Your AI-Trained Oncology Knowledge Connection!
Piver gives his perspective on the management of epithelial ovarian cancer in the elderly. This subject has been dealt with previously by numerous authors, with a general consensus that advancing age is an independent negative prognostic factor when multivariate statistics are applied to the multiple parameters affecting outcome
Dr. Piver presents a personal look at the issues he believes to be important in managing ovarian carcinoma in the elderly patient. He begins with an attempt to define elderly.
Omer Kucuk, MD, has joined Emory University’s Winship Cancer Institute in Atlanta as professor of hematology and medical oncology. Dr. Kucuk conducted the earliest clinical trials on soy and lycopene supplements in prostate cancer treatment. He was previously at the Karmanos Cancer Center at Wayne State University in Detroit.
Ortho Biotech recently announced the submission of a new drug application (NDA) to the US Food and Drug Administration (FDA) for trabectedin (Yondelis) when administered in combination with liposomal doxorubicin (Doxil) for the treatment of women with relapsed ovarian cancer.
SAN FRANCISCO-The “preponderance of the evidence” supports intraperitoneal chemotherapy as the preferred treatment for small-volume residual ovarian cancer after surgical debulking, Robert S. Mannel, MD, said at a debate session of the 2008 Oncology Congress. J. Tate Thigpen, MD, who took the con side of the debate, argued that IP chemotherapy remains experimental because of flaws in the design of the three major trials of IP therapy and its “formidable toxicity.”
Given that in the 21st century many believe 70 years of age is the new 60 and 80 years of age is the new 70, any article on ovarian cancer in the elderly depends on one’s definition of elderly. To put this in a 21st century perspective, in a thoughtful article on aging in The New Yorker (“The Way We Age Now,” April 30, 2007), Atul Gawande points out, “for most of our hundred-thousand-year existence-all but the past couple of hundred years-the average life span of human beings has been 30 years or less (research suggests that subjects of the Roman Empire had an average life expectancy of 28 years).
In the United States, approximately 180,000 women are diagnosed with breast cancer annually.
During this election year, approximately 1.4 million U.S. residents will be diagnosed with cancer. For U.S. presidential hopefuls Sen. Barack Obama and Sen. John McCain, cancer has hit close to home. Sen. McCain, 72, has been treated several times for squamous cell carcinoma and malignant melanoma. Sen. Obama lost his grandfather to prostate cancer and his mother to ovarian cancer.
The human epidermal growth factor receptor 2 (HER2) is a transmembrane receptor with tyrosine kinase activity overexpressed in about 20% to 25% of invasive carcinomas of the breast.
The question of a well-defined role for the use of neoadjuvant chemotherapy in the treatment of ovarian cancer is recognized to be one of the most hotly debated issues in the management of female pelvic malignancies.[1-3] One group of oncologists would argue that it should be the rare patient (eg, with severe comorbidity) who is not a candidate for an initial attempt at maximal cytoreduction.[1]
Ovarian cancer is a unique malignancy. While the disease can spread hematogenously or via the lymphatic system, the bulk of the tumor is found on peritoneal surfaces. This peritoneal disease results from shedding of ovarian tumor cells into the peritoneal cavity, circulation of these cells throughout the abdomen and pelvis, and eventual implantation onto peritoneal surfaces.
Conventional therapy for advanced-stage ovarian cancer-ie, aggressive cytoreductive surgery followed by aggressive chemotherapy-was established more than 3 decades ago [Editor’s note: See Dr. Schwartz’s article, “Cytoreductive Surgery in the Management of Ovarian Cancer,” in last month’s issue of ONCOLOGY]. Since that time, no prospective randomized trials have been reported to confirm the efficacy of this treatment strategy.
The magnitude of the role surgical exploration and extirpation play in the contemporary management of patients with advanced ovarian cancer is hard to overstate. Beyond diagnostic confirmation, the aggressive posture taken to remove bulk disease provides-among other benefits-symptomatic relief, theoretically enhanced immunologic integrity, chemosensitivity, and improved survival characteristics.
As outlined in the comprehensive review by Dr. Schwartz, cytoreductive surgery followed by platinum-based chemotherapy is considered the standard of care in the initial management of patients with advanced ovarian cancer. Considering prognostic factors for patients with advanced disease, residual disease after primary surgery is still considered to be the most important modifiable prognostic factor influencing survival. This has again been recently confirmed by a large retrospective study including six different Gynecologic Oncology Group (GOG) studies.[1]
The standard management for advanced-stage ovarian cancer was established in the mid-1970s. At a 1974 National Cancer Institute Consensus Conference on Ovarian Cancer, Griffiths presented data supporting the role for aggressive cytoreductive surgery as the first step in the management of this disease, followed by cytotoxic chemotherapy.
Women’s reports of persistent, recent-onset symptoms linked to ovarian cancer-abdominal or pelvic pain, difficulty eating or feeling full quickly, and abdominal bloating-combined with CA125 testing may improve the early detection of ovarian cancer by 20%, according to Fred Hutchinson Cancer Research Center investigators (Cancer, published online June 23, 2008).
The population of the United States and other industrialized nations is aging rapidly. The increased life span allows for longer exposure to carcinogens and the accumulation of genetic alterations. Thus, the incidence of cancer is increasing along with the aging of the population.
SAN DIEGO-At the 2008 AACR annual meeting, investigators reported preliminary results with a number of novel compounds entering clinical trials.
Jay R. Harris, MD, will present the Gianni Bonadonna Breast Cancer Award lecture at the upcoming 2008 ASCO Breast Cancer Symposium being held September 5-7 in Washington DC. Dr. Harris is professor and chair of the Department of Radiation Oncology at the Dana-Farber Cancer Institute and the Brigham and Women’s Hospital at Harvard Medical School.
Epothilones, representing a newer class of naturally occurring antimicrotubule macrolides, have emerged as cytotoxic agents with significant antitumor activity against tumors that are resistant to taxanes.
Colorectal cancer is one of the leading causes of cancer-related death worldwide, with almost 20% of all patients presenting with metastatic disease at the time of their diagnosis. The treatment regimens and options of metastatic colorectal cancer have significantly changed in the last 10 years, leading to an improvement of response rates to about 50%, progression-free survival of about 10 months, and overall survival reaching over 2 years.
A team of European investigators is taking a novel immunotherapeutic approach to advanced gastrointestinal tract tumors using the "trifunctional antibody" catumaxomab.
Photography exhibit features breast and ovarian cancer patients and families
FDA removes partial hold on Telcyta clinical development
Liposomal doxorubicin received FDA approval for use in combination with bortezomib in patients with multiple myeloma who have not previously received bortezomib and have received at least one prior therapy.
