Ovarian Cancer

PARIS--The demonstration that adding paclitaxel (Taxol) to platinum boosts survival in advanced ovarian cancer has made this combination the gold standard of chemotherapy for previously untreated patients. [ODAC recently recommended to the FDA that paclitaxel be formally approved for this indication; see page 33.] However, although as many as three-quarters of women will respond to platinum-paclitaxel and one-half will achieve complete clinical remission, most will eventually relapse.

Alterations in a gene discovered last year by UT Southwestern Medical Center in Dallas scientists have been linked to breast, ovarian, and uterine cancers, the researchers reported in the February issue of Human Molecular Genetics.

ORLANDO--In a retrospective review of ovarian cancer patients treated at Memorial Sloan-Kettering, positive findings from second-look surgery in stage I patients were so rare that the researchers no longer perform such surgery in these patients, Stephen C. Rubin, MD, told the Society of Gynecologic Oncologists.

ORLANDO--Breast-conserving therapy appears to be a viable treatment option for breast cancer patients with a family history of breast cancer, Elizabeth Chabner, MD, said at the annual meeting of the American Society for Therapeutic Radiation and Oncology (ASTRO).

Approximately 10% of all epithelial ovarian carcinoma cases are associated with inheritance of an autosomal-dominant genetic mutation conferring a predisposition to cancer with variable penetrance. Two such manifestations

Jefferson Medical College researchers have created what they believe may prove to be an effective ovarian cancer vaccine made from a patient’s own cancer cells. After testing the vaccine on 11 patients, each with advanced disease, the scientists are encouraged after seeing an initial immune reaction. That tells them that the vaccine is effectively stimulating the immune system into action.

Approximately 10% of all epithelial ovarian carcinoma cases are associated with inheritance of an autosomal-dominant genetic mutation conferring a predisposition to cancer with variable penetrance. Two such manifestations

Approximately 10% of all epithelial ovarian carcinoma cases are associated with inheritance of an autosomal-dominant genetic mutation conferring a predisposition to cancer with variable penetrance. Two such manifestations

The past 20 years has seen an increasing trend toward the use of oral chemotherapy for the treatment of patients with a variety of malignancies. The advantages of oral chemotherapy include lower treatment cost, compared with that of intravenous (IV) administration, and more convenient treatment for patients.

SAN ANTONIO-Genetic testing for breast cancer susceptibility appears to confer no adverse psychological effects on mutation carriers or individuals who refuse to be tested, Caryn Lerman, PhD, reported at a general session of the San Antonio Breast Cancer Symposium.

Washington-Available methods to prevent breast cancer might be bettered compared to a flu shot “which hurts and only lasts a year,” than to a polio vaccine, “which comes on a sugar cube and lasts a lifetime,” Malcolm C. Pike, PhD, said at the Department of Defense’s “Era of Hope” meeting.

Malignancies arising in the fallopian tube are extremely rare, accounting for less than 1% of gynecologic malignancies. This rarity makes it unlikely that any single institution will have managed enough patients in a uniform manner to be able to critically evaluate different treatment plans. Most institutions agree that diagnosis, staging, and treatment are analogous to ovarian cancer. Often, the matter of whether an advanced adnexal malignancy is of ovarian or tubal origin cannot be determined until the final pathologic diagnosis is made.

Epithelial ovarian cancer is the leading cause of death from gynecologic malignancies. In 1996, an estimated 26,000 new cases were diagnosed, and approximately 14,000 women died of this disease in the United States alone.[1] Between 75% and 80% of ovarian cancer patients present with advanced disease at diagnosis, and these patients have a 5-year survival rate of 21%.[2,3]

ASH-Topotecan (Hycamtin) given in combination with cytarabine (ara-C) produced a complete response rate of 63% in 35 patients with previously untreated, poor-prognosis myelodys-plastic syndrome (MDS) or chronic myelomonocytic leukemia (CMML), Miloslav Beran, MD, PhD, said at the American Society of Hematology annual meeting in San Diego.

A genetic mutation in the adenomatous polyposis (APC) gene found in 7% of Ashkenazi Jewish families in the United States does not necessarily lead to colon cancer, according to a study in the December 15, 1997, issue of Cancer Research.

Topotecan hydrochloride (Hycamtin), as a single agent or in combination with other agents, may offer a new treatment option for people suffering from small-cell lung cancer, according to results from five clinical trials reviewed at the 15th

ORLANDO-Nearly three decades of clinical trials of multiagent chemotherapy have yet to exceed the results produced in a study from the 1970s of sequential surgery, abdominopelvic radiotherapy and single-agent alkylating chemotherapy, said Ellen E. Bellairs, MD, of the University of Minnesota.

The finding of a high frequency of genetic markers for both breast and ovarian cancers among Ashkenazi Jewish women has prompted a call for genetic testing for all breast and ovarian cancer victims in this population, regardless of family history.

Endometrial cancer is the most common type of female genital cancer in the United States, with an estimated 32,000 new cases and 5,600 deaths per year. During the first half of the 20th century, the incidence of cervical cancer was greater than

After the patient has been evaluated preoperatively, exploratory laparotomy is essential for definitive diagnosis and staging. The patient should be advised of the potential for malignancy based on the physical as well as imaging studies, and an

In a phase II study, 66 patients with advanced breast cancer (median age 56 years; range, 28 to 75 years) were treated with paclitaxel (Taxol), 175 mg/m² infused over 3 hours, and carboplatin (Paraplatin), dosed to attain an

Dr. Therese B. Bevers has been named medical director for Clinical Cancer Prevention at The University of Texas M.D. Anderson Cancer Center. The program, in the Division of Cancer Prevention, works to translate medical science and research into applications that make cancer prevention and early detection a reality. Dr. Bevers was formerly medical director of the MediClinic Corporation.

Over the past few years, several promising new therapeutic agents have been approved by the FDA for the treatment of

Despite the development of chemotherapeutic agents, radiation techniques, and improved surgical procedures, many women with gynecologic malignancies will die from recurrent disease. In this broad review, Gurski and Steller examine potential vaccine strategies to improve disease control. The use of vaccines in both prophylactic and therapeutic settings is discussed, and a general overview of vaccines directed against both viral and nonviral tumor-associated antigens is presented.

The development of topotecan (Hycamtin) and the encouraging preliminary results of its use in clinical trials are comprehensively reviewed by Takimoto and Arbuck. The successful development of topotecan demonstrates that focused research and developmental efforts by the pharmaceutical industry in anticancer therapeutics can actually “pay off.” Approximately 15 years ago, the prototypic topoisomerase I inhibitor camptothecin was “placed back on the shelf” because it induced severe, unpredictable toxicity when administered as a sodium salt (sodium camptothecin). After recognition that camptothecin was active by virtue of a novel mechanism of action (topoisomerase I inhibition), developmental research efforts at SmithKline Beecham led to the synthesis of a myriad of camptothecin analogs, significant structure-function information, and the ultimate selection of topotecan as a lead camptothecin analog for clinical development.[1-3]

Immune responses are generated in a complex network of cellular and humoral factors. The complexity of this system makes it difficult to generate subsets of cells in vivo that are most effective against cancer cells. The goal of vaccine strategies is to redirect the immune system against cancer cells primarily by generating specific T-cell responses which would be the most effective anti-tumor effector cells.

The article by Drs. Takimoto and Arbuck reviews the chemistry, mechanism of action, pharmacology and clinical trials of topotecan (Hycamtin), one of two topoisomerase I inhibitors approved recently by the FDA. Topotecan was approved for refractory ovarian cancer and irinotecan (Camptosar) for advanced colorectal cancer. These drugs represent a new drug class designed to inhibit topoisomerase I, an enzyme involved in relaxation of torsional strain in supercoiled DNA allowing replication and translation. The authors’ overview is informative and unbiased.

Topotecan (Hycamtin) is a promising new topoisomerase I-targeting anticancer agent that first entered clinical trials in 1989 under National Cancer Institute sponsorship in collaboration with SmithKline Beecham. In 1996, it

Therapeutic and prophylactic vaccines that harness the potential of the immune system against a number of gynecologic cancers are now being developed. The therapeutic vaccines coerce the cellular components of the

The treatment of advanced pancreatic carcinoma has been viewed with pessimism. Because of the lack of activity of commonly used agents, there is no consensus regarding a standard chemotherapy regimen. Assessment of