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Ovarian Cancer

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I looked after one of my partner’s patients who is approaching death from advanced, refractory ovarian cancer. She asked me not to talk about anything negative with her. We can’t really make any decisions without discussing negative things. Should I just remain silent about them at her request?

Ongoing studies are attempting to understand the reasons that tumor cells engage in aerobic glycolysis in lieu of oxidative phosphorylation. In this review, we discuss known benefits to tumor cells from this metabolic switch, and we highlight key enzymes that play a role in aerobic glycolysis. We also describe novel therapeutic options targeting glucose metabolism.

Therapy for recurrent ovarian cancer is not curative, and presumed overall survival benefits of standard strategies are uncertain and often based on low-level evidence. Treatment toxicity and patient quality of life should be considered at all points during disease management.

Risk factors for breast cancer can be parsed into genetic and biological factors, and environmental and lifestyle factors; and the general consensus is that screening and prevention strategies should be tailored based on an individual’s risk assessment.

Work remains in the development of a clinically useful tumor classification system that includes molecular characterization of tumors, in our understanding of the implications of tumor heterogeneity, and in the development of more relevant and efficient clinical trials. Nonetheless, there is great excitement that a new era in the treatment of cancer is beginning.

During the past decade, targeted therapeutics have changed the landscape of cancer therapy with bold brush strokes, but the resulting images are still unclear. As we enter into the second decade of targeted therapy, our increased understanding of tumor biology together with cancer genomic sequencing tools will clearly show the way forward. It is imperative that we use these fine brushes, not only to improve precision, but in the end to realize the art of medicine.

CancerNetwork speaks with Dr. Sara Hurvitz, director of the breast cancer program at the University of California in Los Angeles. Dr. Hurvitz is actively involved in translational phase I/II breast cancer clinical trials as well as in research to better define distinct types of breast tumors to better design novel targeted therapies.

A study published today details a scoring system that may predict which ovarian cancer patients responded to first-line platinum chemotherapy based on a DNA-repair pathway-focused score. The score is based on a gene expression profile of 23 DNA-repair genes that normally function to repair platinum-induced DNA damage.