Dana-Farber Oncologists Differ Widely on the Use of Multiplex Tumor Genomic Testing

A new study by researchers at the Dana-Farber Cancer Institute suggests that not all doctors are ready to embrace tests that may identify hundreds of genomic changes in a patient’s tumor sample for the purpose of determining appropriate treatment.

Many cancer researchers believe that cutting-edge advances in genomics will pave the way for personalized or “precision” cancer medicine for all patients in the near future. A new study by researchers at the Dana-Farber Cancer Institute, however, suggest that not all doctors are ready to embrace tests that look for hundreds of genomic changes in a patient’s tumor sample, while others plan to offer this type of cancer genomic tumor testing to most of their patients. The study findings were published recently in the Journal of Clinical Oncology [1], along with an accompanying editorial. [2]

The wide variation in attitudes was in part determined by physicians’ “genomic confidence.” Physicians who had a lot of confidence in their ability to use and explain genomic findings were more likely to want to prescribe the test and consider using test results when making treatment recommendations. Other physicians had lower levels of genomic confidence and were more reluctant to offer such testing. These findings are particularly interesting because the survey was carried out at the Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC), which has a comprehensive research program. The DF/BWCC research program allows all consenting patients to have genomic tumor testing, which is capable of finding gene mutations and other DNA alternations that drive a patient’s cancer. In some cases, the genomic tumor profiles identify “druggable” targets that may allow doctors to use specific drugs known to be effective against particular gene mutations or alterations.

The researchers were perplexed by another key study survey finding: 42 percent of responding oncologists approved of telling patients about genomic tumor test results even when their significance for the patient’s outlook and treatment is uncertain. This issue comes with the growing use of predictive multiplex genomic testing, which can identify tens or hundreds of gene mutations simultaneously and often detects rare DNA variants that may or may not be relevant to the treatment of an individual’s cancer.

“Some oncologists said we shouldn’t return these results to the patient, and others say ‘of course we should give them to the patient’,” said Stacy W. Gray, M.D., AM, of Dana-Farber, first author of the report. “I think the fact that we found so much variation in physicians’ confidence about their ability to use genetic data at a tertiary care, National Cancer Institute-designated Comprehensive Cancer Center makes us pause and wonder about how confident physicians in the community are about dealing with this,” she said. “It begs the question at a national level, how are we going to make sure that this technology for cancer care is adequately delivered?”

The study survey was conducted in 2011 and early 2012 as a baseline assessment of physicians’ attitudes prior to the rollout of the genomic tumor testing project referred to as “Profile” (which formerly utilized a technology platform called “OncoMap“) at DF/BWCC.

For purposes of the study, a total of 160 Dana-Farber adult cancer physicians – including medical oncologists (43%), surgeons (29%), and radiation oncologists (19%) – participated in the survey. They were asked about their current use of multiplex tumor genomic testing, their attitudes about multiplex testing, and their confidence in the ability to understand and use genomic data. The survey did not include a direct test of the physicians’ knowledge.

Among the many intriguing findings of this study, a wide variability in interest in multiplex tumor genomic testing was identified—25% of respondents anticipated testing more than 90% of their patients, whereas 17% of respondents anticipated testing 10% or less. Beliefs related to the potential value of multiplex tumor genomic testing were largely positive; most expressed belief that this form of testing would increase treatment (73%) and research options (90%) for patients, as well as both physician (80%) and patient satisfaction (80%).

Despite the foregoing, less than 50% of the physicians planned to view the multiplex tumor genomic testing results routinely. Moreover, the majority of respondents planned only to “rarely” or “sometimes” use the clinically relevant results (58%), called “Tier 1″ by the study authors, and potentially actionable results (88%), called “Tier 2,” to assist them in the treatment of patients. However, the respondents more often indicated that results of multiplex tumor genomic tests should be shared with patients, particularly findings revealing the presence of a Tier 1 (clinically relevant) genomic variant—87% believed that these findings should be discussed—versus a Tier 2 (potentially actionable) genomic variant (50%), or a Tier 3 (uncertain significance) genomic variant (40%). A substantial minority (39%) also disagreed with a Dana-Farber Cancer Institute policy prohibiting the disclosure of Tier 3 genomic variants to patients.

Interestingly, despite limited exposure to routine genomic tests for a large portion of the respondents, the stated “genomic confidence” of participating physicians was quite high. The majority of participants reported that they were “somewhat” or “very” confident in their (i) knowledge of genomics (78%), (ii) ability to explain genomics (86%), and (iii) ability to use genomic results to guide treatment (74%); however, a substantial minority of the Dana-Farber physicians (28%) reported genomic confidence of “not very” or “not at all confident.”

Based upon the study survey findings, Dr. Gray and her colleagues conclude that there is “little consensus” on how physicians plan to use multiplex tumor genomic testing for personalized cancer care, and they suggest the need for evidence-based guidelines to help doctors determine when testing is indicated.

“I think one of the strengths of this study is that its information comes from an institution where ‘precision cancer medicine’ is available to everyone,” commented Barrett Rollins, M.D., Ph.D., Dana-Farber’s Chief Scientific Officer and a co-author of the paper. “It highlights the fact there’s a lot of work to be done before this can be considered a standard approach in oncology.”

The senior author of the study is Jane Weeks, M.D., MSc, of Dana-Farber; additional authors include Angel Cronin, MS, of Dana-Farber and Katherine Hicks-Courant, BA, of the University of Massachusetts Medical School.

The research was supported by the Dana-Farber Cancer Institute. Dr. Gray also receives support from the American Cancer Society (120529-MRSG-11-006-01-CPPB) and the National Human Genome Research Institute (U01HG006492)

Pursuant to a new phase of Profile, initiated by Dana-Farber in 2013, a more advanced technology platform (called “OncoPanel“) utilizes “massively parallel” or “next-generation” sequencing to read the genetic code of approximately 300 genes in each patient’s tumor sample. “Massively parallel” refers to the technology’s capacity for sequencing large numbers of genes simultaneously. The 300 genes evaluated in connection with the OncoPanel were chosen because they have been implicated in a variety of cancers.

In addition to the complete DNA sequencing of more than 300 genomic regions to detect known and unknown cancer-related mutations, the OncoPanel technology can also examine those regions for gains and losses of DNA sequences and rearrangements of DNA on chromosomes. The results are entered into a database for research purposes, but, if a patient agrees, the clinically important findings can also be returned to their doctor for use in the clinic.

The OncoPanel advanced sequencing platform is an important update to Dana-Farber’s original OncoMap platform. OncoPanel can detect not only commonly known gene mutations, but also other critical types of cancer-related DNA alterations not previously identified. In contrast, OncoMap was limited to screening for known cancer-related gene mutations. The OncoPanel testing is done at the Center for Advanced Molecular Diagnostics, a CLIA-certified laboratory operated by the Department of Pathology at Brigham and Women’s Hospital.

References:

1./ Gray SW, et al. Original Reports – Health Services and OutcomesPhysicians’ Attitudes About Multiplex Tumor Genomic TestingJ. Clin. Oncol., published online before print on March 24, 2014, doi:10.1200/JCO.2013.52.4298.

2./ Hall MJ. Conflicted Confidence: Academic Oncologists’ Views on Multiplex Tumor Genomic Testing. J. Clin. Oncol. Editorial, published online before print March 24, 2014, doi:10.1200/JCO.2013.54.8016

 

2010-2011 U.S. News & World Report “Best Hospitals” List

This week, U.S. News & World Report issued its 2010-2011 rankings of the best U.S. hospitals for adults. The University of Texas, M.D. Anderson Cancer Center is rated #1 in cancer treatment, and Johns Hopkins is rated #1 in gynecology and #1 overall based upon all medical specialties.

If you would like more information regarding the 2010-2011 U.S. News & World Report best U.S. hospital rankings, click here. To better understand how U.S. News & World Report ranked the hospitals in each specialty, read Best Hospitals 2010-11: The Methodology, written by U.S. News & World Report’s Avery Comarow.  If you would like to review the current U.S. News & World Report America’s Best Children’s Hospitals list, click here.

Top 10 U.S. Hospitals: Cancer

Top 10 U.S. Hospitals: Gynecology

Top 10 U.S. Hospitals (highest scores in at least six medical specialties)
1. Univ. of Texas M.D. Anderson Cancer Center, Houston, Texas Johns Hopkins Hospital, Baltimore, Maryland Johns Hopkins Hospital, Baltimore, Maryland
2. Memorial Sloan-Kettering Cancer Center, New York, New York Mayo Clinic, Rochester, Minnesota Mayo Clinic, Rochester, Minnesota
3. Mayo Clinic, Rochester, Minnesota Brigham and Women’s Hospital,Boston, Massachusetts Massachusetts General Hospital, Boston, Massachusetts
4. Johns Hopkins Hospital, Baltimore, Maryland Cleveland Clinic, Cleveland, OH Cleveland Clinic, Cleveland, Ohio
5. University of Washington Medical Center, Seattle, Washington Massachusetts General Hospital, Boston, Massachusetts Ronald Reagan UCLA Medical Center, Los Angeles
6. Dana-Farber Cancer Institute, Boston, Massachusetts Magee-Womens Hospital of Univ. of Pittsburgh Medical Center, Pittsburgh, Pennsylvania New York-Presbyterian Univ. Hospital of Columbia & Cornell, New York, New York
7. Massachusetts General Hospital, Boston, Massachusetts Duke University Medical Center, Durham, North Carolina Univ. of California, San Francisco (UCSF) Medical Center
8. Univ. of California, San Francisco (UCSF) Medical Center Univ. of California, San Francisco (UCSF) Medical Center Barnes-Jewish Hospital/Washington University, St. Louis
9. Cleveland Clinic, Cleveland, Ohio New York-Presbyterian Univ. Hospital of Columbia & Cornell, New York, New York Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
10. Ronald Reagan UCLA Medical Center, Los Angeles Memorial Sloan-Kettering Cancer Center, New York, New York Duke University Medical Center, Durham, North Carolina

MAGP2 Gene Expression Signature: A Potential Ovarian Cancer Personalized Treatment Target

A multi-institutional study has identified a potential personalized treatment target for the most common form of ovarian cancer. In the December 8 issue of Cancer Cell, the research team describes finding that a gene called MAGP2 – not previously associated with any type of cancer – was overexpressed in papillary serous ovarian tumors of patients who died more quickly. They also found evidence suggesting possible mechanisms by which MAGP2 may promote tumor growth.

A multi-institutional study has identified a potential personalized treatment target for the most common form of ovarian cancer. In the December 8 issue of Cancer Cell, the research team describes finding that a gene called MAGP2 (microfibril-associated glycoprotein 2) – not previously associated with any type of cancer – was overexpressed in papillary serous ovarian tumors of patients who died more quickly. They also found evidence suggesting possible mechanisms by which MAGP2 may promote tumor growth.

Michael Birrer, MD, Ph.D., Professor, Department of Medicine, Harvard Medical School; Director GYN/Medical Oncology, Medicine, Massachusetts General Hospital

“Ovarian cancer is typically diagnosed at an advanced stage when it is incurable, and the same treatments have been used for virtually all patients,” says Michael Birrer, MD, PhD, director of medical gynecologic oncology in the Massachusetts General Hospital (MGH) Cancer Center, and the study’s corresponding author. “Previous research from my lab indicated that different types and grades of ovarian tumors should be treated differently, and this paper now shows that even papillary serous tumors have differences that impact patient prognosis.” Birrer was with the National Institutes of Health when this study began but later joined the MGH Cancer Center.

The fifth most common malignancy among U.S. women, ovarian cancer is expected to cause approximately 15,000 deaths during 2009. Accounting for 60 percent of ovarian cancers, papillary serous tumors are typically diagnosed after spreading beyond the ovaries. The tumors typically return after initial treatment with surgery and chemotherapy, but while some patients die a few months after diagnosis, others may survive five years or longer while receiving treatment.

To search for genes expressed at different levels in ovarian cancer patients with different survival histories, which could be targets for new treatments, the researchers conducted whole-genome profiling of tissue samples that had been microdissected – reducing the presence of non-tumor cells – from 53 advanced papillary serous ovarian cancer tumors. Of 16 genes that appeared to have tumor-associated expression levels, MAGP2 had the strongest correlation with reduced patient survival.

Further analysis confirmed that MAGP2 expression was elevated in another group of malignant ovarian cancer tumors but not in normal tissue. MAGP2 gene expression was also reduced in patients whose tumors responded to chemotherapy. Recombinant expression of MAGP2 in samples of the endothelial cells that line blood vessels caused the cells to migrate and invade normal tissue.  In addition, MAGP2 gene overexpression increased microvessel density — a measurement used to determine the extent of tumor angiogenesis. The latter two observations suggest a potential role for MAGP2 gene overexpression in the growth of an ovarian cancer tumor’s blood supply.

“By confirming that different ovarian tumors have distinctive gene signatures that can predict patient prognosis, this study marks the beginning of individualized care for ovarian cancer,” says Birrer, a professor of Medicine at Harvard Medical School. “MAGP2 and the biochemical pathways it contributes to are definitely targets for new types of therapies, and we plan to pursue several strategies to interfere with tumor-associated pathways. But first we need to validate these findings in samples from patients treated in clinical trials.”

About The Study

Co-lead authors of the Cancer Cell paper are Samuel Mok, M.D., M.D. Anderson Cancer Center, and Tomas Bonome, National Cancer Institute (NCI). Additional co-authors are Kwong-Kowk Wong, M.D. Anderson; Vinod Vathipadiekal, Aaron Bell, Howard Donninger, Laurent Ozbun, Goli Samimi, John Brady, Mike Randonovich, Cindy Pise-Masison, and Carl Barrett, NCI; Michael Johnson, Dong-Choon Park, William Welch and Ross Berkowitz, Brigham and Women’s Hospital; Ke Hao and Wing Wong, Harvard School of Public Health; and Daniel Yip, University of South Florida. The study was supported by grants from the National Institutes of Health, the Ovarian Cancer Research Fund and the National Cancer Institute.

About Massachusetts General Hospital

Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $600 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, systems biology, transplantation biology and photomedicine.

Sources:

2009-2010 U.S. News & World Report Best U.S. Hospital Rankings

Today, U.S. News & World Report issued its 2009-2010 rankings of the best U.S. hospitals for adults. The University of Texas, M.D. Anderson Cancer Center is rated #1 in cancer treatment; Brigham and Women’s Hospital is rated #1 in gynecology; and Johns Hopkins is rated #1 overall based upon all medical specialties.

If you would like more information regarding the 2009-2010 U.S. News & World Report best U.S. hospital rankings, click here. To better understand how U.S. News & World Report ranked the hospitals in each specialty, read America’s Best Hospitals: Here’s How We Selected Them – Deaths, reputation, and patient safety were among the factors the rankings took into account, written by U.S. News & World Report’s Avery Comarow.  If you would like to review the current U.S. News & World Report America’s Best Children’s Hospitals list, click here.

Top 10 U.S. Hospitals: Cancer

Top 10 U.S. Hospitals: Gynecology

Top 10 U.S. Hospitals (highest scores in at least six medical specialties)

1. Univ. of Texas M.D. Anderson Cancer Center, Houston, Texas Brigham and Women’s Hospital, Boston, Massachusetts Johns Hopkins Hospital, Baltimore, Maryland
2. Memorial Sloan-Kettering Cancer Center, New York, New York Johns Hopkins Hospital, Baltimore, Maryland Mayo Clinic, Rochester, Minnesota
3. Johns Hopkins Hospital, Baltimore, Maryland Mayo Clinic, Rochester, Minnesota Ronald Reagan UCLA Medical Center, Los Angeles
4. Mayo Clinic, Rochester, Minnesota Duke University Medical Center, Durham, North Carolina Cleveland Clinic, Cleveland, Ohio
5. Dana-Farber Cancer Institute, Boston, Massachusetts Univ. of California, San Francisco (UCSF) Medical Center Massachusetts General Hospital, Boston, Massachusetts
6. University of Washington Medical Center, Seattle, Washington Cleveland Clinic, Cleveland, Ohio New York-Presbyterian Univ. Hospital of Columbia & Cornell, New York, New York
7. Massachusetts General Hospital, Boston, Massachusetts Magee-Womens Hospital of Univ. of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Univ. of California, San Francisco (UCSF) Medical Center
8. Univ. of California, San Francisco (UCSF) Medical Center New York-Presbyterian Univ. Hospital of Columbia & Cornell, New York, New York Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
9. Duke University Medical Center, Durham, North Carolina Massachusetts General Hospital, Boston, Massachusetts Barnes-Jewish Hospital/Washington University, St. Louis
10. Stanford Hospital and Clinics, Stanford, California Ronald Reagan UCLA Medical Center, Los Angeles Brigham and Women’s Hospital, Boston, Massachusetts

Patty Franchi Flaherty Loses Battle to Ovarian Cancer, But Deserves a Long Standing Ovation

It is with deep regret that I must inform you that, Patty Franchi Flaherty, founder of the nonprofit organization Ovations for the Cure of Ovarian Cancer, peacefully succumbed to her nine-year battle with the disease on August 18, 2008, surrounded by friends and family. She was 53 years old. Patty was a legendary ovarian cancer advocate, who spoke for ovarian cancer survivors that lacked a voice. Inspired by the death of her mother from ovarian cancer nearly 35 years ago and driven by her personal struggle, she founded the Natick-based nonprofit Ovations for the Cure in 2005. The organization has since comforted countless women and donated over $1 million to various ovarian cancer research programs at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital, including the world-renowned Desensitization Program, through fundraising programs such as the annual Stuart Weitzman Fashion Show.

It is with deep regret that I must inform you that, Patty Franchi Flaherty, founder of the nonprofit organization Ovations for the Cure of Ovarian Cancer (Ovations For the Cure), peacefully succumbed to her nine-year battle with the disease on August 18, 2008, surrounded by friends and family. She was 53 years old. Patty was a legendary ovarian cancer advocate, who spoke for ovarian cancer survivors that lacked a voice.

Inspired by the death of her mother from ovarian cancer nearly 35 years ago and driven by her personal struggle, she founded the Natick-based nonprofit Ovations for the Cure in 2005. The organization has since comforted countless women and donated over $1 million to various ovarian cancer research programs at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital, including the world-renowned Desensitization Program, through fundraising programs such as the annual Stuart Weitzman Fashion Show.

We provide below a bylined article about Patty Franchi Flaherty that was graciously provided to us by Ovations For the Cure. If you would like to learn more about the warnings signs and symptoms of ovarian cancer, CLICK HERE (Ovarian Cancer Symptoms Consensus Statement (Adobe Reader PDF Document)

“Patty Franchi Flaherty loses battle to ovarian cancer

Patty Franchi Flaherty, Founder of Ovations For the Cure of Ovarian Cancer (February 26, 1955 – August 18, 2008)

Patty Franchi Flaherty, Founder of Ovations For the Cure of Ovarian Cancer (February 26, 1955 – August 18, 2008)

Natick, MA (August 19, 2008) – Patty Franchi Flaherty, Founder and President of Ovations for the Cure, lost her courageous 9-year battle with ovarian cancer and died peacefully at home on August 18, 2008, surrounded by family and friends.

Patty was a native of Weston who graduated from Bentley College in Waltham. Afterward, she joined Natick-based Franchi Management Company, Inc., where she worked as General Manager for over 30 years overseeing all business operations. She was also a long-standing trustee at Boston’s Dana-Farber Cancer Institute.

Diagnosed with ovarian cancer in early 1999, Patty lived 9 years before succumbing to the same disease that took her mother Madeline’s life 25 years earlier. After a promising remission, the cancer resurfaced in 2005. Frustrated by how little ovarian cancer diagnosis and treatment had changed in a quarter-century, Patty was certain that she wasn’t alone in her fight with ovarian cancer or in her frustration over medical insufficiencies. She was determined to help improve the odds for all ovarian cancer patients.

In early 2006, Patty co-hosted the Stuart Weitzman Fashion Show and Luncheon as a fundraiser. Proceeds from the show helped fund the Madeline Franchi Ovarian Cancer Research Fund at the Dana-Farber Cancer Institute. Then, with the help and support of her dearest friends, Patty launched a non-profit organization called Ovations for the Cure to fuel other research initiatives around the country and actively change the face of ovarian cancer.

In the 9 years she lived with ovarian cancer, Patty Franchi Flaherty turned a very personal crusade into a meaningful legacy for all women facing the disease. Thanks to Patty, women can now share information the likes of which her mother never had, and have hope where before there had been none. In just over 3 years’ time, Patty led Ovations’ growth from a lingering idea to a thriving organization-with momentum that continues to build across North America.

In July of 2008, The Savings Bank Life Insurance Company of Massachusetts awarded Patty its highest community honor, the prestigious Brandeis Award, which Patty’s husband Paul accepted on her behalf. The award pays homage to [U.S. Supreme Court] Justice Louis Brandeis and his defense of the rights of individuals, and was given to Patty in recognition of her innovation, bravery, and commitment to furthering the research and awareness of ovarian cancer.

Known for her unshakable determination, Patty turned her mission to beat ovarian cancer into a nationwide entity. In so doing, she created a living legacy of hope for everyone who faces the disease. Patty’s personal contributions to the fight against ovarian cancer have earned her a champion’s status in the hearts of those she has forever touched.

Creating a brighter future

Compared with other diseases making headlines today, ovarian cancer is far from attention-grabbing. Its foremost symptoms are so common and nonspecific that they are often mistaken for something else, if not ignored. Meanwhile, early detection methods are still in their infancy and late-stage diagnosis makes for only a limited number of successfully treated patients. Perhaps most surprisingly, ovarian cancer has the highest mortality rate of all gynecologic cancers.

Contributing to the high mortality rates of ovarian cancer is the lack of accurate screening and clear symptoms. As a result, only 19 percent of cases are detected before the cancer has spread beyond the ovaries, when treatment options are limited.

‘Ovarian cancer is often misunderstood, misinterpreted, and unfortunately misdiagnosed,’ said Dr. Ursula Matulonis, attending physician at Dana-Farber Cancer Institute and Brigham and Women’s Hospital and medical advisor to Ovations for the Cure.

‘In an effort to overcome this silent killer, Ovations for the Cure is dedicated to supporting cancer research centers to find accurate and early detection screenings. If caught in the early stages of diagnosis, ovarian cancer patients have a 90 percent chance of survival beyond five years and increased odds of beating the disease,’ Matulonis added. ‘Ovations for the Cure has helped change the dynamics of the medical profession by contributing valuable research funds for detection and treatment while educating women on its subtle symptoms.’

Today, Ovations continues to help make miracles possible for all women with ovarian cancer by shedding light on a disease that is still full of darkness. They have launched an aggressive ovarian cancer educational program, distributing awareness brochures to more than 3,000 physicians’ offices across the nation. Additionally, the development of their television and radio public service announcements outlining ovarian cancer symptoms has helped women identify the disease before it spreads to advanced stages. By spring of 2008, Ovations had already dedicated nearly one million dollars to ovarian cancer initiatives through the Dana-Farber Cancer Institute, Brigham and Women’s Hospital, City of Hope Hospital in L.A., and the University of Pennsylvania.

From loss to legacy

‘Patty started Ovations for the Cure with the idea of saving women from this horrible disease,’ said Debbie Soprano, one of Patty’s closest friends and first Executive Director of Ovations for the Cure. ‘While she could not save herself, her everlasting optimism and spirit will forever lead the fight against ovarian cancer until we find a cure.’

Patty Franchi Flaherty may have lost her own battle against ovarian cancer, yet through Ovations for the Cure, she’ll continue to help thousands of women to win the war. For more information about ovarian cancer visit www.ovationsforthecure.org”

About Ovations for the Cure

The Ovations for the Cure Foundation, a 501(c)(3) non-profit organization, is dedicated to the relentless pursuit of a cure for ovarian cancer. Ovations for the Cure has donated over $1 million to various ovarian cancer research initiatives such as the Dana-Farber Cancer Institute, Children’s Hospital Boston, City of Hope, University of Pennsylvania, and Brigham and Women’s Hospital. The Foundation spreads awareness of the most deadly gynecological disease through national events including the renowned Happy Feet Program, fashion shows with celebrity designers Stuart Weitzman and Carmen Marc Valvo, regional golf outings, 5k runs/walks, and various other initiatives. For more information about Ovations, please visit www.ovationsforthecure.org.

“I’m Strongs to the Finish, ‘Cause I Eats Me Spinach”* — Popeye May Have It Right When It Comes to Ovarian Cancer Prevention

Brigham and Women’s Study Finds Eating a Flavonoid-Rich Diet Helps Women Decrease Risk of Ovarian Cancer –Findings from the Nurses’ Health Study

Boston, MA – New research out of the Channing Laboratory at Brigham and Women’s Hospital (BWH) reports that frequent consumption of foods containing the flavonoid kaempferol, including non-herbal tea and broccoli, was associated with a reduced risk of ovarian cancer. The researchers also found a decreased risk in women who consumed large amounts of the flavonoid luteolin, which is found in foods such as carrots, peppers and cabbage. These findings appear in the November 15, 2007 issue of the International Journal of Cancer.

‘This is good news because there are few lifestyle factors known to reduce a woman’s risk of ovarian cancer,’ said first author Margaret Gates, ScD, who is a research fellow at BWH. “Although additional research is needed, these findings suggest that consuming a diet rich in flavonoids may be protective.”

The causes of ovarian cancer are not well understood. What is known is the earlier the disease is found and treated, the better the chance for recovery; however, the majority of cases are diagnosed at an advanced (metastasized) stage after the cancer has spread beyond the ovaries. According to the National Cancer Institute, the 5-year relative survival rate for women diagnosed with localized ovarian cancer is 92.4 percent. Unfortunately, this number drops to 29.8 percent if the cancer has already metastasized.

In this first prospective study to look at the association between these flavonoids and ovarian cancer risk, Gates and colleagues calculated intake of the flavonoids myricetin, kaempferol, quercetin, luteolin and apigenin among 66,940 women enrolled in the Nurses’ Health Study. In this population, 347 cases of epithelial ovarian cancer were diagnosed between 1984 and 2002.

Although total intake of these five common dietary flavonoids was not clearly beneficial, the researchers found a 40 percent reduction in ovarian cancer risk among the women with the highest kaempferol intake, compared to women with the lowest intake. They also found a 34 percent reduction in the risk of ovarian cancer among women with the highest intake of luteolin, compared to women with the lowest intake.

‘In this population of women, consumption of non-herbal tea and broccoli provided the best defense against ovarian cancer,’ concluded Gates, who is also a research fellow at the Harvard School of Public Health. ‘Other flavonoid-rich foods, such as onions, beans and kale, may also decrease ovarian cancer risk, but the number of women who frequently consumed these foods was not large enough to clearly evaluate these associations. More research is needed.’

The National Cancer Institute funded this research.”

[Quoted Source: “Brigham and Women’s Study Finds Eating a Flavonoid-Rich Diet Helps Women Decrease Risk of Ovarian Cancer — Findings from the Nurses’ Health Study,” Brigham and Women’s Hospital Press Release, dated November 13, 2007 (citing findings from “A prospective study of dietary flavonoid intake and incidence of epithelial ovarian cancer;” Gates, M.A. et. al.; International Journal of Cancer, Volume 121, Issue 10, Pages 2225 – 2232 (November 15, 2007))].

Comment: In addition to spinach, foods richest in kaempferol include tea (nonherbal), onions, curly kale, leeks, broccoli, and blueberries.

* In 1933, Max and Dave Fleischer’s Fleischer Studios adapted Thimble Theatre characters into a series of Popeye the Sailor theatrical cartoon shorts for Paramount Pictures. These cartoons proved to be among the most popular of the 1930s, and the Fleischers-and later Paramount’s own Famous Studios-continued production through 1957. Since then, Popeye has appeared in comic books, television cartoons, a 1980 live-action film (Popeye, directed by Robert Altman), arcade and video games, and hundreds of advertisements and peripheral products.

Early references to spinach in the Fleischer cartoons and subsequently in further stories of Popeye are attributed to the publication of a study which, because of a misprint, attributed to spinach ten times its actual iron content. The error was discovered in the 1930s but not widely publicized until T.J. Hamblin wrote about it in the British Medical Journal in 1981. Until that time, the popularity of Popeye helped boost sales of the leafy vegetable 33% in the U.S.