Tag Archives: ovarian cancer

Who? Where? Two of the Most Important Choices When Facing An Ovarian Cancer Diagnosis.

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Robert Bristow, M.D., Director of the Kelly Gynecologic Oncology Service and the Johns Hopkins Ovarian Cancer Center of Excellence, and colleagues highlight the importance of referring patients with suspected ovarian cancer to expert centers for their first surgery. By combining multiple studies of patients with stage III or IV ovarian carcinoma (6,885 patients) Bristow et al showed that consistent referral of patients with apparent advanced ovarian cancer to expert centers for primary surgery may be the best means currently available for improving overall survival. Even with the use of platinum based chemotherapy, maximal (or optimal or complete) cytoreduction was one of the most powerful determinants of cohort survival among patients with stage III or IV ovarian carcinoma. While the influence of platinum dose-intensity upon survival was not statistically significant, maximal cytoreduction was associated with a 50% increase of actuarial survival.

PubMed medical study abstract: “Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis,”Bristow, R.E., Tomacruz, R.S., Armstrong, D.K., Trimble, E.L., Montz, F.J., Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, MD 21287-1248, USA. rbristo@jhmi.edu, J. Clin. Oncol. 2002 Mar 1;20(5):1248-59.

Full Text of medical study: Journal of Clinical Oncology, Vol. 20, Issue 5 (March), 2002: pp.1248-1259.

Additional medical studies:

COMMENT: If you were recently diagnosed with ovarian cancer, these studies suggest that you should seek treatment from a medical institution(s) that (i) utilizes Gynecologic Oncologists as an essential part of the cancer diagnosis and treatment process, (ii) utilizes surgeons that possess high-end expertise with respect to gynecologic oncology surgical procedures such as maximum cytoreduction (e.g., gynecologic oncology surgeons), and (iii) conducts a high volume of gynecologic oncology surgeries and procedures resulting in best outcome. Refer to the resources below.

Advanced-stage Ovarian Cancer Patients With BRCA Live Longer, May Respond Better To Standard Treatment

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“Two abstracts underscoring the importance of testing for BRCA1/2 mutations in women with ovarian cancer were presented at this week’s Society of Gynecologic Oncologists 39th Annual Meeting on Women’s Cancers, by researchers from The University of Texas M. D. Anderson Cancer Center.

In the first study, a multicenter research team led by M. D. Anderson found advanced- stage ovarian cancer patients with non-Ashkenazi Jewish BRCA (non-AJ BRCA) mutations experience longer progression-free and overall survival rates compared to those with sporadic ovarian cancer. The data confirms previous research which reported that among ovarian cancer patients of Ashkenazi-Jewish heritage, BRCA1/2 mutations (AJ BRCA) are associated improved long-term survival.

For this study, researchers examined 85 advanced-stage ovarian cancer patients with non-AJ BRCA mutations and 116 patients who did not express any type of BRCA mutation. Compared to patients without BRCA mutations, non-AJ BRCA carriers had longer progression-free survival of 19.0 vs. 27.8 months and improved overall survival of 65.6 vs. 101.4 months. Non-AJ BRCA patients had a 2.15 times greater odds of complete response to initial chemotherapy response over sporadic, non-carrier patients.

Karen Lu, M.D., associate professor in the Department of Gynecologic Oncology at M. D. Anderson and senior author on the study said the difference in survival rates indicate that individuals with BRCA mutations might respond better to standard chemotherapy for ovarian cancer. ‘Thus, it becomes increasingly valuable to know a patient’s BRCA status to guide and personalize treatment decisions,’ Lu said.

Majority of Patients Unaware BRCA Testing Available
A second study conducted at M. D. Anderson concluded that, despite being available for more than 10 years, a majority of women with ovarian cancer were unaware genetic counseling and testing for BRCA1/2 mutations was an option. Of the 225 ovarian cancer patients surveyed, 56 percent had not heard of BRCA testing. This lack of awareness was more profound in minorities – 69 percent of Hispanic and 88 percent of African American respondents were unaware of BRCA testing compared to 52 percent of white women.

Patients typically associate genetic testing with benefiting family members and offspring,’ Lu said. ‘Both of these studies illustrate that it is equally important for the cancer patient to get information from their doctors about genetic testing because it not only has implications for their family, but their own treatment and prognosis.’

She said that more than 85 percent of ovarian cancer patients surveyed would be willing to undergo BRCA testing if it would affect their care, but the cost of testing may be a barrier. ‘Currently, oncologists are inconsistent in their testing for BRCA mutations. Based on the treatment implications of our findings and the surprisingly low knowledge that such testing is available, we recommend developing ways to systematically evaluate every ovarian cancer patient for BRCA,’ Lu said.

A family history of breast and/or ovarian cancer is reported in approximately five percent to 15 percent of ovarian cancer cases, with BRCA1/2 mutations expressed in a significant proportion of these cases. …”

Quoted Source: [“Advanced-stage Ovarian Cancer Patients With BRCA Live Longer, May Respond Better To Standard Treatment,” M.D. Anderson News Release, dated March 10, 2008.] See also Survival in advanced-stage ovarian cancer patients with non-Ashkenazi Jewish BRCA mutations, Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement), 2007: Abstract #5514.

Comment: Both studies illustrate the importance of obtaining genetic testing information from your doctor. This information is important for your family and relatives and your own treatment and prognosis.

SNS-595 Shows Promise For Platinum-Resistant Ovarian Cancer Patients

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“Sunesis Pharmaceuticals, Inc. (Nasdaq: SNSS), a clinical-stage biopharmaceutical company focused on the discovery, development and commercialization of novel small-molecule therapeutics, announced positive interim data from the company’s ongoing Phase 2 clinical trial of its lead product candidate, SNS-595, in platinum-resistant ovarian cancer patients.

In this Phase 2 clinical trial, single agent SNS-595 has demonstrated disease control (defined as stable disease, partial response or complete response) in 31 of 35 patients evaluable for best response using GOG-RECIST criteria. Of these 31 patients, one patient had a complete response, four patients had partial responses (two unconfirmed) and 26 patients had a best response of stable disease. All patients enrolled in the trial have previously failed treatment with platinum-containing regimens, and fourteen of the 35 patients have also failed prior treatment with doxorubicin HCl liposome injection (Doxil(R)). Both platinum-resistant and Doxil-resistant patients in the Phase 2 clinical trial have responded to SNS-595 therapy.

‘Recurrence rates among ovarian cancer patients remain high, and the majority of refractory patients are resistant to platinum-based therapies. Based on these interim data, SNS-595 appears to be a promising, active agent in a difficult-to-treat ovarian cancer patient population,’ said William P. McGuire, M.D., Medical Director of the Harry and Jeanette Weinberg Cancer Institute at Franklin, and a lead investigator for the Phase 2 trial.

Among forty-five patients with sufficient follow-up to yield safety data, SNS-595 was generally well tolerated at a dose level of 48mg/m2 administered once every three weeks. The most common adverse events reported thus far include nausea, fatigue, vomiting and alopecia. There was a low rate of febrile neutropenia or other Grade 3/4 adverse events, and manageable Grade 1/2 nausea or vomiting.

Based on the indications of clinical activity and the acceptable tolerability profile demonstrated to date among this patient population, the dose of SNS-595 in this trial has been increased to 60 mg/m2 over twenty-eight days. Patient accrual at this dose level is ongoing.

‘We are pleased by the strong signal of activity emerging from our Phase 2 clinical trial of SNS-595 at the 48mg/m2 dose level. Based on the drug’s observed safety profile and recommendations from advisors, we are exploring a higher dose of SNS-595 in this trial. Enrollment has begun at 60 mg/m2 and we expect to enroll approximately 30 patients at this dose by the third quarter of this year,’ said Daniel C. Adelman, M.D., Senior Vice President, Development and Chief Medical Officer of Sunesis. ‘Enthusiasm for SNS-595 among our clinical investigators is growing and enrollment in this trial has been accelerating. We expect to present further data from this Phase 2 clinical trial this year.’

The interim clinical results are being presented in a poster, “A Phase 2 Trial of SNS-595 in Women with Platinum-Refractory Epithelial Ovarian Cancer” (Abstract # 290), at the 39th Annual Meeting on Women’s Cancer hosted by the Society of Gynecologic Oncologists (SGO) in Tampa, Fla. through March 12, 2008.”

About SNS-595

SNS-595 is a novel naphthyridine analog, structurally related to quinolones, a class of compounds which has not been used previously for the treatment of cancer. SNS-595 is a specific DNA intercalator and topoisomerase II poison, causing replication-dependent site-selective double strand DNA damage, irreversible G2 arrest and rapid apoptosis. In non-clinical evaluations, SNS-595 demonstrates broad and potent activity in xenograft, syngeneic and drug-resistant models. In addition to the Phase 2 clinical trial in ovarian cancer patients, SNS-595 is currently being evaluated in combination with cytarabine in a Phase 1b acute leukemia clinical trial. In clinical trials conducted to date, SNS-595 has been generally well tolerated and has shown objective responses in both solid and hematologic tumor types.”

Quoted Source: [“Sunesis Pharmaceuticals Reports Positive Interim Data for SNS-595 Single-Agent Activity in Platinum-Resistant Ovarian Cancer”, MedicalNewsToday.com, March 11, 2008. (Emphasis added by posting author)].

Updates:

Yale Blood Test Detects Early Stage Ovarian Cancer With 99% Accuracy

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“Researchers at Yale School of Medicine have developed a blood test with enough sensitivity and specificity to detect early stage ovarian cancer with 99 percent accuracy.Results of this new study are published in the February 15 issue of the journal Clinical Cancer Research. The results build on work done by the same Yale group in 2005 showing 95 percent effectiveness of a blood test using four proteins.

‘The ability to recognize almost 100 percent of new tumors will have a major impact on the high death rates of this cancer,’ said lead author Gil Mor, M.D., associate professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale. ‘We hope this test will become the standard of care for women having routine examinations.’

Epithelial ovarian cancer is the leading cause of gynecologic cancer deaths in the United States and three times more lethal than breast cancer. It is usually not diagnosed until its advanced stages and has come to be known as the “silent killer.”

This new phase II clinical trial included 500 patients; 350 healthy controls and 150 ovarian cancer patients. Mor and colleagues validated the previous research and used a new platform called multiplex technology to simplify the test into one single reaction using very small amounts of serum from the blood. The new platform uses six protein biomarkers instead of four, increasing the specificity of the test from 95 to 99.4 percent. The team looked for the presence of specific proteins and quantified the concentration of those proteins in the blood.

The Early Detection Research Network (EDRN) of the National Cancer Institute (NCI) independently evaluated the results of the test.

‘This is the most sensitive and specific test currently available,’ said Mor. ‘Previous tests recognized 15 to 20 percent of new tumors. Proteins from the tumors were the only biomarkers used to test for ovarian cancer. That is okay when you have big masses of tumors, but it is not applicable in very early phases of the tumor. Testing the proteins produced by the body in response to the presence of the tumor as well as the proteins the tumors produce, helped us to create a unique picture that can detect early ovarian cancer.’

Mor and colleagues have begun a phase III evaluation in a multi-center clinical trial. In collaboration with EDRN/NCI and Laboratories Corporation of America (LabCorp), they are testing close to 2,000 patients.

The test is available at Yale through the Discovery to Cure program. Yale has licensed the test to three companies: Lab Corp in the United States, Teva in Israel and SurExam in China.”

Quoted Source: [Yale University Press Release entitled, “Yale Test Detects Early Stage Ovarian Cancer With 99% Accuracy,” dated February 13, 2008 (citing source as Clinical Cancer Research Journal 14 (4) February 15, 2008.) ]

There Is Always Hope — Just Ask Sean Swarner!

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Sean Swarner’s ESPN Segment


“CLIMB EVERY MOUNTAIN IN LIFE,” by Sean Swarner.

“I’m actually the first (and only) cancer survivor to summit the world’s highest mountain … Mt. Everest. When I was only 13, I was diagnosed with Hodgkin’s disease and given three months to live. When I was 15, I was diagnosed with Askin’s Sarcoma. The prognosis was much worse as the doctors gave me only two weeks to live. Again, I survived. …

Being the only person in the world to have ever had these two cancers, I really felt I should share my story to help motivate others and influence lives. On May 16th, 2002 at 9:32am, I became the first cancer survivor to summit Mt. Everest.

Since then, I have been lucky enough to reach the summits of three more of the world’s seven highest peaks and have spoken internationally about my life and adventures to countless people and organizations. On the summit of Everest I brought a flag adorned with names of people who have been affected by cancer and left it on the top of the world forever commemorating the struggle of cancer patients worldwide.

I did the same to the highest point in Africa, Europe and just recently returned from 23,000-foot Aconcagua in South America! My ultimate goal is to climb the highest mountain on each continent AND trek to the North and South poles.

… The reason for these expeditions is to inspire those affected by cancer (as well as anyone with a pulse!) to dream big and never give up. ”

Sean Swarner was the recipient of the “Don’t Ever Give Up Award” presented by the Jimmy V Foundation and ESPN in 2007. Sean told ESPN Radio’s Bob Valvano, brother of Jimmy, that he would have been more likely to win the lottery four or five times with the same numbers than to have survived both cancers.

Sean did survive and achieved this monumental feat with only one fully functioning lung due to removal of a golf ball sized tumor (and the lung in which it was embedded) as part of his Askin’s diagnosis. He graduated from high school in 1993. To date, Sean has climbed the “Seven Summits” of the world — the tallest mountain peaks located on each of the seven continents — and provides hope and inspiration to thousands if not millions of people living with cancer. Sean’s ultimate goal is to complete the “Explorer’s Grand Slam” — Seven Summits, North and South Geographical Poles and North and South Magnetic Poles. To date, only four other individuals accomplished this feat.

Sean established his own foundation known as “The Cancer Climber Association,” which promotes cancer awareness and helps raise money for cancer research. He also authored “Keep Climbing,” which is the title of his book that recounts his story and journey from the depths of his near death experience to the peaks that he climbed to reach the top of the world 17 years later.

If you were recently diagnosed with ovarian cancer, do not let anyone tell you that there is no hope. Just ask Sean Warner!