Wednesday, June 20, 2012
paywalled: Nanocarrier systems for delivery of siRNA to ovarian cancer tissues, Expert Opinion on Drug Delivery
Nanocarrier systems for delivery of siRNA to ovarian cancer tissues, Expert Opinion on Drug Delivery
Expert opinion:
Gene silencing therapy based on siRNA represents a possible opportunity
for treatment of ovarian cancer patients. However, this approach
requires selection of suitable nanocarriers that can safely and
effectively deliver siRNA to the target site to induce its effect. Very
little work has been done in this field; therefore, it is a good
direction for future development.
paywalled: Cochrane Review - Removal of nail polish and finger rings to prevent surgical infection.
Cochrane Database Syst Rev. 2012 May 16;5:CD003325.
Removal of nail polish and finger rings to prevent surgical infection.
Abstract
BACKGROUND:
Surgical wound infections may be caused by the transfer of bacteria from the hands of surgical teams to patients during operations. Surgical scrubbing prior to surgery reduces the number of bacteria on the skin, but wearing rings and nail polish on the fingers may reduce the efficacy of scrubbing, as bacteria may remain in microscopic imperfections of nail polish and on the skin beneath rings.OBJECTIVES:
To assess the effect of the presence or absence of rings and nail polish on the hands of the surgical scrub team on postoperative wound infection rates.MAIN RESULTS:
We identified: no new trials; no RCTs that compared wearing of rings with the removal of rings; and no trials of nail polish versus no nail polish that measured surgical infection rates. We found one small RCT (102 scrub nurses) that evaluated the effect of nail polish on the number of bacterial colony forming units left on hands after pre-operative surgical scrubbing. Nurses had either unpolished nails, freshly-applied nail polish (less than two days old), or old nail polish (more than four days old). There were no significant differences in the number of bacteria on hands between the groups before and after surgical scrubbing.AUTHORS' CONCLUSIONS:
No trials have investigated whether wearing nail polish or finger rings affects the rate of surgical wound infection. There is insufficient evidence to determine whether wearing nail polish affects the number of bacteria on the skin post-scrub.Characteristics and Outcomes of Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Patients with Cancer Treated with Vancomycin: 9-Year Experience at a Comprehensive Cancer Center - The Oncologist
Abstract
Abstract Background. Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) can cause significant morbidity and mortality in patients with cancer. However, data
on outcomes of patients treated with vancomycin are lacking.
Methods. We identified
223 patients with cancer who developed MRSA BSIs between January 2001
and June 2009 and were treated with vancomycin.
Treatment failure was defined as death within 60
days of infection, persistent bacteremia ≥5 days, fever ≥4 days,
recurrence
or relapse, and secondary MRSA infection.
Results. The treatment
failure rate was 52% (116 of 223 patients). These patients were more
likely to have been hospitalized, been
treated with steroids within the previous 3
months, developed acute respiratory distress syndrome, required
mechanical ventilation,
required intensive care unit care, and
community-onset infections (all p < .05). Risk factors for
MRSA-associated mortality (27 of 223 patients; 12%) included hematologic
malignancy and hematopoietic
stem cell transplantation, community-onset
infection, secondary BSI, MRSA with minimum inhibitory concentration
(MIC) ≥2.0
μg/mL, mechanical ventilation, and a late switch
to an alternative therapy (≥4 days after treatment failure; all p
< .05). On multivariate analysis, mechanical ventilation and recent
hospitalization were identified as independent predictors
of vancomycin failure, and community-onset
infection, secondary BSIs, and MIC ≥2 μg/mL were identified as
significant predictors
of MRSA-associated mortality.
Conclusions. We found a
high treatment failure rate for vancomycin in patients with cancer and
MRSA BSIs, as well as a higher mortality.
A vancomycin MIC ≥2 μg/mL was an independent
predictor of MRSA-associated mortality. An early switch to an
alternative therapy
at the earliest sign of failure may improve
outcome.
paywalled: Causes of death of mutation carriers in Finnish Lynch syndrome families.
Fam Cancer. 2012 Jun 9. [Epub ahead of print]
Abstract
Lynch syndrome (LS) is an autosomal dominant cancer syndrome including increased life-long risk for colorectal (CRC) and endometrial (EC) cancer, but also for cancers of other types. The risk for CRC is up to 70-80 % and for EC up to 50-60 %. Due to screening and early diagnosing the mortality related to CRC and EC seems to be low. In spite of many studies on surveillance of mutation carriers, there is no comprehensive evaluation on causes of death in LS families. The disease history and cause of death of all the deceased, tested mutation carriers and their mutation negative relatives in the Finnish LS families (N = 179) was examined utilizing hospital records and relevant national registries. Out of 1069 mutation carriers 151 had succumbed; 97 (64 %) from cancer. Out of 1146 mutation-negative family 44 members had died; 11 (25 %) of them from cancer. In 12 (7.7 %) of the deceased mutation carriers no cancer had been diagnosed. The mean age of death from cancer was 63.2 years vs. 68.8 years from non-cancer causes. Only 7.9 % of the patients with CRC had died from CRC and 5 % of those with EC, respectively. 61 % of the cancer deaths were related to extra-colonic, extra-endometrial cancers. The cumulative overall and cancer specific death rates were significantly increased in Mut+ compared to Mut- family members. Even surveillance yields decrease in the life-long risk and mortality of the most common cancers CRC and EC in LS, almost all mutation carriers will contract with cancer, and two thirds of the deceased have died from cancer. This should be taken in account in genetic counseling. Mutation carriers should be encouraged to seek help for abnormal symptoms.Monday, June 18, 2012
paywalled - Survival of ovarian cancer patients in Germany in the early 21st century: a period analysis by age, histology, laterality, and stage
European Journal of Cancer Prevention:
Abstract
Population-based studies on ovarian cancer providing
survival estimates by age, histology, laterality, and stage have been
sparse. We aimed to derive the most up-to-date and detailed survival
estimates for ovarian cancer patients in Germany. We used a pooled
German national dataset including data from 11 cancer registries
covering 33 million populations. A total of 21 651 patients diagnosed
with ovarian cancer in 1997-2006 were included. Period analysis was
carried out to calculate the 5-year relative survival (RS) for the years
2002-2006. Trends in survival between 2002 and 2006 were examined using
model-based period analysis. Age adjustment was performed using five
age groups (15-44, 45-54, 55-64, 65-74, and 75+ years). Overall, the
age-adjusted 5-year RS in 2002-2006 was 41%. A strong age gradient was
observed, with a decrease in the 5-year RS from 67% in the age group
15-49 years to 28% in the age group 70+ years. Furthermore, the
prognosis varied markedly by histology, laterality, and stage, with the
age-adjusted 5-year RS ranging from 25% (for carcinoma not otherwise
specified) to 81% (for stromal cell carcinoma), reaching 46% for
unilateral and 32% for bilateral carcinoma and reaching 82% for
Federation of Gynecology and Obstetrics (FIGO) stages I and II, 36% for
FIGO stage III, and 18% for FIGO stage IV. No improvement in survival
could be observed for any of the subgroups in the period between 2002
and 2006. Our analyses suggest that an improvement in the 5-year RS for
ovarian cancer may have stagnated in the early 21st century and
underline the need for a more effective translation of therapeutic
innovation into clinical practice.
CDC- Cancer Survivorship Twitter Chat Tuesday, June 19th 2-3 pm EDT
Join Us! Cancer Survivorship Twitter Chat Tomorrow
Centers for Disease Control and Prevention (CDC)
CDC's Division of Cancer Prevention and
Control (DCPC) will host a Twitter chat about cancer survivorship on
Tuesday, June 19 from 2:00 to 3:00 pm EDT.
Subject matter experts Blythe Ryerson and Dr. Elizabeth Rohan will answer questions. Visit DCPC's Twitter account at twitter.com/CDC_Cancer. You can follow the chat using the hashtag #CDCCancerChat, and you can send questions for the chat using that hashtag now.
Division of Cancer Prevention and Control
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Subject matter experts Blythe Ryerson and Dr. Elizabeth Rohan will answer questions. Visit DCPC's Twitter account at twitter.com/CDC_Cancer. You can follow the chat using the hashtag #CDCCancerChat, and you can send questions for the chat using that hashtag now.
Division of Cancer Prevention and Control
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Imperfect measure of hospital safety - CIHI
Imperfect measure of hospital safety
Imperfect measure of hospital safety
The failure to include hospital-acquired infections or medication errors as a performance indicator limits the utility of
the Canadian Institute for Health Information’s (CIHI) new hospital benchmarking tool, critics say....
Predisposed to risk but not change CMAJ (genetic testing series)
......Of course, considering that the predictive power of genetic
testing tends to be underwhelming, perhaps it’s no surprise that
personalized genetic information induces more shoulder
shrugs than lifestyle changes. “One of the challenges is that people
are behaving rationally, to a degree, when they don’t
change their behaviours. These genetic tests aren’t very predictive,”
says Timothy Caulfield, a Canada Research Chair in
Health Law and Technology who teaches in the law faculty and school of
public health at the University of Alberta. “If you
find you have a health risk of 2% instead of 1%, that type of risk is
lost in the noise of risk in your life.”
Editor’s note: Sixth of a multipart series on genetic testing.
Part 1: Separating hype from reality in the era of the affordable genome (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4143).
Part 2: Popping the genetics bubble (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4142).
Part 3: Who should hold the keys to your DNA? (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4141).
Part 4: A race-based detour to personalized medicine (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4133).
Part 5: Race and genetics in the doctor’s office (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4134).
Substantially Modified Ratios of Effector to Regulatory T Cells During Chemotherapy in Ovarian Cancer Patients Return to Pre-Treatment Levels at Completion: Implications for Immunotherapy
Published: 18 June 2012
(This article belongs to the Special Issue Cancer Vaccines and Immunotherapy)
Abstract:
Ovarian
cancer is the leading cause of death from gynaecological malignancy.
Despite improved detection and treatment options, relapse rates remain
high. Combining immunotherapy with the current standard treatments may
provide an improved prognosis, however, little is known about how
standard chemotherapy affects immune potential (particularly T cells)
over time, and hence, when to optimally combine it with immunotherapy
(e.g., vaccines). Herein, we assess the frequency and ratio of CD8+
central memory and effector T cells as well as CD4+ effector and
regulatory T cells (Tregs) during the first 18 weeks of standard
chemotherapy for ovarian cancer patients. In this pilot study, we
observed increased levels of recently activated Tregs with tumor
migrating ability (CD4+CD25hiFoxp3+CD127−CCR4+CD38+ cells) in
patients when compared to controls. Although frequency changes of Tregs
as well as the ratio of effector T cells to Tregs were observed during
treatment, the Tregs consistently returned to pre-chemotherapy levels at
the end of treatment.
Tuesday, May 29, 2012
SUSTAINING ACTION TOWARD A SHARED VISION - 2012–2017 Strategic Plan - Partnership Against Cancer Canada (does not include ovarian/gyn)
Blogger's Note: search of 'ovarian'/'ovary'/'gyn' yields null results
SUSTAINING ACTION TOWARD A SHARED VISION - 2012–2017 Strategic Plan - Canada
CONTENTS
2 MESSAGE FROM THE CHAIR AND CEO
4 EXECUTIVE SUMMARY
1. 2012–2017 Strategic Plan
10 THE GROWING CHALLENGE OF CANCER
16 ADVANCING A SHARED VISION
34 2012–2017 STRATEGIC FRAMEWORK
38 STRATEGIC PRIORITIES
52 CORE ENABLING FUNCTIONS
2. 2012–2017 Business Plan
64 PLANNING FOR RESULTS
70 STRATEGIC PRIORITIES
103 CORE ENABLING FUNCTIONS
3. Moving Forward Together
122 TRANSFORMING CANCER CONTROL
Ovarian Cancer and Us - blogger's note
short sabbatical - blog postings to return in ~ one week - thanks!
Journal of Experimental & Clinical Cancer Research |- Chemotherapy and skin reactions
Journal of Experimental & Clinical Cancer Research Chemotherapy and skin reactions
Research
Chemotherapy and skin reactions
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
Journal of Experimental & Clinical Cancer Research 2012
Published: 28 May 2012Abstract (provisional)
Background
New chemotherapic agents and new protocols in oncology have led to an increasing survival
rate in patients affected by tumors. However, this increased use has been accompanied
by a growth in the incidence of cutaneous side effects and a worsening of patients'
quality of life. Appropriate management of skin toxicity associated with chemotherapic
agents is therefore necessary for suitable drug administration and to improve quality
of life and clinical outcomes.
Methods
We have clinically examined 100 patients affected by cancer, determining type, frequency,
treatment, and evolution of side effects related to chemotherapy.
Results
The prevalent cutaneous side effects in patients undergoing chemotherapy are skin
rash, xerosis, pruritus, paronychia, hair abnormality, and mucositis. The clinical
cases are reported in detail.
Conclusion
Oncological therapies have become more selective and have low systemic toxicity because
of their high specificity, but cutaneous side effects are common and may worsen the
quality of life of these patients.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
paywalled: Long-term survival in patients with clear cell adenocarcinoma of ovary treated with irinotecan hydrochloride plus cisplatin therapy as first-line
Long-term survival in patients with clear cell adenocarcinoma of ovary treated with irinotecan hydrochloride plus cisplatin therapy as first-line chemotherapy
Article first published online: 28 MAY 2012
DOI: 10.1111/j.1447-0756.2012.01884.x
© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology
Issue
Journal of Obstetrics and Gynaecology Research
Abstract
Aim:
Several previous reports showed that irinotecan hydrochloride plus
cisplatin (CPT-P) was a candidate first-line chemotherapy regimen for
clear cell adenocarcinoma of the ovary (CCC). However, long-term
survival in CCC patients treated with CPT-P as first-line chemotherapy
remains to be determined. The aim of the present study was to evaluate
the long-term results of CPT-P as first-line chemotherapy for CCC.
Material and Methods: We performed a retrospective review of 31 patients with CCC who were treated with CPT-P between 1996 and 2004.
Results:
The median follow-up period was 91 months.........
Conclusion:
The long-term results suggest CPT-P as a candidate in first-line
chemotherapy for CCC in not only stage I, but also in optimally debulked
stage II-IV patients with pT1/pT2 disease.
HRT Risk Holds Steady Based on Updated Review - in OB/Gyn, HRT from MedPage Today
HRT Risk Holds Steady Based on Updated Review - in OB/Gyn, HRT from MedPage Today
Action Points
- A systematic review of papers published since 2002 (post-WHI study) found that the risks of hormone replacement therapy still outweighed any benefits in primary prevention of chronic conditions.
- Point out that both estrogen plus progestin and estrogen alone prevented fractures, but increased the risk of stroke, thromboembolic events, gallbladder disease, and urinary incontinence.
Earlier detection of bone loss may be in future
Earlier detection of bone loss may be in future
“Right now, pain is usually the first indication that cancer is affecting bones. If we could detect it earlier by an analysis of urine or blood in high-risk patients, it could significantly improve their care,” Fonseca said.
Monday, May 28, 2012
Bill C-38 protest has 13,000 websites going dark across Canada this June | Canada Politics - media (c-38 bill/Canadian healthcare)
Bill C-38 protest has 13,000 websites going dark across Canada this June | Canada Politics
"When it comes to politics, Canadians are generally an
apathetic bunch. Often, a controversy will brew and within a week or two
we forget about it and move on.
It appears Bill C-38 is one issue we're not willing to let go....Jobs, Growth and Long-term Prosperity Act
An Act to implement certain provisions of the budget tabled in Parliament on March 29, 2012 and other measures
C-38: What it means for health care (media)
IL-13 regulates cancer invasion and metastasis through IL-13Rα2 via ERK/AP-1 pathway in mouse model of human ovarian cancer.
IL-13 regulates cancer invasion and metastasis through IL-13Rα2 via ERK/AP-1 pathway in mouse model of human ovarian cancer
"Taken together, IL-13Rα2 is involved in cancer metastasis through activation of ERK/AP-1 and that targeting IL-13Rα2 might not only directly kill primary tumors but also prevent cancer metastasis."
Neurocognitive function impairment after whole brain radiotherapy for brain metastases: actual assessment
Neurocognitive function impairment after wholebrain radiotherapy for brain metastases: actual assessment
Conclusion
......The results of this review will enable physicians to inform
patients about benefits and risks of these two treatment options.
paywalled: Bevacizumab-induced perforation of the gastrointestinal tract: clinical and radiographic findings in 11 patients
Bevacizumab-induced perforation of the gastrointestinal tract: clinical and radiographic findings in 11 patients:
Abstract
Methods
A computerized search identified 11 patients with GI complications of bevacizumab therapy on abdominal CT (n = 11) and fluoroscopic
GI contrast studies (n = 4) who met our study criteria (including five patients with ovarian cancer, five with colon cancer,
and one with cervical cancer). The medical records and imaging studies were reviewed to determine the clinical and radiographic
findings in these patients.
Results
All 11 patients had findings of GI perforation on CT, or CT and GI contrast studies. CT revealed a localized extraluminal
collection containing gas, fluid, and/or contrast material in eight patients (73%) with focal perforation, and free abdominal
air and fluid in three (27%) with free perforation The imaging studies also revealed seven fistulas, including two colovaginal,
one rectovaginal, one enterocutaneous, one colocutaneous, one gastrocolic, and one colorectal fistula. Eight (73%) of the
11 patients died within 1 year of the development of GI perforation, and the perforation was felt to be the cause of death
in four patients (36%).
Conclusion
Abdominal CT and fluoroscopic GI contrast studies are useful imaging tests for the diagnosis of potentially life-threatening
GI perforation as a complication of bevacizumab therapy. When GI perforation is detected on abdominal imaging studies, treatment
with bevacizumab should immediately be discontinued.
Complete clinical responses to cancer therapy caused by multiple divergent approaches: a repeating theme lost in translation
Complete clinical responses to cancer therapy caused by multiple diver
Complete clinical responses to cancer therapy caused by multiple divergent approaches: a repeating theme lost in translation (click on 'pdf' for full paper; references to ovarian cancer; hormonal therapy; angiogenesis...)
Abstract:
Over 50 years of cancer therapy history reveals complete clinical responses (CRs) from remarkably divergent forms of therapies (eg, chemotherapy, radiotherapy, surgery, vaccines, autologous cell transfers, cytokines, monoclonal antibodies) for advanced solid malignancies occur with an approximately similar frequency of 5%–10%. This has remained frustratingly almost static.
However, CRs usually underpin strong durable 5-year patient survival. How can this apparent paradox be explained?
Sunday, May 27, 2012
Does HE4 have a role in the recurrence of ovarian cancer? | 2012 ASCO Annual Meeting Abstracts (+ links to related ovarian abstracts)
Does HE4 have a role in the recurrence of ovarian cancer? | 2012 ASCO Annual Meeting Abstracts
Abstract:
Background: Human epididymis protein 4 (HE4) has been recently described as a new marker for early ovarian cancer, with higher sensitivity (76.9%) compared to CA125. This is the third study in literature on the role of HE4 in recurrence of ovarian cancer and the first evaluating the sensitivity of HE4 and CA125 in these patients
Methods: Plasma was obtained 24 hours before secondary cytoreductive surgery from consecutive patients with suspicious recurrence ovarian cancer operated from November 2010 to April 2011 at University Campus Bio-Medico of Rome. CA125 levels were evaluated by a one-step "sandwich" radioimmunoassay. HE4 levels were determined using the HE4 enzymatic immune assay. The CA125 cut-off was less than 35 U/mL. Two cut-off were considered for HE4: less than 150 pmol/L (according to the manufacturer's indications) and less than 70 pmol/L.
Results: Fourteen patients were histologically confirmed as recurrence ovarian cancer. Mean Ca125 plasma concentration was 31.95 ± 22.09 U/mL (range 1.1 – 64.3). Mean HE4 plasma concentration was 225.83± 286.82 pmol/L (range 21.61- 633.6). The sensitivity of CA125 was 35.7 %. The sensitivity of HE4 was 71.4% and 28.6% above the cut-off of 70 pmol/L and 150 pmol/L, respectively. The dual marker combination of CA125 and HE4 at 70 pmol/L cut-off yielded the highest sensitivity (85.7%) to detect recurrence ovarian cancer.
Conclusions: Even if a standard cut-off point has not been determined, this study suggested that HE4 may potentially be a more sensible marker for recurrence ovarian cancer than CA125 and the association between CA125 and HE4 at cut-off of 70 pmol/L seems to yield the highest sensitivity.
Other Abstracts in this Sub-Category:| 1. Randomized
phase III study of erlotinib versus observation in patients with no
evidence of disease progression after first-line platin-based
chemotherapy for ovarian carcinoma: A GCIG and EORTC-GCG study. Meeting: 2012 ASCO Annual Meeting Abstract No: LBA5000 First Author: Ignace B. Vergote Category: Gynecologic Cancer - Ovarian Cancer | |
| 2. Olaparib
plus paclitaxel plus carboplatin (P/C) followed by olaparib maintenance
treatment in patients (pts) with platinum-sensitive recurrent serous
ovarian cancer (PSR SOC): A randomized, open-label phase II study. Meeting: 2012 ASCO Annual Meeting Abstract No: 5001 First Author: Amit M. Oza Category: Gynecologic Cancer - Ovarian Cancer | |
| 3. AURELIA:
A randomized phase III trial evaluating bevacizumab (BEV) plus
chemotherapy (CT) for platinum (PT)-resistant recurrent ovarian cancer
(OC). Meeting: 2012 ASCO Annual Meeting Abstract No: LBA5002^ First Author: Eric Pujade-Lauraine Category: Gynecologic Cancer - Ovarian Cancer | |
| More... |
Time to Ovarian Cancer Return Not Tied to BMI - in Meeting Coverage, ASCO from MedPage Today
Medical News: Time to Ovarian Cancer Return Not Tied to BMI - in Meeting Coverage, ASCO from MedPage Today
Action Points
- Note that this study was published as an abstract and will be presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
- A study found that obesity did not affect recurrence, time to recurrence, or progression-free survival in women with epithelial ovarian cancer following surgery and adjuvant chemotherapy without evidence of disease during treatment.
- Note that the approximately one-third of patients who had BMI >30 kg/m2 had similar recurrence rates and time to recurrence as the two-thirds of non-obese patients.
Saturday, May 26, 2012
PLoS ONE: Increased Expression of PITX2 Transcription Factor Contributes to Ovarian Cancer Progression (clear cell ovarian/high grade)
PLoS ONE: Increased Expression of PITX2 Transcription Factor Contributes to Ovarian Cancer Progression
"....According to FIGO grading classification, high-grade ovarian tumor cells are usually poorly histological differentiated [20], grow faster and highly metastatic [7]. In addition, prognosis of high-grade ovarian tumor is poor thereafter it often associates with poor survival rate [21], [22].The clear cell subtype ovarian cancer accounts for approximately 6% of all epithelial ovarian tumors and most cases of this subtype are high-grade tumor exhibiting an aggressive phenotype [3], [22], [23]. Our study showed that both mRNA and protein levels of PITX2 was frequently upregulated in ovarian cancer particularly in the high-grade and clear cell subtypes, indicating that PITX2may play an important role in driving aggressive phenotypes in ovarian cancer.....
see blogger's note: Medical News: More Good Data for PARP Blocker (Olaparib) in Ovarian Ca - in Meeting Coverage, ASCO from MedPage Today
Blogger's Note: see blog postings 'olaparib' (searchable) of March 27th and March 8th and others; also use NEJM search for more information on ovarian cancer/Olaparib
Medical News: More Good Data for PARP Blocker in Ovarian Ca - in Meeting Coverage, ASCO from MedPage Today
not yet recruiting: Cyclophosphamide and Vaccine Therapy in Treating Patients With Stage II-III Breast, Ovarian, Primary Peritoneal, or Fallopian Tube Cancer - Full Text View - ClinicalTrials.gov
Cyclophosphamide and Vaccine Therapy in Treating Patients With Stage II-III Breast, Ovarian, Primary Peritoneal, or Fallopian Tube Cancer - Full Text View - ClinicalTrials.gov
This study is not yet open for participant recruitment.
Verified May 2012 by Mayo Clinic
First Received on May 23, 2012.
Last Updated on May 24, 2012
History of Changes
| Sponsor: | Mayo Clinic |
|---|---|
| Information provided by (Responsible Party): | Keith Knutson, Ph.D., Mayo Clinic |
| ClinicalTrials.gov Identifier: | NCT01606241 |
Massachusetts Moves to Require End-of-Life Talks
Mass. Moves to Require End-of-Life Talks:
WBUR radio and Kaiser Health News report that the Massachusetts Senate has quietly approved a measure requiring doctors and nurses to discuss end of life options with patients who have a terminal illness. The Palliative Care Awareness bill was included as part of a sweeping health reform measure and, remarkably, was not controversial. It was supported by both Republicans and Democrats and by a wide range of advocacy groups, including leading right-to-life organizations.
Family perspectives in lynch syndrome becoming a family at risk, patterns of communication and influence on relations
Family perspectives in lynch syndrome becoming a family at risk, patterns of communication and influence on relations
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
Abstract:
Background: A growing number of individuals are diagnosed with hereditary cancer. Though increased levels of anxiety and depression have been demonstrated around the time of genetic counselling, most individuals handle life at increased risk well. Data have, however, been collected on individual basis, which led us to focus on family perspectives of hereditary cancer.
Methods: Lynch syndrome represents a major type of hereditary colorectal and gynaecological cancer. We preformed open-ended interviews with 27 informants from 9 Lynch syndrome families. Inductive content analysis revealed three major themes: transition to a risk family, patterns of communication and influence on family relations and individual roles.
Results: Family members described how learning about Lynch syndrome shifted focus from daily issues to concerns about cancer. Changes in communication related to difficulties in talking to children about heredity and informing new family members and distant relatives about an increased risk of cancer. Influence on relations was exemplified by family members taking on different roles, e.g. females often being responsible for coordinating information about heredity and providing support. Families in which members had experienced cancer at young age typically informed children soon after learning about heredity and at young age, whereas families with experience of cancer at higher age postponed information and thereby also genetic counselling.
Conclusions: Three major family perspectives are described in Lynch syndrome families; becoming a risk family, patterns of communication and influence on family relations. Since these issues are central, our findings suggests that such family perspectives should be considered during genetic counselling in order to contribute to information spread, help family members cope with the increased risk, and motivate family members at risk to undergo surveillance.
What's Hot at ASCO This Year? (Brentuximab/ovarian cancer/CD30)
What's Hot at ASCO This Year?
".... Another study that builds on a previous breakthrough screened more than 1000 patients with nonlymphoma malignancies for high CD30 expression (Abstract 3069). A drug targeting this molecular defect, brentuximab (Adcetris, Seattle Genetics), has recently been approved for Hodgkin's lymphoma, but the new study found the CD30 defect in patients with mesothelioma and in those with testicular and ovarian cancer. The next step will be to see if these patients respond to the drug, Dr. Vogelzang explained.....
Physician Group Says No to Kittens in Medical Training
Physician Group Says No to Kittens in Medical Training
The group, the Physicians Committee for Responsible Medicine (PCRM), asked a branch of the US Department of Agriculture (USDA) yesterday to investigate the use of kittens in the center's pediatric residency program. The PCRM said that the medical center is violating the Animal Welfare Act, which governs healthcare facilities that use live animals for research, testing, or training.
Squamous Cell Carcinoma of the Oral Cavity in Nonsmoking Women: A New and Unusual Complication of Chemotherapy for Recurrent Ovarian Cancer? PLD (pegylated liposomal doxorubicin)
Squamous Cell Carcinoma of the Oral Cavity in Non smokingWomen: A New and Unusual Complication of Chemotherapy for Recurrent Ovarian Cancer?
Abstract
Purpose.
To describe occurrences of oral squamous cell carcinoma (SCC) in patients who had received long-term pegylated liposomal doxorubicin (PLD) for ovarian cancer.
Patients and Methods.
In our cohort of patients on maintenance PLD for ovarian and related mullerian epithelial malignancies, we encountered two patients with invasive SCC of the oral cavity (one of them multifocal) and one with high-grade squamous dysplasia. Review of patients at our institution receiving PLD for recurrent ovarian cancer identified three additional patients. The duration of treatment, cumulative PLD dose, human papillomavirus (HPV) positivity, BRCA status, stage at diagnosis, outcome, and other characteristics are reviewed.
Results.
All five cases were nonsmokers with no known risk factors for HPV and four were negative for p16 expression. Four of the patients had known BRCA mutations whereas one tested negative. Cumulative doses of PLD were >1,600 mg/m(2) given over 30-132 months. Three had SCCs staged as T1N0 oral tongue, alveolar ridge (gingival), and multifocal oral mucosa; one had a T2N0 oral tongue; and one had dysplasia. After excision, two were given radiation but recurred shortly thereafter; the others remain well and have had no further exposure to cytotoxic drugs, including PLD.
Conclusion.
Awareness of this possible long-term complication during PLD treatment should enhance the likelihood of early detection of oral lesions in these patients. Decisions to continue maintenance PLD after complete response of the original cancer should perhaps consider the benefits of delaying ovarian cancer recurrence versus the possible risk for a secondary cancer.
The finding of oral SCC in patients on long-term PLD
maintenance should alert oncologists to have a high index of
suspicion with any oral complaints that arise, and suggests a
possible need for regular oral examinations in this treatment
population. How long to continue maintenance with PLD after
a CR has been achieved is an unanswered question. The possible
risks to patients receiving maintenance PLD beyond CR
must be weighed against the presumed benefits of delaying
ovarian cancer recurrence on an individual basis.
paywalled: Early Postoperative CT as a Prognostic Biomarker in Patients With Advanced Ovarian, Tubal, and Primary Peritoneal Cancer Deemed Optimally Debulked at Primary Cytoreductive Surgery
Early Postoperative CT as a Prognostic Biomarker in Patients With Advanced Ovarian, Tubal, and Primary Peritoneal Cancer Deemed Optimally Debulked at Primary Cytoreductive Surgery
CONCLUSION:
Our study showed that residual disease larger than 1 cm was present on early postoperative CT in almost half of the patients deemed to have optimally debulked disease at primary cytoreduction.[Biomarker for colorectal cancer] - Lynch Syndrome/MSI/KRAS/BRAF
[Biomarker for colorectal cancer]
Abstract
Discovery of usable molecular biomarkers is the step closer to a realization of personalized therapy for patients with colorectal cancer(CRC). Herein we present an update of the most recent data on promising biological prognostic and/or predictive markers, including microsatellite instability(MSI) and KRAS/BRAF mutations. Additionally, we propose a new genetic classification for CRC based on MSI and KRAS/BRAF mutation status (a 2 x 3 matrix). The 2 x 3 matrix is constructed of 6 cells that are made by [MSI/non-MSI] x [BRAF mutant/KRAS mutant/wild type of the both genes].
All of CRC including Lynch syndrome could be classified without overlapping into the 6 cells. More interestingly, each cell has each promising biological prognostic and/or predictive feature, which will help clinicians to make personalized treatment strategy for each CRC patient.
paywalled: Management and Prognosis of Clear Cell Borderline Ovarian Tumor.
Management and Prognosis of Clear Cell Borderline Ovarian Tumor.:
Abstract
BACKGROUND: The clear cell borderline ovarian tumor (CCBOT) of the ovary is a rare tumor accounting for less than 1% of BOT. Fewer than 25 cases have been reported in the literature (including details on clinical management and outcomes). The aim of this study was to determine the prognosis of a series of CCBOTs collected in 2 reference centers.
PATIENTS AND METHODS: This was a retrospective review of patients with CCBOT treated or referred to our institutions. A centralized histological review by a reference pathologist and data on the clinical characteristics, management, and outcomes of patients were required for inclusion.
RESULTS: Twelve patients were identified between 2000 and 2010. The median age of patients was 68 years (range, 36-83 years). Two had been treated conservatively and 9 radically (data unknown in 1). The tumor was unilateral in 11 cases. All patients had stage I disease. All cases were CCBOT with an adenofibromatous pattern. Stromal microinvasion or intraepithelial carcinoma was histologically associated in 2 and 3 cases, respectively. Four of the 12 patients had synchronous endometrial disorders (but no endometrioid carcinoma). No cases were histologically associated with endometriosis. Four patients were lost to follow-up. Among 8 other patients, after a median period of 28 months (range, 2-129 months), no recurrence had occurred (1 patient had died of another disease).
CONCLUSION: Clear cell borderline ovarian tumor carries a good prognosis. All tumors are (blogger's note - 'were' in this study of 12 pts) stage I; therefore, surgical staging is not necessary in most of the cases. Conservative treatment could be proposed to young patients, but uterine curettage would then be required in cases of uterine preservation.
paywalled: Comparability of stage data in cancer registries in six countries: lessons from the international cancer benchmarking partnership - Walters - International Journal of Cancer - Wiley Online Library
Comparability of stage data in cancer registries in six countries: lessons from the international cancer benchmarking partnership
Abstract
The
International Cancer Benchmarking Partnership is investigating cancer
survival differences between six high-income nations using
population-based cancer registry data. Differences in overall survival
are often explained by differences in the stage at diagnosis and
stage-specific survival. Comparing stage at diagnosis using cancer
registry data is challenging because of different regional practices in
defining stage, despite the existence of international staging
classifications such as TNM. This paper describes how stage data may be
reconciled for international analysis. Population-based cancer registry
data were collected for 2.4 million adults diagnosed with colorectal,
lung, breast (women) or ovarian cancer during 1995-2007 in Australia,
Canada, Denmark, Norway, Sweden and the United Kingdom. The stage data
received were coded to a variety of international systems, including the
TNM classification, Dukes' for colorectal cancer, FIGO for ovarian
cancer, and to national 'localised, regional, distant” categorisations.
To optimise comparability for analysis, a rigorous and repeatable
process was defined to produce a final stage variable for each patient.
An algorithm was also defined to map TNM, Dukes' and FIGO to a
“localised, regional, distant” categorisation. We recommend how stage
data should be recorded and processed to optimise comparability in
population-based international comparisons of stage-specific cancer
outcomes. The process we describe to produce comparable stage data forms
a benchmark for future research. The algorithm to convert between TNM
and a “localised, regional, distant” categorisation should be valuable
for international studies, until global consensus is achieved to adhere
to a single staging system like TNM.
Is Renal Thrombotic Angiopathy a Potential Problem in the Chronic Treatment of Ovarian Cancer?
UNC Kidney Center: thrombotic microangiopathy
~~~~~~~~~~~~~~~~~~
Is Renal Thrombotic Angiopathy a Potential Problem in the Chronic Treatment of Ovarian Cancer?
"Treatments for recurrent ovarian cancer result in clinical
benefit and prolongation of survival times. However, our findings suggest that platinums, PLD (in large cumulative doses), bevacizumab, and possibly gemcitabine may result in cumulative kidney damage. Awareness of these long-term complications should open the way for studies on treatment strategies designed to minimize renal complications."
Abstract
Abstract Background and Objective
Ovarian
cancer is usually diagnosed at an advanced stage, with most patients
undergoing surgery followed by platinum- and
taxane-based chemotherapy. After initial
clinical remission, the majority recur, leading to additional
treatments, including
not only platinums and taxanes but also
pegylated liposomal doxorubicin (PLD), gemcitabine, topotecan, and, more
recently,
bevacizumab, which may extend survival times.
PLD, in particular, has been extensively studied by our group, with
encouraging
therapeutic results. We, however, observed
instances of chronic kidney disease (CKD) developing among patients who
received
long-term treatment for recurrent ovarian
cancer. To document the frequency and contributing factors to the
emergence of CKD,
we initiated a retrospective review at two
institutions.
(Kidney damage was defined by pathologic abnormalities
or markers of damage, including abnormalities on blood
and urine tests and radiologic studies.)
(Kidney damage was defined by pathologic abnormalities
or markers of damage, including abnormalities on blood
and urine tests and radiologic studies.)
Patients and Methods.
Fifty-six
consecutive patients with recurrent ovarian cancer receiving treatment
at New York University Cancer Institute were
reviewed for the presence of renal disease in
1997–2010. At Shaare Zedek Medical Center, 73 consecutive patients with
ovarian
cancer were reviewed in 2002–2010. Patients were
diagnosed with CKD if they had an estimated GFR <60 mL/minute per
1.73 m2 for >3 months and were staged according to the National Kidney Foundation guidelines.
Results.
Thirteen
patients (23%) developed stage ≥3 CKD. Three patients had renal biopsies
performed that showed thrombotic microangiopathy.
Conclusions.
CKD (chronic kidney disease) is emerging as a potential long-term consequence of current chemotherapy for recurrent ovarian cancer.
PLoS ONE: The KRAS-Variant Is Associated with Risk of Developing Double Primary Breast and Ovarian Cancer (study of pts with both ovarian and breast cancers)
Blogger's Note: the other cancers (KRAS mutations) referred to beyond ovarian and breast cancers include references to lung and melanoma cancers; KRAS mutations have been established in colorectal cancers, however, there are no references on this particular subject within this research article regarding Lynch Syndrome -
an ongoing area of specific research (re: KRAS/Lynch Syndrome/blog posting of May 16, 2012 Jnl ASCP)
~~~~~~~~~~~~~~~~~~~
PLoS ONE: The KRAS-Variant Is Associated with Risk of Developing Double Primary Breast and Ovarian Cancer
Table 1. The KRAS-variant is significantly associated with uninformative breast and ovarian cancer patients.
doi:10.1371/journal.pone.0037891.t001
Purpose
A germline microRNA binding site-disrupting variant, the KRAS-variant (rs61764370), is associated with an increased risk of developing several cancers. Because this variant is most strongly associated with ovarian cancer risk in patients from hereditary breast and ovarian families (HBOC), and with the risk of premenopausal triple negative breast cancer, we evaluated the association of the KRAS-variant with women with personal histories of both breast and ovarian cancer, referred to as double primary patients.Conclusions
These findings further validate the importance of the KRAS-variant in breast and ovarian cancer risk, and support the association of this variant as a genetic marker for HBOC families previously considered uninformative.Introduction
Hereditary breast and ovarian cancer (HBOC) syndrome is an inherited cancer-susceptibility syndrome marked by an increased risk of developing both ovarian cancer and breast cancer [1]. Families generally considered as having HBOC syndrome are those with multiple family members that have one of these cancers, especially at young ages, or an individual with a cancer in both organs, a “double primary” patient. While this is a relatively rare presentation, a substantial number of women develop both breast and ovarian primaries over their lifetime. While BRCA1 and BRCA2 are strongly associated with HBOC syndrome [2], a large number of HBOC families and women with double primary cancer do not have detectable genetic mutations (herein referred to as “uninformative” patients).The chances of identifying a mutation causative for HBOC increase when testing individuals diagnosed with double breast/ovarian primaries [3]–[5]. However, a recent report suggests that the rates of BRCA mutations are not higher in a patient with a double primary without a family history than that for isolated first degree relative pairs with single primaries (14% versus 17% with mutations, respectively) [4]. This supports the importance of family history even in patients with double primary cancers. Although BRCA mutations were found in 49% of double primary patients in this recent analysis, it should be noted that this indicates that over half of double primary patients do not have a known genetic cause for their disease. This is consistent with other reports of these patients [3], [5].............The goal of this study was to determine the association of the KRAS-variant with women with double primary breast and ovarian cancer, to further validate the association of this variant with HBOC families. Findings here support the importance of the KRAS-variant in uninformative HBOC families as well as in predicting the risk of multiple primary cancers in women.......
Association of the KRAS-variant with Multiple Cancers in All Patients
Because the KRAS-variant has been found to be associated with an increased risk for other cancers besides breast and ovarian cancer [11], [15] we tested the hypothesis that the KRAS-variant would predict for an increased risk of developing additional cancers in this double primary cohort, regardless of BRCA mutation status. For 183 of the patients in our study where this information was available, 79.2% (n = 145) had reported just the two cancers (breast and ovarian), 12.0% (n = 22) had two separate primary breast cancers and also ovarian cancer, and 8.7% (n = 16) had cancer in an additional organ outside of the breast and ovary (triple primary).Friday, May 25, 2012
Full-Exon Pyrosequencing Screening of BRCA Germline Mutations in Mexican Women with Inherited Breast and Ovarian Cancer
Full-Exon Pyrosequencing Screening of BRCA Germline Mutations in Mexican Women with Inherited Breast and Ovarian Cancer:
Hereditary breast cancer comprises 10% of all breast cancers. The most prevalent genes causing this pathology are BRCA1 and BRCA2 (breast cancer early onset 1 and 2), which also predispose to other cancers. Despite the outstanding relevance of genetic screening of BRCA deleterious variants in patients with a history of familial cancer, this practice is not common in Latin American public institutions. In this work we assessed mutations in the entire exonic and splice-site regions of BRCA in 39 patients with breast and ovarian cancer and with familial history of breast cancer or with clinical features suggestive for BRCA mutations by massive parallel pyrosequencing. First we evaluated the method with controls and found 41–485 reads per sequence in BRCA pathogenic mutations. Negative controls did not show deleterious variants, confirming the suitability of the approach. In patients diagnosed with cancer we found 4 novel deleterious mutations (c.2805_2808delAGAT and c.3124_3133delAGCAATATTA in BRCA1; c.2639_2640delTG and c.5114_5117delTAAA in BRCA2). The prevalence of BRCA mutations in these patients was 10.2%. Moreover, we discovered 16 variants with unknown clinical significance (11 in exons and 5 in introns); 4 were predicted as possibly pathogenic by in silico analyses, and 3 have not been described previously. This study illustrates how massive pyrosequencing technology can be applied to screen for BRCA mutations in the whole exonic and splice regions in patients with suspected BRCA-related cancers. This is the first effort to analyse the mutational status of BRCA genes on a Mexican-mestizo population by means of pyrosequencing.
How Much Weight Should Anecdotes Really Have In Health Policy?
How Much Weight Should Anecdotes Really Have In Health Policy?:
By D. Brad Wright
There’s something compelling about the personal narrative that vast mountains of quantitative data cannot rival. Anecdotes are, quite simply, powerful. They tap into our shared humanity, making something seem somehow more real by putting a face on it. This is why, if you follow politics for very long, you will find numerous cases of policymakers championing issues that have touched their own lives in some way. For example, Senator X doesn’t care about issue Y, until they discover that their son or daughter is affected by it. Then, almost overnight, they seem to care more about issue Y than almost anything else. Such a shift is completely understandable, but often out of proportion to the true scale of the issue in society.
Surgical site infection prevention: a survey to identify the gap between evidence and practice in University of Toronto teaching hospitals - Can J Surg. 2012 Jun 1
Blogger's Note: surgical site infections safety checklist: WHO (World Health Organization) program in patient safety
Surgical site infection prevention: a survey to identifythe gap between evidence and practice in University of Toronto teaching hospitals
"Surgical site infections (SSIs) are the most common
complication following surgery, with reported rates
ranging from 5% to 30%.1 The attributable morbidity
and mortality is significant, with patients who experience
SSIs being 60% more likely to spend time in the
intensive care unit, 5 times more likely to be readmitted to
hospital and twice as likely to die than patients without
SSIs.2 Whereas many risk factors for the development of
SSIs are related to patient characteristics that cannot be easily
modified, there are a variety of system or hospital factors
that can be manipulated. These include improper selection
and administration of antibiotic prophylaxis, intraoperative
hypothermia and intraoperative hyperglycemia.3
Despite clear evidence and guidelines to direct SSI prevention
strategies, compliance is uniformly poor......
paywalled: The risk of metachronous cancers in patients with small-intestinal carcinoid tumors: a US population-based study
Blogger's Note: while rare, and there is no specific reference in this abstract, carcinoid ovarian cancer tumors do exist so this research will be of interest for those diagnosed, this blog has some research on ovarian carcinoid tumors
The risk of metachronous cancers in patients with small-intestinal carcinoid tumors: a US population-based study
"In conclusion, almost one-third of patients with SICs have an associated metachronous primary tumor. When these primaries occur prior to (but not after) the SIC diagnosis, the prognosis is worse than with an initial SIC. The type of malignancies associated with SICs may guide future screening efforts.."
paywalled: Evolutionary Pathways in BRCAl-Associated Breast Tumors
Evolutionary Pathways in BRCAl-Associated Breast Tumors
Abstract
BRCAl-associated breast tumors display loss of BRCA1 and frequent somatic mutations of PTEN and TP53.
Here we describe the analysis of BRCA1, PTEN, and p53 at the single
cell level in 55 BRCA1-associated breast tumors and computational
methods to predict the relative temporal order of
somatic events, on the basis of the frequency of cells with single or
combined
alterations. Although there is no obligatory order
of events, we found that loss of PTEN is the most common first event and
is associated with basal-like subtype, whereas in
the majority of luminal tumors, mutation of TP53 occurs first and mutant PIK3CA is rarely detected. We also observed intratumor heterogeneity for the loss of wild-type BRCA1 and increased cell proliferation
and centrosome amplification in the normal breast epithelium of BRCA1 mutation carriers. Our results have important implications for the design of chemopreventive and therapeutic interventions
in this high-risk patient population.
SIGNIFICANCE: Defining
the temporal order of tumor-driving somatic events is critical for early
detection, risk stratification, and the
design of chemopreventive therapies. Our combined
experimental and computational approach reveal that the loss of
wild-type
BRCA1 may not be the first event in the majority of
BRCA1-associated breast tumors and may not be present in all cancer
cells
within tumors.
Cancer Discov; 2(6); 1–9. ©2012 AACR.
Bionomics launches ovarian cancer trial - BNC105 Australia/U.S. (134 women/18 locations)
Bionomics launches ovarian cancer trial - clinical trials, cancer, Bionomics, Biotechnology - Australian Life Scientist
Bionomics (ASX:BNO) has launched a clinical trial of its BNC105 cancer treatment candidate in women with ovarian cancer.
The Phase I/II trial will involve up to 134 women across 18 sites in Australia, New Zealand and the US.
In
Australia, the trial be conducted by the Australian and New Zealand
Gynaecological Oncology Group in conjunction with the National Health
and Medical Research Council Clinical Trials Centre.
Patients will receive BNC105 in conjunction with standard chemotherapy drugs carboplatin and gemcitabine......
Interval colon cancer in a Lynch syndrome patient under annual colonoscopic surveillance: a case for advanced imaging techniques? (including Lynch Syndrome background information/research)
Blogger's Note: worth reading even for those without colorectal cancer but with a familial interest in Lynch Syndrome cancers, discusses research on surveillance timing, discordance in mutation carriers, risk variances (% risk) etc...
Background
Lynch syndrome confers increased risk for various malignancies, including colorectal cancer.
Colonoscopic surveillance programs have led to reduced incidence of colorectal cancer and reduced mortality from colorectal cancer. Colonoscopy every 1–2 years beginning at age 20– 25, or 10 years earlier than the first diagnosis of colorectal cancer in a family, with annual colonoscopy after age 40, is the recommended management for mutation carriers. Screening programs have reduced colon cancer mortality, but interval cancers may occur.
Lynch syndrome is defined as the presence of a germline mutation in a DNA mismatch repair gene [1]. Mutation carriers have increased risk for various malignancies, including carcinomas of the colorectum (CRC), endometrium, ovary, small bowel, stomach, biliary tract, bladder, ureter and renal pelvis [2].
Interval colon cancer in a Lynch syndrome patient under annual colonoscopic surveillance: a case for advanced imaging techniques?
"This report highlights several features of Lynch syndrome. First, individuals carrying deleterious mutations in a DNA mismatch repair gene (MLH1, MSH2, MSH6, PMS2) deserve annual colonoscopic examinations with a careful search for, and removal of, all mucosal lesions. Second, adenoma is the precursor lesion for CRC in Lynch syndrome.....
CancerGEM KB|Home - searchable database/online resource
Blogger's Note: see the results of the search using 'Lynch Syndrome' as a test per example below:
CancerGEM KB|Home
About CancerGEM KB
CancerGEM KB is a continuously updated searchable online resource that provides access to scientific information on the use of genomic information in cancer care and prevention. more
Search CancerGEM KB
162 abstracts in HuGE published Literature
No GWAS/meta-analysis entry
1 evidence review/recommendation entries
1 genomic tests in transition to practice
Office of Public Health Genomics/CDC launches the CancerGEM KB
:
CDC Office of Public Health Genomics in collaboration with NCI
Division of Cancer Control and Population Sciences launches the
CancerGEM KB: CancerGEM KB is an online resource for researchers, public
health professionals, policy makers, and health care providers
interested in the use of genomic information in cancer care and
prevention. CancerGEM KB provides objective synthesis and timely
dissemination of information on cancer human genome epidemiology
(genetic associations, gene-environment interactions and gene prevalence
information) and aggregated evidence on cancer genomic tests in
transition to clinical and public health practice. CancerGEM KB also
offers summary information on Genomic Tests through PLoS Currents
Evidence on Genomic Tests, an open-access journal for systematic reviews
and structured short summaries of evidence for the validity and utility
of genetic tests.
Read more about CancerGEM KB
Changing Roles and Responsibilities for Caregivers - free telephone workshop NCI June 19th
The Tenth Annual Cancer Survivorship Series:
Living With, Through & Beyond Cancer
Living With, Through & Beyond Cancer
On Tuesday, June 19th, CancerCare, in
collaboration with the National Cancer Institute: Office of Cancer
Survivorship and Office of Communications and Education, LIVESTRONG, American
Cancer Society, Intercultural Cancer Council, Living Beyond Breast
Cancer and National Coalition for Cancer Survivorship, will present
a free, telephone workshop entitled: Changing Roles and Responsibilities for Caregivers. You can listen to this program on the telephone or via live streaming through the internet.
This workshop is the third of a four-part series. This free series is made possible by support from the National Cancer Institute and LIVESTRONG and offers
cancer survivors, their families, friends and health care
professionals practical information to help them cope with concerns that
arise after treatment ends.
The faculty for this program includes:
- Suzanne Martz-Dones, RN, MA, CCRN, NE-BC, Caregiver Perspective, Administrative Nurse Manager, Mount Sinai Hospital
- Barbara A. Given, PhD, RN, FAAN, University Distinguished Professor, Associate Dean for Research and Doctoral Program, College of Nursing, Michigan State University
- Stewart B. Fleishman, MD, Founding Director, Cancer Supportive Services, Continuum Cancer Centers of New York: Beth Israel & St. Luke's-Roosevelt
The fourth and final workshop of the series - Managing Post-Treatment Neuropathy - will take place on July 17th.
These workshops are free – no phone charges apply. However, pre-registration is required. To register, and for more information, simply go to the CancerCare website, www.cancercare.org/connect.
If you missed Parts I or II of the series, they are available as podcasts, 24 hours a day, 7 days a week:
Part I: Using Mind/Body Techniques to Cope with the Stress of Survivorship
Part II: Recapturing Joy and Finding Meaning
We are very excited to offer this telephone workshop series to you. We hope that you will join us and that you will share this information with your patients and colleagues.
Old drug (Thioridazine) could have new use as cancer stem cell destroyer | CTV News
Old drug could have new use as cancer stem cell destroyer | CTV News
.....Thioridazine is known to work as a psychiatric and Parkinson's medication by targeting receptors in the brain for dopamine, which is a neurotransmitter that plays a variety of roles in the brain.
It turns out that leukemia cells (and other cancer types including ovarian) have a dopamine receptor on their surfaces too — making them vulnerable to the drug. The drug doesn't kill these cancerous stem cells, but rather encourages them to become normal again.
The team's research is published in the science journal, Cell.
.....The next step is to test thioridazine in clinical trials on cancer patients. The first study will focus on 30 patients with acute myeloid leukemia, or AML, whose disease has relapsed after chemotherapy.....
"By targeting the rare population of cells that seed, that drive the cancer, what we are hoping with the drug is to eliminate those cells and prevent patients from getting sick again," he says.
While researchers are excited, there are some concerns about side effects. Thioridazine was once widely used as a psychiatric medication, but its use has been curtailed after studies showed it can lead to heart and eye problems in patients taking it long term.
Health Canada took thioridazine off the market in Canada in 2005 after reports it could boost the risk of rare but potentially fatal changes in heart rhythm. Those problems happened only in patients who took the drug daily for more than two years. Bhatia says that for the cancer study, the drug would be used in low doses for about 20 to 30 days, much like standard chemotherapy.
A note of caution – many drugs that show effects in the lab may not work in people, so this is an exciting but very preliminary finding, say doctors.
Thursday, May 24, 2012
Cancer Resources | OncoLink - The Web's First Cancer Resource
Cancer Resources | OncoLink - The Web's First Cancer Resource
You may have come to OncoLink searching for information for your friend or family member who has a diagnosis of cancer. At the same time you may be wondering about your own risk of cancer. Why them? Could it be me? What can I do differently to lower my risk of developing cancer?
What's My Risk? is a comprehensive program designed to help the user learn about factors that determine their personal risk of many types of cancer and what they can do to decrease that risk.
We collect the answers people provide to be used in future development of the program and research related to use of such a program. Your use of the program is completely voluntary. We will not ask you for any personally identifiable information. We collect internet protocol (IP) addresses (a numerical label assigned to each device (e.g., computer, printer) in a computer network using the Internet) in order to remove duplicate entries from our data analysis. However, the IP address is removed from the data after duplicates are removed and is not linked to the responses of a user. If you choose to email your report to yourself, be advised that we do not store your email address or use it for anything other than delivering the report. Because of this, we cannot respond to any questions submitted in the user satisfaction survey at the end of the program. If you require assistance, please:- visit our contact page or
- send us your comment or question.
What's My Risk? Questionnaire
The following questionnaire is comprehensive and asks about your habits, lifestyle and health history. Please be aware that your answers will be kept private. We do not ask for your name, address or date of birth. The more accurately you answer the questions, the more complete your What's My Risk? profile will be.Ovarian reserve and response to IVF and in vitro maturation treatment following chemotherapy.
Ovarian reserve and response to IVF and in vitro maturation treatment following chemotherapy.
Hum Reprod. 2012 May 22;
Abstract
BACKGROUND
Chemotherapy and radiotherapy can result in ovarian failure and premature menopause. However, there is still a paucity of information on the ovarian reserve and efficacy of assisted reproduction treatment (ART) procedures in patients with cancer previously exposed to chemotherapy or radiotherapy. The aim of our study was to evaluate the ovarian reserve and ovarian response to IVF or in vitro maturation (IVM) treatment in women who had previously been treated with chemotherapy.
METHODSI
In this retrospective cohort study, we compared 23 women with cancer who had undergone chemotherapy and subsequently underwent fertility treatment with IVF (n= 14) or IVM (n= 9). In the IVF group, patients mostly had hematologic, gynecologic, gastro-intestinal, bone and soft tissue cancers, whereas in the IVM group patients had estrogen-receptor positive breast cancer, hematologic and brain cancers. The control (unexposed) group consisted of 70 age-matched women with male factor infertility undergoing the same treatment protocol (IVF n= 42 and IVM n= 28). All women were aged <42 years and undergoing their first cycle of ART.
RESULTS
There were no differences in age and FSH levels between the cancer and the control groups. However, the antral follicle count (AFC) was lower in the cancer-IVF group (median: 5, range: 3-12) than in the control group (median: 15, range: 12-18; P = 0.0009). Women with cancer treated with IVF had lower peak estradiol levels on the day of hCG administration than controls (P = 0.006) and lower number of oocytes retrieved [median: 4.5, range: 2-7; versus 12 (8-16) in controls; P < 0.0001]. In patients with cancer treated with IVM, the AFC was lower than in the control group (median: 14, range: 9.5-17; versus median: 20.5 range: 16-23, respectively; P = 0.0007). Likewise, the number of oocytes retrieved was lower in the cancer-IVM group (median: 6, range: 4-10) than that in the control group (median 10.5, range: 7.5-17; P = 0.01). The percentage of mature metaphase II oocytes was comparable in the cancer and control groups.
CONCLUSIONS
The ovarian reserve, response to gonadotrophins and number of oocytes retrieved are adversely affected by previous chemotherapy. This study reports the first series of IVM outcomes in cancer patients with a prior history of chemotherapy. In women with estrogen-receptor positive breast cancer, IVM of oocytes with cryopreservation of oocytes or embryos is a viable option. Since the efficacy of ART is significantly reduced after chemotherapy, early referral for fertility preservation before gonadotoxic treatment will give these young women the best chance to conceive.
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