Ovarian Cancer

Drs. Randall and Rubin address three subjects important to all patients with advanced-stage epithelial ovarian cancer: (1) the incidence and annual mortality associated with the disease, (2) the use of intestinal surgery at the time of initial surgery, and (3) the use of surgery for intestinal obstruction in patients with recurrent (or progressive) ovarian cancer. I believe that progress in all three areas has been made, albeit slowly.

In their excellent review of intestinal obstruction in women with advanced and recurrent ovarian cancer, Drs. Randall and Rubin indicate that median survivals and quality of life for these patients have improved substantially. Data from the International Federation of Obstetrics and Gynecology (FIGO)[1] and the National Cancer Institute’s Survival, Epidemiology, and End Results (SEER) program[2] indicate that the 5-year disease-free survival for advanced-stage disease has risen over the past several decades from approximately 5% to 20%. Therefore, the palliation of intestinal obstruction secondary to metastatic ovarian cancer has become a more urgent issue. The management of recurrent or chronic intestinal obstruction is often complex, and the authors have carefully substantiated issues related to this complication of the malignancy.

Authors Thomas Randall, MD, and Stephen Rubin, MD, provide a thoughtful, state-of-the-art discussion on current controversies in the management of intestinal obstruction in patients with ovarian cancer.

DALLAS-Doxorubicin encapsulated in liposomes (Doxil) and topotecan (Hycamtin) were equally effective in women with relapsed ovarian cancer, but had different toxicities, according to results presented at the 36th annual meeting of the American Society of Clinical Oncology.

ASCO-Although paclitaxel (Tax-ol) plus cisplatin (Platinol) as initial therapy for ovarian cancer cost a good deal more than cyclophosphamide plus cisplatin, it is cost-effective by the usually accepted guidelines, said Hugh Walker, PhD, a health economist at the National Cancer Institute of Canada’s Clinical Trials Unit, Kingston, Ontario.

BIRMINGHAM, United Kingdom-Early trials of Iressa (ZD1839), a novel anticancer compound, reveal encouraging antitumor activity and disease stabilization, according to reports presented at the ASCO meeting.

ASCO-In contrast to many recent studies, the ICON3 trial finds that paclitaxel (Taxol) plus carboplatin (Paraplatin) is no more effective than other chemotherapy regimens as first-line therapy of ovarian cancer. ICON3-the Third International Collaborative Ovarian Neoplasm study-is an international multicenter trial involving 2,074 women with newly diagnosed ovarian cancer requiring chemotherapy.

LINKOPING, Sweden-The optimal schedule for dosing paclitaxel (Taxol) has not been determined. However, a study that compared two dosing schedules with the same dose intensity in ovarian cancer patients found equivalent efficacy, with somewhat varying toxicities.

NEW YORK-Prolonged topotecan (Hycamtin) infusion combined with cisplatin (Platinol) is an effective first-line therapy for ovarian cancer, with almost all patients in a recent study responding.

The search for new combination chemotherapeutic regimens for the treatment of non–small-cell lung cancer is motivated not only by the desire to increase the objective tumor response and survival rates, but also by the desire

Cross-sectional imaging of the abdomen in oncology patients presents unique challenges and opportunities. A close working relationship between the oncologist and radiologist is essential for the exchange of the clinical and

AstraZeneca has announced the launch of a new website that will help keep researchers and physicians up to date on

SAN DIEGO-Doses of topotecan (Hycamtin) one third lower than the label recommends are still effective as ovarian cancer salvage therapy and cause much less hematologic toxicity, Michael Rodriguez, MD, reported at the 31st Annual Meeting of the Society of Gynecologic Oncologists (SGO).

The results of a new study demonstrate that one-third of patients with recurrent ovarian cancer who are

SAN DIEGO-Conservative surgery can preserve fertility in young women with epithelial ovarian cancer and achieve survival rates comparable to standard surgery (total abdominal hysterectomy and removal of the fallopian tubes and ovaries), researchers from Memorial Sloan-Kettering Cancer Center reported at the 31st annual meeting of the Society of Gynecologic Oncologists (SGO).

Weighing in unambiguously on the controversy over the National Institutes of Health (NIH) consensus statement on

SAN DIEGO-Most women with ovarian cancer have previous abdominal or gastrointestinal (GI) complaints, and diagnoses are often delayed because neither patients nor physicians recognize these early warning signs, Barbara A. Goff, MD, reported at the 31st Annual Meeting of the Society of Gynecologic Oncologists (SGO).

SAN DIEGO-Preliminary data show that a new outcomes measurement tool developed by the Society of Gynecologic Oncologists (SGO) Outcomes Task Force is a reliable method for demonstrating quality of care to third parties. Lead author Alexander W. Kennedy, MD, of the Department of Gynecology and Obstetrics, Cleveland Clinic Foundation, reported on behalf of the task force at the SGO’s 31st Annual Meeting.

Each year close to 600,000 women undergo a hysterectomy in the United States.[1] Although the number of these

The borderline category of ovarian tumors is one of the most controversial topics in gynecologic oncology and pathology, and is confusing to both clinicians and patients. Although numerous reviews have appeared in the literature, most of them rehash the prevailing views on borderline tumors without critically evaluating the published data that allegedly validate some rather puzzling and perplexing notions. For example, although these tumors are considered to be a subset of carcinoma, most patients are cured even when they have “metastatic” disease that has been inadequately treated. In addition, reports cite recurrence and death as late as 39 years after the diagnosis of tumors that appear histologically bland and noninvasive.

Ovarian tumors of low malignant potential (LMP) would benefit from a new name, not to mention a deeper understanding of their biology, effective treatment, and a framework within which they can be studied. Fortunately, for a pathologic entity that is poorly understood and also is unresponsive to current therapy, most LMP ovarian tumors carry a benign prognosis.

Low malignant potential (LMP) ovarian tumors represent a small subset of epithelial ovarian cancers that were first identified 70 years ago but were recognized in a systematic way only within the last 30 years. These lesions

WASHINGTON-All cancer patients should have the opportunity to participate in clinical trials, something that will occur only if Congress passes pending legislation to guarantee insurance coverage for the cost of routine patient care for study participants, speakers told a Capitol Hill briefing sponsored by the American Society of Clinical Oncology (ASCO).

SAN DIEGO-Annual transvaginal ultrasound screening permitted early detection of most ovarian cancers and improved 5-year survival from about 50% to 88% in screened patients, John R. van Nagell, MD, reported at a plenary session of the 31st Annual Meeting of the Society of Gynecologic Oncologists (SGO).

NEW ORLEANS-More than 300,000 US patients a year who receive chemotherapy will experience significant thrombocytopenia, Howard Ozer, MD, PhD, said at a symposium preceding the American Society of Hematology 41st annual meeting. The symposium was sponsored by MCP Hahnemann University, where Dr. Ozer is director of the Cancer Center, and supported by an unrestricted educational grant from Pharmacia & Upjohn.

Drs. Olin and Muss provide an excellent review of current state-of-the-art treatments and treatment strategies for patients with metastatic breast cancer. They explore a number of the existing questions in the treatment of metastatic breast cancer and emphasize the need for ongoing clinical trials.

Recent studies have elucidated some of the molecular and cellular mechanisms that determine the sensitivity or resistance to ionizing radiation. These findings ultimately may be useful in devising new strategies to improve the

NEW YORK-Cancer Care, Inc. has established a new program-The AVONCares Program for Medically Underserved Women-through a generous gift from The Avon Products Foundation. The program will provide financial assistance and relevant education and support to low-income, underinsured and uninsured, underserved women throughout the country in need of diagnostic and/or related services for the treatment of breast, cervical, and ovarian cancers.

SAN DIEGO-Data from a major randomized phase III trial show that carboplatin (Paraplatin)/paclitaxel (Taxol) should replace cisplatin (Platinol)/paclitaxel as standard treatment for optimal stage III ovarian cancer, Robert F. Ozols, MD, PhD, said at the Society of Gynecologic Oncologists 31st Annual Meeting.

A study released at the recent annual meeting of the Society of Gynecologic Oncologists (SGO) challenges the traditional management of ovarian cancer in young women by suggesting that conservative surgery (which often allows for future