SGO: Menopause Symptoms Common After Gyn Cancer - in Meeting Coverage, SGO from MedPage Today

Linus Pauling Institute at Oregon State University (research institute vitamins/micronutriends/phytochemicals)

Researchers at the Linus Pauling Institute investigate the role that vitamins and essential minerals (micronutrients) and chemicals from plants (phytochemicals) play in human aging, immune function, and chronic diseases, especially heart disease, cancer, and neurodegenerative diseases. A major emphasis is to understand the role of oxidative stress and inflammation in disease etiology, and the preventive effects of dietary constituents with antioxidant or anti-inflammatory properties.

The goal of these studies is to understand the mechanisms by which diet, micronutrients, and dietary supplements affect disease initiation and progression and can be used in the prevention or treatment of human diseases, thereby enhancing lifespan and healthspan......cont'd

NIH/NCCAM
Center of Excellence

The Linus Pauling Institute is one of the nation's first two Centers of Excellence for Research on Complementary and Alternative Medicine designated by the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH).

ELC : Imedex e-learning center March 8th, 2011 video (30 min) interviews from SGO

Note: requires password/registration to view videos (free), risk factors, hereditary, KRAS mutation/variant (in many other cancers as well), MiRnA, ICON7 (Avastin).....    

Featured Activity:

	You must be a registered Imedex.com member to access this. Please enter your email address and password. Email Password Remember me Don't have an account? Forgot your password?

Best of the Day: 2011 Society of Gynecologic Oncologists Annual Meeting on Women’s Cancer

Dr Bradley Monk interviews 6 nationally recognized experts in GYN oncology about their interpretations of clinically relevant data presented at the annual meeting. Drs Deborah Armstrong, Barbara Goff, Tom Herzog, Warner Huh, Robert Coleman, and Robert Burger comprise the esteemed faculty.

update on ovariancancerandus blog stats - just for fun

Pageviews today:  323

Pageviews yesterday:  323

Pageviews last month:  8,231 by Country in order of most popular (top 10) U.S. Canada Italy Germany UK Hungary Vietnam Russia United Arab Emirates China

Genetic Tests Sold Direct To Consumers Should Be Supervised By Doctors Says FDA Panel (and the debating issues)

A First Medical Opinion Can Influence The Second - Medical News Today

Dr Henry Lynch, Sr (Lynch Syndrome) - Omaha doctor pioneered genetic cancer concept - LivewellNebraska.com

Conflicts-of-interest in drug studies sneaking back into medical journals, say investigators Jewish General/McGill - press release

2011 journal issues - current content listings Jan/March 2011 including supplement (SGO meeting)

Articles in Press

	Volume 120 (2011)
		Volume 120, Issue 3 - selected pp. 317-492 (March 2011) Technologic Innovations and Novel Surgical Approaches for Patients with Gynecologic Malignancies
		Volume 120, Issue 2 pp. 165-316 (February 2011)
		Volume 120, Issue 1 pp. 1-164 (January 2011)
		Volume 120, Supplement 1 pp. S1-S150 (March 2011) ABSTRACTS PRESENTED FOR THE 42ND ANNUAL MEETING OF THE SOCIETY OF GYNECOLOGIC ONCOLOGISTS, ABSTRACTS PRESENTED FOR THE 42ND ANNUAL MEETING OF THE SOCIETY OF GYNECOLOGIC ONCOLOGISTS

abstracts/index - Gynecologic Oncology, Volume 120, Issue 3, Pages 317-492 (March 2011)

abstract: A phase II study of two topotecan regimens evaluated in recurrent platinum-sensitive ovarian, fallopian tube or primary peritoneal cancer: (GOG 146Q)

Journal Gynecologic Oncology, Volume 120, Supplement 1, Pages S1-S150 (March 2011) abstracts to be presented at 2011 annual SGO meeting

Note: this journal is by subscription ($$$) for full access, the actual abstracts via this indexed list are not available - titles of presentations only - abstracts either have been previously published or to come


Volume 120, Supplement 1, Pages S1-S150 (March 2011)

ABSTRACTS PRESENTED FOR THE 42ND ANNUAL MEETING OF THE SOCIETY OF GYNECOLOGIC ONCOLOGISTS
Orlando, FL USA
March 2011

Ovarian cancer: early detection saves lives | McGill University (Montreal) Health Centre - the Dove Project

For more information about DOVE: http://muhc.ca/royalvic/article/dove-project

financial news: Healthcare Stock on Watch; Vermillion (OVA1) climbs on Poster Presentation | Beacon Equity: Penny Stocks, Stock Alerts

Healthcare Stock on Watch; Vermillion climbs on Poster Presentation

Posted by g.zalesak on Mar 08, 2011

Vermillion Inc. (NASDAQ: VRML) shares are up nearly 2.5% to $4.99 mid-day on word of the company’s poster presentation of its preliminary results from its collaboration with John Hopkins University School of Medicine to identify biomarkers that improve the identification of malignant ovarian tumors.
The poster evaluated more than 20 candidate biomarkers for their ability to complement the company’s CA125 in distinguishing benign ovarian tumors from malignant ones.

Medical News: Bevacizumab Value in Ovarian Cancer Questioned - in Clinical Context, Ovarian Cancer from MedPage Today

Note: the actual study including those related to Avastin/breast cancer were previously posted (on this blog) but this particular Medscape article may be easier to read.
Search blog (top left hand column or sidebar) via key word Avastin.

NCI Cancer Bulletin Mar 2011: Ovarian Cancer Study Raises Questions about Developing Markers for Early Detection

 IMPORTANT/Blogger's Note:  longterm ovarian cancer survivours and caregivers will recall the historical 'hype' on new early detection tests - caution advised and confirming this as per the NCI Bulletin below (LPA would be one example only)

"During the last decade, Dr. Ransohoff noted, some researchers made strong claims about potential markers for ovarian cancer based on preliminary data. And though the markers did not pan out, these claims were repeated by members of the media, raising false hopes about early detection."



"A long-awaited assessment of potential biomarkers for detecting early ovarian cancer shows that blood levels of the CA-125 protein remain the best predictor of the disease. But if there is to be any hope that screening will reduce deaths from this disease, then more accurate markers would have to be developed, researchers concluded in the March Cancer Prevention Research.         (note: also see blog postings for related abstracts)

None of the 28 potential serum markers tested in the study outperformed CA-125. But for screening, the researchers noted, doctors would need a test that could detect a signal from tumors more than 6 months before diagnosis; CA-125 had its strongest signal within 6 months of diagnosis.

Although the results may seem disappointing, the findings can inform future efforts to detect the disease early, the study authors wrote. This idea was echoed by several biomarker experts who were not involved in the work but who stressed the importance of the findings......."cont'd

2011 March Cancer Prevention Research articles/references: Ovarian Cancer Biomarker Performance in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Specimens — Cancer Prev Res

Ovarian Cancer Biomarker Performance in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Specimens

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  
• 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

Articles citing this article

• The Sine Qua Non of Discovering Novel Biomarkers for Early Detection of Ovarian Cancer: Carefully Selected Preclinical Samples Cancer Prev Res March 1, 2011 4:299-302
  • Abstract
  •  
• A Framework for Evaluating Biomarkers for Early Detection: Validation of Biomarker Panels for Ovarian Cancer Cancer Prev Res March 1, 2011 4:375-383
  • Abstract
  •  
• Challenges Related to Developing Serum-Based Biomarkers for Early Ovarian Cancer Detection Cancer Prev Res March 1, 2011 4:303-306
  • Abstract

Mabcure Study Results on a New Ovarian Cancer Diagnostic Blood Test Being Presented at the Annual Meeting of the SGO - financial news

SGO: MicroRNA May Help Predict Ovarian Ca Response - in Meeting Coverage, SGO from MedPage Today

"Changes in expression of a microRNA showed potential for predicting response to the angiogenesis inhibitor bevacizumab (Avastin) in recurrent serous ovarian cancer, according to results of a small study reported here..........."

worth reading - Medical News: SGO: PARP Inhibitor Active in Ovarian Cancer - in Meeting Coverage, SGO from MedPage Today

......"Antitumor activity was observed in heavily pretreated BRCA1 and BRCA2 mutation carriers, and preliminary antitumor activity was seen in patients with sporadic cancers," said Robert Wenham, MD, of the H. Lee Moffitt Cancer Center in Tampa, Fla...........During the initial dose-escalation phase, the patient population was enriched with BRCA1/2 mutation carriers. In the dose-expansion phase of the trial, investigators enrolled patients with sporadic platinum-resistant high-grade serous ovarian cancer......cont'd

full free access: Supporting Clinical Practice Decisions With Real-Time Patient-Reported Outcomes JCO

Drug naming standard for electronic health records enhanced, March 8, 2011 News Release - National Institutes of Health (NIH)

Cancer Clinical Trial: Existential Issues in Elderly People With Cancer [Conditions: Cancer] (aged people with cancer)

Detailed Clinical Trial Description

Existential and spiritual issues in elderly people with cancer are scarcely investigated with respect to the content and importance of these aspects to this patient group in terms of living with their disease and benefit from specialist health treatment and care. The present study is an independent doctoral study that also has an initial function for an intended multidisciplinary research project with the working title "Aged people with cancer".

Arms, Groups and Cohorts in this Clinical Trial

: Cancer in elderly people

Data Points Publication Series - Series Overview | AHRQ Effective Health Care Program

Planned Data Points Publications:

Utilization of erythropoietin-stimulating agents
Utilization of anti-cancer biologic products
Utilization of anti-cancer biologic products by diagnosis
Medicare reimbursements by recurrent ICD-9 categories

The Pot Calling the Kettle Black « Dr. Robert A. Nagourney – Rational Therapeutics – Blog (regarding ovarian cancer research....)

abstract: Health-related quality of life and cancer clinical trials (University of British Columbia)

Note: consider values? whose?

".....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. However, there is still a need for a clear method for determining the clinical meaningfulness of changes in scores. The answer will probably come from the greater use of patient-reported outcomes and the consequent growth of experience that is necessary to make such judgements."

Review - EvidenceUpdates: Congestive heart failure risk in patients with breast cancer treated with bevacizumab/Avastin (including professional commentary)

1) link including professional commentary (BMJ Evidence Centre/McMaster)

2) additional link to abstract (JCO)

Hormone Therapy: The Next Chapter - Harvard Health Publications

March 2011 Hormone therapy still has a place for treating menopause symptoms - Harvard Health Publications

Note: WHI (Women's Health Initiative)

"....But the WHI left many questions unanswered.....cont'd

(references SGO presentation) PCPs less likely to refer patients to gynecologic oncologists | HemOncToday

"..........Just 39.3% of family physicians and 51% of internists reported that they would refer the patient to the gynecologic oncologist. They were much more likely to refer their patients to obstetrician-gynecologists. Among obstetrician-gynecologists, however, two-thirds reported that they would refer a patient with abdominal pain and a suspicious ovarian mass to a gynecologic oncologist.........One-third of the obstetrician-gynecologists reported that they would operate on the patient themselves.........."

Goff B. #10. Presented at: the 42nd Annual Meeting of the Society of Gynecologic Oncologists; March 6-9, 2011, Orlando, Fla.

(OVA1) Vermillion Attends 42nd Annual Meeting of the SGO March 7, 2011 /PRNewswire/ --

Note: see press release for more details "OVA1 improves the sensitivity of the ACOG referral guidelines for an ovarian mass" "OVA1 Has High Sensitivity in Identifying Ovarian Malignancy Compared to Preoperative Assessment and CA125"

JCO series: Art of Oncology Hope and Realism: The Perfect Balance?

Art of Oncology Hope and Realism: The Perfect Balance?

• Shirish M. Gadgeel

JCO published online on March 7, 2011; DOI:10.1200/JCO.2010.34.5348.

• [PDF]

abstract: JCO - Natural History of (Taxol) Paclitaxel-Associated Acute Pain Syndrome: Prospective Cohort Study NCCTG N08C1

Abstract

Purpose The characteristics and natural history of the
paclitaxel–acute pain syndrome (P-APS) and paclitaxel's
more chronic neuropathy have not been well delineated. 

Methods Patients receiving weekly paclitaxel (70 to 90 mg/m²) completed daily questionnaires and weekly European
Organisation for Research and Treatment of Cancer (EORTC) Chemotherapy-Induced Peripheral Neuropathy (CIPN) –20
instruments during the entire course of therapy. 

Results P-APS symptoms peaked 3 days after chemotherapy.
Twenty percent of patients had pain scores of 5 to 10 of 10 with
the first dose of paclitaxel. Sensory neuropathy symptoms wer
e more prominent than were motor or autonomic neuropathy

symptoms. Of the sensory neuropathy symptoms, numbness and
tingling were more prominent than was shooting or burning pain. Patients with higher P-APS pain scores with the first dose of
paclitaxel appeared to have more chronic neuropathy. 

Conclusion These data support that the P-APS is related to nerve pathology as opposed to being arthralgias and/or myalgias.
Numbness and tingling are more prominent chronic neuropathic symptoms than is shooting or burning pain. 

define:  arthralgias: Aches or pains in joints, without obvious
swelling, warmth, or redness.
vasculitis.med.jhu.edu/whatis/glossary.html

define: myalgias:  pain in a muscle or group of muscles
wordnetweb.princeton.edu/perl/webwn

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