- Cancer Types
Information about risk, prevention, screening, symptoms, diagnosis, treatment, and support for all cancers Cancer A to Z - Cancer Treatment
Cancer Treatment
Information about cancer treatment, including surgery, chemotherapy, radiation therapy, clinical trials, proton therapy, complementary medicine, and cutting edge technologies.
- Risk and Prevention
- Cancer Drugs
- Support
Support
Ways for cancer patients and caregivers to cope with cancer, side effects, nutrition, general cancer support issues, grief/end of life issues, and shared survivor's experiences.
- Healthcare Professionals
- Clinical Trials
My Patient Treatment Binder
OncoLink Blogs
What's My Cancer Risk?
OncoPilot: Navigating Your Cancer Journey
Community Events Calendar
OncoLink eNews
Abramson Cancer CenterNCI CANCERLIT® Search: Therapy of Ovarian Cancer - July 2002
National Cancer Institute®
Last Modified: July 1, 2002
- Topoisomerase I levels in white blood cells of patients with ovarian cancer treated with paclitaxel-cisplatin-topotecan in a phase I study.
- A phase I clinical trial of sequentially administered doxorubicin and topotecan in refractory solid tumors.
- Caelyx and ovarian cancer.
- Adenoviral delivery of A-FOS, an AP-1 dominant negative, selectively inhibits drug resistance in two human cancer cell lines.
- Ovarian tumor cell detection in peripheral blood progenitor cells harvests by RT-PCR.
- [Guidelines for proper use of antineoplastic agents. Gynecologic cancer]
- [Early results of topotecan therapy in patients with recurrent ovarian cancer]
- A rapid and systematic review of the effectiveness and cost-effectiveness of the taxanes used in the treatment of advanced
- Laparoscopic management of adnexal masses. Safety and effectiveness.
- [Interpretation of the CA125 kinetics during first line chemotherapy of the ovarian cancer: methodological aspects and characteristic profiles]
- [Second-line chemotherapy for ovarian cancer: the potential of Taxol]
- Paclitaxel and platinum chemotherapy for malignant mixed mullerian tumors of the ovary.
- A phase II trial of daily perillyl alcohol in patients with advanced ovarian cancer: Eastern Cooperative Oncology Group Study E2E96.
- Evaluation of prognostic factors and treatment modalities in ovarian cancer patients with brain metastases.
- Current clinical practices for ovarian cancers.
- Optimal doses of paclitaxel and carboplatin combination chemotherapy for ovarian cancer: a phase I modified continual reassessment method study.
- Early ovarian cancer.
- Advanced ovarian cancer.
- Chemotherapy, early surgical reassessment, and hyperfractionated abdominal radiotherapy in stage III ovarian cancer: results of a
- Chemotherapy in epithelial ovarian cancer.
- Gene therapy of ovarian cancer.
- Novuspharma announces preliminary results of phase II trials for BBR 3464.
- Adoptive immunotherapy of ovarian carcinoma.
- Long-term survival and patterns of care in women with ovarian tumors of low malignant potential.
- Can serum CA-125 levels predict the optimal primary cytoreduction in patients with advanced ovarian carcinoma?
- [Effects of wild-type p53 gene on the chemotherapy sensitivity of ovarian cancer SKOV-3 cells to cisplatin]
- Preoperative CA 125 levels: an independent prognostic factor for epithelial ovarian cancer.
Table of Contents
1
UI - 11914645
AU - Schoemaker NE; Herben VM; de Jong LA; van Waardenburg RC; Pluim D; ten
TI -
Bokkel Huinink WW; Beijnen JH; Schellens JH
Topoisomerase I levels in white blood cells of patients with ovarian
cancer treated with paclitaxel-cisplatin-topotecan in a phase I study.
SO - Anticancer Drugs 2002 Jan;13(1):87-91
AD - Department of Medical Oncology, Antoni van Leeuwenhoek Hospital/The
Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands.
APNSC@SLZ.nl
Topotecan stabilizes the topoisomerase I (Topo I) cleavable complex. We
measured Topo I levels in white blood cells of patients with ovarian
cancer treated with topotecan. Topotecan was given i.v. daily x 5 q 3
weeks in combination with paclitaxel (1 day before topotecan) and
cisplatin (just prior topotecan). Our aim was to correlate Topo I levels
to pharmacokinetics and toxicity. Topo I levels were determined using
Western blotting and were expressed relative to the Topo I level present
in 10 microg cell lysate of the human IGROV1 ovarian cancer cell line.
We found no correlation between Topo I levels and (non-)hematological
toxicity. Topo I levels after the fifth topotecan infusion were
significantly negatively correlated with the AUC of topotecan (R =
-0.64, p = 0.026), in contrast with Topo I levels prior to (R = -0.25, p
= 0.4) and after (R = -0.30, p = 0.3) the first topotecan infusion. Topo
I levels after the fifth topotecan infusion (48 +/- 27%, mean +/- SD)
were higher than Topo I levels prior to and after the first topotecan
infusion (3.0 +/- 4.7 and 2.7 +/- 3.6%, respectively) (p = 0.001). In
conclusion, we detected a significant inverse correlation between Topo I
level and topotecan AUC at day 5, and we found increasing Topo I levels
during a daily x 5 schedule of treatment with topotecan.
2
UI - 11895897
AU - Seiden MV; Ng SW; Supko JG; Ryan DP; Clark JW; Lynch T; Huang KC;
TI -
Kwiatkowski D; Skarin A; Eder JP Jr
A phase I clinical trial of sequentially administered doxorubicin and
topotecan in refractory solid tumors.
SO - Clin Cancer Res 2002 Mar;8(3):691-7
AD - Department of Medicine, Massachusetts General Hospital, Boston 02114,
USA. mseiden@partners.org
PURPOSE: To determine whether agents that target topoisomerase I and II
could be administered sequentially. DESIGN: A Phase I study was
conducted to evaluate sequential treatment with bolus IV doxorubicin
followed 48 h later by topotecan given as a 30-min i.v. infusion on 3
consecutive days, with additional cycles of therapy repeated every 3
weeks. Characteristics of the 22 patients entered into the study were:
13 male and 9 female; median age, 49.5 (range 33-66) years; Eastern
Cooperative Oncology Group performance status, 0-1; and normal cardiac,
hematological, hepatic, and renal function. All patients had received
prior therapy (median >or=2 prior regimens). RESULTS: The maximum
tolerated dose of the combination was 25 mg/m(2) doxorubicin and 5.25
mg/m(2) topotecan (1.75 mg/m(2)/day x 3). Neutropenia was the
dose-limiting toxicity. Attempts to further escalate the dose using 5
microg/kg granulocyte colony-stimulating factor proved unsuccessful
because of thrombocytopenia. Among the 17 patients who were evaluable
for response, 6 had a partial response, and 4 showed evidence of disease
stabilization. The partial responses occurred in patients with small
cell lung cancer (3 of 7), non-small cell lung cancer (1 of 6),
esophageal adenocarcinoma (1 of 2), and ovarian carcinoma (1 of 1), and
it lasted for 3-6 months. Administration of doxorubicin 2 days before
topotecan did not alter topotecan pharmacokinetics. Changes in
topoisomerase mRNA levels were observed during chemotherapy.
CONCLUSIONS: The sequential combination of doxorubicin followed by
topotecan is highly active in several chemotherapy refractory long,
ovary, and esophageal cancers. Despite significant neutropenia, toxicity
is manageable and well tolerated. Phase II trials to further evaluate
the efficacy of this promising combination regimen against non-Hodgkin's
lymphoma and lung cancer have been initiated.
3
UI - 11829050
AU - Anonymous
TI -
Caelyx and ovarian cancer.
SO - Eur J Cancer Care (Engl) 2001 Jun;10(2):79
4
UI - 11916245
AU - Bonovich M; Olive M; Reed E; O'Connell B; Vinson C
TI -
Adenoviral delivery of A-FOS, an AP-1 dominant negative, selectively
inhibits drug resistance in two human cancer cell lines.
SO - Cancer Gene Ther 2002 Jan;9(1):62-70
AD - Laboratory of Metabolism, Medicine Branch, National Cancer Institute,
Bethesda, Maryland 20892, USA.
Activator protein-1 (AP-1) transcription factor has been linked to
chemotherapeutic resistance. To assess the clinical efficacy of AP-1
inhibition toward reversing drug resistance, we have developed an
adenovirus expressing a dominant negative that inhibits AP-1 DNA
binding, namedAdA-FOS. We examined the consequence of AdA-FOS infection
on two paired human cancer cell lines, each pair consisting of a
parental cell and the drug- resistant derivative. The first pair of
cells is the parental human ovarian cancer cell line A2780 and the
cisplatin-resistant A2780/CP70 cell line. The second pair of cells is
the parental epidermal carcinoma cell line KB8 and the
multidrug-resistant (mdr) KB85 cell line. Because of an association of
up-regulated AP-1 activity with their drug resistance, these cell lines
were considered good targets of AdA-FOS therapy. Following infection of
the drug-sensitive and drug-resistant cells, we observed a significant
decrease in cell viability of KB85 and A2780/CP70 cells at drug doses
normally not lethal to the cell. The parental cell lines, A2780 and KB8
cells, were not similarly affected by AdA-FOS. This decrease in
viability was specific to AdA-FOS as an adenovirus control (Advector)
did not reverse drug resistance. Although the efficiency of AdA- FOS in
therapy would need to be further analyzed with other cisplatin-resistant
and mdr cell lines, these results suggest that AP-1 is a therapeutic
molecular target and that inhibition of AP-1 DNA binding may be of
clinical value in treating chemotherapeutic resistance.
5
UI - 12047311
AU - Kurata H; Takakuwa K; Tsuneki I; Aoki Y; Tanaka K
TI -
Ovarian tumor cell detection in peripheral blood progenitor cells
harvests by RT-PCR.
SO - Acta Obstet Gynecol Scand 2002 Jun;81(6):555-9
AD - Department of Obstetrics and Gynecology, Faculty of Medicine, Niigata
University, Japan. tounin@med.niigata-u.ac.jp
BACKGROUND: To evaluate the frequency of tumor cell contamination in
autologous peripheral-blood progenitor cells from patients with ovarian
cancer, and to determine the impact of infusing such cells on relapses
after high-dose chemotherapy. METHODS: Seventy-three samples of
peripheral-blood progenitor cells from 24 ovarian cancer patients were
studied for contaminated tumor cells by cytokeratin 7 and cytokeratin 20
reverse transcriptase polymerase chain reaction. RESULTS: Tumor cell
contamination in peripheral-blood progenitor cells was detected in 11 of
24 patients (46%) and, among these, in four of 11 patients who received
transplantations of peripheral-blood progenitor cells. There was no
trend towards longer relapse-free survival in patients infused with
cytokeratin-negative peripheral-blood progenitor cells as compared with
positive ones. Interestingly, two of four patients who received
transplantations of peripheral-blood progenitor cells containing tumor
cells were free from progression at 20 and 41 months after
transplantation. CONCLUSION: Tumor cell contamination of
peripheral-blood progenitor cells was frequently noted by transcriptase
polymerase chain reaction in patients with ovarian cancer. The
biological and clinical significance of this finding remains to be
elucidated.
6
UI - 12109445
AU - Ochiai K; Okamoto A; Katsumata N
TI -
[Guidelines for proper use of antineoplastic agents. Gynecologic cancer]
SO - Gan To Kagaku Ryoho 2002 Jun;29(6):1047-54
7
UI - 12053883
AU - Lehoczky O; Bagameri A; Lehoczky G; Pulay T
TI -
[Early results of topotecan therapy in patients with recurrent ovarian
cancer]
SO - Orv Hetil 2002 Apr 21;143(16):825-8
AD - Nogyogyaszati Onkologiai Osztaly, Orszagos Onkologiai Intezet, Budapest.
lehoczky@oncol.hu
INTRODUCTION: Topotecan inhibits the topoisomerase-I enzyme resulting
its stabilisation on the DNA and the suspension of replication and
transcription. AIMS: The authors summarized their first experience on
second-line topotecan treatment in a prospective non-randomized study.
METHOD: Topotecan was given for recurrent epithelial ovarian cancer in
the dose of 1.5 mg/m2/d for 5 days repeated in every 3 weeks in a
30-minute infusion intravenously. RESULTS: Twenty five recurrent ovarian
cancer patients were treated between March, 1999 and March, 2001.
Complete and partial response rates were found 12% and 12%,
respectively. Stable disease was observed in 48% of patients for 4-8
courses, then progression continued. In these 3 groups of patients the
median progression free interval was shown as 12 weeks. CONCLUSION: When
comparing to previous chemotherapies, topotecan treatment failed to show
a definitive improvement in the outcome of recurrent ovarian cancer.
8
UI - 11074389
AU - Lister-Sharp D; McDonagh MS; Khan KS; Kleijnen J
TI -
A rapid and systematic review of the effectiveness and
cost-effectiveness of the taxanes used in the treatment of advanced
breast and ovarian cancer.
SO - Health Technol Assess 2000;4(17):1-113
AD - NHS Centre for Reviews and Dissemination, University of York, York, UK.
SECOND-LINE TREATMENT, PACLITAXEL (MEDIAN PROGRESSION-FREE SURVIVAL):
The median progression-free survival in the paclitaxel arm was 3.5
months. This was significantly longer than the mitomycin control arm
(1.6 months, p = 0.026). BREAST CANCER - SECOND-LINE TREATMENT,
PACLITAXEL (MEDIAN OVERALL SURVIVAL): The median length of overall
survival in the paclitaxel arm was 12.7 months, compared with 8.4 months
in the mitomycin arm. BREAST CANCER - SECOND-LINE TREATMENT, PACLITAXEL
(QUALITY OF LIFE): Quality of life was not reported. BREAST CANCER -
SECOND-LINE TREATMENT, PACLITAXEL (ECONOMIC EVALUATION): The only
economic evaluation that compared paclitaxel with control (mitomycin)
was submitted in confidence and has been removed from this report. Six
economic evaluations involved comparisons of paclitaxel and docetaxel,
which are given below. BREAST CANCER - SECOND-LINE TREATMENT, DOCETAXEL:
Four randomised controlled Phase III trials were identified: 303 Study,
304 Study, Scand and Bonneterre. A total of 1092 patients were included.
One of these was a preliminary report of a study before completion of
accrual (Bonneterre). Patients in the 303 Study had previously received
chemotherapy involving alkylating agents; those in the other three had
received anthracyclines. There were six economic evaluations on
docetaxel. BREAST CANCER - SECOND-LINE TREATMENT, DOCETAXEL (QUALITY OF
TRIALS): The 303 and 304 Studies were analysed on an intention to treat
basis; the Scand trial excluded a single patient. The length of
follow-up ranged from 11 months (Scand) to 23 months (303 Study). At
least two-thirds of the participants in these trials had died. The Scand
study recommended cross-over to alternate treatment on objective signs
of disease progression. Patients crossing over in this way were
violating the randomisation; however, no details were given concerning
whether or not such patients were censored. In the economic analyses,
there were no direct comparisons for the estimation of benefits. BREAST
CANCER - SECOND-LINE TREATMENT, DOCETAXEL (MEDIAN PROGRESSION-FREE
SURVIVAL): The median progression-free survival in the docetaxel arm
ranged from 4.75 months (304 Study) to 7 months (Bonneterre). Patients
in the docetaxel arms of the 304 and Scand studies had significantly
longer progression-free survivals than controls (4.75 months versus 2.75
months, p = 0.001; 6.3 months versus 3 months, p = 0.001). BREAST CANCER
- SECOND-LINE TREATMENT, DOCETAXEL (MEDIAN OVERALL SURVIVAL): The median
overall survival in the docetaxel arm ranged from 10.4 months (Scand) to
15 months (303 Study). Patients in the docetaxel arms of the 304 Study
survived for significantly longer than the mitomycin plus vinblastine
arm (11.4 months versus 8.7 months, p = 0.03). BREAST CANCER -
SECOND-LINE TREATMENT, DOCETAXEL (QUALITY OF LIFE): Quality of life was
evaluated in two of the trials: the 303 and 304 Studies. There were no
significant differences between docetaxel and control in either of these
trials in terms of global health status, although differences were
apparent on some subscales. These did not appear to follow a consistent
pattern across the trials. BREAST CANCER - SECOND-LINE TREATMENT,
DOCETAXEL (ECONOMIC EVALUATIONS): All six of these involved comparisons
of paclitaxel and docetaxel, where the range of cost-utility ratios for
incremental quality-adjusted life-years (QALYs) gained was pound
1990-pound 2431. In addition, three analyses compared docetaxel and
vinorelbine. The cost-utility ratio for incremental QALYs gained was
pound 14,050 in the only one of these carried out in the UK. OVARIAN
CANCER - FIRST-LINE TREATMENT, PACLITAXEL: Four randomised controlled
Phase III trials were identified: EORTC, TITGANZ, E1193 and CA139-278.
(ABSTRACT TRUNCATED)
9
UI - 11838308
AU - Mendilcioglu I; Zorlu CG; Trak B; Ciftci C; Akinci Z
TI -
Laparoscopic management of adnexal masses. Safety and effectiveness.
SO - J Reprod Med 2002 Jan;47(1):36-40
AD - Department of Obstetrics and Gynecology, Akdeniz University School of
Medicine, Antalya, Turkey. imendilcioglu@hotmail.com
OBJECTIVE: To evaluate the effectiveness and safety of the laparoscopic
approach to adnexal masses. STUDY DESIGN: Sixty-one patients who
underwent laparoscopic intervention due to various types of adnexal
assessed retrospectively. Patients with strong evidence of advanced
ovarian cancer, such as large masses, ascites or omental cake, were
excluded. Frozen section was performed intraoperatively, if indicated.
In cases of malignancy, laparotomy was performed. RESULTS: Mean
operation time was 67.2 minutes; average hospital stay was 1.2 days.
Cyst enucleation was performed in 34% of patients. Two of 61 patients
were diagnosed as having malignant disease and converted to laparotomy.
Chemical peritonitis was encountered after dermoid cyst removal due to
spillage of contents in spite of using an endobag and irrigating
copiously with saline. No other complications were seen. CONCLUSION:
Laparoscopy is a safe approach to adnexal masses and may decrease the
rate of unnecessary laparotomies for benign cysts, which give no
suspicious ultrasonographic signs.
10
UI - 11937443
AU - Riedinger JM; Eche N; Basuyau JP; Daver A; Touzery C; Mayer F; Coudert
TI -
B; Fargeot P; Chauffert B; de Gislain C; Zanetta S
[Interpretation of the CA125 kinetics during first line chemotherapy of
the ovarian cancer: methodological aspects and characteristic profiles]
SO - Ann Biol Clin (Paris) 2002 Mar-Apr;60(2):183-91
AD - Laboratoire de biologie medicale, Centre Georges-Francois-Leclerc, 1,
rue du Professeur-Marion, 21079 Dijon cedex.
Mathematical analysis of CA125 kinetics during first line chemotherapy
allows calculation of various biologic parameters which are powerful
indicators of the therapeutic efficiency. The purpose of this study is
to present an original method of interpretation of CA125 kinetics based
on both CA125 profile and its half-life value. The first part of this
study reviews the practical modalities of CA125 kinetics analysis, the
methods of calculation of the biologic parameters as well as the
guidelines of interpretation. The second part of this work is dedicated
to the presentation of CA125 profile characteristics in responders to
chemotherapy, partially or totally nonresponders to chemotherapy,
tumoral growth under treatment and tumor lysis syndrome.
11
UI - 12101579
AU - Maksimov SIa
TI -
[Second-line chemotherapy for ovarian cancer: the potential of Taxol]
SO - Vopr Onkol 2002;48(1):99-101
12
UI - 12051874
AU - Duska LR; Garrett A; Eltabbakh GH; Oliva E; Penson R; Fuller AF
TI -
Paclitaxel and platinum chemotherapy for malignant mixed mullerian
tumors of the ovary.
SO - Gynecol Oncol 2002 Jun;85(3):459-63
AD - Vincent Gynecology Service, Massachusetts General Hospital, Boston,
Massachusetts 02114, USA. lduska@partners.org
OBJECTIVE: Malignant mixed mullerian tumor (MMMT) of the ovary is a rare
tumor with a dismal prognosis. The most effective therapy is unknown.
The current study was undertaken to characterize a group of patients
treated as if they had aggressive epithelial ovarian tumors, with
cytoreductive surgery and combination paclitaxel/platinum chemotherapy.
METHODS: Retrospective analysis of data obtained from tumor registry and
hospital records of cases of malignant mixed mullerian tumor between
January 1, 1992 and January 1, 2000 treated at the Massachusetts General
Hospital, Brigham and Women's Hospital, and University of Vermont was
performed. Only patients treated with combination paclitaxel and
platinum therapy were included in the analysis. Data were collected
regarding cytoreduction, response to chemotherapy, disease-free
interval, and survival. RESULTS: Fifty-five patients were identified
with MMMT. Twenty-eight patients with a clearly ovarian primary had
received treatment with combination paclitaxel and platinum. Paclitaxel
and carboplatin was given as second-line therapy in 2 patients who had
chemoresponsive but incurable disease; the remaining patients were
treated with paclitaxel and platinum therapy as first-line therapy.
These 28 patients had a median (range) age of 66 (46-84 years) and stage
was I in 2 patients, II in 3, III in 18, and IV in 5. Treatment was
generally well tolerated. Sixteen patients of 26 treated with paclitaxel
and platinum as first-line therapy achieved a complete clinical response
(55%) and 6 patients achieved partial response for a total response rate
of 72%. Optimal cytoreduction was associated with increased time to
recurrence (P = 0.001) but not with survival. Overall median survival
for the 28 patients is 27.1 months. CONCLUSION: Although treatment fails
many patients, a minority of patients with MMMT in this highly selected
population do unexpectedly well. An aggressive approach with surgery and
combination paclitaxel-platinum chemotherapy appears to offer very
effective therapy.
13
UI - 12051875
AU - Bailey HH; Levy D; Harris LS; Schink JC; Foss F; Beatty P; Wadler S
TI -
A phase II trial of daily perillyl alcohol in patients with advanced
ovarian cancer: Eastern Cooperative Oncology Group Study E2E96.
SO - Gynecol Oncol 2002 Jun;85(3):464-8
AD - University of Wisconsin-Madison, Madison, Wisconsin 53792, USA.
hhbailey@facstaff.wisc.edu
OBJECTIVE: This was a phase II study of perillyl alcohol in the
treatment of advanced ovarian cancer. The primary endpoint was to
evaluate the 6-month progression-free rate of perillyl alcohol as
compared with historic controls. Secondary objectives were to evaluate
the objective response rate, time to progression and survival, dropout
rate, and number of cycles administered; define the qualitative nature
of acute and chronic toxicities; and evaluate the effect of perillyl
alcohol on triglycerides and total, HDL, and LDL cholesterol levels.
Methods. Women who had received prior platinum-based therapy and had
residual or recurrent disease were eligible. Perillyl alcohol was
administered orally, four times daily, at a dose of 1200 mg/m(2). This
was repeated until disease progression or unacceptable toxicity was
experienced. RESULTS: The 6-month progression-free rate was 17%. None of
the patients achieved a complete or partial response. The median
progression-free survival was 1.7 months. The median overall survival
was 9.1 months. Compliance was greater than 90% but gastrointestinal
toxicity (grade 1-2 nausea, satiety, eructation in 70%) and fatigue
(grade 1-2 in 40%) were common and limited the ability to escalate the
dose from 1200 to 1500 mg/m(2). CONCLUSION: Perillyl alcohol
administered at this dose and formulation did not exhibit signs of
extending the time-to-progression in patients with advanced ovarian
carcinoma.
14
UI - 12051879
AU - Anupol N; Ghamande S; Odunsi K; Driscoll D; Lele S
TI -
Evaluation of prognostic factors and treatment modalities in ovarian
cancer patients with brain metastases.
SO - Gynecol Oncol 2002 Jun;85(3):487-92
AD - Division of Gynecologic Oncology, Department of Surgery, Roswell Park
Cancer Institute, Elm & Carlton Streets, Buffalo, New York 14263, USA.
OBJECTIVE: The objective of this study is to evaluate the impact of
different clinical variables and treatment modalities on survival in
patients with brain metastases from ovarian carcinoma. METHODS: Methods
included: (1) retrospective chart review of all patients with ovarian
cancer and brain metastases from 1986 to 2000 at Roswell Park Cancer
Institute and (2) Medline search was performed to extract data from all
published reports with three or more cases of ovarian cancer with brain
metastases. Cox regression analysis, Kaplan-Meier test, and log rank
test were used to calculate survival and compare the impacts of clinical
variables and treatment modalities. RESULTS: Fifteen patients with brain
metastases out of 1042 women with ovarian carcinoma were identified from
our institution, an incidence of 1.4%. The median time from initial
diagnosis to detection of brain metastases was 22 months. Patients who
were not treated after brain metastasis had a median survival of 0.5
month versus 6 months with therapy. In the subgroup of patients treated
with a combination of radiation, surgery, and chemotherapy, the median
survival was 22 months. Literature analysis combined with our data
generated 124 patients. The only clinically significant variable
impacting survival was the presence or absence of additional distant
recurrence with median survivals of 3 and 8 months, respectively (P =
0.005). Among patients who received treatment, the combination of
radiation and surgery with or without chemotherapy appears to be
beneficial, with a median survival of 20 months (P < 0.001). CONCLUSION:
Patients with brain metastases from ovarian cancer without any evidence
of disease in other sites appear to benefit from aggressive combined
treatment with external radiation and surgery with or without
chemotherapy with a median survival of 20 months.
15
UI - 12082646
AU - Harper P
TI -
Current clinical practices for ovarian cancers.
SO - Semin Oncol 2002 Jun;29(3 Suppl 8):3-6
AD - Medical Oncology Department, Guy's Hospital, London, UK.
Ovarian cancer is one of the most aggressive gynecologic cancers. It
shows its symptoms late and is consequently often diagnosed at an
advanced stage. The search for a more effective chemotherapy regimen,
therefore, is of great importance. Since 1996, the combination of
cisplatin and paclitaxel has been proven to prolong survival in
comparison with older regimens containing cisplatin and
cyclophosphamide. In addition, the introduction of carboplatin in
combination with paclitaxel showed similar efficacy but preferable
toxicity profiles when compared with cisplatin in combination with
paclitaxel. Representative studies evaluating paclitaxel combination
therapies as well as new trends in the treatment of ovarian cancer are
summarized in this article. Copyright 2002, Elsevier Science (USA). All
rights reserved.
16
UI - 11828945
AU - Kuzuya K; Ishikawa H; Nakanishi T; Kikkawa F; Nawa A; Fujimura H; Iwase
TI -
A; Arii Y; Kawai M; Hattori S; Sakakibara K; Sasayama E; Furuhashi Y;
Suzuki T; Mizutani S; Tokai Gynecologic Oncology Group
Optimal doses of paclitaxel and carboplatin combination chemotherapy for
ovarian cancer: a phase I modified continual reassessment method study.
SO - Int J Clin Oncol 2001 Dec;6(6):271-8
AD - Department of Gynecology, Aichi Cancer Center Hospital, 1-1 Kanoko-den,
Chikusa-ku, Nagoya 464-8681, Japan. 105182@acc.pref.aichi.jp
BACKGROUND: A multicenter, phase I study of combination therapy with
paclitaxel and carboplatin for epithelial ovarian cancer was conducted
to determine the safety and recommended dosages for Japanese women.
METHODS: Paclitaxel was administered intravenously over a 3-h period,
followed by carboplatin administered intravenously over a 1.5-h period.
A modified continual reassessment method (mCRM) was used in two
treatment arms to establish the maximum tolerated dose (MTD) and
recommended doses of the combination. In group A, the dose of paclitaxel
(175 mg/m2) was constant and the dose of carboplatin was increased from
4 to 7 in terms of the target area under the plasma
concentration-versus-time curve (AUC). In group B, the dose of
carboplatin was constant (AUC 6) and paclitaxel was administered at two
dose levels (160 and 175 mg/m2). In both groups, the carboplatin dose
was limited to a maximum of 800 mg/body for each administration.
RESULTS: Because the calculated probability of toxicity was greatest at
a dose of paclitaxel 175 mg/m2 and carboplatin AUC 7, this dose was
designated the MTD in group A. Based on this result, treatment in group
B was initiated at doses of paclitaxel of 160 mg/m2 and carboplatin AUC
6. While the dose of paclitaxel was escalated to 175 mg/m2, the safety
of the combination was confirmed. The most frequent adverse effect was
neutropenia, which resolved promptly with the appropriate use of
granulocyte-colony stimulating factor (G-CSF). No other severe
hematologic or nonhematologic toxicities were observed. CONCLUSIONS: Our
study demonstrated that the recommended dose for this combination
regimen should be paclitaxel 175 mg/m2 plus carboplatin AUC 6 (maximum
dose, 800 mg/body).
17
UI - 12057050
AU - Coukos G; Rubin SC
TI -
Early ovarian cancer.
SO - Curr Treat Options Oncol 2000 Jun;1(2):129-37
AD - Division of Gynecologic Oncology, University of Pennsylvania Hospital,
3400 Spruce Street, Philadelphia, PA 19104, USA.
Epithelial ovarian cancer may appear to be confined to the ovaries or
pelvis in approximately one-third of patients at exploration, but up to
30% of them will be upstaged following surgical staging. Substage and
histotype are the most important prognostic factors that determine the
need for adjuvant treatment. Patients with stage Ia or Ib and
well-differentiated (other than clear cell) tumors do not require
adjuvant treatment. Patients with stage Ia or Ib grade 3 or clear cell
histology, as well as any stage Ic and II disease, are at high risk for
recurrence. Platinum-based chemotherapy is the mainstay of treatment.
Four to six courses are probably adequate, although grade 3 tumors may
require further treatment. Preservation of the uterus and the uninvolved
contralateral ovary is a viable option in young women with unilateral
early disease.
18
UI - 12057051
AU - Chi DS; Sabbatini P
TI -
Advanced ovarian cancer.
SO - Curr Treat Options Oncol 2000 Jun;1(2):139-46
AD - Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY
10021, USA.
State-of-the-art treatment for advanced ovarian cancer requires a
multimodality approach. Aggressive surgical debulking with the goal of
optimal cytoreduction is the initial step. After primary cytoreductive
surgery, standard treatment for patients with stage III and IV disease
is systemic combination chemotherapy consisting of six cycles of
paclitaxel and carboplatin. Approximately 70% of patients enter a
clinical remission with this approach, yet less than 30% remain disease
free. Options following primary therapy include observation or second
surgical assessment if no clinical evidence of disease is present. Novel
strategies for consolidation are needed. Second-look surgery can be
performed safely and effectively laparoscopically, and this is the most
accurate means of identifying patients who appear to be clinically free
of disease but actually harbor persistent cancer. Although this
procedure is an extremely accurate means of identifying these patients,
women who have pathologically negative second-look surgery are still at
risk for relapse. Patients can receive additional treatment following
second-look surgical assessment via the intraperitoneal route if they
are pathologically negative or if they have microscopic or small volume
disease. Alternatively, additional systemic chemotherapy can be given
with non-cross-resistant systemic agents, but no current standard
approach for consolidation therapy exists for patients following the
completion of primary treatment. Unfortunately, most patients relapse.
Multiple agents with similar activity in phase II trials are available
to treat patients with advanced recurrent disease. Combination therapy
in this setting has not been shown to have significantly superior
progression-free or overall survival compared with single agents. The
selection of treatment for patients with recurrent disease is currently
based on a determination of the treatment-free interval since last
treatment, as well as the route, schedule, and expected side effects of
the agent.
19
UI - 12118543
AU - Randall ME; Barrett RJ; Spirtos NM; Chalas E; Homesley HD; Lentz SL;
TI -
Hanna M
Chemotherapy, early surgical reassessment, and hyperfractionated
abdominal radiotherapy in stage III ovarian cancer: results of a
gynecologic oncology group study.
SO - Int J Radiat Oncol Biol Phys 1996 Jan 1;34(1):139-47
AD - Department of Radiation Oncology, Indiana University School of Medicine,
Indianapolis, USA. Marc_randall@iucc.iupui.edu
PURPOSE: To determine outcomes and treatment toxicities in patients with
optimal (< or = 1 cm residual) Stage III ovarian carcinoma treated with
three courses of cisplatin-cyclophosphamide, surgical reassessment
(SRA), and hyperfractionated whole abdominal irradiation (WAI). METHODS
AND MATERIALS: Forty-two eligible patients entered this prospective
Phase II study conducted by the Gynecologic Oncology Group (GOG).
Disease characteristics were as follows: age range, 32-76 years (median
58); Stage IIIA (n = 1, 2%), IIIB (n = 2, 5%), IIIC (n = 39, 93%);
histology-serous papillary (n = 21, 50%); other (n = 21, 50%); Grade 1
(n = 1, 2%); 2 (n = 14, 33%); 3 (n = 27, 54%); residual disease after
initial surgery (present: n = 23, 55%; absent: n = 19, 45%). Five
patients progressed while on chemotherapy, could not be effectively
cytoreduced, and were not eligible for WAI. Of the remaining 37
patients, 35 received WAI. Surgical reassessment was not performed in
five patients. RESULTS: Of 37 patients with known SRA status after
chemotherapy, 21 (57%) were grossly positive, 4 (11%) were
microscopically positive, and 12 (32%) were negative. Based on
measurements recorded following initial laparotomy and surgical
reassessment, progression during chemotherapy was noted in 40%, stage
disease in 37%, and objective response in 23%. Toxicity during
hyperfractionated WAI was limited and reversible. No patient beginning
WAI failed to complete or required a significant treatment break.
Following WAI, six patients underwent laparotomies for abdominal
symptoms; five had recurrent disease. Five additional patients were
managed conservatively for small bowel obstruction (SBO) or
malabsorption, of whom three subsequently developed recurrence.
Twenty-two patients having pelvic boosts were significantly more likely
to require management for gastrointestinal morbidity (p = 0.0021).
Considering all eligible patients, median disease-free and overall
survivals were 18.5 and 39 months, respectively. Considering patients
completing chemotherapy and WAI, median disease-free and overall
survivals were 24 and 46 months, respectively. CONCLUSIONS: (a) Disease
progression occurred within three cycles of cisplatin and
cyclophosphamide chemotherapy in 40% of patients with optimal (< or = 1
cm residual) Stage III ovarian carcinoma. (b) Following limited
chemotherapy, hyper-fractionated WAI was acutely well tolerated. (c)
Late radiation-related toxicity was observed in only three patients
(8.6%) in the absence of recurrent disease. Late gastrointestinal
morbidity was significantly associated with the administration of a
pelvic radiotherapy (RT) boost. (d) Short duration chemotherapy followed
by SRA and hyperfractionated WAI without a pelvic boost is a promising
management option for patients with optimal Stage III ovarian cancer. A
Phase III trial will be necessary to determine how this treatment
strategy compares with chemotherapy or RT alone in this patient
population.
20
UI - 12112979
AU - Wang J; Li AJ; Karlan BY
TI -
Chemotherapy in epithelial ovarian cancer.
SO - Curr Womens Health Rep 2002 Feb;2(1):20-6
AD - Division of Gynecologic Oncology, Cedars-Sinai Medical Center, UCLA
School of Medicine, 8700 Beverly Boulevard, #160W, Los Angeles, CA
90048, USA.
The management of epithelial ovarian carcinoma can be the most
challenging of all the gynecologic malignancies partly because of the
paucity of effective screening tools for early-stage disease. Numerous
randomized clinical trials identified several cytotoxic agents that are
active against epithelial ovarian cancer, but the current standard of
care remains optimal surgical cytoreduction followed by platinum and
taxane-based chemotherapy. When disease recurs or progresses,
alternative chemotherapy regimens often have efficacy, either as a
single agent or in combination. While treatment recommendations should
be individualized, the disease-free interval after induction
chemotherapy is often the most clinically useful parameter to determine
selection of second-line therapy. Investigations into novel
chemotherapeutic agents and other biologic molecules have led to
advances in the therapeutic armamentarium and have improved survival for
women with ovarian cancer.
21
UI - 12112982
AU - Bauknecht T; Meinhold-Heerlein I
TI -
Gene therapy of ovarian cancer.
SO - Curr Womens Health Rep 2002 Feb;2(1):39-46
AD - Department of Obstetrics and Gynecology, University of Bonn Medical
School, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany.
t.bauknecht@uni-bonn.de
For the treatment of ovarian cancer, gene therapy is increasingly viewed
as the fourth therapeutic concept (in addition to surgery, chemotherapy,
and irradiation). Many approaches that use viral and nonviral delivery
systems have been employed to introduce genes into tumor cells, thus
changing their malignant phenotype. The development of tissue-specific
promoters has enhanced the specificity of adenoviral transduction, the
most commonly used transfer method. Phase I clinical trials (targeting
p53, BRCA1, Her2/neu, Bcl-2, MDR, EIA, and HSV-TK genes) have been
performed to test the relative safety of different strategies. Further
studies are needed to evaluate the effectiveness of these treatments.
New studies must evaluate gene therapy alone and in combination with
cytostatic regimens because preclinical studies have shown the
chemosensitizing effects of several target genes. The increasing
knowledge about the genetic background of ovarian cancer will provide
many targets for novel gene therapy approaches.
22
UI - 12113097
AU - Anonymous
TI -
Novuspharma announces preliminary results of phase II trials for BBR
3464.
SO - Expert Rev Anticancer Ther 2001 Oct;1(3):325-6
23
UI - 12079309
AU - de Gramont A; Gangji D; Louvet C; Garcia ML; Tardy D; Romet-Lemonne JL
TI -
Adoptive immunotherapy of ovarian carcinoma.
SO - Gynecol Oncol 2002 Jul;86(1):102-3
24
UI - 12079297
AU - Trimble CL; Kosary C; Trimble EL
TI -
Long-term survival and patterns of care in women with ovarian tumors of
low malignant potential.
SO - Gynecol Oncol 2002 Jul;86(1):34-7
AD - Department of Gynecology and Obstetrics, The Johns Hopkins Hospital,
Baltimore, Maryland, USA.
OBJECTIVES: The objectives of this study were to ascertain long-term
survival and patterns of care among women diagnosed with ovarian tumors
of low malignant potential (LMP) in a population-based data set.
METHODS: Using the NCI's Surveillance, Epidemiology, and End Results
(SEER) database, we identified 2818 women diagnosed with ovarian tumors
of low malignant potential between 1988 and 1997. RESULTS: By FIGO
stage, 10-year relative survival was as follows: stage I, 99%; stage II,
98%; stage III, 96%; and stage IV 77%. One-quarter of women with stage I
disease underwent partial or unilateral oophorectomy only, while women
with more advanced disease commonly underwent omentectomy, unilateral or
bilateral oophorectomy, and hysterectomy. Adjuvant chemotherapy was
given to about 30% of women with stage III and IV disease. Radiation
therapy was rarely used. We observed no significant changes in primary
surgery or adjuvant treatment over time. CONCLUSIONS: The diagnosis of
an ovarian tumor of LMP conveys a relatively benign prognosis.
Conservative surgery should be considered in younger women with
early-stage disease. There are insufficient data to support a role for
adjuvant chemotherapy for women with advanced disease. (c) 2002 Elsevier
Science (USA).
25
UI - 12079301
AU - Saygili U; Guclu S; Uslu T; Erten O; Demir N; Onvural A
TI -
Can serum CA-125 levels predict the optimal primary cytoreduction in
patients with advanced ovarian carcinoma?
SO - Gynecol Oncol 2002 Jul;86(1):57-61
AD - Department of Obstetrics and Gynecology, Dokuz Eylul University School
of Medicine, Izmir, Turkey. Saygiliu@hotmail.com
OBJECTIVE: The aim of this study was to investigate the predictive value
of serum CA-125 levels to ability of optimal primary cytoreduction in
patients with advanced epithelial ovarian carcinoma. METHODS:
Preoperative serum CA-125 levels were determined by a commercial enzyme
immunoassay kit in a series of 92 patients with stage IIIC epithelial
ovarian carcinoma. The abilities of various cutoff value of CA-125 to
predict suboptimal cytoreductive surgery were determined. A receiver
operating characteristic curve was used to find the most clinically
useful CA-125 cutoff value. RESULTS: Optimal cytoreduction was obtained
in 48 patients (52%) using the diameter of the largest residual tumor
nodule less than 1 cm. Receiver operating characteristic curve showed
that the most clinically suitable CA-125 cutoff value was 500 U/ml.
Forty-seven patients (51%) had preoperative serum CA-125 levels below
500 U/ml. Of these patients, optimal cytoreductive surgery was performed
in 36 (77%). Of the 45 patients with serum CA-125 levels greater than
500 U/ml, optimal cytoreductive surgery was achieved in 12 (27%). True-
and false-positive rates were 73 and 23%, respectively. CONCLUSIONS:
Although our results showed that preoperative serum CA-125 levels might
predict the optimal resectable patients, larger prospective studies are
needed to prove its predictivity. Gynecologic oncologists should
evaluate the sum of all criteria until more data are available. (c) 2002
Elsevier Science (USA).
26
UI - 12048682
AU - Jin Z; Guan T; Li S
TI -
[Effects of wild-type p53 gene on the chemotherapy sensitivity of
ovarian cancer SKOV-3 cells to cisplatin]
SO - Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2002 Jun;19(3):218-20
AD - Department of Obstetrics and Gynecology, the Second Hospital, China
Medical University, Shenyang, Liaoning, 110004 P. R. China.
peiling@ihw.com.cn
OBJECTIVE: To assess the effect of wild-type p53 gene on the
chemotherapy sensitivity of ovarian cancer SKOV-3 cells to cisplatin.
METHODS: Recombinant eukaryotic expression vector pcDNA3 containing
full-length human wild-type p53 cDNA was introduced by
lipofectamine-mediated gene transfection into SKOV-3 cultured cells
which were acted on by cisplatin of different concentrations. The
chemotherapy sensitivity of tumor cells with different-status p53 was
observed. RESULTS: The inhibitive rate of formation of clones after p53
cDNA transfection was 56.4% compared with the untransfected one. The
formation of clones decreased by 76.2% and 84.1% respectively after
being acted on by 0.5 ug/ml cisplatin for 24 hours and 48 hours
respectively. The formation of clones decreased by 89.5% and 93.7%
respectively after being acted on by 1 ug/ml cisplatin for 24 hours and
48 hours respectively. After the introduction of p53 cDNA, the S phase
and the ratio of G(2)/M phase of tumor cells decreased, and the ratio of
G(1)/G(0) phase increased. The introduction of p53 gene into cells led
to cell cycle arrest in G(1) phase. CONCLUSION: The exogenous
introduction of wild-type p53 cDNA into ovarian cancer SKOV-3 cells
increased the chemotherapy sensitivity to cisplatin.
27
UI - 12100804
AU - Cooper BC; Sood AK; Davis CS; Ritchie JM; Sorosky JI; Anderson B; Buller
TI -
RE
Preoperative CA 125 levels: an independent prognostic factor for
epithelial ovarian cancer.
SO - Obstet Gynecol 2002 Jul;100(1):59-64
AD - Division of Gynecologic Oncology, Department of Obstetrics and
Gynecology, the University of Iowa Hospitals and Clinics, Iowa City
52242, USA.
OBJECTIVE:To estimate the association of preoperative CA 125 levels with
outcome in primary ovarian cancer patients.METHODS:One hundred forty-two
patients with epithelial ovarian cancer, who had a serum CA 125 level
drawn before surgery, were retrospectively evaluated. The relationship
of preoperative CA 125 levels and various preoperative and postoperative
variables was evaluated. CA 125 levels were determined using a
solid-phase immunoassay.RESULTS:The median CA 125 value for all patients
was 582 U/mL (range 7-52,930 U/mL). Preoperative CA 125 values did not
correlate with increasing age (P =.40), but were found to be
significantly associated with serous histology compared with other
histology (median CA 125 of 870 versus 334 U/mL, P =.02), high-stage
(III/IV) compared with low-stage (median CA 125 of 893 versus 174 U/mL,
P <.001), high tumor grade (3) compared with grade 1 or 2 (median CA 125
of 928 versus 323 U/mL, P <.001), and the presence of ascites compared
with absence of ascites (median CA 125 of 893 versus 220 U/mL, P <.001).
Suboptimal cytoreduction (more than 1 cm residual) was associated with
significantly higher CA 125 levels (1067 U/mL) compared with individuals
with optimal cytoreduction (399 U/mL, P <.001). Preoperative CA 125
values less than 500 U/mL had a positive predictive value for optimal
cytoreduction of 82%, but a poor negative predictive value of 48%. After
adjusting for covariates, there was a significant association between CA
125 levels and disease-specific survival. As preoperative CA 125 levels
increased, the risk of death increased except at the highest values of
CA 125.CONCLUSION:Preoperative CA 125 is an independent risk factor for
death due to disease in ovarian cancer, but not a reliable predictor of
optimal cytoreduction.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
Cancer Types
Bone Cancer
Brain Tumors
Breast Cancer
Carcinoid Tumors
Endocrine System Cancers
Gastrointestinal Cancers
Gynecologic Cancers
Head and Neck Cancers
Leukemia
Lung Cancers
Lymphomas
Myelomas
Pediatric Cancers
Penile Cancer
Prostate Cancer
Sarcomas
Skin Cancers
Testicular Cancer
Thyroid Cancer
Urinary Tract Cancers
OncoLink Vet
Cancer Treatment
Biologic Therapy
Bone Marrow Transplants
Chemotherapy
Clinical Trials
Complementary Medicine
Gene Therapy
General Treatment Concerns
Hormone Therapy
PDT Center
Proton Therapy
Radiation Oncology
Surgical Oncology
Targeted Therapies
Vaccine Therapies
Cancer Support
Caregivers
Hospice Care and Bereavement
Nutrition and Cancer
Sexuality & Fertility
Side Effects
Support
Survivorship
Exercise and Cancer
Cancer Resources
Cancer News
OncoLink University
Nurses' Notes
Conferences
Newly Diagnosed Patients
Causes and Prevention
Legal and Financial Information for Patients
LGBT Resources
NCI Resources
Global Resources
Cancer Resource List
Resources for Young Adults
OncoLink Media Library
OncoLink TV
Book, Music and Video Reviews
Ask the Experts
Brown Bag Chat
Tracy's Corner
About OncoLink
About OncoLink
Giving to OncoLink
Contact Information
Usage Policy
Editorial Board
How to Partner with OncoLink
Link to OncoLink
Mission Statement
