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Ovarian Cancer

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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).

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.

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.

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.

Endometrial cancer is the most common type of female genital cancer in the United States, with an estimated 32,000 new cases and 5,600 deaths per year. During the first half of the 20th century, the incidence of cervical cancer was greater than

After the patient has been evaluated preoperatively, exploratory laparotomy is essential for definitive diagnosis and staging. The patient should be advised of the potential for malignancy based on the physical as well as imaging studies, and an

In a phase II study, 66 patients with advanced breast cancer (median age 56 years; range, 28 to 75 years) were treated with paclitaxel (Taxol), 175 mg/m² infused over 3 hours, and carboplatin (Paraplatin), dosed to attain an

People & Places

Dr. Therese B. Bevers has been named medical director for Clinical Cancer Prevention at The University of Texas M.D. Anderson Cancer Center. The program, in the Division of Cancer Prevention, works to translate medical science and research into applications that make cancer prevention and early detection a reality. Dr. Bevers was formerly medical director of the MediClinic Corporation.