Ovarian Cancer

LOS ANGELES--Interim analysis of a major German-Austrian trial comparing cisplatin (Platinol)/paclitaxel (Taxol) with carboplatin (Paraplatin)/paclitaxel as first-line treatment in ovarian cancer found significantly less toxicity with carboplatin/paclitaxel, with no apparent loss of efficacy.

As Drs. Sabbatini and Spriggs point out in their review, the majority of ovarian cancer patients continue to present with advanced-stage disease, and only a minority are cured after primary surgery and chemotherapy. At present, recurrent disease is best viewed as a chronic illness that requires ongoing management. A number of therapeutic options are available, but opportunities for cure remain limited. My comments will focus on post-remission therapy, small-volume residual disease, intraperitoneal therapy, secondary cytoreductive surgery, choice of second-line chemotherapy, and participation in phase II studies.

Approximately, 27,000 new cases of ovarian cancer are reported in the United States each year, and about 15,000 of those result in death. The 5-year survival rate of patients with advanced disease is about 50%. However, when cancer is diagnosed

NEW ORLEANS--After delivery with a cationic liposome complex, the tumor-suppressor gene E1A was expressed by cells in many places in the body, Naoto Ueno, MD, of the M.D. Anderson Cancer Center, reported at the 89th annual meeting of the American Association for Cancer Research (AACR).

Despite the activity of initial chemotherapy in ovarian cancer, the majority of women presenting with advanced disease will ultimately experience disease recurrence and be required to consider second-line, or salvage, chemotherapy options. The well-written, informative article by Sabbatini and Spriggs provides a fairly comprehensive overview of important factors to consider when determining the most appropriate treatment options in this clinical setting.

Patients with epithelial ovarian cancer must receive optimal surgical care and state-of-the-art chemotherapy in the primary treatment setting. The salvage treatment of women with recurrent or persistent ovarian cancer remains a

The distribution of abdominal serous carcinoma in the female ranges from ovarian carcinoma with no tumor involvement of the peritoneum to peritoneal carcinoma with no evidence of carcinoma in the ovary. For the purposes of investigation and patient care, it has been necessary to formulate criteria to distinguish tumors that are most probably primary ovarian carcinomas from those that are most likely primary peritoneal cancers.

Drs. Eltabbakh and Piver present a comprehensive review of the management and prognosis of patients with extraovarian primary peritoneal carcinoma (EOPPC). Increased recognition and more precise definition have led many physicians and scientists to recognize EOPPC as a distinct clinical entity with a unique etiology. However, staging and treatment criteria for EOPPC have been modeled after criteria for papillary serous ovarian cancer, which is clinically and histologically similar. The Gynecologic Oncology Group (GOG) has allowed the inclusion of patients with EOPPC into clinical trials designed for patients with epithelial ovarian cancer.

BUFFALO, NY--It appears possible to break immune tolerance to carcino-embryonic antigen (CEA) utilizing a vaccine that is the internal image of CEA, said Kenneth A. Foon, MD, director of the University of Kentucky Markey Cancer Center, Lexington.

Extraovarian primary peritoneal carcinoma (EOPPC), a relatively newly defined disease that develops only in women, accounts for approximately 10% of cases with a presumed diagnosis of ovarian cancer. Characterized by

NEW ORLEANS--Most women with a family history of breast cancer have a familial predisposition to the disease, rather than true hereditary breast cancer. A comprehensive family history should guide the recommendations regarding testing for a genetic mutation, which, at about $2,400, should not be taken lightly, said speakers at an AMA-sponsored program on genetic medicine and the practicing physician.

Breast cancer, the most common malignancy in women, frequently develops during the premenopausal years. The great majority of these breast cancers can be successfully treated, and the decision to have children remains a real and important consideration. The relationship between breast cancer and a subsequent pregnancy is complex, and decisions regarding one may ultimately affect the course or outcome of the other.

BETHESDA, Md--Bristol-Myers Squibb went 2-for-2 before the FDA’s Oncologic Drugs Advisory Committee (ODAC). The panel recommended that the FDA approve injectable Taxol (pacli-taxel), in combination with cisplatin (Platinol), for both the first-line treatment of ovarian cancer and for the treatment of non-small-cell lung cancer (NSCLC) in patients who are not candidates for potentially curative surgery and/or radiation therapy.

PARIS--The demonstration that adding paclitaxel (Taxol) to platinum boosts survival in advanced ovarian cancer has made this combination the gold standard of chemotherapy for previously untreated patients. [ODAC recently recommended to the FDA that paclitaxel be formally approved for this indication; see page 33.] However, although as many as three-quarters of women will respond to platinum-paclitaxel and one-half will achieve complete clinical remission, most will eventually relapse.

Alterations in a gene discovered last year by UT Southwestern Medical Center in Dallas scientists have been linked to breast, ovarian, and uterine cancers, the researchers reported in the February issue of Human Molecular Genetics.

ORLANDO--In a retrospective review of ovarian cancer patients treated at Memorial Sloan-Kettering, positive findings from second-look surgery in stage I patients were so rare that the researchers no longer perform such surgery in these patients, Stephen C. Rubin, MD, told the Society of Gynecologic Oncologists.

ORLANDO--Breast-conserving therapy appears to be a viable treatment option for breast cancer patients with a family history of breast cancer, Elizabeth Chabner, MD, said at the annual meeting of the American Society for Therapeutic Radiation and Oncology (ASTRO).

Approximately 10% of all epithelial ovarian carcinoma cases are associated with inheritance of an autosomal-dominant genetic mutation conferring a predisposition to cancer with variable penetrance. Two such manifestations

Jefferson Medical College researchers have created what they believe may prove to be an effective ovarian cancer vaccine made from a patient’s own cancer cells. After testing the vaccine on 11 patients, each with advanced disease, the scientists are encouraged after seeing an initial immune reaction. That tells them that the vaccine is effectively stimulating the immune system into action.

Approximately 10% of all epithelial ovarian carcinoma cases are associated with inheritance of an autosomal-dominant genetic mutation conferring a predisposition to cancer with variable penetrance. Two such manifestations

Approximately 10% of all epithelial ovarian carcinoma cases are associated with inheritance of an autosomal-dominant genetic mutation conferring a predisposition to cancer with variable penetrance. Two such manifestations

The past 20 years has seen an increasing trend toward the use of oral chemotherapy for the treatment of patients with a variety of malignancies. The advantages of oral chemotherapy include lower treatment cost, compared with that of intravenous (IV) administration, and more convenient treatment for patients.

SAN ANTONIO-Genetic testing for breast cancer susceptibility appears to confer no adverse psychological effects on mutation carriers or individuals who refuse to be tested, Caryn Lerman, PhD, reported at a general session of the San Antonio Breast Cancer Symposium.

Washington-Available methods to prevent breast cancer might be bettered compared to a flu shot “which hurts and only lasts a year,” than to a polio vaccine, “which comes on a sugar cube and lasts a lifetime,” Malcolm C. Pike, PhD, said at the Department of Defense’s “Era of Hope” meeting.

Malignancies arising in the fallopian tube are extremely rare, accounting for less than 1% of gynecologic malignancies. This rarity makes it unlikely that any single institution will have managed enough patients in a uniform manner to be able to critically evaluate different treatment plans. Most institutions agree that diagnosis, staging, and treatment are analogous to ovarian cancer. Often, the matter of whether an advanced adnexal malignancy is of ovarian or tubal origin cannot be determined until the final pathologic diagnosis is made.

Epithelial ovarian cancer is the leading cause of death from gynecologic malignancies. In 1996, an estimated 26,000 new cases were diagnosed, and approximately 14,000 women died of this disease in the United States alone.[1] Between 75% and 80% of ovarian cancer patients present with advanced disease at diagnosis, and these patients have a 5-year survival rate of 21%.[2,3]

ASH-Topotecan (Hycamtin) given in combination with cytarabine (ara-C) produced a complete response rate of 63% in 35 patients with previously untreated, poor-prognosis myelodys-plastic syndrome (MDS) or chronic myelomonocytic leukemia (CMML), Miloslav Beran, MD, PhD, said at the American Society of Hematology annual meeting in San Diego.

A genetic mutation in the adenomatous polyposis (APC) gene found in 7% of Ashkenazi Jewish families in the United States does not necessarily lead to colon cancer, according to a study in the December 15, 1997, issue of Cancer Research.

Topotecan hydrochloride (Hycamtin), as a single agent or in combination with other agents, may offer a new treatment option for people suffering from small-cell lung cancer, according to results from five clinical trials reviewed at the 15th

ORLANDO-Nearly three decades of clinical trials of multiagent chemotherapy have yet to exceed the results produced in a study from the 1970s of sequential surgery, abdominopelvic radiotherapy and single-agent alkylating chemotherapy, said Ellen E. Bellairs, MD, of the University of Minnesota.