Ovarian 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.

A single-center study analyzed the frequency of breast cancer susceptibility mutations among black women diagnosed with breast cancer. The findings suggest that broader genetic screening may be beneficial for these women. The study also suggests that family history is not the only criteria by which patients at risk for breast cancer can be identified.

Two genome-wide studies have identified a total of 12 new genetic loci associated with a higher risk of testicular cancer. The risk-associated genetic variations could help clinicians single out higher-risk men for screening and early detection.

I looked after one of my partner’s patients who is approaching death from advanced, refractory ovarian cancer. She asked me not to talk about anything negative with her. We can’t really make any decisions without discussing negative things. Should I just remain silent about them at her request?

Ongoing studies are attempting to understand the reasons that tumor cells engage in aerobic glycolysis in lieu of oxidative phosphorylation. In this review, we discuss known benefits to tumor cells from this metabolic switch, and we highlight key enzymes that play a role in aerobic glycolysis. We also describe novel therapeutic options targeting glucose metabolism.

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.

Different dosing schedules of the pan-AKT inhibitor AZD5363 revealed key details about maximum tolerable dosages, and biochemical efficacy was suggested by analyzing biomarkers, according to the results of a phase I study presented at the 2013 annual meeting of the American Association of Cancer Research.

A new agent, SAR245409, that simultaneous targets two pathways important for the growth of tumors--the PI3K/mTOR pathway and the MAPK pathway--has shown activity in advanced solid tumors, according to results from a phase I trial presented at the American Association for Cancer Research Annual Meeting.

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.

Risk factors for breast cancer can be parsed into genetic and biological factors, and environmental and lifestyle factors; and the general consensus is that screening and prevention strategies should be tailored based on an individual’s risk assessment.

Colorectal cancer patients testing positive for Lynch Syndrome on MSI and IHC were most likely to seek genetic counseling when contacted by a genetic counselor.

Work remains in the development of a clinically useful tumor classification system that includes molecular characterization of tumors, in our understanding of the implications of tumor heterogeneity, and in the development of more relevant and efficient clinical trials. Nonetheless, there is great excitement that a new era in the treatment of cancer is beginning.

This second article in our two-part series on targeted therapies in solid tumors covers the emergence of targeted therapies for the treatment of two common malignancies: lung cancer and breast cancer.

During the past decade, targeted therapeutics have changed the landscape of cancer therapy with bold brush strokes, but the resulting images are still unclear. As we enter into the second decade of targeted therapy, our increased understanding of tumor biology together with cancer genomic sequencing tools will clearly show the way forward. It is imperative that we use these fine brushes, not only to improve precision, but in the end to realize the art of medicine.

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.

The proposition that a consumer smartphone could somehow become part of the diagnostic toolkit of an oncologist may seem ridiculous. There are, however, many researchers and start-ups that would disagree.

Schrader and colleagues provide four compelling examples of the power of genetic testing to impact medical management for probands and their family members.

In this article, we use a case-based approach to focus on the hereditary aspects of the most common GI cancers, including pancreatic, gastric, and colon cancer.

In this review, we will present the current data on commercially available molecular profiling assays in breast cancer and discuss the challenges surrounding their incorporation into routine clinical practice as prognostic and predictive tools.

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.

Selumetinib, a small-molecule MEK inhibitor, controlled recurrent low-grade serous ovarian cancer in 81% of patients treated. Current first-line defense against this disease (surgery followed by cytotoxic chemotherapy) has met with limited success.

Researchers have identified a marker of DNA damage that may be able to predict a patient’s response to platinum-based chemotherapy agents such as cisplatin and carboplatin.

Following a large survey of more than 22,000 US women, researchers from H. Lee Moffitt Cancer Center, in Tampa, Florida, have concluded that a significant proportion of female cancer survivors have poor health behaviors, compared with women who have not had cancer.

This article reviews the trials that have been conducted with PARP inhibitors in epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer, and places the impact of those results in the larger context of PARP inhibitor development.

Four publications on cancer treatment during pregnancy were published last week in the journal Lancet, serving as new treatment guidelines for chemotherapy and surgery in pregnant patients with solid tumors and hematologic malignancies.

The development of poly(ADP-ribose) polymerase (PARP) inhibitors as a new class of anticancer agents has created a tremendous amount of hope in the ovarian cancer community, especially in the high-risk, difficult-to-screen, hereditary ovarian cancer population.