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Thursday, June 30, 2011
Wednesday, June 29, 2011
The Cancer Genome Atlas completes detailed ovarian cancer analysis - GenOmics
also: A more detailed press release on the study will be available from the National Institutes of Health at http://nih.gov/news/.
Cochrane Collaboration Review:Evaluation of follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment
Plain language summary
Evaluation of follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment
Ovarian cancer is the sixth most common cancer and seventh commonest cause of cancer death in women worldwide. Traditionally, many patients who have been treated for cancer undergo long-term follow up in hospitals. Whilst there may be other benefits from follow up, it has been suggested that the use of routine review may not result in women with this disease living longer given that recurrent ovarian cancer is incurable.
We set out to review the evidence for different types of follow up of women who have completed treatment for the commonest type (epithelial, that is coming from the surface of the ovary) of ovarian cancer. Only one good quality (blogger's note: Rustin trial) randomised (toss of a coin to choose which group) trial was found which could give any evidence on what to do. This trial suggested no increase in length of life from early treatment with chemotherapy for women with recurrence that was identified by a tumour marker (CA125) blood test compared to waiting to give treatment when women developed symptoms from their cancer.
We conclude that the very limited evidence suggests that there may be no benefit from early detection by the blood test and subsequent early chemotherapy for recurrent ovarian cancer. Also, the women having early chemotherapy treatment of their relapsed cancer may have led to a decreased quality of life for these women compared to the group who were treated when they noticed symptoms.
Randomised controlled trials are needed to compare different types of follow up, looking at quality of life and anxiety outcomes. If new treatments become available for relapsed ovarian cancer, the methods of follow up may need re-assessing to see if earlier intervention improves survival or other outcomes.
New drugs hope for those with 'resistant' cancers - media - Prof Hani Gabra/UK
"But now scientists at the charity Ovarian Cancer Action have discovered the reason why their cancers apparently develop this resistance. Rather than the cancers developing immunity, they found that minute traces of cancers that were always resistant to platinum therapy were there from the beginning. This discovery has helped them identify four or five different molecular "targets" that could be the focus of new drugs, said Prof Hani Gabra, director of the charity's research centre. He said: "These cancers look like they are platinum-resistant, but in fact they were there from the outset and they were never touched by the drugs." .....cont'd
Tuesday, June 28, 2011
Abstract/full free access: Symptom Interpretation and Health Care Seeking In Ovarian Cancer
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
(abstract) Conclusions
Diagnostic delay in ovarian cancer seems far from being exclusively a medical problem, as the delay proved to be influenced by organisational, cultural, and social factors, too. Initiatives facilitating the diagnostic process and research concerning the selection of individuals for further investigation are indicated. The way in which the women interpreted their symptoms was influenced by their personal experiences, their cultural, and their social background. This became crucial to the diagnostic process. These issues need to be explored through further research on women's experiences during the diagnostic process.
June 3rd: Personalized Therapy Benefits Late-Stage Cancer Patients in Clinical Trial - Cancerwise | Cancer blog from MD Anderson Cancer Center
"Researchers analyzed tumors of 1,144 patients with metastatic or inoperable cancer. Their median age was 58, and the median number of prior treatments was four. Of these, 460 had one or more gene defects targetable by available approved or experimental drugs."
abstract- Gynecologic Oncology : Polymorphisms in the CASP8 gene and the risk of epithelial ovarian cancer
Research highlights
► Three variants in CASP8 gene decreased risk of epithelial ovarian cancer (EOC).
► A reduced risk of EOC was significantly associated with the del-C-T haplotype of those 3 SNPs.
► A notable later age at onset of EOC was associated with rs3834129 of CASP8 gene.
HRT Post Oophorectomy Adds No Breast Cancer Risk : Internal Medicine News
"....The PROSE database was developed by 20 centers in the United States and Europe who identified and prospectively followed women with a deleterious BRCA1 or BRCA2 mutation. For the study, the investigators focused on those who at ascertainment had at least one ovary, no prior breast or ovarian cancer, no prior bilateral mastectomy, and at least 6 months of follow-up. ...."
abstract- Gynecologic Oncology : Comparison of candidate serologic markers for type I and type II ovarian cancer
Objective
To examine the value of individual and combinations of ovarian cancer associated blood biomarkers for the discrimination between plasma of patients with type I or II ovarian cancer and disease-free volunteers.Research highlights
► We compared 14 biomarkers to discriminate the plasma samples of healthy volunteers and ovarian cancer patients.► Autoantibodies to p53 and NY-ESO-1 were present in plasma of type II but not type I ovarian cancer patients.
► Combining p53 AAbs with CA125 significantly improved discrimination of plasma of type II cancer patients from that of healthy volunteers.
ongoing: Research Study in Patients With Advanced Epithelial Ovarian Cancer - Full Text View - ClinicalTrials.gov
Purpose
RATIONALE: Analyzing tissue samples from patients in the laboratory may help doctors learn more about cancer.
PURPOSE: The purpose of this study is to analyze tissue samples from patients with ovarian cancer in the laboratory.
| Condition | Intervention |
|---|---|
| Ovarian Cancer | Genetic: comparative genomic hybridization Genetic: cytogenetic analysis Genetic: gene rearrangement analysis Genetic: microarray analysis Genetic: mutation analysis Genetic: polymerase chain reaction |
phase 11 - Evaluation of TRC105 in the Treatment of Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Carcinoma - Full Text View - ClinicalTrials.gov (not yet recruiting)
Biological: Chimeric monoclonal antibody (TRC105) to CD105
10 mg/kg weekly by intravenous administration on Days 1, 8, 15 and 22 of each 28-day cycle
Other Names:
- TRC105
- NSC#754227
Abstract/full free access: BRCA in the Ashkenazi Population: Are Current Testing Guidelines Too Exclusive?
(The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production)
Abstract:
The BRCA1/2 genes account for a significant portion of hereditary breast and ovarian cancers and they are especially prevalent in the Ashkenazi Jewish population. Women who have a mutation can prevent breast and ovarian cancer with surgical intervention. We describe an Ashkenazi Jewish patient who illustrates that current testing criteria are too restrictive, particularly for this population of patients. The patient's sister was diagnosed with breast cancer at age 33; however, she was not a mutation carrier. Based on practice guidelines, the patient was not recommended genetic testing. She subsequently underwent direct-to-consumer (DTC) testing and discovered that she was a mutation carrier. This case demonstrates the need for clinicians to be aware of the higher prevalence of BRCA mutations in the Ashkenazi population. It also exemplifies the need to involve medical professionals, including genetic counselors, in the dissemination of DNA test results.
NBOCC News - June 2011 - National Breast and Ovarian Cancer Centre (NBOCC)
In this issue...
- A reflection on National Breast and Ovarian Cancer Centre's achievement
- Cancer Australia and National Breast and Ovarian Cancer Centre amalgamate
- Not just a woman's disease: Information about breast cancer in men
- New clinical practice guidelines on use of bisphosphonates in advanced breast cancer
- GP online learning on cancer screening
- Understanding ductal carcinoma in situ resource
- New Clinical Update: Ovarian Cancer
Monday, June 27, 2011
(2nd article) FDA Safety Alerts for Human Medical Products > Erythropoiesis-Stimulating Agents (ESAs) In Chronic Kidney Disease: Drug Safety Communication - Modified Dosing Recommendations
Erythropoiesis-Stimulating Agents (ESAs) In Chronic Kidney Disease: Drug Safety Communication - Modified Dosing Recommendations
Epoetin alfa (marketed as Epogen and Procrit) and darbepoetin alfa (marketed as Aranesp)
Response Rates | 2010 National Physician Survey Canada
| Response Rates |
Contact mode
| |
| Completion mode |
Paper
|
Email
|
| Paper |
17.5%%
|
2.6%
|
| Online |
2.0%
|
14.8%
|
| Subtotal Survey Respondents |
19.5%
|
17.4%
|
| Did not respond |
80.5%
|
82.6%
|
| Total |
100%
|
100%
|
Sunday, June 26, 2011
Saturday, June 25, 2011
Managing pain effectively : The Lancet (full free access)
"Management of chronic pain has shown better results for patients with cancer, when guidelines are adhered to, but often they are not. Disturbingly, about 43% of patients with cancer receive inappropriate care for pain."
full free access: PLoS Medicine: Strengthening the Reporting of Genetic Risk Prediction Studies: The GRIPS Statement (multinational)
Summary Points
- The rapid and continuing progress in gene discovery for complex diseases is fueling interest in the potential application of genetic risk models for clinical and public health practice.
- The number of studies assessing the predictive ability is steadily increasing, but the quality and completeness of reporting varies.
- A multidisciplinary workshop sponsored by the Human Genome Epidemiology Network developed a checklist of 25 items recommended for strengthening the reporting of Genetic RIsk Prediction Studies (GRIPS), building on the principles established by prior reporting guidelines.
- These recommendations aim to enhance the transparency of study reporting, and thereby to improve the synthesis and application of information from multiple studies that might differ in design, conduct, or analysis.
- A detailed Explanation and Elaboration document is published as supporting information (Text S1).
Safety Concerns Prompt New Recommendations for Anemia Drugs « news@JAMA (patients with chronic kidney disease)
"The revised recommendations apply to epoetin alfa, which is marketed as Epogen and Procrit, and to darbepoetin alfa, marketed as Aranesp."
Friday, June 24, 2011
Top Cancer News — Cancer Matters podcasts - Johns Hopkins
full free access: Journal of Ovarian Research: On the Path to Translation: Highlights from the 2010 Canadian Conference on Ovarian Cancer Research
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
"This report summarizes the key findings presented at the fifth biennial Canadian Conference on Ovarian Cancer Research held in Toronto, Canada, and includes the important issues and challenges we still face in the years ahead to make a significant impact on this devastating disease."
FDA Should Not Mandate Comparative-Effectiveness Trials
"Consumer groups are pushing for a new drug approval mandate that would require drug companies to conduct "comparative effectiveness" trials to win Food and Drug Administration (FDA) approval for new medicines. Proponents of this policy argue that new drugs should have to prove superior to older medicines to gain marketing approval. These requirements would add a major hurdle to the development and approval of new medicines, adding significant time and cost, says Scott Gottlieb, M.D. and a resident fellow at American Enterprise Institute.
- Consumer groups are pushing to add a step to the FDA drug approval process: "comparator" trials, which test a new drug against the current standard treatment.
- But these trials are already being conducted in important cases; a new FDA approval requirement would slow down the drug approval process elsewhere.
- If such an FDA mandate were adopted, the resulting studies would likely be "noninferiority trials," which are unlikely to conclusively show whether a new medicine is indeed more effective than an existing alternative.
- Achieving the goal consumer groups want -- safer and more cost-effective drugs -- requires innovation in clinical trial design, not a congressional mandate.
National Comprehensive Cancer Network - New Paradigms in Advanced Ovarian Cancer CME - Dr Deborah K. Armstrong (repeat post)
Note: requires registration to view (free)
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Wednesday, June 22, 2011
financial news: Immunovaccine Nominates Brad Thompson for Appointment to the Board - DepoVax™
Brad Thompson, Ph.D., is Executive Chairman, Chief Executive Officer and President of Oncolytics Biotech Inc. and is the current Chairman of BIOTECanada. Prior to joining Oncolytics, he served as Chief Executive Officer of Iteration Energy Ltd. (formerly SYNSORB Biotech Incorporated), from May 1994 to February 1999, and was Head of Biotechnology at The Alberta Research Council. Dr. Thompson received his Ph.D. from the University of Western Ontario in the Department of Microbiology and Immunology.
Immunovaccine Inc. (TSX VENTURE:IMV) is a clinical stage vaccine development company focused on the commercialization of its patented vaccine delivery technology and product candidates.
media: FDA OKs clinical trials for cancer vaccine (DPX-Suvivac)
"In the trials of DPX-Suvivac, ovarian cancer patients will be treated with the vaccine after surgery and chemotherapy treatments."
full free access: Personalized Medicine and Cancer Supportive Care: Appropriate Use of Colony-Stimulating Factor Support of Chemotherapy
"Unfortunately, patients in RCTs (randomized clinical trials) are often highly selected, and toxicities, including FN, are frequently underreported (18). In addition, chemotherapy dose intensity and the use of prophylactic CSF or antibiotics are infrequently reported in RCTs, making it difficult to assess the true burden of neutropenic complications associated with a chemotherapy regimen (18)." "....Although there is little debate that both underuse and overuse of the CSFs occur in clinical practice, accurate estimates of the true magnitude and impact of such considerations remain elusive. What is clear is that there is a need for greater attention to chemotherapy-associated toxicities along with accurate prediction tools for the assessment of individual patient risks, including FN (febrile neutropenia) and its complications. Such tools could improve the evidence base for practice guidelines and aid clinicians in the selection of patients with cancer who are at an individual increased risk for FN, and therefore, appropriate candidates for the clinically effective and cost-effective use of the CSFs (40)."
extract: Estrogen's Dual Nature? Studies Highlight Effects on Breast Cancer
Note: to read full text $$$ (requires subscription)
Tuesday, June 21, 2011
Cancers | Free Full-Text | Clinical Trial Design for Testing the Stem Cell Model for the Prevention and Treatment of Cancer
Cancers 2011, 3(2), 2696-2708; doi:10.3390/cancers3022696
Review
Clinical Trial Design for Testing the Stem Cell Model for the Published: 20 June 2011
(This article belongs to the Special Issue Cancer Stem Cells)
Abstract:
The cancer stem cell model introduces new strategies for the prevention and treatment of cancers. In cancers that appear to follow the stem cell model, pathways such as Wnt, Notch and Hedgehog may be targeted with natural compounds such as curcumin or drugs to reduce the risk of initiation of new tumors. Disease progression of established tumors could also potentially be inhibited by targeting the tumorigenic stem cells alone, rather than aiming to reduce overall tumor size. These new approaches mandate a change in the design of clinical trials and biomarkers chosen for efficacy assessment for preventative, neoadjuvant, adjuvant, and palliative treatments. Cancer treatments could be evaluated by assessing stem cell markers before and after treatment. Targeted stem cell specific treatment of cancers may not result in “complete” or “partial” responses radiologically, as stem cell targeting may not reduce the tumor bulk, but eliminate further tumorigenic potential. These changes are discussed using breast, pancreatic, and lung cancer as examples.
The cancer stem cell model introduces new strategies for the prevention and treatment of cancers. In cancers that appear to follow the stem cell model, pathways such as Wnt, Notch and Hedgehog may be targeted with natural compounds such as curcumin or drugs to reduce the risk of initiation of new tumors. Disease progression of established tumors could also potentially be inhibited by targeting the tumorigenic stem cells alone, rather than aiming to reduce overall tumor size. These new approaches mandate a change in the design of clinical trials and biomarkers chosen for efficacy assessment for preventative, neoadjuvant, adjuvant, and palliative treatments. Cancer treatments could be evaluated by assessing stem cell markers before and after treatment. Targeted stem cell specific treatment of cancers may not result in “complete” or “partial” responses radiologically, as stem cell targeting may not reduce the tumor bulk, but eliminate further tumorigenic potential. These changes are discussed using breast, pancreatic, and lung cancer as examples.
repost: WORD of HOPE Podcast | Ovarian Cancer News, Research and Information
The Launch of the WORD of HOPE™ Ovarian Cancer Podcast - In case you missed it a few weeks ago - We are proud to partner with Libby's Hope™ in the launch of this new podcast. Here are four links to learn more. Episode 5 is being launched very soon.
Read our blog post about WORD of HOPE.
Read Libby's Hope™ Blog Post.
Read our Press Release.
Go to the WORD of HOPE website.
Friday, June 17, 2011
(from asco 2011) video: Dr Steven Joffe – Dana-Farber Cancer Institute, Boston - Ethics of early-phase clinical trials on ecancer tv. Cancer journal: online cancer news, clinical oncology research, cancer information and latest cancer studies - open access cancer journal: ecancermedicalscience
Ethics of early-phase clinical trials
Dr Joffe talks to ecancer tv at ASCO 2011 about the arguments around
patient recruitment and expectation management in early-phase clinical
trials.Canadian Patient Safety Institute - and the patients are where????
Blogger's Note: and the patients are still not at the table as equal 'partners' - only in Canada, eh? Reminder of the "Nothing for us, without us" (UK)
"The Canadian Patient Safety Institute (CPSI) is a not-for-profit organization that exists to raise awareness and facilitate implementation of ideas and best practices to achieve a transformation in patient safety. We envision safe healthcare for all Canadians and are driven to inspire extraordinary improvement in patient safety and quality.
We invite governments, health organizations, leaders, and healthcare providers to join us and use the evidence-based tools and resources we develop and provide. Together, we can inspire, learn, apply, and improve the quality of care for patients, residents, and clients...."
Editorial :: VIEWPOINT: Randomised controlled trials using invasive ‘placebo’ controls are unethical and should be excluded from Cochrane Reviews - The Cochrane Library
"Placebo controls are frequently used to ‘blind’ participants, trial personnel and outcome assessors to intervention and control in clinical trials. Effective blinding of treatment reduces the risk of performance bias (differences between groups in the care provided apart from the intervention being evaluated) and detection bias (differences between groups in how outcomes are ascertained, diagnosed or verified). A placebo has traditionally been defined as an “inert or innocuous substance”,[1] such as a ‘sugar pill’. However, some randomised controlled trials (RCTs) have been shown to erroneously use the term ‘placebo’ to describe an invasive intervention that exposes participants, allocated to a control group, to risks of serious harm.[2,3] In this context therefore, the term ‘placebo’ describes an invasive intervention which is neither inert nor innocuous.
In a recent study of local anaesthesia RCTs, over half the RCTs used an invasive ‘placebo’ control.[2] The ‘placebo’ interventions mostly involved deep-needle insertion through body tissues with potential damage to nerves, vessels and other structures such as liver and bowel. These interventions exposed control group participants to risks of serious morbidity.[2,3].......
Thursday, June 16, 2011
Wednesday, June 15, 2011
Sustainability is not the issue: Let's focus on quality -- Hébert et al. 183 (8): 885 -- Canadian Medical Association Journal
"It’s no exaggeration to say that people have been proclaiming a crisis in Canadian health care for decades. Perhaps that rhetoric is wearing thin....)
Private clinics continue explosive growth - Canadian Medical Association Journal
"While private health providers argue that patients are demanding private health care and triggering the growth, those who oppose two-tier systems say patients are feeling increasingly coerced into paying out of pocket for services caused by underfunding in the public system.
"Provinces are delisting services. The medicare blanket is shrinking," says McBain. "The government is letting us down."
Tuesday, June 14, 2011
Video: Ovarian cancer cells bully their way through tissue
When researchers placed ovarian cancer cells and mesothelial cells together in a dish, the cancer cells formed a hole in the mesothelial layer, mirroring behavior that would occur in the body as an invasion proceeds. The team interfered with molecular components of the cancer cells one by one and used time-lapse microscopy to watch the result. If the hole failed to form, the researchers knew that they'd discovered a critical player in the invasion process.
GEN | News Highlights:Scientists Find Ovarian Cancer Cells Barge Through Mesothelium to Invade New Organs
Mesothelium
From Wikipedia, the free encyclopedia
| Mesothelium | |
|---|---|
| A layer of mesothelial cells grown in cell culture, featuring the typical "cobblestone" appearance | |
| MeSH | Mesothelium |
| Code | TH H2.00.02.0.02017 TH H3.04.08.0.00003 |
LHINs (Ontario, Canada) at Five years – What Now? :: Longwoods.com
Power throttled
On paper, the LHINS are exceedingly powerful, with over $20billion of funding authority and the power to issue integration orders compelling healthcare organizations to alter and even merge services to improve healthcare. In spite of these formidable powers, in 2006, I wrote: “Many fear that LHINs will simply be a funding conduit, perpetuating the status quo; or that they will simply do the Ministry’s bidding and add another layer of unnecessary bureaucracy and contribute further to the inefficiency of the “system”. Sadly, this prediction has largely come true, with LHINs largely reverting to traditional planning exercises, throttled by Ministry directives, and acting much like their predecessor District Health Councils, which were broadly viewed within the Ontario healthcare community as ineffectual......So what went wrong?..........
Leaving Critical Functions Outside
“While the role of the new LHINs is massive, at least on paper, there are significant omissions that may limit their effectiveness in truly improving patient care. Public health, physician services, ambulance services, laboratories and provincial drug programs are all excluded from the mandate of the new organizations.” I wrote this five years ago and these omissions continue to hamper an effective integration model today. Primary care is particularly problematic. Ontario now has an alphabet soup of primary care models, with Family Health Teams holding the most promise, but with none of them being held publicly accountable for service or performance standards. It is past time to move to truly integrated care.......
Lessons Learned in Changing Healthcare... and how we learned them :: Longwoods.com
Who Is the Customer?
........ "Who's the customer?" Well, of course, our answer was, "It's the patient." The board told us to take a closer look.So we did. We performed a deep dive on our processes, and we found out that most of them were designed around us, not the patient. If you think about it, what are waiting rooms but places for patients to hurry up, be on time and then wait for us? What happens in most hospitals on Saturdays and Sundays? Patients wait for Monday so that things can get done.
The more we probed, the more we realized that the patient did not come first. I emphasize this point, because it is our true north and basic to everything we have done in the years since.
full free access: - Pathways to the diagnosis of ovarian cancer in the UK: a cohort study in primary care - 2010 - BJOG
Implications of the findings
"The main finding is that only a minority of patients take the standard route of GP referral to a gynaecologist........"
Canada's Pathologists Issue Guidelines on Investigations into Labs - Press Release - Digital Journal
Note: as specialists key in cancer diagnoses, the number of professional pathologists in Canada is at such a low level that patient care is impacted (negatively)
Monday, June 13, 2011
Levels of acute health service use among cancer survivors in the United Kingdom
Interpretation
A considerable proportion of cancer survivors in the UK have a high level of hospital utilisation soon after diagnosis or before death, but the large majority of them are neither recently diagnosed nor near the end of their life, and do not utilise acute health services for cancer-related care.
abstract - Cochrane Review: Selenium for preventing cancer
Selenium for preventing cancer
Selenium is a trace element that is important for human health, but might also be harmful for humans when the taken in excess.Fifty-five studies with more than one million participants were included in this systematic review. Forty-nine studies observed and analysed whether healthy people with high selenium levels in blood or toenail samples or with a high selenium intake developed cancer more or less often than other people. We found that people with higher selenium levels or intake had a lower frequency of certain cancers (such as bladder or prostate cancer) but no difference for other cancers such as breast cancer.
However, it was not possible to determine from these studies that selenium levels or selenium intake were really the reason for the lower risk of cancer in some people. Factors apart from higher selenium levels could also influence the cancer risk: They might have had a healthier nutritional intake or lifestyle, have had a more favourable job or overall living conditions.
Six randomised controlled trials (RCTs) assessed whether the use of selenium supplements might prevent cancer. In general, there are two types of selenium supplements: one type uses the salt of selenium as main ingredient, the other type uses organic selenium. These two types may act differently in the human body when ingested. We assessed the quality of each trial according to four established methodological criteria. The trials with the most reliable results found that organic selenium did not prevent prostate cancer in men and increased the risk of non-melanoma skin cancer in women and men. Other trials found that participants using selenium salt or organic supplements had a decrease in liver cancer cases. However, due to methodological shortcomings this evidence was less convincing. We advise further investigation of selenium for liver cancer prevention before translating results into public health recommendations. We also recommend that there should be further evaluation of the effects of selenium supplements in populations according to their nutritional status as they may differ between undernourished and adequately nourished groups of people.
To maintain or improve health, access to healthy food and a healthy diet is important. Currently, there is no convincing evidence that individuals, particularly those who are adequately nourished, will benefit from selenium supplementation with regard to their cancer risk.
abstract: Nutritional intervention for improving treatment tolerance in cancer patients
Summary:
Supplementation with ω3 fatty acids appears to offer benefits that are verifiable at a biochemical, clinical and functional level. Related literature, however, provides conflicting results; therefore further studies will be required to confirm their efficacy.
Supplementation with glutamine appears to support the efficacy of chemoradiotherapy treatment while reducing toxicity of the tissues and improving outcomes. Oral supplementation with branched amino acid appears to reduce the length of hospital stay, decrease morbidity and improve the quality of life, without any changes in mortality. Perioperative supplementation with arginine has shown a reduced incidence of complications and a significant increase in long-term survival.
abstract : Changes in the management and outcome of central nervous system involvement from ovarian cancer since 1994
Objective
To identify differences in the management and outcome of patients with central nervous system metastases from epithelial ovarian cancer.
Methods
The clinical and pathologic characteristics, treatment, and outcome of 23 patients with brain metastases from epithelial ovarian cancer who were treated during 1982–1994 were compared with those of 20 patients treated during 1995–2010 at the same center.
Results
No differences were found in terms of primary tumor characteristics, time interval from ovarian cancer diagnosis to brain involvement diagnosis, sites of metastasis, and presence of extracranial disease. The main difference between the 2 groups was the therapeutic approach. During 1982–1994, most patients received radiotherapy only, whereas most patients during 1995–2010 underwent surgical resection followed by radiotherapy and/or chemotherapy. The duration of survival during 1982–1994 was 5 months, which was significantly shorter than the duration of survival (18 months) during 1995–2010.
Conclusion
An aggressive multimodal treatment approach might prolong the survival of patients with brain involvement from ovarian cancer.
abstract : Circulating tumor cells predict progression free survival and overall survival in patients with relapsed/recurrent advanced ovarian cancer - multinational trial
Objective
Serial circulating tumor cell (CTC) counts have demonstrated predictive and prognostic value in patients with metastatic breast, colorectal, and prostate cancer.
In a phase III study of pegylated liposomal doxorubicin (PLD) with trabectedin vs. PLD for relapsed ovarian cancer, we evaluated the correlation, if any, between numbers of CTCs and progression free survival, (PFS) and overall survival (OS).
Conclusions
Results from this study indicate that elevated numbers of CTCs impart an unfavorable prognosis for ovarian cancer patients.
abstract: Consolidation paclitaxel is more cost-effective than bevacizumab following upfront treatment of advanced epithelial ovarian cancer (taxol/avastin)
Introduction
Randomized trials have demonstrated significant improvements in progression-free survival (PFS) with consolidation paclitaxel (P) and bevacizumab (B) following cytoreduction and adjuvant carboplatin/paclitaxel (CP) for advanced epithelial ovarian cancer (EOC). We sought to evaluate the cost-effectiveness (C/E) of these consolidation strategies.
Conclusions
In this model, B consolidation for advanced EOC was associated with a modest improvement in effectiveness that is less than that with P consolidation and more costly. A statistically significant improvement in survival may improve the value of B consolidation.
abstract: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as upfront therapy for advanced epithelial ovarian cancer: Multi-institutional phase-II trial
Conclusions.
In selected patients with advanced stage EOC, upfront CRS and HIPEC provided promising results in terms of outcome. Morbidity was comparable to aggressive cytoreduction without HIPEC. Postoperative recovery delayed the initiation of adjuvant systemic chemotherapy but not sufficiently to impact negatively on survival. These data warrant further evaluation in a randomized clinical trial.
Highlights
► Maximal surgical effort and intraperitoneal chemotherapy have been proposed as upfront treatment in epithelial ovarian cancer.
► Primary cytoreduction and hyperthermic intraperitoneal chemotherapy was performed in advanced epithelial ovarian cancer patients.
► Promising survival rates and acceptable morbidity were reported.
abstract - Gynecologic Oncology : The revolving door: Hospital readmissions of gynecologic oncology patients
Deals Of The Week: The ASCO Edition (blogger)
Deals Of The Week: The ASCO Edition: "
ASCO is just moving into full swing, but already the press releases are flying fast and furious. Biotechs have long looked to this meeting as a means to showcase their smarts and increase their profile with public investors. But as big pharmas have set their sights on oncology as the therapeutic area of choice -- given its high unmet medical need and, historically, generous reimbursement, there's no doubt ASCO is now a critical meeting for even the biggest players in the industry......cont'd
© Copyright 2007-2011 Windhover Information Inc.
www.windhover.com/blog
www.windhover.com/blog
"
Live From ASCO: Time To Cool Down? (see blogger's note on ovarian cancer)
Live From ASCO: Time To Cool Down?: "
It's day three of ASCO and the meeting is at a fever pitch, as the National Cancer Institute's Antonio Tito Fojo wryly observed during a panel on designing randomized controlled trials to achieve meaningful benefits. Not that it's an unusual state for the world's largest meeting on the largest field of drug development.
There is the typical fervor surrounding promising early data, a few major advances to report (for instance, the melanoma data from Roche and BMS covered by among others, the NYT, WSJ, Reuters, and, of course, 'The Pink Sheet' Daily), and the meeting halls are packed with clinicians, investors, and journos. (Saturday's clinical science symposium on ovarian cancer had such throngs waiting for it to start that McCormick Place called in bouncers, from 'Armageddon Security,' nonetheless. And if you weren't in the initial crush, you probably got diverted to an overflow room. Or the second overflow room.)
Still, compared to other years, analysts aren't finding much to write home about. And, increasingly, the importance of the data being presented before packed meeting halls is being questioned. 'We need to get away from things that add cost but not value,' UnitedHealthcare's Lee Newcomer noted during a panel on health care reform.................cont'd
Image courtesy of flickrer Joe Seggiola through a creative commons license.
There is the typical fervor surrounding promising early data, a few major advances to report (for instance, the melanoma data from Roche and BMS covered by among others, the NYT, WSJ, Reuters, and, of course, 'The Pink Sheet' Daily), and the meeting halls are packed with clinicians, investors, and journos. (Saturday's clinical science symposium on ovarian cancer had such throngs waiting for it to start that McCormick Place called in bouncers, from 'Armageddon Security,' nonetheless. And if you weren't in the initial crush, you probably got diverted to an overflow room. Or the second overflow room.)
Still, compared to other years, analysts aren't finding much to write home about. And, increasingly, the importance of the data being presented before packed meeting halls is being questioned. 'We need to get away from things that add cost but not value,' UnitedHealthcare's Lee Newcomer noted during a panel on health care reform.................cont'd
Image courtesy of flickrer Joe Seggiola through a creative commons license.
© Copyright 2007-2011 Windhover Information Inc.
www.windhover.com/blog
www.windhover.com/blog
"
BioMed Central Blog : Read the lay summary of a clinical trial - UK
A lay summary (eg. plain english version) is the description of the research question of a trial in laymen's terms and should aim to answer the following questions:
• Background and study aims
• What does the study involve
• Who can take part
• Where does the study take place
• What are the risks to participants
• Who is funding the project
• Who is the main contact
End-of-Life Care for Advanced Lung Cancer Differs Markedly Between U.S. and Ontario
Note: study on lung cancer but pertinent for all cancer patients/families
Even more important, he writes, patient preferences vary from one individual to another and these preferences are often unheard: “Quality in end-of-life care will continue to elude us if we assume that societal average preferences indicate the care individual patients want and need,” he writes.
HER3 - Turning off cancer's growth signals (pancreatic/ovarian)
Drugs that interfere with HER3’s better-known cousins, EGFR and HER2, have already proven effective in treating many types of cancer, and early-stage clinical trials are underway with antibodies directed against HER3. HER3 is of great interest to cancer biologists because it is commonly involved in two of the deadliest forms of the disease, ovarian and pancreatic cancer, says MIT Professor Linda Griffith, who led the research team with Harvard Stem Cell Institute and Brigham and Women’s cardiologist Richard Lee.
The study, published online May 26 in the Journal of Biological Chemistry....
Sunday, June 12, 2011
abstract: Randomized surgical training for medical students: resident versus peer-led teaching (trial and error)
Blogger's Note: tip - get it in writing who will be performing the surgery before the surgery; trial, error, adverse events and living WITH the failures = patients' lives; "low-threat" = system issue
Randomized surgical training for medical students: resident versus peer-led teaching
Scott C. Graziano MDRandomized surgical training for medical students: resident versus peer-led teaching
, a, 
Available online 16 March 2011.
Objective
Medical students spend significant portions of their time in the operating room, with many learning skills through trial and error. Peer-assisted learning is a useful teaching and learning method. Our hypothesis is that students will perform basic skills in the operating room environment more often when taught by their peers.
Study Design
Sixty third-year medical students participated in an operating room introduction course. Learners were randomized into 2 cohorts: 1 led by obstetrics and gynecology residents, 1 led by fourth-year medical students. Assessment was performed using an objective, structured clinical exercise.
Results
Peer-assisted learners performed more steps correctly during the objective exercise compared with resident-assisted learners (16.1 vs 14.4 of 22 total steps assessed, P < .01).
Conclusion
Peer-assisted learning may be a useful teaching method for simulation training. Third-year medical students may benefit from this low threat and informal environment.
abstract: Treating cervical cancer: Breast and Cervical Cancer Prevention and Treatment Act patients - access to care
abstract : Posttreatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncologists recommendations authors U.S./Canada
Review
Posttreatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncologists recommendations
Ritu Salani MD, MBAa, , , Floor J. Backes MDa, Michael Fung Kee Fung MB, BSb, Christine H. Holschneider MDc, Lynn P. Parker MDd, Robert E. Bristow MD, MBAe and Barbara A. Goff MDf
Received 19 February 2011;
accepted 8 March 2011.
Available online 11 June 2011.
Although gynecologic cancers account for only 10% of all new cancer cases in women, these cancers account for 20% of all female cancer survivors. Improvements in cancer care have resulted in almost 10 million cancer survivors, and this number is expected to grow. Therefore, determining the most cost-effective clinical surveillance for detection of recurrence is critical. Unfortunately, there has been a paucity of research in what are the most cost-effective strategies for surveillance once patients have achieved a complete response. Currently, most recommendations are based on retrospective studies and expert opinion. Taking a thorough history, performing a thorough examination, and educating cancer survivors about concerning symptoms is the most effective method for the detection of most gynecologic cancer recurrences. There is very little evidence that routine cytologic procedures or imaging improves the ability to detect gynecologic cancer recurrence at a stage that will impact cure or response rates to salvage therapy. This article will review the most recent data on surveillance for gynecologic cancer recurrence in women who have had a complete response to primary cancer therapy.
Key words: cervical cancer; cytology; endometrial cancer; gynecologic cancer; imaging; ovarian cancer; surveillance
abstract: Description of anaphylactic reactions to paclitaxel and docetaxel reported to the FDA, with a focus on the role of premedication
Purpose: Anaphylactic reactions (ARs) have been frequently reported with taxanes. The authors' purpose was to summarize published case reports and describe ARs from taxanes reported to the Food and Drug Administration (FDA) with a focus on use of package insert-specified prophylactic premedications (PPMs).
Conclusions: Mortality was reported in more docetaxel ARs than paclitaxel. Documented use of PPMs did not significantly impact mortality from ARs with docetaxel, but was associated with significantly lower mortality from ARs with paclitaxel.
New lesions versus growth of existing disease: Does it impact prognosis? ASCO Meeting Abstract
Note: this study concerns the clinical criteria for evidence of progressive/new disease
Conclusions:
In 9,741 (patients), survival after development of new lesions as the sole reason for progression did not significantly differ from patients with other reasons of PD (progressive disease). These findings give further validation to the use of new lesions as a classifier of PD according to established criteria. (RECIST)
Background:
Clinical trials use established criteria (RECIST or WHO) to determine objective tumor behavior on therapy. Participants are labeled to have progressive disease (PD) and are taken off study if they meet specific parameters of increase in size of their known lesions, but can also be labeled as PD if they develop new lesions without meeting criteria for progression in known lesions. To determine whether there are outcome disparities among these patients, we explored survival differences by reason of progression among patients who developed PD on study using data from the phase III Intergroup trial N9741 which compared IFL, FOLFOX4, and IROX as first-line therapy in advanced colorectal cancer (Goldberg JCO 2004).
multinational study: Brivanib -oral- (BMS-582664) in advanced solid tumors (AST): Results of a phase II randomized discontinuation trial (RDT)-- ASCO Meeting Abstract
Background:
Brivanib (B) is an oral once daily selective dual inhibitor of FGF and VEGF signaling currently in phase III development for advanced hepatocellular carcinoma and colorectal cancer.
"Biomarker exploration with potential for enrichment continues; breast and ovarian cohorts have been added to the trial."
Long-Term Doxorubicin Linked to Secondary Oral Cancers
".......Four patients who received long-term PLD for advanced-stage ovarian cancer developed malignant and/or premalignant lesions of the tongue and/or oral cavity. Dr. Cannon points out that there were only about 16 patients who received PLD for an extended period of time, "so 4 out of 16 patients is quite high."
All 4 of the patients had received maintenance therapy with PLD for at least 3 years. Of this group, 3 women were subsequently diagnosed with squamous cell carcinoma (SCC) of the tongue and/or oral cavity, and 1 patient was diagnosed with sublingual mucosa high-grade dysplasia. All 3 cases of SCCs were negative for human papillomavirus.
Of note, said Dr. Cannon, was a patient who presented with 3 separate lesions of SCC of the oral cavity.
"I don't think this is a coincidence, that 4 of 16 patients receiving this treatment developed oral cancers," he said. "If this treatment for ovarian cancer becomes more popular, then this is something that should become known. Early dental screening would need to be initiated, and the treatment may need to be stopped after a certain time period."
It is relatively uncommon for ovarian cancer patients to receive PLD for this length of time.......cont'd
also: see chart
Canadian Medicine: End of the line for the gravy train? (pharma/AstraZeneca)
"Pharma giant AstraZeneca will no longer fund.....cont'd
webconference - Grey Literature - consumer's perspective section (free web conference)
Grey Lit 102: Advanced Search Strategies for Grey Literature
NEW: View the Grey Lit 102 archived recording and access the presentation slides here.Date: Thursday, April 7, 2011 12:00 p.m.-1:00 p.m. (EDT)
Course Level: 101
Faculty: Melissa Ratajeski, M.L.I.S., R.L.A.T., University of Pittsburgh; Ahlam Saleh, M.D., M.L.S., University of Pittsburgh
Duration: 60 min.
Overview: This free Web conference (the "consumer's" perspective) discussed the challenges inherent in conducting advanced searches for grey literature and presents tactics for overcoming these challenges. Participants in this session learned:
- Who are the major users of grey literature, and why?
- What are best practices for searching and incorporating grey literature evidence into larger research efforts?
- Is it possible to systematically review grey literature (why or why not)?
- Are there critical assumptions or search parameters that can target a search and efficiently find desired evidence?
Grey Literature in Public Health Web Conference Series 2011 | Open Medicine Blog
AcademyHealth is pleased to announce that the archived recordings for all three Web conferences in the Grey Literature Web Conference Series are now available on the AcademyHealth website.
Presentation slides are also available.
To access the archived recordings, visit the Grey Literature Web Conference Series page.
ASCO - the End Part II - posting by Dee
ASCO - the End Part II: "All the Focus on Research Advocates where asked to video a testimonial about their experience as a Focus on Research Advocate at ASCO. Below is my testimonial.
I am an ovarian cancer survivor and advocate. Being part of the Focus on Research program this year has been an honor.
The preparation offered prior to attending the conference was invaluable. Learning about biomarkers, drug development and clinical trial design has increased my understanding of cancer research. Interacting with the webinar lecturers, Drs Byers, Hong and Bemis helped to improve my communication skills and raised my confidence to discuss research topics with poster presenters and education session lecturers. Knowing the language and acronyms of cancer pathways, drugs and agents was an asset during the conference.
At ASCO the interaction with other advocates and hearing about their experiences has been both enjoyable and inspirational. I look forward to maintaining these relationships for years to come.
Another benefit of my attendance has ben an increased respect for cancer researchers and the challenges they face in both the US and internationally. I was thrilled to interact with a large number of international researchers at poster sessions and in the lecture hall. Learning about advances such as PARP inhibitors, monoclonal antibodies and other individualized medicine agents gives me hope for the future of cancer research.
I look forward to working with my dissemination partner. My goal is to share the exciting research developments I learned about this weekend in terms that are understandable by patients and caregivers.
Thank you to the Research Advocacy Network for the incredible opportunity.
Dee
Every Day is a Blessing!
Saturday, June 11, 2011
Holistic Health Research Foundation of Canada - winding up operations
May 2011
Announcement
"The Board of Directors of the Holistic Health Research Foundation of Canada has voted to wind up its operations due to insufficient financial and physical resources. After seven years working in this still-emerging field, we have not been able to attract the significant operational funding needed to sustain the organization and grow our programs.
While we are greatly saddened to see the organization come to an end, we are proud of what we have achieved since launching publicly in late 2004......"
Announcement
"The Board of Directors of the Holistic Health Research Foundation of Canada has voted to wind up its operations due to insufficient financial and physical resources. After seven years working in this still-emerging field, we have not been able to attract the significant operational funding needed to sustain the organization and grow our programs.
Friday, June 10, 2011
Cancer patients struggle as drug costs soar - Michigan News
Blogger's Note: decisions eg "buy groceries or not" is not new to cancer patients/families and is a rather old comment which seemingly has not made an impact (on instititional decision makers)
"Overall, this study provides a patient-centered view of a reality of modern day cancer care -- something that we call 'financial toxicity,'" senior author Dr. Amy Abernethy, an associate professor in Duke's medical oncology division, said in a Duke news release.
"We used to think about chemotherapy toxicity in terms of bad side effects like vomiting, nerve pain, confusion and risk of fatal infection. Now we are starting to think in terms of how treatment choices impact real aspects of daily living such as the ability to buy groceries or not," she added."
Editorial: World Report on Disability : The Lancet
Note: this editorial does not mention cancer specifically
"Disability is a common, though uniquely personal experience that will affect increasing numbers of people as populations age. Common, because 1 billion people (15% of the world's population) are thought to have a disability. Unique, because how that disability affects an individual is mediated by environment and resources. For these reasons, the World Report on Disability, published on June 9, makes compelling reading for any citizen, and compulsory reading for health professionals, whose actions can moderate the effect of disabilities on people's lives."
"....This report reminds health professionals that people with disabilities are entitled to the highest standard of health without discrimination. Responsibilities go beyond primary prevention of disability, for instance by antenatal care, or secondary prevention after a cardiovascular event. To provide best care across the spectrum of comorbid physical and mental disabilities, health professionals need a sound understanding of access and communication needs, which should be central to all curricula.
The report makes care and policy recommendations for practitioners at all levels, as well as calling for better public understanding."
"Disability is a common, though uniquely personal experience that will affect increasing numbers of people as populations age. Common, because 1 billion people (15% of the world's population) are thought to have a disability. Unique, because how that disability affects an individual is mediated by environment and resources. For these reasons, the World Report on Disability, published on June 9, makes compelling reading for any citizen, and compulsory reading for health professionals, whose actions can moderate the effect of disabilities on people's lives."
"....This report reminds health professionals that people with disabilities are entitled to the highest standard of health without discrimination. Responsibilities go beyond primary prevention of disability, for instance by antenatal care, or secondary prevention after a cardiovascular event. To provide best care across the spectrum of comorbid physical and mental disabilities, health professionals need a sound understanding of access and communication needs, which should be central to all curricula.
JCO link - Germ-line BRCA mutations in high-grade ovarian cancer: A case for routine BRCA mutation screening after a diagnosis of invasive ovarian cancer. -- ASCO Meeting Abstracts
Conclusions: Pathogenic BRCA1/2 mutations are common in invasive ovarian cancer and are associated with improved overall survival and response to systemic chemotherapy. BRCA testing should be implemented for all ovarian cancer patients as mutation status has important prognostic and therapeutic clinical utility.
Search Results JCO - abstract search results 'ovarian'
Note: search 'ovarian' brings up abstracts from ASCO 2011 (secondary source of info as a FYI)
Thursday, June 09, 2011
ovarian cancer - Google 'Fast Flip'
FYI - Tip: Google has a site which is called 'fast flip' (recent news stories/searchable eg. ovarian cancer - scan headlines, share and/or view the full news article/s)
abstract & full free access: Impact of tumour volume on the potential efficacy of therapeutic vaccines | Gulley | Current Oncology
Abstract:
Impact of tumour volume on the potential efficacy of therapeutic vaccines
J.L. Gulley, MD PhD*, R.A. Madan, MD*, J. Schlom, PhD*
*Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, U.S.A.
With the recent approval by the U.S. Food and Drug Administration of the first therapeutic vaccine for cancer, the long-awaited goal of harnessing a patient’s immune system to attack cancer through this modality is finally realized. However,
OCNA - webinar registration/Dr Deborah Armstrong **June 16th** Ovarian Cancer News from 2011 ASCO
Ovarian Cancer News from the 2011 ASCO Meeting
Thursday, June 16, 2011 1:00 PM - 2:00 PM EDT
Webinar Registration
More than 30,000 oncology professionals recently gathered in Chicago to share their latest research and findings at the American Society of Clinical Oncology Annual Meeting. We've sifted through the new data to bring you an update on studies that are relevant to women with ovarian cancer. Join us as Dr. Deborah Armstrong of The Johns Hopkins School of Medicine reviews the most important findings from the ASCO meeting and how they could affect women with ovarian cancer.
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