open access
(MPMT = multiple primary malignant tumors)
Wednesday, May 13, 2015
Tuesday, May 12, 2015
Critical appraisal of bevacizumab in the treatment of ovarian cancer
open access
Conclusion
This article provides the latest evidence and
predicted further developments in BV treatment for ovarian cancer. BV is
the first molecular targeting agent to be indicated for gynecological
cancers, and, based on the specific tumor characteristics of ovarian
cancer, BV could be potentially much more effective for ovarian cancer
than for other cancer types. As a result of the four clinical trials
described above, in the treatment of both primary and recurrent cancers,
BV is believed to prolong the disease control of ovarian cancer and is a
very promising agent.15,31
Although adverse events of BV contained events not commonly observed
with cytotoxic agents used to treat ovarian cancer, these events can be
adequately managed with careful attention to severe adverse events such
as gastrointestinal tract perforation. Furthermore, in recurrent ovarian
cancer patients who present with various difficult-to-treat abdominal
symptoms, BV effectively improves QOL with regard to abdominal symptoms,
which is a very important clinical finding. However, the improvement in
QOL should be confirmed in the future through a placebo-controlled
trial. Although BV is effective for ovarian cancer, currently BV
treatment has not prolonged OS for either primary or recurrent cancer,
and we believe that, given the high cost associated with the treatment,32
patients who receive BV treatment should be carefully selected.
Therefore, the establishment of biomarkers that predict the
effectiveness of BV will be an important factor in determining the
importance of BV in the future treatment of ovarian cancer.
Monday, May 11, 2015
Molecular pathogenesis of ovarian clear cell carcinoma, Future Oncology, Future Medicine
abstract
Ovarian clear cell carcinoma is a distinct subtype of epithelial ovarian cancer, characterized by an association with endometriosis, glycogen accumulation and resistance to chemotherapy. Key driver events, including ARID1A mutations and HNF1B overexpression, have been recently identified and their functional characterization is ongoing. Additionally, the role of glycogen in promoting the malignant phenotype is coming under scrutiny. Appreciation of the notion that ovarian clear cell carcinoma is essentially an ectopic uterine cancer will hopefully lead to improved animal models of the disease, in turn paving the way for effective treatments.
Trends in Relative Survival for Ovarian Cancer From 1975 to 2011
abstract
OBJECTIVE: To examine relative survival (a metric that
incorporates changes in survival within a population) in women with
ovarian cancer from 1975 to 2011.
METHODS: Women diagnosed with ovarian cancer from 1975 to
2011 and recorded in the National Cancer Institute's Surveillance,
Epidemiology, and End Results database were examined. Relative survival,
estimated as the ratio of the observed survival of cancer patients
(all-cause mortality) to the expected survival of a comparable group
from the general population, was matched to the patients with the main
factors that are considered to affect patient survival such as age,
calendar time, and race. Hazard ratios were adjusted for age, race, year
of diagnosis, time since diagnosis, and the interaction of age and
years since diagnosis (except for stage II).
RESULTS: A total of 49,932 women were identified. For
stage I ovarian cancer, the adjusted excess hazard ratio for death in
2006 was 0.51 (95% confidence interval [CI] 0.41-0.63) compared with
those diagnosed in 1975. The reduction in excess mortality remained
significant when compared with 1980 and 1985. For women with stage
III-IV tumors, the excess hazard of mortality was lower in 2006 compared
with all other years of study ranging from 0.49 (95% CI 0.44-0.55)
compared with 1975 to 0.93 (95% CI 0.87-0.99) relative to 2000. For
women aged 50-59 years, 10-year relative survival was 0.85 (99% CI
0.61-0.95) for stage I disease and 0.18 (99% CI 0.10-0.27) for stage
III-IV tumors. For women aged 60-69 years, the corresponding 10-year
relative survival estimates were 0.89 (99% CI 0.58-0.98) and 0.15 (99%
CI 0.09-0.21).
CONCLUSION: Relative survival has improved for all stages of ovarian cancer from 1975 to 2011.
Menopausal hormone therapy and mortality among women diagnosed with ovarian cancer in the NIH-AARP Diet and Health Study
open access
Highlights
- •
- We examined pre-diagnosis use of menopausal hormone therapy (MHT) and ovarian cancer-specific mortality.
- •
- Estrogen-only and estrogen plus progestin-only therapy were unrelated to ovarian cancer-specific death.
- •
- Recency of MHT use was unrelated to ovarian cancer-specific death.
- •
- Women who used MHT prior to ovarian cancer diagnosis do not experience higher mortality.
Sunday, May 10, 2015
Prompting Primary Care Providers about Increased Patient Risk As a Result of Family History: Does It Work?
Blogger's Note: study included history of colorectal cancer (eg. Lynch Syndrome)
PDF open access/abstract
Conclusion
We found that prompting academic family physicians
about patients with family histories showing
risk for 6 common conditions did not seem to
increase the identification or screening of these
patients. Other experts reached a similar conclusion
after examining and debating the value of
family history.11 One study did show that automated
collection of family history can identify
more patients at risk for heart disease, but it did not
go on to demonstrate improved patient care outcomes
from the availability of such information.47
More studies that examine the clinical utility of
family history, including the best way to engage
PCPs in using this information are needed before
we begin to use automated prompts and alerts for
high-risk family histories.
Friday, May 08, 2015
Ethnic Disparities in Ovarian Cancer - SHARE webinar June 15th
SHARE
Disparities in gynecologic cancer incidence and mortality exist among American women based on ethnicity. Dr. Holcomb, Associate Attending Obstetrician and Gynecologist, NY Presbyterian Hospital, Associate Professor of Clinical Obstetrics and Gynecology, Weill Cornell Medical College, will outline these disparities with regard to ovarian, uterine, and cervical cancers as well as explore possible causes and discuss potential solutions. Register here.
| Location | Time(s) | Date(s) |
|---|---|---|
| WEBINAR Email rsvp@sharecancersupport.org or Call (212) 719-2943 to register | 6:00 pm - 7:30 pm | Mon, Jun 15, 2015 |
Thursday, May 07, 2015
Company Creates Bioethics Panel on Trial Drugs - Johnson & Johnson
NYTimes.com
.....
Johnson & Johnson said the bioethicist, Arthur L. Caplan
of New York University, who has written extensively about the issue of
experimental drug availability — known as “compassionate use” — would
oversee an independent panel of doctors, ethicists and patient advocates
that will review requests for access to a limited array of experimental
medicines and decide how Johnson & Johnson should respond.
The
pilot program will be funded by the company, which will have no
influence on the panel’s decisions, Johnson & Johnson said, adding
that payments will go directly to the university. Dr. Caplan will not be
paid for his work in the program.
Dr.
Caplan, who has argued that the industry needs a fairer, more
consistent system for deciding whose requests should be granted, said he
was intrigued when company executives approached him about the idea.
“If we could structure this right, this would be a chance to not just
complain about what’s wrong, but maybe to suggest a way forward,” he
said in an interview......
▶ NOT MY TIME -- official music video - YouTube
▶ NOT MY TIME -- official music video - YouTube
NOT MY TIME LYRICS
CHANT
Ahum Arogyam, Ahum Arogyam, Ahum Arogyam
VERSE 1
It's not my time
I will resist
My trembling hands
Turn into fists
Cause I'm strong enough
Yeah, I'm strong enough
I got no time
For bucket lists
A longer life's
My only wish
Cause I won't give up
No, I won't give up
PRE-CHORUS
With every breath
This moment's real
With every breath
I'm gonna heal
CHORUS
It's not my time (no-oh)
I can beat it
I'm gonna fight
It's not my time (no-oh)
I won't be cheated
Out of this life
It's not my time
(No-oh-oh-oh-oh-oh-oh
No-oh-oh-oh-oh-oh-oh
No-oh-oh)
VERSE 2
It's not my time
Got nothing to fear
The trenches are full
My friends are near
Cause we're strong enough
Yeah, we're strong enough
I got no time
For hopeless tears
My body's at war
My mind is clear
Cause I won't give up
No, I won't give up
PRECHORUS
With every breath
I am alive
With every breath
I can survive
CHORUS
It's not my time (no-oh)
I can beat it
I'm gonna fight
It's not my time (no-oh)
I won't be cheated
Out of this life
It's not my time
(No-oh-oh-oh-oh-oh-oh
No-oh-oh-oh-oh-oh-oh
No-oh-oh)
No, it's not my time
(No-oh-oh-oh-oh-oh-oh
No-oh-oh-oh-oh-oh-oh
No-oh-oh)
BRIDGE
Ahum Arogyam, Ahum Arogyam, Ahum...
I won't ignore my battle scars
I'm so much more than missing parts
When vanity's a casualty
A tragedy brings majesty
It's given me a chance to start
Again
CHORUS
It's not my time (no-oh)
I can beat it
I'm gonna fight
It's not my time (no-oh)
I won't be cheated
Out of this life
It's not my time
(No-oh-oh-oh-oh-oh-oh
No-oh-oh-oh-oh-oh-oh
No-oh-oh)
Got a new lease on life
(No-oh-oh-oh-oh-oh-oh
No-oh-oh-oh-oh-oh-oh
No-oh-oh)
Everything's gonna be fine
(No-oh-oh-oh-oh-oh-oh
No-oh-oh-oh-oh-oh-oh
No-oh-oh)
It's not my time
Thursday, April 30, 2015
Prevalence of Founder Mutations in the BRCA1 and BRCA2 genes among Unaffected Women from the Bahamas
abstract
Population-based testing for BRCA1/2 mutations detects a high proportion of carriers not identified by cancer family history-based testing. We sought to determine whether population-based testing is an effective approach to genetic testing in the Bahamas, where 23% of women with breast cancer carry one of seven founder mutations in the BRCA1 or BRCA2 gene. We determined the prevalence of founder BRCA mutations in 1,847 Bahamian women without a personal history of breast or ovarian cancer, unselected for age or family history. We found that 2.8% (20/705) of unaffected women with a family history of breast/ovarian cancer and 0.09% (1/1,089) of unaffected women without a family history carry a BRCA mutation. 38% of unaffected women with a known mutation in the family were found to carry the familial mutation. We previously suggested that all Bahamian women with breast or ovarian cancer be offered genetic testing. These current data suggest that additionally all unaffected Bahamian women with a family history of breast/ovarian cancer should be offered genetic testing for the founder BRCA mutations.
Body mass index does not influence human epididymis protein 4 concentrations in serum (+CA125)
abstract
Serum human epididymis protein 4 (HE4), a novel tumour marker of ovarian cancer, has been reported to be influenced by some biological factors as body mass index (BMI). Accordingly, we enrolled 103 women without history or current ovarian disease or other gastrointestinal/gynaecological benign or malignant diseases, no smokers, aged ≤55 years and with serum creatinine concentrations ≤0.96 mg/dL and a BMI ranging from 19 to 57 kg/m2. Enrolled subjects underwent HE4 and carbohydrate antigen (CA) 125 measurements by Roche Diagnostics assays. Multiple regression models were used to estimate the potential influence on HE4 and CA 125 concentrations of BMI, age, serum creatinine, menopausal status, menstrual cycle phase and use of oral contraceptives. Age and creatinine increases induced HE4 increase, whereas the use of oral contraceptives appeared to decrease marker concentrations. BMI, as well as menopausal status and menstrual cycle phase, did not influence HE4 concentrations. None of the tested factors influenced CA 125 concentrations.
Wednesday, April 29, 2015
update Apr 9th: Ovarian, Fallopian Tube, and Peritoneal Cancer Prevention - NCI
National Cancer Institute
It is not clear whether the following affect the risk of ovarian, fallopian tube, and primary peritoneal cancer:
Diet
Alcohol
Studies have not shown a link between drinking alcohol and the risk of ovarian cancer.
Aspirin and non-steroidal anti-inflammatory drugs
Some studies of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) have found a decreased risk of ovarian cancer and others have not.
Smoking
Some studies found a very small
increased risk of one rare type of ovarian cancer in women who were
current smokers compared with women who never smoked. (blogger's note: cell type is mucinous)
Talc
Infertility treatment
Overall, studies in women using fertility drugs have not found clear evidence of an increased
risk of ovarian cancer. Risk of ovarian borderline malignant tumors may be higher in women who take fertility drugs. The risk of invasive ovarian cancer may be higher in women who do not get pregnant after taking fertility drugs.
Palliative Care: If It Makes a Difference, Why Wait?
open access
......Together with earlier findings on the benefits associated with the early integration of palliative care, the ENABLE III trial6,7 urges a change of practice and culture. If palliative care makes a difference for patients and family caregivers, and if earlier is better, why wait?
Long-Term Survival Advantage and Prognostic Factors Associated With Intraperitoneal Chemotherapy Treatment in Advanced Ovarian Cancer: GOG
abstract
Conclusion The advantage of IP over intravenous chemotherapy extends beyond 10 years. IP therapy enhanced survival of those with gross residual disease. Survival improved with increasing number of IP cycles.
Intraperitoneal Chemotherapy: Long-Term Outcomes Revive a Long-Running Debate
open access
In conclusion, our cumulative experience with IP therapy has demonstrated sustained improvement in median OS (HR, 0.76) without an impact on long-term disease-specific mortality at the expense of increased complexity, toxicity, and cost. Similar gains in OS have been observed with other approaches, including IV therapy that incorporates dose-dense weekly paclitaxel, especially in high-risk patients with larger-volume residual disease.8 Important questions remain regarding patient selection (in terms of the extent of residual disease), mechanism of action, treatment modifications, timing, optimal number of IP cycles, and integration with targeted agents. Some of these questions will be addressed in the context of GOG-0252, and it remains to be seen whether better IV chemotherapy might match the outcomes previously associated with IP chemotherap
Symptoms and Distress in Children With Advanced Cancer PediQUEST study
abstract
Symptoms and Distress in Children With Advanced Cancer: Prospective Patient-Reported Outcomes From the PediQUEST Study
Conclusion Children with advanced cancer experience high symptom distress. Strategies to promote intensive symptom management are indicated, especially with disease progression or administration of intensive treatments.
25/25 vision needed to see through Ovarian cancer misunderstandings Australia
abstract
"Ovarian Cancer Australia's (OCA) recent study of the level of understanding and awareness of ovarian cancer by Australians conducted by Wallis Market and Social Research in February in the lead up to Ovarian Cancer Awareness Month revealed that knowledge on the disease's symptoms and prevention is still widely misunderstood."
MYChart News: May 9th Odette Cancer Centre - ovarian cancer event FROM PATIENTS TO PEERS TO PRACTITIONERS
MyChart™ News - On Saturday, May 9th, The Odette Cancer Centre, Sunnybrook Health Sciences Centre is pleased to present: FROM PATIENTS TO PEERS TO PRACTITIONERS: Learning from each other about ovarian cancer. For more Information, please contact: patienteducation@sunnybrook.ca or by calling 416 480 4836
Time: 8:30am – 3:45pm
Location: Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5
Registration and Parking: Free
Tentative Agenda:
- 8:30 – 9:00 am: Registration
- 9:00 – 9:30 am: Welcome and Opening Remarks
- 9:30 – 11: 15 am: Myth busting: Learning from Practitioners (speakers include: gynecologic oncologist, genetic counsellor, clinical researcher, and palliative care specialist.)
- 11:15 – 11:30 am: Break and Community Resource Displays
- 11:30 – 12:30 pm: Expert Wisdom: Learning from Peers
- 12:30 – 1:30 pm: Lunch
- 1:30 – 2:45 pm: Breakout Sessions
- Caregiver Booster (exclusively for family members and caregivers)
- The Writing Workshop. Sharing Our Stories
- Nutrition and You
- 2:50-3:15 pm: Closing Remarks
- 3:15-3:30 pm: Mindful Meditation
This event is part of the Winberg Patient Education Series.
Tuesday, April 28, 2015
Monday, April 27, 2015
FDA’s Orphan Drug Designation to Cantrixil for Ovarian Cancer
Oncology Times
FDA’s Orphan Drug Designation to Cantrixil for Ovarian Cancer
The
U.S. Food and Drug Administration has granted orphan drug designation
to the chemotherapy drug Cantrixil for the treatment of patients with
ovarian cancer. Cantrixil is a cyclodextrin envelope containing the
active ingredient, TRXE-002.
The
Orphan Drug designation—to encourage development of drugs in the
diagnosis, prevention, or treatment of a medical condition affecting
fewer than 200,000 people in the U.S.—grants a product market
exclusivity for a seven-year period if the sponsor complies with certain
FDA specifications, as well as tax credits and prescription drug user
fee waivers. The designation does not, though, shorten the duration of
the regulatory review and approval process.
Pre-clinical
data were presented at the American Association of Cancer Research
Annual Meeting in April. A Phase I study is currently enrolling patients
and a Phase IIa study is being planned.
Cantrixil is being developed by Novogen and CanTx, Inc.
Search Results
[PDF]Cantrixil - Novogen
www.novogen.com/pdf/cantrixil.pdf
Different Patterns of Disease Spread between Advanced-Stage Type I and II Epithelial Ovarian Cancer
abstract
Background and Aims: Two types of epithelial ovarian carcinoma (EOC) have been recently distinguished. Type I comprises low-grade serous, endometrioid and clear-cell tumors. High-grade endometrioid and serous tumors belong to type II. The aim of this study was to compare patterns of disease spread in advanced-stage type I and II EOCs at primary surgery.
Methods: Surgical and pathological data of 233 patients with advanced-stage EOCs were collected, 42 with type I and 191 with type II. The two groups were compared for tumor localization at primary surgery. Intraoperative mapping of ovarian cancer (IMO) was used to assess tumor dissemination.
Results: Tumor involvement was significantly higher in the type II group for the following: peritoneum (68.1 vs. 40.5%, p < 0.001), pouch of Douglas (60.2 vs. 40.5%, p = 0.06), vesicouterine ligament (40.8 vs. 19%, p = 0.027), diaphragm (45.0 vs. 11.9%, p < 0.001), serosa of liver (17.2 vs. 4.8%, p = 0.05), omentum (81.1 vs. 59.5%, p = 0.007), mesentery (42.9 vs. 16.7%, p = 0.005), pleural effusions (19.4 vs. 4.6%, p = 0.01) and ascites (60.7 vs. 21.4%, p < 0.001). IMO levels were different between the two groups (p = 0.001).
Conclusions: This study provides clinical evidence in favor of the dualistic model of carcinogenesis, since types I and II are characterized by different findings at primary surgery.
Socioeconomic Status as a Predictor of Adherence to Treatment Guidelines for Early-Stage Ovarian Cancer
abstract
Highlights
- •
- Disadvantaged populations experience substandard ovarian cancer care
- •
- Specifically, lower socioeconomic status is an independent predictor of receiving sub-optimal ovarian cancer treatment that deviates from the NCCN guidelines
- •
- Adherence to NCCN guidelines has the potential to improve ovarian cancer survival rates amongst all populations of women
Diagnostic Error in Medicine 8th International Conference - Society to Improve Diagnosis in Medicine
conference notice
Mark your calendar to attend the Diagnostic Error in Medicine 8th International Conference on
27-29 September 2015 at the Hilton Alexandria Mark Center just outside Washington, D.C. Our theme this year is After the IOM Report: What's Next?
In 2015, the Institute of Medicine (IOM) will release a
report on diagnostic error as a quality of care challenge. The report
will examine current definitions of diagnostic error, the epidemiology,
burden of harm, costs associated with diagnostic error, and efforts to
improve diagnosis. We anticipate release of the report prior to the
conference, but regardless, the meeting will ensure a timely discourse
on the subject by featuring experts who presented to the committee as
well as members of the committee. We will also begin to focus on what we
each can do to drive improvements in diagnostic performance whether in
the practice of medicine, the preparation of physicians, research,
policy or the role of the patient.
Download the save the date flyer.
Sunday, April 26, 2015
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