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Tuesday, August 07, 2012

: Venous thromboembolism is a relevant and underestimated adverse event in cancer patients treated in phase I studiesBritish Journal of Cancer




Clinical Study

British Journal of Cancer 107, 612-616 (7 August 2012) |doi:10.1038/bjc.2012.325

Venous thromboembolism is a relevant and underestimated adverse event in cancer patients treated in phase I studies

Background:

To investigate, retrospectively, the role of tumour histotype and antiangiogenic drugs for venous thromboembolism (VTE) development in advanced cancer patients treated in phase I studies.

Methods:

Patients enrolled and treated in phase I studies conducted by SENDO (Southern Europe New Drugs Organisation) were considered.

Results:

Data of 1415 patients were included in the analysis: 526 (37.2%) patients were males, median age was 57.3 years (range: 13–85). Fifty-six (3.96%) patients developed a VTE. At multivariate analysis gynaecologic (hazard ratio (HR): 2.8, 95%confidence interval (CI): 1.29–6.23, P=0.009) and gastrointestinal tumours (HR: 3.23, 95% CI: 1.18–8.87, P=0.023) as well as combination regimens of cytotoxic and antiangiogenic agents (HR: 2.6, 95%CI: 1.11–6.30, P=0.028), white blood cell >11000μl−1 (HR: 2.59, 95% CI: 1.10–6.09, P=0.028) and haemoglobin<10gdl−1 (HR: 3.1, 95%CI: 1.07–8.94, P=0.037) were statistically correlated with VTE development. Venous thromboembolism was the fourth most common cause of drug discontinuation. The median time from first drug administration to discontinuation was 1.4 for VTE and 2.3 months for the other adverse events (P=0.02).

Conclusion:

Venous thromboembolism is a relatively common complication among patients treated in the context of phase I studies, and may lead to early drug discontinuation. A greater risk of developing VTE is associated with the diagnosis of gynaecologic and gastrointestinal tumours and the combined use of chemotherapy and antiangiogenic drugs.




Foundation Medicine and Clovis Oncology form alliance - Mass High Tech Business News



Foundation Medicine and Clovis Oncology form alliance - Mass High Tech Business News

Oxigene Announces Phase 2 Ovarian Cancer Trial of Zybrestat Plus Bevacizumab Achieves Important Interim Safety Objective



http://pharmalive.com/News/Index.cfm?articleid=851802

What is symptom burden: a qualitative exploration of patient definitions.



What is symptom burden: a qualitative exploration of patient definitions.


J Palliat Care. 2012 Summer

Abstract

Current definitions of "symptom burden" are largely derived from clinicians, and there are many variations in the way the term is used, defined, and operationalized. The aim of this study was to explore patient perceptions of symptom burden in the context of advanced and incurable disease. A group of 58 cancer patients followed by a palliative care team answered a single open-ended question: "Please define 'symptom burden'". Three authors independently coded and analyzed patient responses using a grounded theory approach. They identified six themes, the most frequently coded of which were: "can't do usual activities", "psychological suffering" and "specific severe symptoms". Our findings indicate that the concept of symptom burden is complex and extends beyond numerical symptom-scoring systems. In addition to inquiring about specific symptoms, it may be important to directly ask patients about their overall burden or experience of symptoms.





Ovarian cancer and smoking





Reply to "How to improve cytoreductive surgery for advanced ovarian cancer and talk about it in a common language" pay walled



http://www.ncbi.nlm.nih.gov/m/pubmed/22864110/?i=12&from=ovarian%20cancer

Metformin Targets Ovarian Cancer Stem ...



Abstract

PURPOSE: Studies in non-gynecologic tumors indicate metformin inhibits growth of cancer stem cells (CSC). Diabetic patients with ovarian cancer who are taking metformin have better outcomes than those not taking metformin. The purpose of this study was to directly address the impact of metformin on ovarian CSC.

METHODS: The impact of metformin on ovarian cancer cell line growth and viability was assessed ......,,


Impact of Routine Follow-Up Examinations on Life Expectancy in Ovarian Cancer Patients: A Simulation Study.



Impact of Routine Follow-Up Examinations on Life Expectancy in Ovarian Cancer Patients: A Simulation Study.

 

Abstract

OBJECTIVE: The clinical benefit of routine follow-up in patients treated for ovarian cancer is subject to debate. In this study, the magnitude of the potential survival benefit of routine examinations was evaluated by Markov modeling.

METHODS: The clinical course of ovarian cancer was simulated using a 4-state nonstationary Markov model. Risk of recurrence and mortality probabilities were derived from individual patient data and Statistics Netherlands. The life expectancy was simulated for 3 follow-up scenarios: a current, withholding (all recurrences detected symptomatically), and perfect follow-up program (all recurrences detected asymptomatically). The impact of effective recurrence treatment in the future was modeled by varying the mortality ratio between patients with asymptomatically versus symptomatically detected recurrences. The model was validated using empirical data.

RESULTS: The mean life expectancy of patients, aged 58 years and in complete clinical remission after primary treatment, was 10.8 years. Varying the transition probabilities with ±25% changed the life expectancy by up to 1.1 years. The modeled life expectancy for the withholding and perfect follow-up scenarios was also 10.8 years and insensitive to model assumptions. In patients with stages IIB to IV, the life expectancy was 7.0 years, irrespective of follow-up strategy. A mortality ratio of 0.8 for patients with asymptomatically versus symptomatically detected recurrences resulted in a gain in life expectancy of 5 months for withholding versus perfect follow-up.

CONCLUSIONS: Routine follow-up in ovarian cancer patients is not expected to improve the life expectancy. The timing of detection of recurrent ovarian cancer is immaterial until markedly improved treatment options become available.




Systematic lymphadenectomy in ovarian cancer at second-look surgery: a randomised clinical trial.



http://www.ncbi.nlm.nih.gov/m/pubmed/22864456/?i=8&from=ovarian%20cancer

High frequency of BRCA1 founder mutation in Polish women with non familial breast cancer



High frequency of BRCA1 founder mutations in Polish women with nonfamilial breast cancer.

Abstract

Possession of a BRCA1/2 mutation increases risk of contralateral breast and ovarian cancer recurrence and may have an impact on health management decisions, such as imaging screening, preventive surgical interventions and systemic therapies. A hospital-based study was conducted to assess the frequency and spectrum of pathogenic germline BRCA1 and BRCA2 mutations in Polish women with familial and nonfamilial breast cancer. Genomic DNA was extracted from 1581 women with breast cancer and from 2225 healthy individuals. For genotyping BRCA1 (5382insC, T300G, 3819del5, 185delAG, C5370T, 3875del4, 3896delT, 4153delA, 4184del4, 4160delAG, G5332A) mutations and BRCA2 (G1408T, 5467insT, 6174delT, 6192delAT, 6675delTA, 8138del5, 9152delT, C9610T, 9630delC) mutations, a Custom TaqMan (Applied Biosystems) PCR-based technology was adopted. A BRCA1 mutation was found in 26 and 12.5 % of women with familial breast cancer and in 13 and 8.3 % nonfamilial (sporadic) breast cancer, diagnosed before or after 50 years of age, respectively. A much lower frequency of BRCA2 mutation was observed. The predominance of seven BRCA1 mutations (5382insC, T300G, 3819del5, 185delAG, C5370T, 3875del4, 4153delA) studied in the Masovian voivodeship population confirmed a strong founder effect for BRCA1 mutations in the Polish population, and the results of BRCA2 testing confirmed a high diversity in the studied pathogenic mutations in BRCA2 gene. We propose offering inexpensive testing for the presence of BRCA1 founder mutations to all Polish women at the time of initial breast cancer diagnosis, regardless of the patient's family history or age of disease onset.




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The Microculture-Kinetic (MiCK) Assay: The Role of a Drug-Induced Apoptosis Assay in Drug Development and Clinical Care.



http://www.ncbi.nlm.nih.gov/m/pubmed/22865459/?i=5&from=ovarian%20cancer

Sunday, August 05, 2012

Vitamins & Supplements - Sept 2012 Consumer Reports Investigates



Vitamins & Supplements - Consumer Reports Investigates

paywalled: Patients with Lynch Syndrome Mismatch Repair Gene Mutations Are at Higher Risk for Not Only Upper Tract Urothelial Cancer but Also Bladder Cancer



Patients with Lynch Syndrome Mismatch Repair Gene Mutations Are at Higher Risk for Not Only Upper Tract Urothelial Cancer but Also Bladder Cancer

Abstract

Background

Lynch syndrome (LS), or hereditary nonpolyposis colorectal cancer, is caused by mutations in mismatch repair (MMR) genes. An increased risk for upper tract urothelial carcinoma (UTUC) has been described in this population; however, data regarding the risk for bladder cancer (BCa) are sparse.

Objective

To assess the risk of BCa in MMR mutation carriers and suggest screening and management recommendations.

Design, setting, and participants

Cancer data from 1980 to 2007 were obtained from the Familial Gastrointestinal Cancer Registry in Toronto for 321 persons with known MMR mutations: mutL homolog 1, colon cancer, nonpolyposis type 2 (E. coli) (MLH1); mutS homolog 2, colon cancer, nonpolyposis type 1 (E. coli) (MSH2); mutS homolog 6 (E. coli) (MSH6); and PMS2 postmeiotic segregation increased 2 (S. cerevisiae) (PMS2).

Outcome measurements and statistical analysis

Standardized incidence ratios from the Ontario Cancer Registry, using the Surveillance Epidemiology and End Results public database, were used to compare cancer risk in patients with MMR mutations with the Canadian population. Microsatellite instability analysis and immunohistochemistry (IHC) of the MMR proteins were also performed and the results compared with matched sporadic bladder tumors.

Results and limitations

Eleven of 177 patients with MSH2 mutations (6.21%, p < 0.001 compared with the Canadian population) were found to have BCa, compared with 3 of 129 patients with MLH1 mutations (2.32%, p > 0.05). Of these 11 tumors, 81.8% lacked expression of MSH2 on IHC, compared with the matched sporadic cases, which all displayed normal expression of MSH2 and MLH1. The incidence of UTUC among MSH2 carriers was 3.95% (p < 0.001), and all tumors were found to be deficient in MSH2 expression on IHC. Mutations in the intron 5 splice site and exon 7 of the MSH2 gene increased the risk of urothelial cancer. Limitations include possible inflated risk estimates due to ascertainment bias.

Conclusions

LS patients with MSH2 mutations are at an increased risk for not only UTUC but also BCa and could be offered appropriate screening.


Figures and tables from this article:
Full-size image (105K)
Fig. 1. Tumor sections at ×200 magnification: (A) abnormal MSH2 expression—nuclear expression is lost in the tumor, with normal nuclear staining in the adjacent tissue; (B) normal MLH1 expression—normal strong nuclear expression in the tumor and normal tissue.
View Within Article
Table 1. Distribution of patients with mismatch repair mutations
View table in article
M:F = male-to-female; MLH1 = mutL homolog 1, colon cancer, nonpolyposis type 2 (E. coli); MSH2 = mutS homolog 2, colon cancer, nonpolyposis type 1 (E. coli); MSH6 = mutS homolog 6 (E. coli); PMS2 = PSM2 postmeiotic segregation increased 2 (S. cerevisiae).
View Within Article
Table 2. Total incidence of urothelial cancers due to MLH1 and MSH2
View table in article
MLH1 = mutL homolog 1, colon cancer, nonpolyposis type 2 (E. coli); MSH2 = mutS homolog 2, colon cancer, nonpolyposis type 1 (E. coli); NS = not significant.
View Within Article
Table 3. Urothelial cancers in patients with confirmed MSH2 mutations and comparison with matched sporadic bladder cancer patients
View table in article
− = absent expression; +  = normal expression; CR = colorectal; Dx = diagnosis; EM = endometrial; F = female; GA = gastric; HG = high grade; IHC = immunohistochemistry; LG = low grade; LS = Lynch syndrome; M = male; MSH2 = mutS homolog 2, colon cancer, nonpolyposis type 1 (E. coli); MSI = microsatellite instability; MSI-H = high microsatellite instability; MSS = microsatellite stable; OR = occupational risk; OV = ovarian; RP = renal pelvis; U = ureter.Patients H1 and H2 are related.
View Within Article
Table 4. Urothelial cancers in patients with confirmed MLH1 mutations
View table in article
− = absent expression; +  = normal expression; CR = colorectal; HG = high grade; IHC = immunohistochemistry; LG = low grade; LS = Lynch syndrome; M = male; MLH1 = mutL homolog 1, colon cancer, nonpolyposis type 2 (E. coli); MSI = microsatellite instability; MSI-H = high microsatellite instability; OR = occupational risk; RP = renal pelvis.

How to generalize efficacy results of randomized trials: recommendations based on a systematic review of possible approaches



How to generalize efficacy results of randomized trials: recommendations based on a systematic review of possible approaches:

Abstract

Rationale, aims and objectives

Randomized controlled trials (RCTs) are the preferred source for evidence for the effect of treatment. However, patients participating in RCTs often manifest important differences from patients seen in practice. Therefore, guideline developers have to decide whether the results are generalizable to the target population not represented in RCTs.

Method

A systematic review of the literature was undertaken to identify methods to decide whether to generalize the results from RCTs to patients who were not represented in these trials.

Results

One approach is to examine the in- and exclusion criteria of trials and infer from these whether the trial population was sufficiently representative. Other authors suggest, because of the inclusion of a broader range of patients, reliance on observational studies if no direct evidence for the target population is available.
Another approach is to apply the relative effect of treatment found in trials to patients in practice unless there is a compelling reason to believe the results would differ substantially as a function of particular characteristics of those patients. Although there are exceptions, this approach is supported by empirical evidence that, in general, relative effect of treatment on benefit outcomes seldom differs to an important extent across subgroups of patients.

Conclusion

We propose this last approach: focusing on RCTs unless there is a compelling reason not to do so. Compelling reasons will most often be found with respect to issues of rare adverse effects, for which observational studies are likely to provide the best estimates.

Medscape: Long-term Risk of Colorectal Cancer After Adenoma Removal




Long-term Risk of Colorectal Cancer After Adenoma Removal

Sessile serrated adenomas: high-risk lesions?



Sessile serrated adenomas: high-risk lesions?

Authors

Salaria SN, et al. Show all

Journal

Hum Pathol. 2012 Jul 9. [Epub ahead of print]

Affiliation

The Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.

Abstract

Sessile serrated adenomas (SSAs) were unrecognized in pathology and gastroenterology practice until about 2005; we have diagnosed them since 2001, allowing up to 10 years of follow-up. We evaluated follow-up of patients with sessile serrated adenoma diagnosed between 2002 and 2004 in our teaching institution and compared it to follow-up of randomly selected tubular adenomas. Materials from patients diagnosed with sessile serrated adenoma from January 2002 to December 2004 were reviewed. A control group of patients with sporadic tubular adenomas was selected. Ninety-nine sessile serrated adenomas from 93 patients were diagnosed between January 2002 and December 2004. Forty three patients (46.2%) had follow-up colonoscopy. One or more lesions were found in 42 (97.6%) of 43 patients. Mucinous adenocarcinoma was diagnosed in 1 (2.3%) of 43 patients, and 1 (2.3%) of 43 patients had high-grade dysplasia in an sessile serrated adenoma. Sessile serrated adenomas were found in 22 (51.2%) of 43 patients, 16 (37.2%) of 43 patients had tubular adenomas, and hyperplastic polyps were diagnosed in 18 (41.9%) of 43. Ninety-two patients with tubular adenomas between January 2002 and December 2004 formed the control group. Sixty-six patients (71.7%) received follow-up colonoscopy. Most (53/66, 80.3%) patients had tubular adenomas on follow-up, 12 (18.2%) of 66 patients had hyperplastic polyps, and 2 (3.0%) of 66 patients had a sessile serrated adenoma. The follow-up of sessile serrated adenomas from the study period (2002 to 2004) was more rigorous than proposed for sporadic tubular adenomas (patients with sporadic tubular adenomas were also followed up more aggressively than suggested by guidelines). Those with follow-up were managed as per advanced adenomas; their clinical outcomes supported this. These results suggest that guidelines for following up patients with sessile serrated adenomas as per advanced adenomas are warranted.




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Friday, August 03, 2012

PPT lynch syndrome



> e/GIM/education/ContinuingEducation/Documents/6-14-2011_AhnenD.pdf

Endocyte Secures DOXIL(R) Supply to Support Ongoing Phase 3 PROCEED Trial in Ovarian Cancer |(+doxil)



http://www.virtual-strategy.com/2012/08/02/endocyte-secures-doxilr-supply-support-ongoing-phase-3-proceed-trial-ovarian-cancer

HealthLinx to commercialise assets in the U.S. after deal with Mane Cancer Diagnostics - Proactiveinvestors (AU) OvPlex



http://www.proactiveinvestors.com.au/companies/news/32037/healthlinx-to-commercialise-assets-in-the-us-after-deal-with-mane-cancer-diagnostics-32037.html


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Vermillion ovarian cancer test shows positive results OVA1



Genetic testing by cancer site: ovary



Genetic testing by cancer site: ovary.

Abstract

ABSTRACT: Approximately 1 in every 4 to 5 women with a diagnosis of ovarian cancer has a hereditary gene mutation that is responsible for the development of her cancer. Identifying women at increased risk of developing ovarian cancer due to a hereditary cancer syndrome can allow for early detection or prevention of not only ovarian cancer, but also other cancers, depending on the causative gene. This review focuses on 3 of the most common hereditary ovarian cancer syndromes, hereditary breast and ovarian cancer syndrome (the BRCA1 and BRCA2 genes), Lynch syndrome (also known as hereditary nonpolyposis colorectal cancer syndrome), and Peutz-Jeghers syndrome, including key features, genetics, and management of these syndromes. In addition, newly discovered genes (eg, RAD51C and RAD51D) linked to ovarian cancer are discussed.

PMID

 22846732 [PubMed - in process]

Back to results 



Tuesday, July 31, 2012

Ovarian cancer in elderly patients: a difference in treatment based on age?



http://www.ncbi.nlm.nih.gov/m/pubmed/22843035/?i=11&from=ovarian%20cancer

Constitutive promoter methylation of BRCA1 and RAD51C in patients with familial ovarian cancer and early-.....



Constitutive promoter methylation of BRCA1 and RAD51C in patients with familial ovarian cancer and early-.....

Journal Genet. 2012 Jul 27

Abstract

Genetic defects in breast cancer susceptibility genes, most importantly BRCA1 and BRCA2 account for approximately 40% of hereditary breast and ovarian cancers. Little is known about the contribution of constitutive (soma-wide) epimutations to the remaining cases. We developed bisulfite pyrosequencing assays to screen > 600 affected BRCA1/BRCA2 mutation-negative patients from the German Consortium for Hereditary Breast and Ovarian Cancer for constitutive hypermethylation of ATM, BRCA1, BRCA2, RAD51C, PTEN, and TP53 in blood cells. In a second step, patients with ≥ 6% promoter methylation were analyzed by bisulfite plasmid sequencing to demonstrate the presence of hypermethylated alleles (epimutations), indicative of epigenetic gene silencing. Altogether we identified 9 (1.4%) patients with constitutive BRCA1 and three (0.5%) with RAD51C hypermethylation. Epimutations were found in both sporadic cases, in particular in 2 (5.5%) of 37 patients with early-onset breast cancer, and familial cases, in particular 4 (10%) of 39 patients with ovarian cancer. Hypermethylation was always confined to one of the two parental alleles in a subset (1240%) of the analyzed cells. Because epimutations occurred in cell types from different embryonal layers, they most likely originated in single cells during early somatic development. We propose that analogous to germline genetic mutations constitutive epimutations may serve as the first hit of tumor development. Because the role of constitutive epimutations in cancer development is likely to be largely underestimated, future strategies for effective testing of susceptibility to breast and ovarian cancer should include an epimutation screen.




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Open access - Multi-center evaluation of post-operative morbidity and mortality after optimal cytoreductive surgery for advanced ovarian cancer.



http://www.ncbi.nlm.nih.gov/m/pubmed/22844394/?i=4&from=ovarian%20cancer

Pre-targeting and direct immunotargetin - Open access



http://www.ncbi.nlm.nih.gov/m/pubmed/22844475/?i=3&from=ovarian%20cancer

Monday, July 30, 2012

Vermillion ovarian cancer test shows positive result



I thought you might be interested in this:

http://reut.rs/Q58BNC

I found this using the Thomson Reuters News Pro for iPhone app.

To install News Pro on your iPhone or iPad, visit:

http://reuters.com/mobile



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Vermillion ovarian cancer test shows positive result



http://reut.rs/Q58BNC

Health scare 'clouded views on HRT' - Health - Media



http://m.bognor.co.uk/news/health/health-scare-clouded-views-on-hrt-1-3968133


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Study investigates molecular markers in drug-resistant ovarian cancer



Study investigates molecular markers in drug-resistant ovarian cancer

A new study by TCD researchers investigates drug-resistant ovarian cancer cells. The findings which have been recently published in the international publication, PLoS One will increase understanding of molecular markers in drug-resistant ovarian cancer with a view to improving clinical treatment.

Worldwide there are more than 204,000 new cases of ovarian cancer each year, accounting for around 4% of all cancers diagnosed in women. For many cancers, including ovarian, chemotherapy remains the only treatment option. While chemotherapy has its success stories, the majority of ovarian cancer patients will go on to develop chemotherapy-resistant disease. Determining which chemotherapy drug to give a patient is a complicated process. Most decisions are made based on the type of cancer the patient has and how advanced it is. Currently, there is a shift towards individually tailoring chemotherapy to each patient. A personalised approach has improved treatment outcomes in breast cancer by targeting therapy according to its subtype.

In the case of ovarian cancer, research fellow and lead author Dr Britta Stordal says:
"If we can subdivide ovarian cancer patients into different resistance categories we can start personalising the treatment of this disease. The cost of patients receiving chemotherapy that they do not respond to is high, both personally for the patients and financially for the healthcare system. By understanding how chemotherapy resistance develops in ovarian cancer we can determine the best drug to prescribe to each patient. The individual tailoring of chemotherapy for relapsed patients can only improve cancer treatment in terms of increased response rates. "

The research studies drug-resistant ovarian cancer cells called IGROVCDDP. The cells were originally developed in a laboratory in the Netherlands. IGROV-1 cells, were firstly derived from an ovarian cancer patient. IGROV-1 cells were put through cycles of chemotherapy in the laboratory to simulate what a cancer patient receives in the clinic. The daughter cells produced are the IGROVCDDP cells, which were grown in tissue culture and examined as to how they became drug resistant.

IGROVCDDP cells are resistant to the two chemotherapy drugs used in the first line treatment of ovarian cancer, cisplatin and paclitaxel. By studying the IGROVCDDP cells we can identify genes and proteins that have changed and may be useful as molecular markers of chemotherapy resistance in the clinic. IGROVCDDP cells have many molecular markers of chemotherapy resistance and highlight the multiple mechanisms that can exist simultaneously in drug-resistant cancer cells. IGROVCDDP cells have increased levels of the drug-efflux pump, P-glycoprotein. This causes resistance to paclitaxel by pumping the drug out of the cancer cell. The study highlights that the P-glycoprotein can co-exist with multiple mechanisms of resistance to cisplatin. Cisplatin resistance is mediated in part by detoxification by the glutathione pathway and decreased uptake of drug into the cell. This is a step towards understanding how molecular markers of drug resistance interact and overlap in in ovarian cancer patients.

"We will now go on to examine molecular markers identified in IGROVCDDP in samples of tumours from ovarian cancer patients. Hopefully we will find markers that can separate patients who respond and those who do not respond to cisplatin and paclitaxel chemotherapy. Patients we think that will respond could be given the standard cisplatin/paclitaxel chemotherapy, and those who have a poor chance of responding could be given alternative treatment," concluded Dr Stordal.


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Study investigates molecular markers in drug-resistant ovarian cancer



http://www.news-medical.net/news/20120727/Study-investigates-molecular-markers-in-drug-resistant-ovarian-cancer.aspx

Sunday, July 29, 2012

Evaluation of HE4, CA125, Risk of Ovarian Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass.



Evaluation of HE4, CA125, Risk of Ovarian Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass.

Abstract

OBJECTIVE: Diagnostic factors are needed to improve the currently used serum CA125 and Risk of Malignancy Index (RMI) in differentiating ovarian cancer (OC) from other pelvic masses, thereby achieving precise and fast referral to a tertiary centre and correct selection for further diagnostics. The aim was to evaluate serum Human Epididymis protein 4 (HE4) and the Risk of Ovarian Malignancy Algorithm (ROMA) for these purposes.

METHODS: Serum from 1218 patients in the prospective ongoing pelvic mass study was collected prior to diagnosis. The HE4 and CA125 data were registered and evaluated separately and combined in ROMA and compared to RMI.

RESULTS: 809 benign tumors, 79 borderline ovarian tumors, 252 OC (64 early and 188 late stage), 9 non-epithelial ovarian tumors and 69 non-ovarian cancers were evaluated. Differentiating between OC and benign disease the specificity was 62.2 (CA125), 63.2 (HE4), 76.5 (ROMA) and 81.5 (RMI) at a set sensitivity of 94.4 which corresponds to RMI=200. The Areas Under the Curve (AUC) were 0.854 (CA125), 0.864 (HE4), 0,897 (ROMA) and 0.905 (RMI) for benign vs. early stage OC. For premenopausal benign vs. OC AUC were 0.925 (CA125), 0.905 (HE4), 0.909 (ROMA) and 0.945 (RMI).

CONCLUSION: HE4 and ROMA increase differentiating OC from other pelvic masses, even in early stage OC. ROMA might be valuable as a first line biomarker for selecting high risk patients for referral to a tertiary centre and further diagnostics. Further improvements of HE4 and ROMA in differentiating pelvic masses are still needed, especially regarding premenopausal women.

Copyright © 2012. Published by Elsevier Inc.

Although bone pain in osteoporosis and skeletal metastasis is an expected consequence of fracture, there are other underlying causes responsible. Our study demonstrated that ovarian cancer G-protein-coupled receptor 1 detected extracellular protons in MG63 cells, and regulated osteoblast functions, such as prostaglandin E2 production, in response to acidic circumstances. In this work, we measured inositol phosphate production, intracellular Ca(2+) concentration, prostaglandin E2 production, and cyclic adenosine monophosphate accumulation in MG63 cells exposed to extracellular acidification. Extracellular acidity induced a transient increase in Ca(2+) concentration and inositol phosphate production. Acidification also induced prostaglandin E2 production, resulting in cyclic adenosine monophosphate accumulation. A small interfering RNA specific for the ovarian cancer G-protein-coupled receptor 1 markedly inhibited these proton-induced actions in MG63 cells. These results indicated that the involvement of ovarian cancer G-protein-coupled receptor 1 in acidic extracellular environment may be an underlying mechanism responsible for bone pain in osteoporosis or bone metastasis without clinically proved fractures.

Copyright © 2012. Published by Elsevier Ltd.


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Evaluation of HE4, CA125, Risk of Ovarian Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass.



Final overall survival results of phase III GCIG CALYPSO trial of pegylated liposomal doxorubicin and carboplatin vs paclitaxel and carboplatin in platinum-sensitive ovarian cancer patients.



http://www.ncbi.nlm.nih.gov/m/pubmed/22836511/?i=4&from=ovarian%20cancer

A phase I trial of dasatinib, a Src-family kinase Inhibitor, in combination with paclitaxel and carboplatin in patients with advanced or recurrent ovarian cancer.



http://www.ncbi.nlm.nih.gov/m/pubmed/22837181/?i=3&from=ovarian%20cancer

Wednesday, July 25, 2012

The Implications of Age and Comorbidity on Survival Following Epithelial Ovarian Cancer: Summary and Results from a Centers for Disease Control and Prevention Study.



The Implications of Age and Comorbidity on Survival Following Epithelial Ovarian Cancer: Summary and Results from a Centers for Disease Control and Prevention Study.




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The management of small-cell carcinomas of the gynecologic tract.



The management of small-cell carcinomas of the gynecologic tract.




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A critical assessment of SELDI-TOF-MS for biomarker discovery in serum and tissue of patients with an ovarian mass



A critical assessment of SELDI-TOF-MS for biomarker discovery in serum and tissue of patients with an ovarian mass




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Cancer treatment according to BRCA1 and BRCA2 mutations.



Cancer treatment according to BRCA1 and BRCA2 mutations.




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Endometriosis in menopause



Endometriosis in menopause: a single institution experience.




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Peritoneal washing cytologic analysis of ovarian serous tumors of low malignant potential to detect peritoneal implants and predict clinical outcome.



Peritoneal washing cytologic analysis of ovarian serous tumors of low malignant potential to detect peritoneal implants and predict clinical outcome.




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Friday, July 20, 2012

Multiple Gastric Metastases from Ovarian carcinoma diagnosed by endoscopic u/s with fine needle aspiration



Multiple Gastric Metastases from Ovarian Carcinoma Diagnosed by Endoscopic Ultrasound with Fine Needle Aspiration.

Case Rep Gastrointest Med. 2012;2012:610527. Epub 2012 Jul 

Abstract

Metastasis to the stomach from nongastric tumors is a rare event. We present a case of ovarian cancer metastasis to the gastric wall that presented as multiple subepithelial gastric lesions. A 55-year-old female with known stage III b serous ovarian cancer was admitted to the hospital with melena and anemia. A 1.5 to 2 cm subepithelial mass with superficial overlying erosion in the antrum was seen in Esophagogastroduodenoscopy (EGD). Initial endoscopic mucosal biopsies were normal. An Endoscopic Ultrasound (EUS) was performed, which revealed two subepithelial lesions with the typical appearance of a gastrointestinal stromal tumor. Fine needle aspiration (FNA) of both masses revealed papillary adenocarcinoma from an ovarian papillary serous adenocarcinoma. This is the first reported case of multiple gastric metastatic lesions from ovarian cancer diagnosed by EUS 



Thursday, July 19, 2012

Ovarian cancer: emerging molecular-targeted therapies




Ovarian cancer: emerging molecular-targeted therapies

Review

Authors: Sourbier C

Published Date June 2012 Volume 2012:6 Pages 147 - 154

Carole Sourbier

Rockville, MD, USA

Abstract: With about 22,000 new cases estimated in 2012 in the US and 15,500 related deaths, ovarian cancer is a heterogeneous and aggressive disease. Even though most of patients are sensitive to chemotherapy treatment following surgery, recurring disease is almost always lethal, and only about 30% of the women affected will be cured. Thanks to a better understanding of the molecular mechanisms underlying ovarian cancer malignancy, new therapeutic options with molecular-targeted agents have become available. This review discusses the rationale behind molecular-targeted therapies and examines how newly identified molecular targets may enhance personalized therapies for ovarian cancer patients. 







Combined panel of serum human tissue kallikreins and CA-125 for the detection of epithelial ovarian cancer (see link for full text)



http://www.gyneoncology.or.kr/journal/viewJournal.html?year=2012&vol=23&num=3&page=175


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Cancer treatment and survivorship statistics, 2012




You have free access to this content

Cancer treatment and survivorship statistics, 2012

CA: A Cancer Journal for Clinicians

CA: A Cancer Journal for Clinicians

Volume 62Issue 4pages 220–241July/August 201
2






Treating Ovarian Cancer « Mayo Clinic Podcasts July 2012



http://podcasts.mayoclinic.org/2012/07/19/treating-ovarian-cancer/

Viral Genetics Begins Phase 1 Clinical Trial for Ovarian Cancer - MarketWatch



http://www.marketwatch.com/story/viral-genetics-begins-phase-1-clinical-trial-for-ovarian-cancer-2012-07-19

Cancer biomarkers re-evaluated



Cancer biomarkers re-evaluated

09:25, Medicine & Health/Cancer


The combination of genomic data and protein measurements in patient samples will speed up the discovery of clinically relevant cancer biomarkers. Credit: istockphoto

(Medical Xpress) -- Researchers from ETH Zurich have developed a procedure to test the clinical benefits of cancer biomarkers. The method could radically shorten the path from the lab to their application.

Protein biomarkers, especially those that circulate in the blood plasma or urine and can therefore be obtained without any major intervention, are vital in personalised medicine. Biomarkers help in detecting diseases in hospitals at an early stage, classifying them, selecting the suitable treatment and monitoring the treatment response.

Thanks to major advancements in proteomic and genomic research and modelling biological processes on the computer, researchers have discovered over a thousand potential protein biomarkers in recent years. Knowledge of the complete gene sequences of individual cancer patients is also on the rise, which will boost the number of possible biomarkers further.

Long list of candidates

However, the majority of the protein biomarkers proposed and recorded in the literature do not progress beyond the status "potential". "The list of candidates for biomarkers has grown longer and longer, but the number approved for clinical use has stagnated," sums up Ruth Hüttenhain, a postdoc from the group headed by professor of molecular systems biology Ruedi Aebersold. After all, in order to gauge whether biomarker candidates are clinically relevant in the first place, they have to be measured and validated in large cohorts of patient samples. The main reason why the development of new biomarkers for clinical use has not progressed is the lack of a verification procedure for most biomarker candidates.

Ruth Hüttenhain and Martin Soste, the first authors of a study that has just been published in Science Translational Medicine, have thus developed a strategy to measure potential biomarkers rapidly on a large scale and verify their clinical uses. The method is based on a targeted mass spectrometric, high-throughput technology, which can determine proteins that are present in biological samples at any particular point in time in a reliable and reproducible way. For this procedure, mass spectrometric coordinates, so-called assays, need to be developed beforehand for every protein.

Test process quickly narrows down list

In their study, the researchers developed assays for 1,157 potential biomarkers, the abundances of which change in different human cancer tissues and which are related to mutated genes that drive the development of cancer. The researchers ultimately tested their assays on blood and urine samples taken from cancer patients and healthy individuals. The scientists were able to detect over 180 different biomarkers in the blood plasma, the concentration of which reached the range of a billionth of a gram per millimetre of fluid. In the urine samples, the systems biologists found over 400 different biomarker proteins.

With the aid of the assays, the list of possible biomarkers can be narrowed down swiftly and efficiently. While these cannot be used directly in a cancer diagnosis, they bridge the gap between basic research and clinical applicability. "We hope that we are advancing studies on cancer biomarkers with our work and helping promising candidates to be used clinically," says the postdoctoral student. To enable other researchers to benefit from the groundwork, the ETH-Zurich scientists have placed all the assays in a publicly accessible database that can be expanded rapidly and easily to include newly discovered biomarker candidates.

Case study on ovarian cancer confirms approach

A case study on the recognition of ovarian cancer confirms the ETH-Zurich researchers' approach in that it verified potential biomarkers in blood plasma. To this end, the researchers not only measured the biomarker candidates described in the literature, but also new biomarkers that they predicted with computational models based on genomic data. "Using the blood plasma measurements, interestingly some of the predicted biomarkers produced extremely promising results for the classification of ovarian cancer patients," stresses Ruth Hüttenhain. The results therefore underscored the great potential of the mass spectrometric method for validating new protein biomarkers. The study also describes an insightful link between cancer, genetic data and proteome measurements to determine the acute status of patients.

The ETH-Zurich researchers see a general strategy in their approach to link studies on gene and protein interactions more strongly. Due to the connection between the genes and gene products, the proteins, involved in tumour formation, the researchers can predict new, previously unknown biomarker candidates on the computer that can be tested with the aid of mass spectrometric assays in patient samples. "Our new method can be used to validate the proposed biomarker candidates in all patient samples," says Martin Soste. The strategy of developing highly specific verification procedures for disease-relevant proteins can also be applied to other diseases.

More information: Hüttenhain R, et al. Reproducible quantification of cancer-associated proteins in body fluids using targeted proteomics. Sci. Transl. Med. 4, 142ra94 (2012).

Provided by ETH Zurich



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Four Abstracts on ChemoFx® to Be Presented at IGCS Annual Meeting | Business Wire



http://www.businesswire.com/news/home/20120718005953/en/Abstracts-ChemoFx%C2%AE-Presented-IGCS-Annual-Meeting

EU Commission backs open-access science publishing



http://reut.rs/LoI7RF

Wednesday, July 18, 2012

JAMA Network | JAMA: The Journal of the American Medical Association | Screening Women for Ovarian Cancer Still Does More Harm Than Good



http://jama.jamanetwork.com/article.aspx?articleid=1187925


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Resveratrol Exerts Differential Effects in vitro and vivo against ovarian cancer cells



Resveratrol Exerts Differential Effects in Vitro and in Vivo against Ovarian Cancer Cells.




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Population-based cancer registration in Indonesia



Population-based cancer registration in indonesia




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Adjuvant Chemotherapy for Stage I Ovariian carcinoma: Is it necessary for stage 1A?



Adjuvant Chemotherapy for Stage I Ovarian Clear Cell Carcinoma: Is it Necessary for Stage IA?




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Social Influences on Clinical Outcomes of patients with ovarian cancer



Social Influences on Clinical Outcomes of Patients With Ovarian Cancer.





Wednesday, July 11, 2012

Cisplatin plus paclitaxel and maintenance of (Avastin) bevacizumab on tumour progression, dissemination, and survival of ovarian carcinoma xenograft models



Cisplatin plus paclitaxel and maintenance of bevacizumab on tumour progression, dissemination, and survival of ovarian carcinoma xenograft models:
 July 2012  doi:10.1038/bjc.2012.261

Background:
Bevacizumab is being incorporated as first-line therapy with standard-of-care chemotherapy on epithelial ovarian carcinoma (EOC). We investigated bevacizumab combined with chemotherapy on tumour progression and mouse survival in EOC xenograft models.
Methods:
Bevacizumab was administered concomitantly with cisplatin plus paclitaxel (DDP+PTX), continued after induction (maintenance) or started after chemotherapy. The effect on tumour progression was monitored by bioluminescence imaging (BLI) (1A9-luc xenograft). Tumour dissemination into the peritoneal organs and ascites formation (HOC22 xenograft) was evaluated by histological analysis at the end of treatment (interim) and at euthanasia (survival). The effects on overall survival (OS) were investigated in both EOC models.
Results:
Bevacizumab with PTX+DDP delayed tumour progression in mice bearing EOC xenografts. OS was significantly extended, with complete responses, by bevacizumab continued after stopping chemotherapy in the HOC22 xenograft. Bevacizumab alone inhibited ascites formation, with only limited effect on tumour burden, but combined with PTX+DDP reduced ascites and metastases. Bevacizumab started after induction with PTX+DDP and maintained was equally effective on tumour progression and survival on 1A9-luc xenograft.
Conclusion:
Bevacizumab combined with chemotherapy not only affected tumour progression, but when administered as maintenance regimen significantly prolonged survival, reducing ascites, and tumour dissemination. We believe our findings are consistent with the clinical results and shed light on the potential effects of this kind of treatment on tumour progression.


paywalled: Preferences for outcomes associated with decisions to undergo or forego genetic testing for Lynch syndrome



Preferences for outcomes associated with decisions to undergo or forego genetic testing for Lynch syndrome

Abstract

BACKGROUND:

Current guidelines recommend offering genetic testing for Lynch syndrome to individuals whose tumors suggest this condition and to relatives of affected individuals. Little is known, however, regarding how patients view the prospect of such testing. In addition, data on preferences (utilities) for the potential outcomes of testing decisions for use in cost-effectiveness analyses are lacking.

METHODS:

Time tradeoff utilities were elicited for 10 potential outcomes of Lynch syndrome testing decisions and 3 associated cancers from 70 participants, representing a range of knowledge about and experiences with Lynch syndrome.

RESULTS:

Highest mean utilities were assigned to scenarios in which only the assessor's sibling had Lynch-associated colorectal cancer (ranging from 0.669 ± 0.231 to 0.760 ± 0.220). Utilities assigned to scenarios in which the assessor had Lynch-associated colorectal cancer ranged from 0.605 ± 0.252 to 0.682 ± 0.246, whereas the lowest mean utilities were assigned to 2 of the general cancer states (0.601 ± 0.238 and 0.593 ± 0.272 for colorectal and ovarian cancer respectively). Only 43% of the sample assigned higher values to undergoing Lynch testing and receiving negative results versus foregoing Lynch testing, whereas 50% assigned higher values to undergoing rather than foregoing surgery to prevent a subsequent cancer.

CONCLUSIONS:

Genetic testing for Lynch syndrome, regardless of results, can have profound effects on quality of life; the utilities we collected can be used to incorporate these effects into cost-effectiveness analyses. Importantly, preferences for the potential outcomes of testing vary substantially, calling into question the extent to which patients would avail themselves of such testing if it were offered to them. Cancer 2012. © 2012 American Cancer Society


Podcast/RSS video: Lynch Syndrome Educational Support Workshop | Memorial Sloan-Kettering Cancer Center (68 min.)



Podcast/RSS video: Lynch Syndrome Educational Support Workshop | Memorial Sloan-Kettering Cancer Center

Runtime
68:00
Medical experts from Memorial Sloan-Kettering discuss Lynch syndrome, a genetic disorder that can cause colon and other cancers.

Medicine 2012 update ovarian cancer



http://emedicine.medscape.com/article/255771-treatment


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Tuesday, July 10, 2012

paywalled: Gynecologic Oncology Impact of Complete Cytoreduction Leaving No Gross Residual Disease Associated with Radical Cytoreductive Surgical Procedures on Survival in Advanced Ovarian Cancer



Impact of Complete Cytoreduction Leaving No Gross Residual Disease Associated with Radical Cytoreductive Surgical Procedures on Survival in Advanced Ovarian Cancer

 Abstract


Background  

To analyze the impact of radical cytoreductive surgery—as part of primary tumor debulking—on the amount of residual tumor and survival in patients with advanced ovarian cancer and to evaluate the prognostic significance of no gross residual disease (RD) after surgery.

Methods  

Medical records of 203 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC–IV ovarian cancer were reviewed. All patients underwent primary cytoreductive surgery followed by taxane- and platinum-based chemotherapy. Various clinicopathologic characteristics were collected.

Results  

Of 203 patients, 119 patients underwent simple surgery, while radical surgery was performed in 84 patients..........

Conclusions  

No gross RD is associated with improved overall survival, and radical surgery was effective for achieving no gross RD.

 

Sunday, July 08, 2012

10 years after hormone therapy study: What doctors know now – USATODAY.com



10 years after hormone therapy study: What doctors know now – USATODAY.com

"It's been 10 years since researchers of the Women's Health Initiative, a large randomized, controlled trial on hormone therapy sponsored by the National Institutes of Health, announced their first findings: that the health risks outweighed the benefits of estrogen plus progestin hormone therapy (HT) in postmenopausal women. Since then, additional research has advanced the understanding of the benefits and risks. JoAnn Manson, one of the study's lead investigators and a professor of medicine at Harvard Medical School, is the president of the North American Menopause Society. She spoke with USA TODAY's Janice Lloyd about what women need to know to get through the challenging time and to protect their health......

Hospital safety - review



http://m.cbsnews.com/fullstory.rbml?catid=57468081&feed_id=999&videofeed=999


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Mismatch Repair Protein Deficiency - sebaceous carcinoma




Mismatch Repair Protein Deficiency is Common in Sebaceous Neoplasms and Suggests the Importance of Screening for Lynch Syndrome.


Ovarian metastases resection from extra - PubMed Mobile



http://www.ncbi.nlm.nih.gov/m/pubmed/22759383/?i=4&from=ovarian%20cancer&filter=loattrfree%20full%20text


"CONCLUSION: Ovarian metastases are more commonly seen to originate from primary gastrointestinal tract. The prognosis of ovarian metastasis is dismal and the benefit of ovarian metastatectomy is limited. Those with combined metastasis outside ovaries, locally invasion and massive intraoperative ascites were independent factors for predicting unfavorable overall survival. The identification of the primary tumor is required to plan for adequate treatment for this group of patients."

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Impact of Complete Cytoreduction



http://www.ncbi.nlm.nih.gov/m/pubmed/22766983/?i=4&from=ovarian%20cancer


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paywalled: Dairy foods and nutrients in relation to risk of ovarian cancer and major histological subtypes - Merritt - International Journal of Cancer - Wiley Online Library



Dairy foods and nutrients in relation to risk of ovarian cancer and major histological subtypes 

Abstract

Inconsistent results for the role of dairy food intake in relation to ovarian cancer risk may reflect the potential adverse effects of lactose, which has been hypothesized to increase gonadotropin levels, and the beneficial anti-proliferative effects of calcium and vitamin D. Using data from the New England case-control study (1909 cases; 1989 controls) we examined dairy foods and nutrients in relation to risk of ovarian cancer overall, histological subtypes, and rapidly fatal versus less aggressive disease. We used logistic regression and polytomous logistic regression to estimate odds ratios and 95% confidence intervals. In models that were simultaneously adjusted for total (dietary plus supplements) calcium, total vitamin D and lactose, we observed a decreased overall risk of ovarian cancer with high intake of total calcium (Quartile 4 (Q4, >1319 mg/day) vs. Quartile 1 (Q1, <655 mg/day), odds ratio (OR)=0.62, 95% Confidence Interval (CI)=0.49 - 0.79); the inverse association was strongest for serous borderline and mucinous tumors. High intake of total vitamin D was not associated overall with ovarian cancer risk, but was inversely associated with risk of serous borderline (Q4, >559 IU/day vs. Q1, <164 IU/day, OR=0.51, 95% CI=0.34-0.76) and endometrioid tumors (Q4 vs. Q1, OR=0.55, 95% CI=0.39-0.80). We found no evidence that lactose intake influenced ovarian cancer risk, or that risk varied by tumor aggressiveness in the analyses of intake of dairy foods and nutrients. The overall inverse association with high intake of calcium, and the inverse associations of calcium and vitamin D with specific histological subtypes warrant further investigation.