Gynecologic Cancers

This article represents the consensus opinion of an expert panel and may be used to inform clinical recommendations in vaginal cancer management.

An analysis of four randomized clinical trials from Europe shows that HPV-based screening resulted in a greater long-term protection from invasive cervical cancer compared with a Pap test.

As advances in treatment strategies continue to focus on individualization of therapy, the identification of disease subsets is crucial to strategizing optimal therapeutic approaches.

In this review, the results and limitations of studies concerning adjuvant radiation therapy and chemotherapy for endometrial cancer will be discussed, focusing on evidence that can help to guide treatment decisions.

Future directions, including nomograms, multi-modality approaches, and more individualized patient care based on genomic profiles, may help to tailor each endometrial cancer patient’s therapy to her individual risk.

Taking advantage of the copious amounts of data generated from The Cancer Genome Atlas (TCGA), researchers have created a comprehensive map of the viruses present in a wide range of cancer types.

Researchers have demonstrated that a two-step screening test can identify ovarian cancer early, before the disease progresses to an advanced, poor prognosis stage.

Using easy-to-obtain risk factors for breast, ovarian, and endometrial cancers, researchers have come up with models that can predict an individual woman’s absolute risk for developing each type of cancer.

Today we speak with Dr. Robert Coleman about several new agents that have shown promise in early-stage clinical trials for ovarian cancer.

The data on HE4 as a prognosticator in both ovarian and endometrial cancer constitute, at most, an interesting observation, but most likely they are simply a reflection of total tumor burden. There are certainly not enough data to justify making major treatment decisions in ovarian or endometrial cancer on the basis of absolute marker levels. Proteomics and genomics seem more likely to make a difference in this area.

While a prominent role for HE4 in these areas remains to be determined, this thorough review of HE4 demonstrates that the biomarker is complementary to, and occasionally more useful than, the widely used CA 125 in the management of gynecologic malignancies.

In this review, we discuss the discovery and biologic significance of HE4 and evaluate available evidence regarding the utility of HE4 as a biomarker for ovarian and endometrial cancer.

Although the combination of CA-125 and HE4 appears indicated for use in symptomatic patients or in patients with an adnexal mass, there is no evidence that it would be indicated as a screening test in asymptomatic patients.

Results from the phase III GOG 240 trial, presented at ASCO, showed the addition of bevacizumab (Avastin) to standard chemotherapy improved overall survival by nearly 4 months in women with advanced or relapsed cervical cancer.

Biennial visual inspection with acetic acid (vinegar) screening by trained public health workers significantly reduced cervical cancer mortality in a large cluster-randomized controlled trial conducted among thousands of women from poor neighborhoods in Mumbai, India.

Women diagnosed with endometrial cancer at age 50 or younger had a fourfold increased risk for a subsequent colorectal cancer diagnosis, according to a historical cohort study published recently in the Journal of Clinical Oncology.

Therapy for recurrent ovarian cancer is not curative, and presumed overall survival benefits of standard strategies are uncertain and often based on low-level evidence. Treatment toxicity and patient quality of life should be considered at all points during disease management.

It is important to help patients with recurrent ovarian cancer recognize and acknowledge when further therapy is likely to be futile. For some patients this might occur very early in their disease course, while for others it may be after many years of treatment.

Emerging therapies in the management of ovarian cancer have resulted in a shift in paradigm, including in the appropriate time to institute therapy, and in the selection of therapy. This review focuses on chemotherapy and emerging biologic agents that present a therapeutic option for patients with recurrent ovarian cancer.

A novel therapy has shown activity in the treatment of difficult-to-treat, advanced, platinum-resistant ovarian cancer. The drug, DMUC5754A, is part of a new class of drugs called antibody-drug conjugates.

In this interview we discuss HPV-associated cancers, which are on the rise, and the low vaccination coverage for HPV with Edgar Simard, PhD, MPH, senior epidemiologist of surveillance research, who studies the impact of prevention and screening on cancer incidence at the American Cancer Society.

A large collaborative sequencing study using data from the Cancer Genome Atlas shows basal-like breast cancers share similar genetic origins and features with serous ovarian tumors.

In updated guidelines, the USPSTF concludes that there is still no adequate evidence of a mortality benefit from routine ovarian cancer screening using transvaginal ultrasonography or CA-125 testing.

Researchers have found that tumors with multiple cancer genomes and the downregulation of the LRP1B gene are associated with chemotherapy resistance among patients with the high-grade serous ovarian cancer.

A new study finds that baseline testing for HPV can better predict long-term negative cervical cancer outcomes compared to a Pap smear.

Lori Smith addresses a side effect that affects 88 percent of women treated for cervical cancer with radiation: vaginal stenosis.

Lori Smith discusses the side effect of incontinence in women being treated for GYN malignancies.

A study published today details a scoring system that may predict which ovarian cancer patients responded to first-line platinum chemotherapy based on a DNA-repair pathway-focused score. The score is based on a gene expression profile of 23 DNA-repair genes that normally function to repair platinum-induced DNA damage.