Ovarian Cancer

Cancer chemoprevention is the use of specific natural or synthetic substances with the objective of reversing, suppressing, or preventing carcinogenic progression to invasive cancer. Currently, numerous chemopreventive agents are in various stages of development and testing. Part 1 of this two-part series provides an overview of issues unique to chemoprevention trials, including the use of surrogate biomarkers as end points. This is followed by a discussion of the retinoids, such as all-trans-retinoic acid (ATRA [Vesanoid]), 9-cis-retinoic acid (9cRA), and isotretinoin (Accutane), and the carotenoids (eg, beta-carotene and lycopene) and other "classic" antioxidants (eg, vitamins E and C and selenium). Research on these agents will be delineated by disease site when applicable. Part 2, which will appear in next month’s issue, will focus on hormonally mediated chemopreventive agents, such as tamoxifen (Nolvadex), finasteride (Proscar), oral contraceptives, and dehydroepiandrosterone (DHEA). Part 2 also will cover nonantioxidant natural agents, such as calcium, the polyphenols, the isothiocyanates, and genistein; nonsteroidal anti-inflammatory drugs (NSAIDS), such as celecoxib, sulindac sulfone, and aspirin; difluro-methylornithine (DFMO [Eflornithine]); oltipraz; and N-acetylcysteine. [ONCOLOGY(11):1643-1658, 1998]

ATLANTA--Cancer programs and hospitals wishing to expand their services to include genetic counseling and testing should be aware that the staff and resource needs are intense, Constance Roche, MSN, RN, CS, said at a conference sponsored by the National Consortium of Breast Centers. Ms. Roche and Kevin Hughes, MD, who were instrumental in establishing the Lahey Clinic Risk Assessment Program, Peabody, Massachusetts, offered advice on establishing and operating such a program.

NEW YORK--Caring for a mother with advanced breast cancer can be a lot to deal with for a daughter. She has the tricky task of reversing roles with her mother. She may have a family of her own to care for--and there is the fear that she is at risk for cancer herself.

SAN FRANCISCO--Whether to administer genetic testing to a patient is a complex issue, Patrice Watson, PhD, of Creighton University School of Medicine, Omaha, said at the American Cancer Society Second National Conference on Cancer Genetics.

LOS ANGELES--While the flurry of media attention on antiangiogenesis drugs has focused on angiostatin and endostatin, other such agents are further along in development. One of them, BAY 12-9566, has stopped tumor growth in patients for up to 11 months in an ongoing trial, Louise Grochow, MD, said at an ASCO session on novel approaches in drug development.

A new survey of more than 11,000 Americans reveals widespread ignorance about lung cancer, the nation’s leading cancer killer.

BETHESDA, Md--As part of his sweeping reorganization and innovative effort at the National Cancer Institute, director Richard D. Klausner, MD, last November named 15 advocates to the Director’s Consumer Liaison Group (DCLG). Its recommendations will go directly to the NCI director, as it becomes a high-powered chartered advisory committee. Dr. Klausner envisioned a threefold purpose for this group of advocates. First, it will provide a forum for advocates to raise and discuss issues of concern regarding the development of NCI programs and research priorities. Second, it will help NCI develop criteria for selecting consumer advocates to serve on a number of NCI program and policy committees, including peer review panels. Third, it will serve as a strong link between NCI and cancer advocacy groups. Oncology News International’s Washington Bureau Chief Patrick Young discussed the DCLG’s role within NCI with Eleanor Nealon, director of NCI’s Office of Liaison Activities, which coordinates the group.

The FDA’s Oncologic Drugs Advisory Committee (ODAC) recommended the approval of topotecan hydrochloride for injection (Hycamtin) for the second-line treatment of sensitive small-cell lung cancer (SCLC).

MINNEAPOLIS--Living With Cancer: A Message of Hope, a conversation with some of the nearly 10 million US cancer survivors, debuts nationally on PBS, Friday, September 25, at 9:00 pm (check local listings).

LOS ANGELES--Bioengineered antibodies against HER2 received major attention at the the 34th Annual Meeting of the American Society of Clinical Oncology, but other approaches to HER2-expressing tumors are waiting in the wings. One uses an antitumor peptide vaccine to induce specific T-cell immunity to HER2. Another uses anti-HER2 immunoliposomes to steer intracellular delivery of antitumor drugs.

NEW YORK--Cancer Care, Inc. has launched a new online resource for ovarian cancer patients and their families and friends. A new section added to Cancer Care’s website (www.cancercare.org) offers a comprehensive overview of ovarian cancer and a resource guide.

Two phase III, multicenter clinical trials are seeking patients to participate in studies evaluating PSC 833, an investigational agent,in combating multidrug resistance in patients with acute myelogenous leukemia. The studies, sponsored by Novartis,

Irinotecan (CPT-11 [Camptosar]) has a broad range of antitumor activity. Extensive preclinical and early clinical work has demonstrated its activity against many tumor types--head and neck, esophagus, stomach, pancreas,

Predisposition testing (ie, genetic testing that provides information about a person’s susceptibility to disease) is now available for several inherited forms of cancer. Individuals who are found to have an altered gene (eg, a

Irinotecan (Camptosar), an active agent in the treatment of fluorouracil-refractory colorectal cancer, has antitumor activity in upper gastrointestinal cancers. Clinical trials from Japan indicate antitumor responses in gastric and

SAN DIEGO--A study of 1,000 patients who received high-dose chemotherapy (HDC) with peripheral blood stem cell (PBSC) support in the community setting showed treatment-related mortality rates similar to those reported at academic centers, said C. Dean Buckner, MD, scientific director of Response Oncology, Inc. and a founder of the Fred Hutchinson Cancer Research Center. He spoke at a symposium sponsored by the University of California, San Diego.

Predisposition testing (ie, genetic testing that provides information about a person’s susceptibility to disease) is now available for several inherited forms of cancer. Individuals who are found to have an altered gene (eg, a

LOS ANGELES--The use of cisplatin (Platinol)/paclitaxel (Taxol) for first-line treatment of advanced ovarian cancer gained additional support from the final survival analysis of a major international study presented at an ASCO scientific session.

GLASGOW--Docetaxel (Taxotere) used in combination with carboplatin (Paraplatin) appears to be an active and well-tolerated first-line treatment for advanced ovarian cancer, producing minimal neurotoxicity. Only 5% of patients experienced neuropathy, said lead investigator Paul Vasey, MD.

In order for the immune system to protect against cancer, it must recognize tumors as "non-self." Markers present on the surface of tumors, known as antigens, allow the immune system to recognize tumors as non-self. However, in order for the

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.