Gastroenterology & Endoscopy News - Gastros Outperform Oncologists in Recognition of Inherited CRC (Lynch Syndrome/PJS/FAP....extracolonic tumors)

Note: access is free/requires registration

"......Overall, physicians benefited from the educational intervention, scoring significantly higher on exams about genetic testing for Lynch syndrome, FAP and Peutz-Jeghers syndrome post-test than at baseline. The education session also significantly improved physicians’ recognition of Lynch syndrome family pedigrees and surveillance of the disease, but did not effectively enhance awareness of extra-colonic manifestations.

Although the educational intervention improved the ability of physicians to identify families with multiple members affected by CRC, it did not help them spot extra-colonic cancers in families with Lynch syndrome. Identifying extra-colonic cancers is important because Lynch syndrome increases a person’s risk for endometrial cancer and is associated with cancers of the stomach (6%-9%); ovaries (6%-12%); and ureter and renal pelvis (3%-8%) (and others), according to the Colon Cancer Alliance for Research and Education for Lynch Syndrome...........cont'd

"Ms. (Kate) Murphy has survived ovarian and breast cancer as well as three episodes of colon cancer."

abstract: Revised Bethesda Guidelines: compliance in identifying HNPCC affected families (Lynch Syndrome)

Conclusion
Based on these results, there is a marked incompliance with revised Bethesda guidelines when assessing patients with colorectal cancer. This has a significant impact on clinical pathways for the management of HNPCC  (Lynch Syndrome) families.

ABC News - Japan Earthquake: before and after photos (google earth)

Sun Mar 13, 2011 3:00pm AEDT

Aerial photos taken over Japan have revealed the scale of devastation across dozens of suburbs and tens of thousands of homes and businesses.
Hover over each satellite photo to view the devastation caused by the earthquake and tsunami.

abstract: Pregnancy after adolescent and adult cancer: A population-based matched cohort study

"In summary, fertility-preserving attempts have succeeded in patients with ovarian or testicular cancer and in males with Hodgkin lymphoma."

abstract: Ovarian cancer linked to lynch syndrome typically presents as early-onset, non-serous epithelial tumors (endometrioid/clear cell cell types) MSH2 MSH6 MLH1

Ovarian cancer linked to lynch syndrome typically presents as early-onset, non-serous epithelial tumors.

Abstract

OBJECTIVE: Heredity is a major cause of ovarian cancer and during recent years the contribution from germline mismatch repair (MMR) gene mutations linked to Lynch syndrome has gradually been recognized.

METHODS: We characterized clinical features, tumor morphology and mismatch repair defects in all ovarian cancers identified in Swedish and Danish Lynch syndrome families.

RESULTS: In total, 63 epithelial ovarian cancers developed at mean 48 (range 30-79) years of age with 47% being early stage (FIGO stage I). Histologically, endometrioid (35%) and clear cell (17%) tumors were overrepresented. The underlying MMR gene mutations in these families affected MSH2 in 49%, MSH6 in 33% and MLH1 in 17%. Immunohistochemical loss of the corresponding MMR protein was demonstrated in 33/36 (92%) tumors analyzed.

CONCLUSION: The combined data from our cohorts demonstrate that ovarian cancer associated with Lynch syndrome typically presents at young age as early-stage, non-serous tumors, which implicates that a family history of colorectal and endometrial cancer should be specifically considered in such cases.

abstract: BRCA1/2 status and clinicopathologic characteristics of patients with double primary breast and ovarian cancer (Slovenia)

abstract: Development and Validation of 11 Symptom Indexes to Evaluate Response to Chemotherapy for Advanced Cancer

Abstract

Recent guidance from the FDA discusses patient-reported outcomes as end points in clinical trials. Using methods consistent with this guidance, the authors developed symptom indexes for patients with advanced cancer. Input on the most important symptoms was obtained from 533 patients recruited from NCCN Member Institutions and 4 nonprofit social service organizations. Diagnoses included bladder, brain, breast, colorectal, head and neck, hepatobiliary/pancreatic, kidney, lung, ovarian, and prostate cancers and lymphoma. Physician experts in each of these diseases were also surveyed to differentiate symptoms that were predominantly disease-based from those that were predominantly treatment-induced. Results are evaluated alongside previously published indexes for 9 of these 11 advanced cancers that were created based on expert provider surveys, also implemented at NCCN Member Institutions. Final results are 11 symptom indexes that reflect the highest priorities of people affected by these 11 advanced cancers and the experienced perspective of the people who provide their medical treatment. Beyond the clinical value of such indexes, they may also contribute significantly to satisfying regulatory requirements for a standardized tool to evaluate drug efficacy with respect to symptomatology.

Penetrance (mutations) - Wikipedia, the free encyclopedia

Associated terminology

• complete penetrance. The allele is said to have complete penetrance if all individuals who have the disease-causing mutation have clinical symptoms of the disease.
• highly penetrant. If an allele is highly penetrant, then the trait it produces will almost always be apparent in an individual carrying the allele.
• incomplete penetrance or reduced penetrance. Penetrance is said to be reduced or incomplete when some individuals fail to express the trait, even though they carry the allele.
• low penetrance. An allele with low penetrance will only sometimes produce the symptom or trait with which it has been associated at a detectable level. In cases of low penetrance, it is difficult to distinguish environmental from genetic factors.

Bevacizumab Doubles Risk of GI Adverse Events in Key Ovarian Cancer Trial : Internal Medicine News SGO/Dr Burger/O'Malley

Visual (slides): Ovarian Cancer Pictures: Cysts, Symptoms, Tests, Stages, Treatments and Risks

News - Penn State Biochemistry and Molecular Biology Colorectal Cancer month/Lynch Syndrome excerpt

"Lynch syndrome, previously referred to as hereditary non-polyposis colorectal cancer or HNPCC, represents the most common hereditary cause of colorectal cancer.
Approximately 1 in 400 to 1 in 500 individuals in the general population are estimated to have Lynch syndrome.

Knowledge, as they say, in this condition, is power. Not only should individuals with Lynch syndrome start their colonoscopies earlier (at 20-25 years of age) and have them more frequently (every 1-2 years), they should also be screened for stomach and small intestine cancer, urinary tract cancers involving the kidneys and ureters, and the hepatobiliary tract, including the gallbladder, bile duct, pancreas and liver.

Further, women with Lynch syndrome should be aware of the increased risk for both endometrial and ovarian cancer and offered the option of prophylactic surgery following childbearing."

March 2011: Hereditary Cancer in Clinical Practice | Full text | Lynch Syndrome - is breast cancer a feature?

Background

The debate on whether or not breast cancer is in the tumor spectrum for Lynch syndrome produces a conundrum for healthcare providers.

The classic tumor spectrum for Lynch Syndrome (LS) includes colon, endometrial, ovarian, stomach, small intestine, hepatobiliary, urinary tract and brain/central nervous system cancers. Muir-Torre Syndrome (MTS) is a variant of LS that is associated with additional skin lesions including sebaceous gland tumors and keratoacanthomas. MTS was observed in 28% of LS families when assessing for MTS skin lesions [1]. It has also been reported that 10-14% of individuals with MTS present initially with breast cancer [2,3]. An extensive study published in 2002 excluded breast cancer as part of the tumor spectrum associated with LS [4].

However, more recently it was reported that DNA mismatch repair (MMR) gene deficiencies were identified in 51% of breast cancers arising in MMR mutation carriers [5]. Another study reported a male with an MLH1 mutation who had both colon and breast cancer. The breast cancer exhibited somatic reduction to homozygosity for the MLH1 mutation [6].

Here we report two unrelated families in which the proband has a germline MMR gene mutation and bilateral breast cancer, and one family in which the proband had ovarian and renal cancer and her daughter, maternal aunt and cousin had breast cancer at age 47, 59, and 48 respectively.

This raises the question are these breast cancers associated with the MMR mutations or a breast cancer susceptibility gene and what testing should be offered?

Conclusion

Our findings indicate that breast cancer is part of the spectrum of tumors in LS families in which the breast cancer segregates with the other LS associated tumors.

Additional hereditary breast cancer gene testing may not be warranted in these circumstances. A future research goal is to perform IHC on the breast tumors from these families to determine if they show loss of expression of the MMR gene that is known to be altered.

....cont'd (full free access)

Doctor and Patient - When Doctors Make Mistakes - NYTimes.com

Note: forwarded from patient safety community, sad situation/s really

Number of U.S. Cancer Survivors Grows to Nearly 12 Million

Thursday, March 10, 2011 2:31 PM

From:

"Centers for Disease Control & Prevention"

The number of cancer survivors in the United States increased from 3 million in 1971 to 11.7 million in 2007, according to a new study by CDC and the National Cancer Institute.
A cancer survivor is defined as anyone who has been diagnosed with cancer, from the time of diagnosis through the balance of his or her life. Cancer survivors largely consist of people who are 65 years of age or older and women. Many people with cancer live a long time after diagnosis; more than a million people were alive in 2007 after being diagnosed with cancer 25 years or more earlier.
Of the 11.7 million people living with cancer in 2007—

• 7 million were 65 years of age or older.
• 6.3 million were women.
• 4.7 million were diagnosed 10 years earlier or more.

The largest groups of cancer survivors were—

• Breast cancer survivors (22%).
• Prostate cancer survivors (19%).
• Colorectal cancer survivors (10%).

Source: Centers for Disease Control and Prevention (CDC). Cancer survivors—United States, 2007. MMWR 2011;60(9):269–272.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6009a1.htm 

TABLE. Estimated number of living persons ever diagnosed with cancer, by age group and cancer type --- United States, January 1, 2007
Cancer type	Age group (yrs)					Overall
	0--19	20--39	40--64	65--84	≥85	No.	(%)
Ovary	1,033	10,357	79,225	73,230	13,315	177,162	(1.5)

DMBN Exclusive: Is your MRI suite safe for patients & staff?

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."