OA: Evaluation of a novel ELISA for the tumor-associated antigen CA 72–4 in patients with ovarian cance

Evaluation of a novel ELISA for the tumor-associated antigen CA 72–4 in patients with ovarian cancer, Future Science OA, Future Science

Lay abstract Cancer antigen 72–4 is a tumor marker for ovarian cancer. It can be measured in blood samples of patients to monitor the disease. We compared an established method of measurement with a newly designed one (DRG TM-CA 72–4 ELISA) and found that the newer one produced reliable results. Therefore, the DRG TM-CA 72–4 ELISA could be an option for the measurement of cancer antigen 72–4 in ovarian cancer patients.

HE4-test of urine and body fluids for diagnosis of gynecologic cancer

abstract and comment

Introduction: Serum epididymis protein 4 (HE4) level is a useful biomarker for the management of ovarian and endometrial cancer patients. Urine HE4-test, with its easier access than serum test, has emerged as a new method with promising application for the diagnosis of ovarian cancer.
Areas covered: This review summarizes data regarding the detection and alteration of HE4 in urine samples collected from ovarian cancer patients and controls. The performance and limitation of the assay and potential direction of future study are also discussed.

Expert commentary: Several studies have demonstrated an appreciable efficiency of urine HE4-test in the discrimination of ovarian cancer patients from general population. However, the data is based on small cohorts, and the performance of urine HE4-test need to be validated in larger groups. An algorithm incorporating other important factors may allow a quantitative assessment of cancer possibility. Future studies on the HE4 renal secretion and HE4 degradation dynamics in urine are also required for the establishment of standard protocols for the application of urine HE4-test in clinical settings.

Malignancy risk of sonographically benign appearing purely solid adnexal masses in asymptomatic postmenopausal women

abstract

2017 Jan 23

OBJECTIVE:

To assess the natural history of benign appearing purely solid ovarian lesions in asymptomatic postmenopausal women.

METHODS:

Retrospective observational cohort study comprising 99 women (mean age, 58.2 years, ranging from 50 to 77 years) diagnosed as having a purely solid ovarian lesion at transvaginal ultrasound between April 2001 and October 2015. Inclusion criteria were as follows: asymptomatic postmenopausal women with a well-defined purely solid ovarian lesion with International Ovarian Tumor Analysis color score 1 or 2, without ascites and/or signs of carcinomatosis. Clinical, sonographic, biochemical (CA-125), and histologic data (in case of surgery) were retrieved for analysis. Patients who were managed conservatively were assessed by transvaginal sonography every 6 months for a minimum of a year. In case of bilateral lesions we used the largest one for analysis.

RESULTS:

Five women (5.1%) had bilateral lesions. Mean size of the lesion was 2.9 cm (range, 1.0-7.8 cm). Most lesions were homogeneous (96.0%). Acoustic shadowing was present in 59.6% of cases. International Ovarian Tumor Analysis color score was 1 in 77.8% and 2 in 22.2% of the cases, respectively. Median CA-125 was 10.8 IU/mL (range, 3.0-403.0 IU/mL). Forty-two women underwent surgery after diagnosis (histologic diagnoses were as follows: fibroma (n = 26), fibrothecoma (n = 5), dermoid (n = 3), Brenner tumor (n = 3), endometrioma (n = 2), thecoma (n = 1), primary invasive cancer (n = 2). One case of invasive cancer CA-125 was 403.0 IU/mL and in the other case CA-125 was 6.0 IU/mL. They both were stage 1. Fifty-seven women were managed with serial follow-up. With a median follow-up time of 36 months (range, 12-142 months) all these lesions had no change and women remain asymptomatic. Considering all 99 cases the risk of malignancy is 2% (95% CI, 0.1-7.5).

CONCLUSIONS:

The risk of malignancy of benign appearing purely solid adnexal masses in asymptomatic postmenopausal women is low. Conservative management of these lesions might be an option.

Chemotherapy vs tamoxifen in platinum-resistant ovarian cancer: a phase III, randomised, multicentre trial (Ovaresist)

abstract:
Chemotherapy vs tamoxifen in platinum-resistant ovarian cancer: a phase III, randomised, multicentre trial (Ovaresist) : British Journal of Cancer

Background:

Chemotherapy in platinum-resistant ovarian cancer (PROC) aims for palliation and prolonging of progression-free survival (PFS). This study compares Health-related Quality of Life (HRQoL) and efficacy between single-agent chemotherapy and tamoxifen in PROC.

Methods:

Patients with PROC were randomised (2 : 1) to chemotherapy (weekly paclitaxel 80 mg m⁻² or four weekly pegylated liposomal doxorubicin 40 mg m⁻²) or tamoxifen 40 mg daily. The primary end point was HRQoL. Secondary end points were PFS by RECIST and overall survival (OS).

Results:

Between March 2002 and December 2007, 156 and 82 patients were randomised to chemotherapy and tamoxifen, respectively.

Cochrane: Metformin during ovulation induction with gonadotrophins in women with polycystic ovary syndrome

abstract:
Metformin during ovulation induction with gonadotrophins followed by timed intercourse or intrauterine insemination for subfertility associated with polycystic ovary syndrome - The Cochrane Library

Plain language summary

Metformin during ovulation induction with gonadotrophins in women with polycystic ovary syndrome

Review question: Cochrane review authors wanted to find out whether the addition of metformin increases the effectiveness of ovulation induction with gonadotrophins.
Background: Women with polycystic ovary syndrome (PCOS) have reduced pregnancy chances caused by absence of or reduction in ovulation requiring medical treatment. About 80% of women will ovulate on clomiphene citrate, and 50% will become pregnant. Remaining women may take gonadotrophins - hormones that act on the ovaries to stimulate ovulation. The association between insulin resistance and anovulation has led to the hypothesis that addition of metformin might increase the effectiveness of ovulation induction.
Study characteristics: We included five randomised controlled trials of women with PCOS undergoing gonadotrophin treatment for ovulation induction. This review of trials compared metformin or placebo added to gonadotrophins for ovulation induction. Evidence is current to July 2016.

Key results: We were able to include only five trials with a total of 264 women. We graded the quality of the evidence as low. We found no evidence of a difference in risk of multiple pregnancy between metformin and placebo, but we noted higher rates of live birth, ongoing pregnancy and clinical pregnancy with metformin.
Quality of the evidence: Evidence was of low quality for live birth, ongoing pregnancy, clinical pregnancy and multiple pregnancy. Limitations of the evidence included inadequate reporting of study methods and blinding of participants and outcome assessors.

Donald Trump Signs Anti-Abortion Executive Order Surrounded by Men

(5,467 comments at last count - some good comments, some 'the usual')

The Huffington Post  
01/23/2017

It seems like women might be interested in this policy too.

 WASHINGTON ― On Monday, surrounded by other white men, President Donald Trump signed an anti-abortion executive order that has far-reaching consequences for women’s reproductive health access worldwide.....

OA: Hereditary cancer syndromes in Latino populations: genetic characterization and surveillance guidelines

Full Text
  authors and on behalf of the Puerto Rico Clinical Cancer Genetics Consortia
  Published: 21 January 2017
 

  In this article, we provide a summary of the genetic basis for three of the leading cancers in Hispanics (breast, ovarian, and colorectal cancer), which have known hereditary contributions. We will discuss the clinical presentation of these cancers in Hispanics and how it differs from other populations. Furthermore, we will discuss the role of multigene testing in advancing genetic testing services in Latino populations.

OB-GYNs Blast Gwyneth Paltrow's Vaginal Jade Egg/V-steam

OB-GYNs Blast Gwyneth Paltrow's Vaginal Jade Egg Remedy 

 For some inexplicable, unfathomable reason, Gwyneth Paltrow has recently been advising women to put jade eggs in their vaginas to enhance their reproductive health. Not only does this sound entirely ludicrous, gynecologists are saying doing this could lead to Toxic Shock Syndrome or other serious health risks.

 She has even promoted and endorsed the strange, and potentially quite painful, act of vaginal steaming. Not only have experts debunked any health benefits of the “V-steam,” they say that doing so could cause women serious burns and infections.

Low uptake of fluorodeoxyglucose in PET/CT in ovarian clear cell carcinoma may reflect glutaminolysis of its cancer stem cell-like properties

 What is glycolysis Where does it occur and what does it produce?

"Glycolysis" means the splitting of glucose (sugar). The first step of the process occurs in the cytoplasm of the cell and yields a small amount of energy (measured in units of ATP) and two molecules of pyruvate. The other steps occur in the mitochondria. It is an ongoing process as your cells have a constant need for energy.

                                          ~~~~~~~~~~~~~~~~~~~
abstract (Japan)
Low uptake of fluorodeoxyglucose in positron emission tomography/computed tomography in ovarian clear cell carcinoma may reflect glutaminolysis of its cancer stem cell-like properties

  In conclusion, we suggested that ovarian CCC showed low activation of glycolysis, and this may reflect glutaminolysis of its CSC-like properties.

The characteristics of ovarian cancers that showed low activation of glycolysis were investigated. Using medical records of patients with ovarian cancers who had undergone fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) prior to their primary surgery at the University of Tokyo Hospital between 2010 and 2015, we identified cases with a low uptake of FDG in PET/CT.

Brief Report About the Role of HIPEC in a Prospective Randomized Phase 3 Study in Recurrent Ovarian Cancer...

NCBI

 Brief Report About the Role of Hyperthermic Intraperitoneal Chemotherapy in a Prospective Randomized Phase 3 Study in Recurrent Ovarian Cancer From Spiliotis et al.

• Format: Abstract

Send to

Int J Gynecol Cancer. 2017 Feb;27(2):246-247. doi: 10.1097/IGC.0000000000000864.

Author information

• ¹*Department of Gynecology & Gynecologic Oncology, Kliniken Essen Mitte, Essen; †Coordinating Center for Clinical Trials, Philipps-University Marburg, Marburg; ‡Department of Gynecology, Charité, Berlin, Germany; and §Department of Gynecology Oncology, MD Anderson Cancer Center, Madrid, Spain.

Abstract

A published so-called phase 3 study regarding HIPEC in ovarian cancer raised multiple questions. This commentary focusses on the weakness of the publication and discusses this in detail.

PMID:

28114231

DOI:

10.1097/IGC.0000000000000864

[PubMed - in process] (note: above link not working??)

Robotic and Advanced Laparoscopic Surgical Training in European Gynecological Oncology Trainees

abstract
 

CONCLUSIONS:

Training and experience in ALS and RS are poorly rated by GO trainees across Europe, and only few centers offer this. There is an urgent need to expand and harmonize training opportunities for ALS and RS. Most trainees want RS included as a formal component of their training.

Classification of Ovarian Cancer Surgery Facilitates Treatment Decisions in a Gynecological Multidisciplinary Team. - PubMed - NCBI

abstract

OBJECTIVE:

Proper planning of intervention and care of ovarian cancer surgery is of outmost importance and involves a wide range of personnel at the departments involved. The aim of this study is to evaluate the introduction of an ovarian surgery classification (COVA) system for facilitating multidisciplinary team (MDT) decisions.

MATERIALS AND METHODS:

Four hundred eighteen women diagnosed with ovarian cancers (n = 351) or borderline tumors (n = 66) were selected for primary debulking surgery from January 2008 to July 2013. At an MDT meeting, women were allocated into 3 groups named "pre-COVA" 1 to 3 classifying the expected extent of the primary surgery and need for postoperative care. On the basis of the operative procedures performed, women were allocated into 1 of the 3 corresponding COVA 1 to 3 groups. The outcome measure was the predictive value of the pre-COVA score compared with the actual COVA performed.

RESULTS:

The MDT meeting allocated 213 women (51%) to pre-COVA 1, 136 (33%) to pre-COVA 2, and 52 (12%) to pre-COVA 3. At the end of surgery, 168 (40%) were classified as COVA 1, 158 (38%) were classified as COVA 2, and 28 (7%) were classified as COVA 3. Traced individually, 212 (51%) patients were correctly preclassified at the MDT meeting and distributed into 110 (52%) COVA 1, 71 (52%) COVA 2, and 17 (32%) COVA 3. Analyzing the subgroup of patients with cancer, 164 (47%) were correctly preclassified. Regarding the International Federation of Gynecology and Obstetrics (FIGO) stages, the pre-COVA classification predicted the actual COVA group in 79 (49%) FIGO stages I to IIIB and in 85 (45%) FIGO stages IIIC to IV.

CONCLUSIONS:

The COVA classification system is a simple and useful tool in the MDT setting where specialists make treatment decisions based on advanced technology. The use of pre-COVA classification facilitates well-organized patient care-relevant procedures to be undertaken. Pre-COVA accurately predicts the final COVA in 51% classified women.

Lynch Syndrome: Frequent MMR Protein Deficiency in Mixed Endometrioid and Clear Cell Carcinoma of the Endometrium

abstract

Mixed endometrioid and clear cell carcinoma of the endometrium refers to a scenario in which the tumor exhibits histologic features of both endometrioid and clear cell carcinoma. We observed a tendency for these tumors to occur in a mismatch repair (MMR) protein-deficient molecular background in a prior study that examined a small cohort of mixed-type endometrial carcinomas. The aim of this study was to determine the rate of MMR protein deficiency in a larger series of endometrial mixed endometrioid and clear cell carcinomas, through a retrospective survey of MLH1, PMS2, MSH2, and MSH6 expression in such tumors at 5 tertiary centers. A total of 41 cases were identified and 27 (66%) tumors demonstrated MMR protein deficiency with a comparable frequency across the contributing centers (ranging from 56% to 83%). Among the MMR protein-deficient cases, 59% showed concurrent MLH1 and PMS2 loss, 33% showed concurrent MSH2 and MSH6 loss, and 4% showed isolated PMS2 or MSH6 loss. Compared with a previously published series of 15 pure endometrial clear cell carcinomas, mixed endometrioid and clear cell carcinomas are associated with significantly better disease-specific survival (P=0.02). In summary, endometrial carcinomas with mixed endometrioid and clear cell histology are frequently MMR protein deficient. This finding has implications both for our understanding of its tumor biology and for the identification of patients with potential Lynch syndrome.

Evidence of a genetic link between endometriosis and ovarian cancer (serous/clear cell)

abstract
 

Fertility and Sterility

January 2016

Purchase $35.95

Objective

To evaluate whether endometriosis-associated genetic variation affects risk of ovarian cancer.

Design

Pooled genetic analysis.

Setting

University hospital.

Patient(s)

Genetic data from 46,176 participants (15,361 ovarian cancer cases and 30,815 controls) from 41 ovarian cancer studies.

Intervention(s)

None.

Main Outcome Measure(s)

Endometriosis-associated genetic variation and ovarian cancer.

Result(s)

There was significant evidence of an association between endometriosis-related genetic variation and ovarian cancer risk, especially for the high-grade serous and clear cell histotypes. Overall we observed 15 significant burden statistics, which was three times more than expected.

Conclusion(s)

By focusing on candidate regions from a phenotype associated with ovarian cancer, we have shown a clear genetic link between endometriosis and ovarian cancer that warrants further follow-up. The functional significance of the identified regions and SNPs is presently uncertain, though future fine mapping and histotype-specific functional analyses may shed light on the etiologies of both gynecologic conditions.

Key Words

• Endometriosis;
• ovarian cancer;
• genetic variation;
• SNPs

updated consumers: Cochrane Gyn, Neuro-oncology and Orphan Cancers

 Blogger's Note: location (country) of consumer reps (updated)

Editorial Team | Cochrane Gynaecological, Neuro-oncology and Orphan Cancers

Our consumer representatives include:
Daloni Carlisle (UK)
Jennifer Cove (UK)
Kathie Godfrey (UK)
Jennifer Hare  (USA)
Carol Jones (UK)
Patricia Jupp (UK)
Mary Lunnen (UK)
Vicky Parker (UK)
Ruth Payne (UK)
Carol Pearett (UK)
Sandi Pniauskas (Can)
Katharine Tylko-Hill (UK)

2017 GI Cancers Symposium: Less Than Half of Recommended Adults Screened for Lynch Syndrome

The ASCO Post
 Posted: 1/23/2017

abstract
 Underuse of microsatellite instability testing and predictors of high microsatellite instability disease among young colorectal cancer patients.

 Key Points

• MSI testing is recommended for all patients younger than 50 years of age because of prognostic and therapeutic implications.
• MSI is a characteristic feature of Lynch syndrome and thus, having a germline mutation may put the patient and family members at risk for additional malignancies.
• Researchers found that although compliance with testing guidelines increased over the years we studied, overall less than half of colorectal cancer patients less than 50 years old were getting tested.

 A team of researchers at Fox Chase Cancer Center found that, despite the recommendation of screening guidelines, less than half of adults younger than 50 years old who have colorectal cancer are being screened for Lynch syndrome, a genetic anomaly that increases the risk of colorectal and several other forms of cancer.

Classification of Ovarian Cancers (video/text) Jan 20th, 2017

http://www.onclive.com/peer-exchange/peritoneal-cancer-therapies/classification-of-ovarian-cancers?sp=

Classification of Ovarian Cancers

Panelists: Bradley J. Monk, MD, University of Arizona and Creighton University School of Medicine at St. Joseph’s Hospital; Robert L. Coleman, MD, MD Anderson Cancer Center; Thomas Herzog, MD, University of Cincinnati; Kathleen N. Moore, MD, Stephenson Cancer Center; Angeles Alvarez Secord, MD, Duke University School of Medicine

Published Online: Friday, Jan 20, 2017

Genetic Variants in Epigenetic Pathways and Risks of Multiple Cancers in the GAME-ON Consortium

 Pleiotropic: Producing or having multiple effects from a single gene
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abstract:
Genetic Variants in Epigenetic Pathways and Risks of Multiple Cancers in the GAME-ON Consortium | Cancer Epidemiology, Biomarkers & Prevention
 Published 23 January 2017

Background: Epigenetic disturbances are crucial in cancer initiation, potentially with pleiotropic effects, and may be influenced by the genetic background.
Methods: In a subsets (ASSET) meta-analytic approach, we investigated associations of genetic variants related to epigenetic mechanisms with risks of breast, lung, colorectal, ovarian and prostate carcinomas using 51,724 cases and 52,001 controls. False-discovery-rate corrected p-values (q-values < 0.05) were considered statistically significant.
Results: Among 162,887 imputed or genotyped variants in 555 candidate genes, SNPs in eight genes were associated with risk of more than one cancer type. For example, variants in BABAM1 were confirmed as a susceptibility locus for squamous cell lung, overall breast, ER-negative breast, overall prostate, overall and serous ovarian cancer; the most significant variant was rs4808076 (odds ratio (OR)=1.14, 95% confidence interval (CI)=1.10-1.19, q=6.87*10-5). DPF1 rs12611084 was inversely associated with ER-negative breast, endometrioid ovarian, overall and aggressive prostate cancer risk (OR=0.93, 95% CI=0.91-0.96, q=0.005). Variants in L3MBTL3 were associated with colorectal, overall breast, estrogen receptor (ER)-negative breast, clear cell ovarian, and overall and aggressive prostate cancer risk (e.g. rs9388766: OR=1.06, 95% CI=1.03-1.08, q= 0.02). Variants in TET2 were significantly associated with overall breast, overall prostate, overall ovarian and endometrioid ovarian cancer risk, rs62331150 showing bidirectional effects.
Analyses of sub-pathways did not reveal gene subsets that contributed disproportionately to susceptibility.
Conclusion: Functional and correlative studies are now needed to elucidate the potential links between germline genotype, epigenetic function, and cancer etiology. Impact: This approach provides novel insight into possible pleiotropic effects of genes involved in epigenetic processes.

2017 World Ovarian Cancer Day (website/links)

World Ovarian Cancer Day