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Gynecologic Oncology

Lisa D Kellenberger, Jim Petrik
INTRODUCTION: Epithelial ovarian cancer (EOC) is notoriously difficult to diagnose in its earlier and more treatable stages, making it one of the deadliest cancers in women. Comorbid diabetes is associated with poor prognosis in EOC and pro-growth insulin signalling is often considered to be the driving factor. However, EOC cells are also highly glycolytic and insulin-independent glucose uptake is essential to their metabolism. Evidence of gluconeogenesis in cancer in vivo suggests that the normal concentration of circulating glucose does not meet the energy demands of the tumor and may therefore be a limiting factor in cancer cell metabolism...
February 17, 2018: Gynecologic Oncology
Jay R Patibandla, Julia E Fehniger, Douglas A Levine, Petar Jelinic
OBJECTIVE: Extra-pulmonary small cell carcinomas of the gynecologic tract (EPSCC-GTs) are a rare group of aggressive malignancies associated with poor prognoses and limited treatment options. Here, we review the clinical and molecular aspects of EPSCC-GTs and discuss how understanding their molecular features can assist in their diagnosis and the identification of novel effective treatments. METHODS: We searched PubMed and Scopus for articles using the following keywords: "small cell carcinoma" in combination with "neuroendocrine", "ovary", "vagina", "fallopian tube", "vulva", "endometrium", "uterus", "cervix", or "gynecologic"...
February 17, 2018: Gynecologic Oncology
Amit Oza, Stanley Kaye, Jan Van Tornout, Cristiana Sessa, Martin Gore, R Wendel Naumann, Hal Hirte, Nicoletta Colombo, Jihong Chen, Seema Gorla, Srinivasu Poondru, Margaret Singh, Joyce Steinberg, Geoff Yuen, Susana Banerjee
BACKGROUND: Linsitinib, an oral, dual inhibitor of insulin-like growth factor-1 receptor and insulin receptor, in combination with weekly paclitaxel, may improve clinical outcomes compared with paclitaxel alone in patients with refractory or platinum-resistant ovarian cancer. PATIENTS AND METHODS: This open-label phase 1/2 clinical trial (NCT00889382) randomized patients with refractory or platinum-resistant ovarian cancer (1:1:1) to receive either oral intermittent linsitinib (600mg once daily on Days 1-3 per week) combined with paclitaxel (80mg/m2 on Days 1, 8, and 15; Arm A) or continuous linsitinib (150mg twice daily) in combination with paclitaxel (Arm B), or paclitaxel alone (Arm C)...
February 14, 2018: Gynecologic Oncology
Yanli Li, Tingting Wu, Yanan Wang, Liu Yang, Chengcheng Hu, Limo Chen, Sufang Wu
OBJECTIVE: High grade serous ovarian cancer (HGSC) remains one of the most lethal malignancies in females. We previously reported that γ-glutamyl cyclotransferase (GGCT) was significantly upregulated in serous ovarian cancer. The current study was aimed to explore the function and underlying mechanism of GGCT in HGSC. METHODS: GGCT expression was assessed by immunohistochemistry in 128 HGSC patients. Stable cell lines with GGCT gene overexpression or knockdown were established to investigate the function of GGCT in HGSC in vitro and in vivo...
February 8, 2018: Gynecologic Oncology
Erin K Crane, Jubilee Brown
Mucinous ovarian carcinomas (MOCs) are an uncommon subset of epithelial neoplasms, both clinically and molecularly distinct from other ovarian cancers. Pathologic diagnosis proves challenging, and metastatic disease from other sites-especially the digestive tract-must be excluded. Fortunately, most patients are diagnosed at an early stage of disease and often present with large, unilateral adnexal masses. Survival for patients with stage IA disease approaches over 90%, and surgery alone is sufficient. Patients with stage IB-II disease should receive adjuvant treatment but the specific regimen is controversial...
February 8, 2018: Gynecologic Oncology
Marta Maria Kemp, Krzysztof Gałczyński, Revaz Botchorishvili, Nicolas Bourdel
No abstract text is available yet for this article.
February 8, 2018: Gynecologic Oncology
C Bethan Powell, Amy Alabaster, Nicole Stoller, Mary Anne Armstrong, Chelsea Salyer, Isabella Hamilton, Tina Raine-Bennett
OBJECTIVE: Estimate the prevalence and identify risk factors for bone loss in women with BRCA mutations. METHODS: Women, age 40 and older, with BRCA mutations identified from the Breast Cancer Surveillance database at Kaiser Permanente Northern California were invited to participate and undergo a dual-energy x-ray absorptiometry scan to assess for bone loss (osteopenia or osteoporosis). Multivariable logistic regression analysis was performed to assess clinical factors associated with bone loss...
February 5, 2018: Gynecologic Oncology
Pinkal Desai, Robert Wallace, Matthew L Anderson, Barbara V Howard, Roberta M Ray, Chunyuan Wu, Monika Safford, Lisa W Martin, Thomas Rohan, JoAnn E Manson, Michael S Simon
BACKGROUND: Statins have anti proliferative activity in vitro against endometrial and ovarian cancer and can affect levels of reproductive hormones. We analyzed data from the Women's Health Initiative (WHI) to assess whether statins are associated with risk of endometrial and ovarian cancer. METHODS: The WHI study included 161,808 postmenopausal women in which incident cases of endometrial (n = 1377) and ovarian cancer (n = 763) were identified over an average of 10...
February 5, 2018: Gynecologic Oncology
Kari E Hacker, R Kevin Reynolds, Shitanshu Uppal
The opioid crisis in the United States has been declared a public health emergency. Various governmental agencies, cancer care organizations and the Centers for Disease Control and Prevention have issued guidelines in hopes of managing this crisis. Curbing over-prescription of opioids by medical professionals has been a central theme in many of these guidelines. Gynecologic oncologists encounter patients with a variety of pain sources, including acute pain secondary to the underlying malignancy or surgical procedures as well as chronic pain related to the malignancy and the sequelae of treatments rendered...
February 3, 2018: Gynecologic Oncology
Casey L Swanson, Amanika Kumar, Joy M Maharaj, Jennifer L Kemppainen, Brittany C Thomas, Megan R Weinhold, Kristine M Slaby, Kristin C Mara, Myra J Wick, Jamie N Bakkum-Gamez
OBJECTIVE: To increase genetic counseling referrals for patients with newly diagnosed epithelial ovarian cancer (EOC). METHODS: A practice-gap analysis was performed after measuring baseline genetic counseling referral rates to identify barriers to referral from the multidisciplinary single institution EOC care group. A Genetics Referral Toolkit consisting of a referral template, a genetic risk checklist, family history worksheet and provider and patient awareness was developed to address identified gaps with the goal of increasing referral rates...
February 3, 2018: Gynecologic Oncology
Katherine R Miller, Jai N Patel, Qing Zhang, Eric J Norris, James Symanowski, Chad Michener, Jalid Sehouli, Ioana Braicu, Darla D Destephanis, Ashley P Sutker, Wendell Jones, Chad A Livasy, Charles Biscotti, Ram N Ganapathi, David L Tait, Mahrukh K Ganapathi
OBJECTIVES: Aberrant homeobox (HOX) gene expression is reported in high-grade serous ovarian carcinoma (HGSOC), however, its prognostic significance remains unclear. METHODS: HOX genes associated with progression-free survival (PFS) in a discovery cohort of primary HGSOC samples with RNA sequencing data, and those previously reported to be associated with clinical outcomes, were selected for qPCR testing in an independent training cohort of primary HGSOC samples (n=71)...
February 2, 2018: Gynecologic Oncology
Ekkasit Tharavichitkul, Somvilai Chakrabandhu, Pitchayaponne Klunklin, Wimrak Onchan, Bongkot Jia-Mahasap, Somsak Wanwilairat, Damrongsak Tippanya, Rungtip Jayasvasti, Patumrat Sripan, Razvan M Galalae, Imjai Chitapanarux
OBJECTIVES: To report the intermediate-term results of trans-abdominal ultrasound (TAUS)-guided brachytherapy in cervical cancer. MATERIALS AND METHODS: Ninety-two patients with cervical cancer (stage IB-IVA, according to FIGO staging), were treated by curative radiotherapy from February 2012 to June 2015. All patients were treated with whole pelvic radiotherapy to 50 Gy in 25 fractions and central shielding after 44 Gy, in combination with TAUS-guided brachytherapy, in order to escalate the total dose (EQD2) to the minimal dose at cervical points (in EQD2 concepts) defined by TAUS, while maintaining low doses to ICRU bladder and rectal points...
February 2, 2018: Gynecologic Oncology
R Wendel Naumann, Jubilee Brown
OBJECTIVES: To measure the effectiveness of ovarian cancer screening using the Risk of Ovarian Cancer Algorithm (ROCA). METHODS: A Markov model was constructed based on the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). This model was used to predict the outcome of ovarian cancer screening with ROCA. RESULTS: The model predicted the ovarian cancer mortality from age 50 to age 85 to be 0.954% with a decrease in life expectancy of 0...
February 1, 2018: Gynecologic Oncology
Kathleen N Moore, Mansoor Raza Mirza, Ursula A Matulonis
Niraparib is an oral poly(ADP ribose) polymerase (PARP) inhibitor that is currently approved by the United States Food and Drug Administration (US FDA) as well as recently approved by the European Medicines Agency (EMA) for the maintenance treatment of women with recurrent ovarian cancer who are in complete or partial response to platinum-based chemotherapy. The mechanisms of action of niraparib include inhibition of PARP enzymatic activity as well as increased formation of PARP-DNA complexes through "trapping" the PARP enzyme on damaged DNA...
January 31, 2018: Gynecologic Oncology
Shannon D Armbruster, Jaejoon Song, Leticia Gatus, Karen H Lu, Karen M Basen-Engquist
OBJECTIVE: To identify the baseline sleep patterns of endometrial cancer survivors and examine the impact of a physical activity intervention on their sleep quality via retrospective secondary analysis. METHODS: Early-stage endometrial cancer survivors participated in a 6-month single-arm exercise intervention using printed materials, telephone-based counseling, and pedometers to encourage adherence to exercise guidelines. Participants completed questionnaires evaluating their sleep (PSQI), physical activity (CHAMPS), quality of life (SF-36), and stress (PSS) at baseline and study completion...
January 30, 2018: Gynecologic Oncology
Summer B Dewdney, Amy C Dancisak, Jason A Lachance, Edward C Grendys, Sean C Dowdy, Matthew Powell, John O Schorge
OBJECTIVE: Clinical registries within medical societies have demonstrated the capacity to promote quality improvement. Opportunities for well-designed data repositories could yield reliable national standards for informing reimbursement, determining adherence to care guidelines, maintaining board certification, and developing bundled payment models. Looking to the future, we set out to develop a gynecologic cancer registry serving the members of the Society of Gynecologic Oncology (SGO)...
January 30, 2018: Gynecologic Oncology
Christoph Grimm, Stephan Polterauer, Samir Helmy-Bader, Michal Zikan, David Cibula, Florian Heitz, Philipp Harter, Arnd Giese, Alexander Reinthaller, Clemens Tempfer
OBJECTIVE: To evaluate the efficacy of a collagen-fibrin patch for the prevention of symptomatic lymphoceles after pelvic lymphadenectomy in women with gynecologic malignancies. METHODS: In a multicenter, randomized, clinical trial, 164 women with pelvic lymphadenectomy were allocated either to bilateral pelvic application of two collagen-fibrin patches or no intervention. Main outcome was efficacy, defined as reduction of symptomatic lymphocele rate diagnosed within four weeks after surgery...
January 30, 2018: Gynecologic Oncology
Camille C Gunderson, Ursula Matulonis, Kathleen N Moore
As precision medicine has become a focus in oncology in recent years, many targeted and biologic agents are being used along with or in place of traditional cytotoxic chemotherapy. As these drugs have been developed and some have received FDA approval, we have gained substantial data about the adverse event profiles. However, the management and approach to the toxicities incurred and subsequent complications are often not well understood, especially for physicians who have a varied clinical practice. The purpose of this review is to provide an overview of the frequency and types of adverse events and appropriate management steps when prescribing modern targeted therapies for gynecologic cancers in the classes of anti-angiogenic agents, poly-ADP-ribose polymerase (PARP) inhibitors, and immunotherapy drugs...
January 30, 2018: Gynecologic Oncology
Roy Kessous, David Octeau, Kathleen Klein, Patricia N Tonin, Celia M T Greenwood, Manuela Pelmus, Ido Laskov, Liron Kogan, Shannon Salvador, Susie Lau, Amber Yasmeen, Walter H Gotlieb
OBJECTIVE: The expression of homologous recombination (HR) genes in high grade ovarian cancer (HGOC) samples from debulking surgeries were correlated to outcomes in patients selected for chemotherapy treatment regimens. STUDY DESIGN: RNA was extracted from 96 fresh frozen tumor samples from debulking surgeries from chemotherapy naïve patients with HGOC (primary derived surgeries (PDS), n = 55) or following neoadjuvant chemotherapy treatment (NACT), n = 41)...
January 29, 2018: Gynecologic Oncology
C E Henry, E Llamosas, B Daniels, A Coopes, K Tang, C E Ford
OBJECTIVE: In recent years, the Wnt signalling pathway and the ROR1 and ROR2 receptors have been implicated in a range of gynecological cancers. These receptors have been described as prospective therapeutic targets, and this study investigated such potential in an endometrial cancer context. METHOD: Immunohistochemistry for ROR1 and ROR2 was performed in a patient cohort, and expression was correlated with clinicopathological parameters including type, stage, grade, myometrial invasion, lymphovascular involvement, patient age and survival...
January 29, 2018: Gynecologic Oncology
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