Ovarian Cancer

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.

Ovarian cancers account for more than 50% of gynecologic cancer deaths. This is attributable to the late stage of the disease at diagnosis.

Tanner et al provide a concise review of lung cancer screening, including discussion of past failed attempts, the success of the National Lung Screening Trial (NLST), and promising new avenues for improving on the NLST results.

A new study has made a step forward toward better characterization of sporadic ovarian tumors by identifying their DNA repair protein expression profile.

The past year in oncology was highlighted by the continuation of breakthroughs in targeted therapies-with new treatments receiving US Food and Drug Administration (FDA) approval for non–small-cell lung cancer (NSCLC), lymphoma, and melanoma.

Coffee is emerging as a protective agent against a number of diseases, including cancer. A study published last week shows that women who drank more than four cups of coffee per day cut their risk of endometrial cancer by 25% compared with those who drank less than one cup per day.

The US Food and Drug Administration announced today that it has revoked the approval of bevacizumab for breast cancer due to the potentially life-threatening side effects associated with the treatment. It was approved for metastatic breast cancer in February 2008, but data later showed that along with an increase in side effects, there was no increase in overall survival.

Breast and ovarian cancer patients with limited tumor burden and minimal prior chemotherapy appear to have benefited from a novel vaccine.

In September 2011, the US Food and Drug Administration (FDA) approved marketing of the HE4 Test (Fujirebio Diagnostics, Malvern, Pennsylvania) along with the CA-125 test in the Risk of Ovarian Malignancy Algorithm, called ROMA, to determine the likelihood of finding malignancy at surgery in premenopausal or postmenopausal women presenting with an ovarian adnexal mass.

Counseling women at high risk for ovarian and uterine cancer is a complex process, from genetic diagnosisto the management of at-risk women. Rimes andcolleagues have presented these challenging issues, andsuggested ways to manage them, very well.

Patient education and counseling are essential in women at increased risk for ovarian and endometrial cancer. Women must be educated regarding the signs, symptoms, and risks associated with these cancers.

The aim of this article is to review the preclinical data and rationale for PARP inhibitor use in the aforementioned settings, as well as the current status of the clinical development of these agents in the treatment of breast cancer, along with future directions for research in this field.

The mining of whole genomes from 656 Icelanders with ovarian cancer and the comparison of these genomes to 41,675 control genotyped Icelanders has led to the identification of 16 million sequence variants that were tested for their association to ovarian cancer, one of the deadliest forms of cancer among women.

The opening chapters in the investigation of poly(adenosine diphosphate [ADP]–ribose) polymerase (PARP) inhibitors as cancer therapeutics have been interpreted by some as a quantum leap forward in targeted and personalized medicine and by others as another example of disappointment following a flurry of promising preclinical and early clinical trials based on elegant biology.

Women with high-grade serous ovarian cancer who also harbor a BRCA2, but not a BRCA1 mutation tend to have a better chemotherapy response and overall survival compared with those patients who are BRCA wild type.

Dr. Josep Tabernero of the Vall D'Hebron University Hospital in Barcelona presented the positive results of the VELOUR study on Sunday September 25, including the newly presented pre-specified subgroup analysis. The primary endpoint results had been reported at the ESMO/WCGC meeting earlier this year.

To improve staging, debulking, and prognosis in cytoreductive surgery, researchers in the Netherlands and Germany have developed a fluorescence imaging technique to visualize ovarian tumors.

Highlight of the Importance of Translational Medicine in Ovarian Cancer

In spite of screening recommendations that now begin only at 50 years of age, breast cancer is often diagnosed in women under the age of 40, and there are specific challenges to management of the disease in this younger population.

A superior overall survival with pegylated liposomal doxorubicin (PLD, Doxil) given with trabectedin (T) compared to PLD monotherapy has been demonstrated for advanced, relapsed ovarian cancer.

This article focuses on the recent debate regarding when-or whether-patients with ovarian cancer should undergo aggressive surgical resection.

Whether advanced ovarian cancer should be treated with neoadjuvant chemotherapy or primary debulking surgery is one of the most debated topics in gynecologic oncology.

Surgical debulking of epithelial ovarian carcinoma has been a mainstay of therapy for more than 50 years-since the approach was first advocated by Meigs in 1934.[1] In 1968, Munnell[2] introduced the idea of the "maximum surgical effort”-essentially the removal of as much cancer as possible.

Ginkgo biloba, one of the oldest living tree species, is cultivated worldwide for its medicinal properties and aesthetic appeal. The leaves and seeds are used in traditional medicine to treat respiratory diseases, circulatory disorders, sexual dysfunction, and loss of hearing.

The results of a study that tracked BRCA mutation carriers suggest that women who inherit BRCA gene mutations develop cancer at a younger age than women in the previous generation. The study is published on-line today in the journal Cancer.

The European Society of Gynaecological Oncology (ESGO) biennial meeting is taking place in Milan, Italy, and will run from September 11-14, 2011.

Last week the FDA cleared the use of blood tests for two proteins, HE4 and CA-125; biomarkers that together can be used to estimate risk for ovarian cancer in women who present with a pelvic mass.

Researchers have discovered that individuals carrying a mutation in the BAP1 gene are at greater risk of developing mesothelioma and uveal melanoma.

Researchers have identified that “maintenance of global heterochromatin integrity” is a novel function of BRCA1 gene, and propose that this DNA-silencing function is linked to the role of BRCA1 as a tumor suppressor, in an article published in Nature.

A phase II trial of BIBF 1120 (Vargatef) in women with relapsed ovarian cancer that were previously treated with chemotherapy showed that BIBF 1120 given as maintenance therapy resulted in improved progression-free survival rates.