Gynecologic Cancers

Expert Point of View: Kathleen Moore, MD

Session moderator Kathleen Moore, MD, Associate Professor of Obstetrics and Gynecology at the University of Oklahoma College of Medicine, Oklahoma City, said that while the response rates are “not incredibly high,” trabectedin offers another line of therapy where there previously was none. “I think ...

Gynecologic Cancers

Trabectedin Improves Progression-Free Survival in Uterine Leiomyosarcoma

In women with uterine leiomyosarcoma, trabectedin (Yondelis), a novel cytotoxic agent, significantly improved progression-free survival, compared with dacarbazine (4.2 vs 1.5 months, hazard ratio [HR] = 0.55, P < .001). According to the study’s authors, a lack of cumulative toxicity allows...

gynecologic cancers

Wui-Jin Koh, MD, on Vulvar Cancer: Guidelines Update

Wui-Jin Koh, MD, of the Fred Hutchinson Cancer Research Center, discusses the multiple services required to best treat this rare cancer.

issues in oncology
gynecologic cancers
head and neck cancer

100% of NCI-Designated Cancer Centers Endorse the Promotion of the HPV Vaccination for Cancer Prevention

All National Cancer Institute (NCI)-designated cancer centers have united to support human papillomavirus (HPV) vaccination (see below). A team of HPV experts drafted a consensus statement that advises widespread use of HPV vaccines to prevent cancer. HPV causes cancer of the cervix, anus, and...

gynecologic cancers

Wui-Jin Koh, MD, on Making NCCN Guidelines Relevant Around the Globe

Wui-Jin Koh, MD, of the Fred Hutchinson Cancer Research Center and the Seattle Cancer Care Alliance, discusses the program to adapt NCCN guidelines to regions of the world with different resource availability. The first guideline to be adapted in this way is for cervical cancer, which is prevalent in the developing world.

global cancer care
gynecologic cancers

Eduardo Cazap, MD, PhD, and James O. Armitage, MD, on The Current State of Cancer Research and Treatment: The Latin American Perspective

Eduardo Cazap, MD, PhD, of the Latin American & Caribbean Society of Medical Oncology, and James O. Armitage, MD, of the University of Nebraska Medical Center, discuss oncology from an international point of view.

gynecologic cancers

Supriya Chopra, MD, on Reducing Late Bowel Toxicity in Cervical Cancer

Supriya Chopra, MD, of Tata Memorial Hospital, discusses results of the PARCER study, which compared conventional 3D conformal radiotherapy to image-guided intensity-modulated radiotherapy in reducing bowel side effects for women with cervical cancer (Abstract 8).

gynecologic cancers
issues in oncology

Could a Screening Test That Would Reduce Deaths From Ovarian Cancer Be on the Way?

"A solid triple but not a home run” is how Karen H. Lu, MD, characterized a study in The Lancet reporting a reduction in deaths from ovarian cancer with the use of multimodal ovarian cancer screening.1 Dr. Lu’s remark was one of several, mostly but not universally, favorable and optimistic comments ...

Gynecologic Cancers

Hormone Replacement and Ovarian Cancer: Competing Risks in Decisions about Bilateral Salpingo-oophorectomy

Recently reported findings that bilateral salpingo-oophorectomy and hysterectomy decreased the risk of ovarian cancer compared to ovarian conservation and hysterectomy, without increasing cardiovascular, fracture, and other cancer risks, should “challenge” current thinking about bilateral...

Gynecologic Cancers

Adding Gemcitabine to Chemoradiation Improves Survival Outcomes for Locally Advanced Cervical Cancer

A phase III, open-label, randomized trial found that adding gemcitabine to concurrent cisplatin chemoradiotherapy and using gemcitabine as adjuvant chemotherapy with cisplatin improved survival outcomes in women with locally advanced cervical cancer. Toxicity was increased compared to standard...

Gynecologic Cancers

Trabectedin New Drug Application Withdrawn

Centocor Ortho Biotech Products, LP, announced that it has voluntarily withdrawn the New Drug Application (NDA) for trabectedin (Yondelis) for the treatment of women with recurrent ovarian cancer. The withdrawal is based on the FDA’s recommendation that an additional phase III study be conducted to ...

Gynecologic Cancers

Important Briefs from the ACOG 59th Annual Clinical Meeting

Several presentations at the 59th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists (ACOG), held April 30–May 4 in Washington, DC, focused on cancers associated with the reproductive tract and issues important to women’s health. Four noteworthy studies presented at...

Gynecologic Cancers

2011 ASCO Annual Meeting: 3-Year Screening Interval Safe for Women with HPV-negative and Normal Pap Tests, Data Show

A large, “real-world” study has validated current recommendations from the American Congress of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS), and American Society for Colposcopy and Cervical Pathology (ASCCP) endorsing a 3-year cervical cancer screening interval for women...

Gynecologic Cancers

Cancer Diagnosis Can Spark Worry over Numerous Health Concerns

The early discovery of my endometrial cancer is a prime example of the health rewards you can reap if you are lucky enough to have good medical care and a dogged physician. Long past menopause, I wasn’t experiencing any of the typical warning signs of the disease—vaginal bleeding or pelvic...

Gynecologic Cancers

Novel Agents Prolong Disease-free Survival in Ovarian Cancer

Novel agents produced high response rates and prolonged remissions in patients with platinum-sensitive recurrent ovarian cancer, in studies reported at the 2011 ASCO Annual Meeting. In an international randomized phase II trial, maintenance therapy with the oral poly [ADP-ribose] polymerase (PARP)...

Gynecologic Cancers

Cervical Cancer Screening Study Should Reassure Physicians and Patients that a 3-Year Screening Interval Is Safe and Effective

Results of a large-scale cervical cancer screening study using concurrent human papillomavirus (HPV) and Pap testing should “reassure” women over 30 who test negative for HPV and have normal Pap tests that “it is extremely safe to go 3 years” before being tested again, Barnett S. Kramer, MD, MPH,...

Gynecologic Cancers

NCI Clinical Investigator Team Leadership Awards: Conversations in Gynecologic Oncology

The National Cancer Institute recognized Cheryl Saenz, MD, and Linda R. Duska, MD, among others, late last year with a Cancer Clinical Investigator Team Leadership Award. The 2-year award includes $50,000 in funding for cancer research programs at NCI-designated cancer centers. The ASCO Post...

Gynecologic Cancers

Bevacizumab Makes Inroads against Ovarian Cancer

Bevacizumab (Avastin) administered with chemotherapy and continued after chemotherapy improves outcomes in ovarian cancer, according to two multicenter, randomized, double-blind phase III investigations presented at the 2011 ASCO Annual Meeting. The first study, ICON7, incorporated bevacizumab as...

Gynecologic Cancers

Screening for Ovarian Cancer Does Not Reduce Mortality and Leads to Unnecessary Tests for False-Positives

Using a CA-125 blood test combined with transvaginal ultrasound for early detection of ovarian cancer failed to reduce the risk of mortality associated with the disease and led to a large number of false-positive tests with unnecessary related biopsies and other follow-up procedures in the large,...

Gynecologic Cancers
Geriatric Oncology

Elderly Patients with Ovarian Cancer Least Likely to Receive Chemotherapy

An analysis of data for 4,617 women aged 65 years or older diagnosed with epithelial ovarian cancer found that those in the oldest age group, 80 and up, were least likely to receive any chemotherapy. While 53% of patients 80 and older received no chemotherapy, the rate was less than half (22%) for...

Gynecologic Cancers

New Biomarker Test Cleared to Evaluate Ovarian Cancer Likelihood

Fujirebio Diagnostics announced that it has received 510(k) clearance from the FDA to market the company’s HE4 Test in an algorithm called ROMA to aid in assessing whether a premenopausal or postmenopausal woman who presents with an ovarian adnexal mass is at high or low likelihood of finding...

Gynecologic Cancers

Screening for Ovarian Cancer May Do More Harm Than Good, but New Therapies for the Disease Are Improving Outcomes

At the Best of ASCO Miami meeting, Daniela Matei, MD, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, described how new approaches are significantly prolonging remission in ovarian cancer. Ovarian Screening Provides No Benefit The Prostate, Lung, Colorectal, and Ovarian (PLCO) ...

Gynecologic Cancers

Alternative Treatment for Advanced Ovarian Cancer Reduces Neurotoxicity and Alopecia

A randomized phase III clinical trial found that carboplatin/pegylated liposomal doxorubicin (Doxil) was not superior in prolonging progression compared to the standard carboplatin/paclitaxel as first-line therapy of patients with advanced ovarian cancer. The carboplatin/liposomal doxorubicin...

Gynecologic Cancers

Fighting to Get Back Control

I’ve had raging hormones since I was 18, when I was diagnosed with a benign pituitary adenoma. The tumor caused unpredictable menstrual cycles that remained constant throughout my life, even after it had been successfully treated. So 2 years ago, when I turned 40 and started having sudden bouts of...

Gynecologic Cancers

FDA Approves Molecular Test to Detect HPV

Gen-Probe recently announced that the FDA has approved its APTIMA HPV assay, an amplified nucleic acid test that detects high-risk strains of human papillomavirus (HPV) that are associated with cervical cancer and precancerous lesions. The test has been approved to run on Gen-Probe’s fully...

Lung Cancer
Gynecologic Cancers
Colorectal Cancer
Hepatobiliary Cancer

Important Briefs from the 2011 European Multidisciplinary Cancer Congress

Nearly 16,000 people from 16 countries attended this year’s European Multidisciplinary Cancer Congress, held recently in Stockholm. The ASCO Post has featured several key reports from the meeting and will offer further coverage in upcoming issues. Additional noteworthy studies presented at the...

Gynecologic Cancers

Advances in Gynecologic Cancer Surgery Continue to Improve Outcomes

Over the past several decades, advances in chemotherapy and surgery have begun to translate into improved survival in gynecologic malignancies. The ASCO Post recently spoke with Ginger Gardner, MD, a surgical oncologist at Memorial Sloan-Kettering Cancer Center, who specializes in the management...

Gynecologic Cancers

New System for Cervical Cancer Screening Approved

Hologic announced that the FDA has approved its Cervista HTA (high throughput automation) system for use with its previously approved Cervista human papillomavirus (HPV) HR test. The Company’s Cervista HTA system automates the DNA extraction and detection steps of the Hologic Cervista HPV HR test,...

Gynecologic Cancers

Nearly Identical Survival for Laparoscopy vs Laparatomy in Patients with Stage I/IIA Disease

Building on previously reported results that laparoscopic surgical management of uterine cancer is superior for short-term safety and length-of-stay endpoints, the Gynecologic Oncology Group reported small and lower than anticipated potential for increase risk of cancer recurrence with laparoscopy...

Gynecologic Cancers

Similar Morbidity, Higher Costs for Robotic vs Laparoscopic Hysterectomy in Women with Endometrial Cancer

A population-based analysis comparing laparoscopic hysterectomy and robotic hysterectomy for endometrial cancer “found similar morbidity but increased cost compared with laparoscopic hysterectomy,” investigators reported in the Journal of Clinical Oncology.1 After adjusting for patient, surgeon,...

Gynecologic Cancers
Issues in Oncology

New Guidelines Recommend Less Frequent Screening for Cervical Cancer, but That Doesn’t Mean Screening Is Less Important

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. In March 2012, the U.S. Preventive...

Gynecologic Cancers

Scoring System Based on DNA Repair Pathways Predicts Outcomes and Response to Platinum Therapy

A potentially important tool to identify patients with advanced-stage ovarian cancer likely to benefit from platinum-based chemotherapy and redirect those with poor predicted outcomes to alternative treatments was developed using gene-expression data and validated in two independent datasets. While ...

Gynecologic Cancers
Issues in Oncology

Gab2 Promotes Characteristics of Epithelial-to-Mesenchymal Transition in Ovarian Cancer

Ovarian cancer is often diagnosed at a late stage, when cancer cells have already migrated and invaded other tissues and organs. Wang and colleagues from the University of Colorado Denver and the Dana-Farber Cancer Institute in Boston, showed that Gab2—a scaffolding adaptor protein that is...

Gynecologic Cancers

Bevacizumab and Olaparib Boost Progression-free Survival in Ovarian Cancer

A trio of randomized, controlled trials of different molecularly targeted therapies showed variable results in ovarian cancer, as reported at the 2012 ASCO Annual Meeting in Chicago. The phase III AURELIA trial demonstrated that the addition of the vascular endothelial growth factor (VEGF)...

Gynecologic Cancers

Adding Bevacizumab to Chemotherapy Improves Progression-free Survival in Platinum-sensitive Recurrent Ovarian Cancer

The addition of bevacizumab (Avastin) to gemcitabine and carboplatin, followed by bevacizumab until disease progression, resulted in significantly improved progression-free survival compared to gemcitabine and carboplatin plus placebo among women with platinum-sensitive recurrent ovarian, primary...

Gynecologic Cancers

SIDEBAR: All Eyes on Trials of IV vs IP Chemotherapy for Ovarian Cancer

The positive findings from the NOVEL trial add to the debate about how intravenous (IV) chemotherapy stacks up against intraperitoneal (IP) chemotherapy when treating ovarian cancer and the role of dose-dense approaches in general, according to Jonathan S. Berek, MD, of the Stanford Women’s Cancer...

Gynecologic Cancers

SIDEBAR: Future of PARP Inhibitors in Ovarian Cancer Hangs in Balance

"It’s become clear that the PARP inhibitors in general … are active in this disease, and we are just trying to find out the level of activity and … get to the point hopefully where at least one of these agents will be approved for use” in ovarian and related cancers, commented Jonathan S. Berek,...

Gynecologic Cancers

Major Strides Seen in Treatment of Gynecologic Cancers

Research reported at this year’s ASCO Annual Meeting shows major strides in treating ovarian and cervical cancers, suggesting the potential of new agents and adding evidence in areas where optimal management is unclear, according to Jonathan S. Berek, MD, of the Stanford Women’s Cancer Center,...

gynecologic cancers

Combination Bevacizumab/Chemotherapy Improves Outcomes in Platinum-resistant Ovarian Cancer

The addition of bevacizumab (Avastin) to chemotherapy improved progression-free survival and response rates in patients with platinum-resistant recurrent ovarian cancer, according to an exploratory analysis of the phase III AURELIA trial. The combination of paclitaxel with bevacizumab achieved very ...

gynecologic cancers

Richard R. Barakat, MD, Elected 2014 President of Two Gynecologic Oncology Medical Societies

Richard R. Barakat, MD, was recently named President-elect of the Society of Gynecologic Oncology (SGO) and the International Gynecologic Cancer Society (IGCS). He will serve as President of both societies beginning in 2014. Dr. Barakat is Vice Chair, Clinical Activities, Department of Surgery;...

gynecologic cancers

Screening and Risk-reduction without Testing Positive for BRCA Mutation

Many women who do not test positive for a BRCA mutation undergo additional ovarian cancer screenings and risk-reducing procedures, despite limited data to determine the effectiveness of these interventions among an average-risk population. Results of an analysis of data from 1,077 women who were...

gynecologic cancers

Internationally Renowned Gynecologic Cancer Researcher Joins Ohio State

Internationally renowned uterine cancer researcher and geneticist Paul Goodfellow, MD, PhD, will lead a new team of three researchers devoted to gynecologic oncology research at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research...

gynecologic cancers

Short-term Survival Advantage of Carrying BRCA Mutation Does Not Extend to Long Term

While carrying a BRCA 1 or BRCA 2 mutation was associated with a better prognosis in the 3-year period after diagnosis of invasive ovarian cancer, this short-term survival advantage did not lead to long-term survival benefit, according to a study published in the Journal of the National Cancer...

gynecologic cancers

Analysis Shows No 10-year Survival Advantage in Patients with Ovarian Cancer and BRCA1 or BRCA2 Mutations 

Several studies have suggested that short-term overall survival for women with ovarian cancer and BRCA1 or BRCA2 mutations is better than that in patients without such mutations. Indeed, a recent report by Kelly L. Bolton, PhD, and colleagues indicated that 5-year overall survival was 36% for...

gynecologic cancers

Intraperitoneal Chemotherapy Gives Ovarian Cancer Patients Better Chance of Survival

Patients with advanced ovarian cancer who undergo intensive treatment with chemotherapy that bathes the abdomen are significantly more likely to live longer than those who receive standard intravenous (IV) chemotherapy, according to a study that analyzed long-term follow-up from two landmark...

gynecologic cancers

Majority of Ovarian Cancer Patients Do Not Receive Recommended Treatment, Study Shows 

Women are 30% less likely to die of ovarian cancer if they have guideline-recommended treatment, yet nearly two-thirds of those with the disease do not receive it, often because they are cared for at hospitals that treat a small number of ovarian cancer patients. These are the findings of a study...

gynecologic cancers

It Takes a Village to Survive Ovarian Cancer 

My odyssey with ovarian cancer started in May 2005, when I saw my gynecologist for an annual exam and mentioned an odd twinge I had been experiencing on my left side. A subsequent pelvic ultrasound followed by an MRI showed that my ovaries were enlarged, and my doctor warned me that the problem...

gynecologic cancers

Higher Prediagnosis Body Mass Index Raises Mortality Risk in Endometrial Cancer

Higher prediagnosis body mass index (BMI) increases risk of overall and disease-specific mortality among women diagnosed with endometrial cancer, suggested a study published in the Journal of the National Cancer Institute. Physical activity was associated with reduced risk of all-cause, but not...

gynecologic cancers

Most Women with Ovarian Cancer Do Not Get Guideline-specified Treatment Linked to Survival Benefits 

Most women with ovarian cancer are not receiving adequate treatment, as specified in National Comprehensive Cancer Network (NCCN) Guidelines,1 and as a result are being deprived of the survival benefits correlated with guideline-recommended treatment, according to a study presented at the Society...

Gynecologic Cancers

Lynch Syndrome: A Multitude of Predispositions 

The current uncertainty regarding the relative frequencies of cancers of various anatomic sites in Lynch syndrome poses a difficulty in commenting on the syndrome’s overall cancer spectrum. It is even more vexing to address the order in which these cancers are prone to occur. What we do know is...

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