session V: Is aging a disease?

	Matthew Farrer, Centre for Molecular Medicine and Therapeutics	Audio	Slides
	Ross Upshur, University of Toronto Joint Centre for Bioethics	Audio	Slides

12:00 pm -- Closing Plenary Speaker

Steven Lewis, Health Care Consultant, Saskatoon

Audio

Cochrane review: Interventions for preventing neuropathy caused by cisplatin and related compounds

AUTHORS' CONCLUSIONS: At present, the data are insufficient to conclude that any of the purported chemoprotective agents (acetylcysteine, amifostine, calcium and magnesium, diethyldithiocarbamate, glutathione, Org 2766, oxycarbazepine, or Vitamin E) prevent or limit the neurotoxicity of platin drugs among human patients.

2011 March - Ovarian Cancer Biomarker Performance in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Specimens — Cancer Prev Res

Abstract

Establishing a cancer screening biomarker's intended performance requires “phase III” specimens obtained in asymptomatic individuals before clinical diagnosis rather than “phase II” specimens obtained from symptomatic individuals at diagnosis. We used specimens from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial to evaluate ovarian cancer biomarkers previously assessed in phase II sets. Phase II specimens from 180 ovarian cancer cases and 660 benign disease or general population controls were assembled from four Early Detection Research Network or Ovarian Cancer Specialized Program of Research Excellence sites and used to rank 49 biomarkers. Thirty-five markers, including 6 additional markers from a fifth site, were then evaluated in PLCO proximate specimens from 118 women with ovarian cancer and 474 matched controls. Top markers in phase II specimens included CA125, HE4, transthyretin, CA15.3, and CA72.4 with sensitivity at 95% specificity ranging from 0.73 to 0.40. Except for transthyretin, these markers had similar or better sensitivity when moving to phase III specimens that had been drawn within 6 months of the clinical diagnosis. Performance of all markers declined in phase III specimens more remote than 6 months from diagnosis. Despite many promising new markers for ovarian cancer, CA125 remains the single-best biomarker in the phase II and phase III specimens tested in this study.  

Cancer Prev Res; 4(3); 365–74. ©2011 AACR. 

Read the Commentary on this article by Jacobs et al., p. 299

Read the Commentary on this article by Mai et al., p. 303

Footnotes

• Note: This is the first of two companion manuscripts submitted under separate cover.

• Received August 10, 2010.
• Revision received November 22, 2010.
• Accepted December 8, 2010.

• ©2011 American Association for Cancer Research

Related articles

Perspectives: The Sine Qua Non of Discovering Novel Biomarkers for Early Detection of Ovarian Cancer: Carefully Selected Preclinical Samples
• Ian Jacobs and
• Usha Menon
Cancer Prev Res March 2011 4:299-302; doi:10.1158/1940-6207.CAPR-11-0048
• Abstract
• Full Text
• Full Text (PDF)
• Related Article
Perspectives: Challenges Related to Developing Serum-Based Biomarkers for Early Ovarian Cancer Detection
• Phuong L. Mai,
• Nicolas Wentzensen,
• and Mark H. Greene
Cancer Prev Res March 2011 4:303-306; doi:10.1158/1940-6207.CAPR-11-0053
• Abstract
• Full Text
• Full Text (PDF)
• Related Article

Patient Safety in Surgery | Full text | Patterns of unexpected in-hospital deaths: a root cause analysis

open access journal: Patient Safety in Surgery | Home

Patient Safety in Surgery is an open access, online journal that publishes papers on all issues related to safety and quality of patient care in surgery and surgical subspecialties.

Is Heart Disease Inevitable for Women? Heart Health Tool Kit for Every Decade of a Woman's Life

Cardiology in Review:

March/April 2011

doi: 10.1097/CRD.0b013e318209a711

Lansley: understaffing is not excuse for 'never events' | News | Nursing Times (patient safety/"never events"....)

CDC Features - Protecting Patients With Central Lines (pic lines)

"One type of infection, called a bloodstream infection, can happen when a doctor puts in a central line (a tube that goes into a large vein of a patient's body – usually chest or neck) to give medicine. If the central line or area around it gets dirty, germs can enter the patient's bloodstream and cause infection. Bloodstream infections in patients with central lines can be deadly, killing as many as 1 in 4 who gets them.

Healthcare providers in hospital intensive care units (ICUs) have been working for years to stop bloodstream infections in patients with central lines. A new CDC Vital Signs report shows that their efforts have been largely successful.....cont'd

Homepage - TCGA Understanding Human Genomics

also:

February 22, 2011
The Cancer Genome Atlas Announces Sessions at the AACR 2011 Annual Meeting

Imedex: conference notice - Great Debates & Updates in Gynecologic Malignacies

Great Debates & Updates
in Gynecologic Malignancies

April 9, 2011

New York, New York

During the scientific sessions, speakers and the audience can exchange information through a “hands-on” computerized speaker-audience interaction system. With this state-of-the-art equipment, participants answer multiple choice questions, and within seconds, the answers are calculated and projected on a screen in tabular or graphic form for all to see. This system maximizes the ability for attendees from diverse disciplines to see differing opinions and compare consensus between the speakers and each other.
Imedex
11675 Rainwater Drive, Suite 600
Alpharetta, GA 30009, USA
Tel.: +1 (770) 751 7332
Fax: +1 (770) 751 7334
Email: meetings@imedex.com
Web: www.imedex.com

Platinum today: (Picoplatin - Phase 1) Platinum-based cancer treatment moves to clinical trial phase

Platinum-based cancer treatment moves to clinical trial phase 1st March 2011

Chinese authorities have given the go-ahead for clinical trials of a new platinum-based cancer treatment.

Poniard Pharmaceuticals was granted Clinical Trial Application (CTA) approval by the Chinese State Food and Drug Administration (SFDA) to progress with two Phase III clinical studies of picoplatin for the treatment of small cell lung cancer and ovarian cancer.

The biopharmaceutical company said picoplatin has already shown promise in treating both these types of cancer.

It is designed to overcome platinum resistance associated with chemotherapy in solid tumours, the company explained.

Ronald A Martell, chief executive officer of Poniard Pharmaceuticals, described the SFDA decision as a "milestone", which combined with two recent draw downs totalling $3.4 million (£2.1 million), will provide the company with additional leverage as it works towards completing its strategic review.

"We believe that CTA approval from the SFDA enhances picoplatin's value proposition to potential partners in two important disease settings in which picoplatin has demonstrated strong clinical potential," he added.

Source:

Poniard Pharmaceuticals Receives Chinese State FDA Approval for Clinical Development of Picoplatin (01/03/11)

(RNA ALK7) York University researchers uncovering how ovarian cancer resists chemotherapy

The study's lead author, Gang Ye, is a Research Associate in Peng's lab. Several trainees in Peng's lab, as well as scientists in Toronto's Sunnybrook Research Institute and in China also participated in the project.
The research was supported by an operating grant from the Canadian Institutes of Health Research (CIHR) and a mid-career award to Peng from the Ontario Women's Health Council/CIHR. Ye was supported in part by a Fellowship from the Toronto Ovarian Cancer Research Network.
York University is the leading interdisciplinary research and teaching university in Canada.

Q&A: Focus on Virtual Colonoscopy - Cancerwise | Cancer blog from MD Anderson Cancer Center

included comment:

What types of research is MD Anderson doing?

"Since bowel preparation is the largest barrier to most people seeking colon cancer screening, my research involves the development of new bowel cleansing approaches. These include solutions to dissolve feces and remove it from below without the need to drink the usual cleansing agents."

podcast/text: Benefits and Dangers of Vitamin Supplements for Cancer Patients - Cancerwise | Cancer blog from MD Anderson Cancer Center

Note: includes discussion regarding cardiovascular risks

Reputable online resources
Through online resources, patients can check into the efficacy and safety of herbal or natural supplements. MD Anderson has several online articles and web pages that provide information about supplements and nutrition. The Learning Center at MD Anderson can also provide information on other reputable online resources.

HVO Welcomes Society of Gynecologic Oncologists as Sponsor

HVO Welcomes Society of Gynecologic Oncologists

as Sponsor



[Washington, DC - February 26, 2011] - Health Volunteers Overseas is pleased to announce that the Society of Gynecologic Oncologists has joined as a sponsor. According to the World Health Organization (WHO), cancer is one of the leading causes of death worldwide. The WHO reports that in 2005, cancer accounted for 7.6 million of all deaths with more than 70% of these cancer deaths occurring in the developing world. WHO projects 9 million people will be dying from cancer in 2015. These startling statistics show the great need for oncology training in the developing world.

How Will Myriad Respond to the Next Generation of BRCA Testing? GenOmics

N.L. may send more cancer tests to Ontario - Nfld. & Labrador - CBC News (pathology)

"The departure of a pathologist from Newfoundland and Labrador's largest health authority last month may force the province to send breast cancer laboratory samples out of the province for assessment.

Breast cancer pathologist Dr. Nikita Makretsov resigned from the health authority, effective February 14, 2011......"cont'd

SGO annual meeting - Special Session Highlights Late-Breaking Abstract -- CHICAGO, Feb. 28, 2011 press release: - adherence with NCCN guidelinelines 144,449 ovarian cancer patient study/database

Featured Late-Breaking Abstract for 2011
The following late-breaking abstract will be highlighted during the LBA session, March 8:

• Adherence with National Comprehensive Cancer Network (NCCN) Guidelines Associated with Improved Survival in Ovarian Cancer Patients, A Study of 144,449 Patients From the National Cancer Data Base: A Project from The Society of Gynecologic Oncologists (SGO) Quality and Outcomes Committee -- M. Powell

"A recent outcomes analysis coordinated by the SGO's Quality and Outcomes Committee indicates that a majority of women with invasive epithelial ovarian carcinoma received care that fell short of National Comprehensive Cancer Network (NCCN) guidelines. Further, women who received care following the guidelines enjoyed improved survival. The study also notes an ongoing opportunity for improved documentation of stage, sub-stage and grade information in the National Cancer Data Base. The abstract will be presented on Tuesday, March 8, during the Late-Breaking Abstracts (LBA) session at the Annual Meeting...cont'd

full free access (pdf) A nomogram for estimating the probability of ovarian cancer

Note:  see Table 1       Distribution of age in years, morphology index ultrasound score, and serum CA125 level among patients with benign and malignant adnexal masses

Objective

Accurate preoperative estimates of the probability of malignancy in women with adnexal masses are essential for ensuring optimal care. This study presents a new statistical model for combining predictive information and a graphic decision support tool for calculating risk of malignancy.

Research Highlights

►This study presents a statistical model for measuring probability of ovarian cancer.
►Model includes age, ultrasound score, CA125 value, and nonlinearity adjustments.
►Excellent discrimination and calibration are obtained across the probability range.

"The nomogram developed in this study is not ready for clinical use, because it reflects the experience of a single institution. Further research using data from multiple institutions is required to develop a final model. However, these results demonstrate that accounting for non-linearity in the effects of age and CA125 yields better estimates of malignancy risk. Utilization of similar models in the treatment decision making process could reduce unnecessary referrals and increase appropriate referrals for women with masses identified pre-operatively as suspicious for malignancy."

full free access (pdf): Improved survival in non-Ashkenazi Jewish ovarian cancer patients with BRCA1 and BRCA2 gene mutations

OBJECTIVES: Previous studies report a survival advantage in ovarian cancer patients with Ashkenazi Jewish (AJ) breast cancer gene (BRCA) founder mutations. The purpose of this study was to determine if this association exists in patients with non-Ashkenazi Jewish (non-AJ) BRCA mutations. We also sought to account for "survival bias" by minimizing lead time that may exist between diagnosis and genetic testing.
CONCLUSIONS: This multicenter study demonstrates a significant survival advantage in advanced stage ovarian cancer patients with non-AJ BRCA mutations, confirming the previous studies in the Jewish population. This improved survival was evident when accounting for the "survival bias" that coincides with genetic testing.

full free access (pdf): A phase I study with an expanded cohort to assess the feasibility of intraperitoneal carboplatin and intravenous paclitaxel in untreated ovarian, fallopian tube, and primary peritoneal carcinoma: A Gynecologic Oncology Group study

Research Highlights

► The MTD (maxium tolerated dose) of IP carboplatin with IV paclitaxel (175 mg/m²) was an AUC 8.
►IP carboplatin can be given with IV paclitaxel over multiple cycles at an AUC 6.
►Dose-limiting toxicities of IP carboplatin were thrombocytopenia and leukopenia.

full free access: Feasibility of same-day discharge after laparoscopic surgery in gynecologic oncology

OBJECTIVE: The purpose of this study is to evaluate whether same-day discharge after laparoscopic gynecologic oncology surgery is feasible and determines factors associated with admission.

METHODS: This retrospective cohort study included all patients consented for laparoscopy by two gynecologic oncologists at a tertiary care academic teaching hospital between January 2006 and June 2009. Procedures included those not typically discharged same-day, such as total laparoscopic simple or radical hysterectomies or radical trachelectomy +/- salpingo-oophorectomy +/- pelvic and para-aortic lymph node dissection +/- omentectomy. Those discharged same-day were compared to those admitted. Multivariate logistic regression analysis was done to determine factors associated with admission.

RESULTS: Three hundred three patients were included. 6.9% were converted to laparotomy. One hundred forty-seven (48.5%) had same-day discharge (median stay 295minutes). Among outpatients, 7 (4.8%) were readmitted within three weeks of surgery. Three patients (2%) could have avoided the ER or hospital admission had they been originally admitted postoperatively. No patients with same-day discharge had a major acute postoperative complication. Factors associated with admission include age (OR 1.76 for age 70years vs 50years, p=0.001), surgeon (OR 6.91, p<0.0001), conversion to laparotomy (p<0.0001), radical hysterectomy (OR 3.43, p=0.002), length of surgery (OR 2.94 for 4hours vs 2hours, p<0.0001), and surgery start time after 1PM (OR 3.77, p=0.0001).

CONCLUSION: Same-day discharge for laparoscopic gynecologic oncology surgery is feasible, with low morbidity and few readmissions within three weeks of surgery. Successful same-day discharge can increase by refining patient selection and operating room scheduling.

full free access: CA125 surveillance increases optimal resectability at secondary cytoreductive surgery for recurrent epithelial ovarian cancer

CONCLUSIONS: Each week delay after first CA125 elevation correlated with a 3% increased chance of suboptimal resection at SCS (secondary cytoreductive surgery). Serial CA125 surveillance for early detection of recurrence may increase rates of optimal SCS and potentially influence overall survival.  (47 vs. 23months, p<0.0001)

full free access: Meta-analysis: Circulating vitamin D and ovarian cancer risk

OBJECTIVE: To review and summarize evidence from longitudinal studies on the association between circulating 25 hydroxyvitamin D (25(OH)D) and the risk of ovarian cancer (OC).


RESULTS: Overall, ten individual-level studies were included that reported on the association between circulating vitamin D levels and OC incidence..........

CONCLUSIONS: A tentative inverse association of circulating 25(OH)D with OC incidence was found, which did not reach statistical significance but which requires clarification by additional studies due to potentially high clinical and public health impact.

Research Highlights

►As we know, this is the first systematic review and meta-analysis evaluating the association between serum 25(OH)D levels and ovarian cancer risk.
►The method for comprehensive trend estimation from summarized dose–response data was used for combining all results from individual studies so far.
►A potential weak inverse association between serum vitamin D and ovarian cancer risk was found in this meta-analysis.

full free access: Wound complications after gynecologic cancer surgery

Definitions of adhesiolysis:
Scar tissue can form as a result of prior surgery or infections involving reproductive tact, urinary tract or vaginal canal causing severe pain. Adhesiolysis is the surgical procedure used to remove this scar tissue.
www.urogyncenter.com/ug-glossary.htm

Research highlights

► Retrospective review of patients undergoing abdominal surgery for suspected cancer.
► Wound complications correlated with BMI, prior surgery, albumin, adhesiolysis, length of surgery.
► A nomogram predicting post-operative wound complications was created and validated.

Nuclear P27 (gene) expression in benign, borderline (LMP) and invasive tumors of the ovary and its association with prognosis: A GOG group study

Abstract

Objective

Nuclear p27 expression was examined in non-invasive and invasive ovarian tumors from a cross-sectional study, and clinical relevance of p27 was evaluated in the primary tumors from women participating in two randomized phase III treatment trials.

Methods

An immunohistochemistry assay was used to detect p27 in formalin-fixed paraffin-embedded ovarian tumors from 3 distinct sources.

Research Highlights

► Low p27 expression is associated with malignant transformation of the ovary.
► A cyclin E to p27 ratio > 1.0 may be associated with shorter survival.
► Study required confirming increased recurrences with low p27 in early stage patients.

Correlation of macroscopic and microscopic pathology in risk reducing salpingo-oophorectomy: Implications for intraoperative specimen evaluation

Abstract Objective

A minority of risk-reducing salpingo-oophorectomy (RRSO) specimens from BRCA mutation carriers will contain clinically occult carcinoma that is detectable only using a specialized pathologic evaluation protocol. Although intraoperative detection of cancer may alter immediate surgical management, technical complications impairing pathologic diagnosis may result if fresh tissue dissection and frozen sections are performed on unselected RRSO specimens. We hypothesize that macroscopic specimen findings may predict which RRSO specimens contain cancer and therefore may guide selection of specimens for intraoperative pathologic evaluation. The aim of this study was to correlate the macroscopic and microscopic pathologic findings in RRSO.

 Research highlights

► Most occult carcinomas detected in RRSO specimens were not grossly visible.
► A minority of visible nodules >5 mm in the ovary or tube harbored occult carcinoma.
► No cancer was identified in any of the grossly visible cysts of the ovary or tube.

Review Multidisciplinary management of malignant ovarian germ cell tumours

Abstract

Objectives

Malignant ovarian germ cell tumours (MOGCT) are rare cancers of young women. Limited prospective trials exist from which evidence-based management can be developed. This review summarizes the available literature concerning MOGT in order to provide the clinician with information relevant to their multidisciplinary management.

Research Highlights

►Ovarian germ cell tumours are highly curable.
►Treatment options are limited for recurrent and residual tumours. ►Long term results suggest no significant impact on fertility and menstrual function.

Multiple synchronous primary ovarian malignancies in a patient with a MLH-1 mutation: Impact on potential fertility preservation (MLH1 is one of the Lynch Syndrome genes) including commentary

"EOC associated with HNPCC syndrome differs compared to sporadic cases with mean age at diagnosis of 42.7"


(Note: Definition synchronous: occurring or existing at the same time)

  Abstract:

Introduction

While the majority of epithelial ovarian cancer (EOC) is due to sporadic mutations, approximately 10% of cases are secondary to hereditary germ line mutations: 85–90% of tumors are caused by BRCA1 and BRCA2 gene mutations while hereditary non-polyposis colorectal cancer (HNPCC), or Lynch syndrome, accounts for the remainder [1].

HNPCC patients may have synchronous primary tumors at the time of prophylactic or therapeutic surgery, involving the colon, ovary, uterus or a combination thereof. We present an unusual case of a patient with HNPCC syndrome and three primary ovarian neoplastic processes without coexisting colon or uterine malignancies, and underscore the importance of hysterectomy and bilateral salpingo-oophorectomy in cancer-associated mutation carriers from Lynch syndrome families........cont'd




Also: link to referenced article:
Cancer 

Fertility preservation in young women with epithelial ovarian cancer 
Volume 115, Issue 18, 15 September 2009, Pages 4118-4126  

METHODS: Women aged ≤50 years with stage IA or IC epithelial ovarian cancer who were registered in the Surveillance, Epidemiology, and End Results database were examined.......cont'd

abstract: A microRNA survival signature (MiSS) for advanced ovarian cancer (serous)

 Abstract

Objectives

MicroRNAs (miRNAs) are a class of small non-coding RNAs that negatively regulate gene expression primarily through post-transcriptional modification. We tested the hypothesis that miRNA expression is associated with overall survival in advanced ovarian cancer.

Results

Of all patients, 80% had high-grade, stage IIIC tumors and 64% underwent optimal cytoreduction. The median survival for the entire cohort was 49 ± 4 months. The training set identified 3 miRNAs associated with survival — miR-337, miR-410, and miR-645. An miRNA signature containing miR-410 and miR-645 was most strongly associated with overall survival in the training set (HR = 2.96, 95% CI: 1.51–5.78). This miRNA survival signature (MiSS) was validated in the test set (HR = 1.71, 95% CI: 1.05–2.78). The MiSS was independent of FIGO stage and surgical debulking.

Conclusions

The data suggest that an MiSS that contains miR-410 and miR-645 is negatively associated with overall survival in advanced serous ovarian cancer. This signature, when further validated, may be useful in individualizing care for the ovarian cancer patient. Pathway analyses identify biologically plausible mechanisms.

Research highlights

► A MicroRNA Survival Signature was developed in advanced ovarian carcinoma.
► The signature was independent of common clinical co-variates.

Cancer claims more in rural areas (references ovarian cancer survivour) - Sunshine Coast Health |- media

Recommended Adult Immunization Schedule --- United States, 2011 including those with health conditions- Fig. 2

FIGURE 2. Vaccines that might be indicated for adults, based on medical and other indications --- United States, 2011

Alternate Text: The figure above shows vaccines that might be indicated for adults, based on medical and other indications in the United States for 2011.

NOTE: The above recommendations must be read along with the footnotes on pages 3--4 of this schedule.

Clinical practice guidelines as marketing tools -- Collier 183 (3): E141 -- Canadian Medical Association Journal

Blogger's Note: bias exist no matter the source, what does matter is the degree and ultimately the intent (ethics)
 ....................................................................................
"If the guidelines are funded by government or private donors, a bias toward recommending particular pharmaceuticals may not be present."

Andrew's Blog » Cancer Survivorship and Fear

Fear. For us it is not clinical routine. It is our lives on the line at diagnosis or at a checkup.

abstract: The use of Chinese herbal medicine to improve quality of life in women undergoing chemotherapy for ovarian cancer: a double-blind placebo-controlled randomized trial with immunological monitoring — Ann Oncol

Background: This study aimed to evaluate traditional Chinese medicine (TCM) in improving quality of life (QOL), reducing chemotoxicity and modulating immune function in patients undergoing chemotherapy.  

Review Article: A Systematic Review of Cancer-Related Fatigue Measurement Questionnaires

Discussion:
Most tools had been validated in mixed populations and are relatively insensitive to differences in fatigue to cancer stage. Most instruments are burdensome for those with advanced cancer.


Conclusions:
In all, 40 CRF instruments were identified. Validity and reliability varied by questionnaire. The ideal item numbers, scale, and domains are not established and may be population dependent.

Warfarin (Coumadin)- fp notebook update

Coumadin (Warfarin Sodium) Drug Information: User Reviews, Side Effects, Drug Interactions and Dosage at RxList

Coumadin

• Coumadin Drug Description
• Coumadin Indications & Dosage
• Coumadin Side Effects & Drug Interactions
• Coumadin Warnings & Precautions
• Coumadin Overdosage & Contraindications
• Coumadin Clinical Pharmacology
• Coumadin Medication Guide
• Coumadin Consumer
• Coumadin Patient

Check Your Warfarin | C3: Colorectal Cancer Coalition

abstract: Prognostic and predictive relevance of CA-125 at primary surgery of ovarian cancer(early/advanced stages)

ESMO: Community Oncology: Ensuring the Best Standards of Care

“The important thing is that community oncologists should not work alone. They should be part of a network and participate in a common reflection and also work with others in clinical research. In France, community oncologists work closely with university hospitals or big cancer centers and are in contact with larger teams. National and international guidelines are followed and ensure that patients receive quality treatment.”

abstract: Pleural Effusion Detected at CT prior to Primary Cytoreduction for Stage III or IV Ovarian Carcinoma: Effect on Survival

Purpose: To determine the prognostic importance of pleural effusions on preoperative computed tomographic (CT) images in patients with advanced epithelial ovarian cancer.

abstract : Red and processed meat consumption and risk of ovarian cancer: a dose-response meta-analysis of prospective studies : British Journal of Cancer

Conclusion:

Results from this dose-response meta-analysis suggest that red and processed meat consumption is not associated with risk of ovarian cancer. Although a lower consumption of red and processed meat may offer protection against other types of cancer, other interventions are needed to reduce the risk of ovarian cancer.

David Moher - Systematic Reviews & Prospero Register | Open Medicine Blog-PROSPERO International

PROSPERO - International prospective register of systematic reviews

PROSPERO is an international database of prospectively registered systematic reviews in health and social care. Key features from the review protocol are recorded and maintained as a permanent record in PROSPERO. This will provide a comprehensive listing of systematic reviews registered at inception, and enable comparison of reported review findings with what was planned in the protocol.

Substantial changes to the review questions or methods

• It can be difficult to decide whether an update to a review is in fact a new review. There is little published guidance on this. PROSPERO adopts a pragmatic approach. If changes to the review questions or methods are so substantial that they require major changes to the original protocol, this should be regarded as a new review rather than an update.

Examples that would constitute a new review

• addition of new treatment comparisons
  e.g. direct comparison of different drugs, when the old review included only comparisons of drug with placebo
• substantial changes to the population being studied
  e.g. adding adults to a review that was previously restricted to children
• exclusion criteria in the old review become inclusion criteria in the new review
• introduction of new analysis techniques
  e.g. a switch from aggregate data meta-analyses to individual participant meta-analyses.
  

If in doubt, a new record for a new review should be created. This will minimise the complexity of the editing to the original record in PROSPERO and make it easier for users to distinguish between the original review and the later version. Links between the new and original review can be added in the registration form.

Mechanical Bowel Preparation for Gynecologic Laparoscopy: A Prospective Randomized Trial of Oral Sodium Phosphate Solution vs Single Sodium Phosphate Enema (including safety issues)

Mechanical Bowel Preparation for Gynecologic Laparoscopy: A Prospective Randomized Trial of Oral Sodium Phosphate Solution vs Single Sodium Phosphate Enema

References and further reading may be available for this article. To view references and further reading you must purchase this article.

Abstract

Study Objective

To compare the effect of mechanical bowel preparation using oral sodium phosphate (NaP) solution vs single NaP enema on the quality of the surgical field in patients undergoing advanced gynecologic laparoscopic procedures.

The Art of Oncology series (ASCO) full free access: Negotiations and Love Songs

full free access: (2010) MSH6 and PMS2 mutation positive Australian Lynch syndrome families: novel mutations, cancer risk and age of diagnosis of colorectal cancer

Background

Approximately 10% of Lynch syndrome families have a mutation in MSH6 and fewer families have a mutation in PMS2. It is assumed that the cancer incidence is the same in families with mutations in MSH6 as in families with mutations in MLH1/MSH2 but that the disease tends to occur later in life, little is known about families with PMS2 mutations. This study reports on our findings on mutation type, cancer risk and age of diagnosis in MSH6 and PMS2 families..........cont'd

"Lynch syndrome is an autosomal dominantly inherited cancer syndrome characterised by early onset epithelial cancers. Patients with Lynch syndrome have an increased risk of developing malignancies during their lifetime, at a mean age of disease onset that is significantly lower than that observed in the general population. In addition to the high risk of developing CRC, Lynch syndrome patients are also at risk of developing malignancies in a variety of organs that include the uterus, small bowel, stomach, ovary, bladder, pancreas and the urinary tract [2,3]."

Groundbreaking Australian Study Examines Treatment For Women With Ovarian Cancer

....More Than A Month To Record Ovarian Cancer Diagnosis In One In 10 Cases

Perspectives: Sleep Deprivation, Elective Surgical Procedures, and Informed Consent — NEJM (including commentaries)

EvidenceUpdates: Comparing the diagnostic performance of 2 clinical decision rules to rule out deep vein thrombosis in primary care patients including commentaries

Note: secondary link below w/o commentaries BUT full free access, also see Table 1 for risk factors including malignancies:

Comparing the Diagnostic Performance of 2 Clinical Decision Rules to Rule Out Deep Vein Thrombosis in Primary Care Patients

(why it's important)

"With an annual incidence of 1 to 2 per 1,000 inhabitants, deep vein thrombosis (DVT) is relatively rare in primary care, but it is feared for its associated morbidity and mortality if left untreated...."

Oncology STAT on IP chemo & dense dose regime | Cancer Survivors Network (discusses Avastin, Taxol, (Japanese study), clear cell, IP....)

Ovarian Cancer—New Thinking on Old Regimens

2011 Feb 23, Nelson Teng

Rare Disease Day 2011 - Find out what is happening in your country

website TCGA Cancer Genomics + 20 cancer study (including ovarian) updated Jan 2011

About Cancer Genomics

Explore information and resources to improve your understanding
of cancer genomics, the importance of tumor samples in genomic
research and the role of cancer genomics in personalized medicine.

plus:

Cancers Selected for Study

Following the success of The Cancer Genome Atlas (TCGA)
Pilot Project, NIH announced in September 2009 that it is
investing $275 million in TCGA over the next two years of
this five-year program to chart the genomic changes
involved in more than 20 types of cancer. To date,
TCGA has achieved comprehensive sequencing,
characterization, and analysis of the genomic changes
in the brain cancer, glioblastoma multiforme, and
ovarian cancer.

CANCER TISSUES BEING COLLECTED FOR POTENTIAL STUDY

Last Updated: January 16, 2011 Expand All | Collapse All

Central Nervous System (Brain)

Cancer Type	Sample Collection Complete	Data Publicly Available
Glioblastoma Multiforme

Breast

Cancer Type	Sample Collection Complete	Data Publicly Available
Breast Lobular Carcinoma
Breast Ductal Carcinoma

Gastrointestinal

Cancer Type	Sample Collection Complete	Data Publicly Available
Colon Adenocarcinoma
Rectal Adenocarcinoma
Stomach Adenocarcinoma

Gynecologic

Cancer Type	Sample Collection Complete	Data Publicly Available
Ovarian Serous Cystadenocarcinoma
Uterine Corpus Endometrial Carcinoma

Head and Neck

Cancer Type	Sample Collection Complete	Data Publicly Available
Head and Neck Squamous Cell Carcinoma
Thyroid Carcinoma

Hematologic

Cancer Type	Sample Collection Complete	Data Publicly Available
Acute Myeloid Leukemia

Thoracic

Cancer Type	Sample Collection Complete	Data Publicly Available
Lung Adenocarcinoma
Lung Squamous Cell Carcinoma

Urologic

CME/Conference Management - Lynch Syndrome Patient Conference - MD Anderson Cancer Center Apr 2, 2011

Lynch Syndrome Patient Conference

April 2, 2011-Saturday 9 a.m. – 3 p.m.

Hyatt Regency Hill Country
9800 Hyatt Resort Drive
San Antonio, Texas

Registration fee: $20. prior to March 11th, 2011

Commentary: microRNAs in stage I epithelial ovarian cancer : The Lancet Oncology

"In epithelial ovarian cancer (EOC), miRNA-expression profiles have been described that are associated with different characteristics of ovarian cancer (eg, tumour subtype, stage, histological grade, prognosis, and therapy resistance)........However, these studies should focus on pure histotypes, as EOC is thought to be a heterogeneous disease in which some histotypes are completely different entities all together, with different response outcomes to standard treatment. Another confounding factor for prognostic marker discovery might be exposure to platinum-based combination chemotherapy. Preferably, only patients who did not receive chemotherapy should be analysed for PFS. Because stage I EOC samples are relatively rare, we encourage additional studies to be done by international consortia. With the above-mentioned considerations in mind, valid miRNA biomarkers will be identified that can be of use in the clinic, and help to personalise treatment."

clinical trial recruiting: Women Who Are At Risk Or May Have Lynch Syndrome - Full Text View - ClinicalTrials.gov

ClinicalTrials.gov Identifier: NCT00508573

Estimated Enrollment:	1000
Study Start Date:	May 2007
Estimated Primary Completion Date:	May 2012 (Final data collection date for primary outcome measure)

abstract: Challenging cases encountered in colorectal cancer screening for Lynch syndrome reveal novel findings: nucleolar MSH6 staining and impact of prior chemoradiation therapy

abstract: Familial Tumors of the Uterine Corpus

Abstract

Women with Lynch syndrome are at considerable risk for developing endometrial carcinoma, but current screening guidelines for detection of Lynch syndrome focus almost exclusively on colorectal carcinoma. Lynch syndrome associated colorectal and endometrial carcinomas have some important differences with implications for screening strategies. These differences are discussed in this review, along with the most effective screening criteria and testing methods for detection of Lynch syndrome in endometrial carcinoma patients.

full free access: The relative risk of second primary cancers in Queensland, Australia: a retrospective cohort study

Association between miR-200c and the survival of patients with stage I epithelial ovarian cancer: a retrospective study of two independent tumour tissue collections : The Lancet Oncology

Interpretation

miR-200c has potential as a predictor of survival, and is a biomarker of relapse, in stage I EOC.

full free access: Bisphosphonate Use and the Risk of Subtrochanteric or Femoral Shaft Fractures in Older Women, February 23, 2011 JAMA

Conclusion Among older women, treatment with a bisphosphonate for more than 5 years was associated with an increased risk of subtrochanteric or femoral shaft fractures; however, the absolute risk of these fractures is low.

Treatment-Related Mortality With Bevacizumab in Cancer Patients, February 2, 2011— JAMA review - 2.5 vs 1.7 % risk not dependent on type of solid tumor/dose

Data Synthesis: A total of 10 217 patients with a variety of advanced solid tumors from 16 RCTs were included in the analysis. The overall incidence of FAEs with bevacizumab was 2.5% (95% CI, 1.7%-3.9%). Compared with chemotherapy alone, the addition of bevacizumab was associated with an increased risk of FAEs, with an RR of 1.46 (95% CI, 1.09-1.94; P = .01; incidence, 2.5% vs 1.7%). This association varied significantly with chemotherapeutic agents but not with tumor types or bevacizumab doses.

Ovarian Cancer Biomarkers for Molecular Biosensors: Medscape review including commentary

video/text: Hysterectomy and Cardiovascular Disease: Conserve the Ovaries?

Dermatological Manifestations of Cancer Syndromes in Children: Medscape (full free access) Lynch Syndrome/others

Note: See Table 1 for syndromes/familial genetics

When the Doctor's Wife Has Breast Cancer - NYTimes.com

Abstract: Persistent Noncompliance With the Work-Hour Regulation (patient safety)

Note:
the Transportation Industry has been dealing with 'hours of service'
issues for decades    (same issues/different industry - fatigue)

 NOTE: A new Hours-of-Service (HOS) Proposed Rulemaking was published
on December 29, 2010. For details, visit the HOS Proposed Rule page to view the complete rulemaking, summary of changes, FAQs, and other related information.

Health-related quality of life and cancer clinical trials — Therapeutic Advances in Medical Oncology

"...Health-related quality of life has become a more accurate predictor of survival than some other clinical parameters, such as performance status. The overall outlook for the routine assessment of patient-reported outcomes in clinical trials is assured and, eventually, it is likely to become a standard part of clinical practice. ...."

Feb 21st, 2011: Ovarian cancer - Cancer Network (worth reading/overview of ovarian cancer)

Note: good overview of ovarian cancer biology, treatments, genetics, diet, environment, hormonal factors...

By Stephen C. Rubin, MD, Paul Sabbatini, MD, and Akila N. Viswanathan, MD, MPH | February 21, 2011

Expert Perspectives in Oncology: Contemporary Approaches in Targeting Angiogenesis prIME Oncology

Note: requires registration to view (free), also speaks about ICON 7 (ovarian cancer/avastin trial) Module Six Practical Considerations in Patient Management Involving Antiangiogenic Therapy

St. Gallen Satellite Symposium titled,: “‘Perplexing Questions in Early Breast Cancer: Answers from the Experts | prIME Oncology

Note: requires registration to view (free)

Meeting Overview
We are pleased to invite you to our St Gallen Satellite Symposium titled, “Perplexing Questions in Early Breast Cancer: Answers from the Experts," to be held on 17 March 2011 in St Gallen, Switzerland.

During this interactive meeting, leaders in the field will discuss clinical issues in the field of early breast cancer.

Women's health: Yearly pelvic exams' effectiveness questioned - latimes.com

Note: 'old' news

Prima BioMed Receives Regulatory Scientific Advice on CVac Phase III Trial -- SYDNEY, Feb. 18, 2011 /PRNewswire/ --

"......The trial will be conducted on 750 patients in a double blind placebo controlled study randomized 1:1 of CVac vs. Standard of Care (currently there is no approved maintenance therapy for ovarian cancer), across multiple sites in Europe, the US and Australia....."

Why negative studies are good for health journalism, and where to find them - Gary Schwitzer's HealthNewsReview Blog

Letter to the Editor: Unexpected gastrointestinal toxicity from Docetaxel/Carboplatin/Erlotinib followed by maintenance Erlotinib treatment for newly diagnosed stage III/IV ovarian cancer, primary peritoneal, or fallopian tube cancer

Note: no abstract/pay-per-view (subscription req'd $$$)

full free access (pdf): Frequencies of BRCA1 and BRCA2 mutations among 1,342 unselected patients with invasive ovarian cancer (Ontario, Canada study including demographics)

Abstract

BACKGROUND: The heritable fraction of ovarian cancer exceeds that of any other common adult cancer. Most inherited cases of ovarian cancer are due to a germline mutation in BRCA1 or BRCA2. It is important to have an accurate estimate of the proportion of ovarian cancer patients who carry a mutation and the specific factors which predict the presence of a mutation.

METHODS: We tested a population-based series of 1342 unselected patients diagnosed with invasive ovarian cancer between 1995-1999 and 2002-2004 in Ontario, Canada, for germline mutations in BRCA1 and BRCA2. The two genes were tested in their entirety, using a range of techniques, including multiplex ligation-dependent probe amplification (MLPA).

RESULTS: Among the 1342 women, 176 women carried a mutation (107 in BRCA1, 67 in BRCA2, and two in both genes) for a combined mutation frequency of 13.3%. Seven deletions were identified using MLPA (3.9% of all detected mutations). The prevalence of mutations was particularly high among women diagnosed in their forties (24.0%), in women with serous ovarian cancer (18.0%) and women of Italian (43.5%), Jewish (30.0%) or Indo-Pakistani origin (29.4%). A mutation was seen in 33.9% of women with a first-degree relative with breast or ovarian cancer and in 7.9% of women with no first-degree relative with breast or ovarian cancer. No mutation was seen in women with mucinous carcinoma.

CONCLUSIONS: BRCA1 and BRCA2 mutations are common in women with invasive ovarian cancer. All women diagnosed with invasive non-mucinous ovarian cancer should be considered to be candidates for genetic testing.

Wound complications after gynecologic cancer surgery (risk factors)

CONCLUSIONS: Wound complications are common in gynecologic oncology. Further studies should explore whether risk factor modification decreases complications.

Zoledronic acid preserves bone mineral density in premenopausal women who develop ovarian failure due to adjuvant chemotherapy: Final results from CAL

Note: side effects

INTERPRETATION: ZA every 3 months is well tolerated and prevents rapid bone loss in premenopausal women that develop CIOF. Giving ZA with rather than 1 year after the start of adjuvant chemotherapy is the preferred sequence to prevent bone loss.

press release: (MUC1) Genus Oncology, LLC Announces Initiation of Phase I Trial of GO-203-2c phase 1 solid tumors

Helping social research make a difference - full free access (science and the arts)

Drawing Out Cancer With Biomarkers

By improving sensitivity, the fraction of false negatives decreases; by increasing specificity, the fraction of unnecessary biopsies falls as well. It is time for us to use all of our molecular tools side-by-side in diagnosing and measuring the progression of cancer.