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Current Opinion in Obstetrics & Gynecology

Yiu-Man Chan, Tin-Chiu Li, Liona C Y Poon
PURPOSE OF REVIEW: To provide updated information on preimplantation genetic testing for aneuploidy (PGT-A), focusing on its implications on prenatal diagnostic approaches after transferal of mosaic aneuploid embryos. RECENT FINDINGS: PGT-A is a technology to screen for chromosome aneuploidy or major chromosome structural rearrangement in embryos before implantation using different cytogenetic analyses. PGT-A has been shown to reduce the negative effect of increasing maternal age on in-vitro fertilization (IVF) outcomes...
January 7, 2019: Current Opinion in Obstetrics & Gynecology
Fengchang Qiao, Ping Hu, Zhengfeng Xu
PURPOSE OF REVIEW: Congenital heart defects (CHDs) are the most common type of birth defects, and are thought to result from genetic-environmental interactions. Currently, karyotype and chromosomal microarray analyses are the primary methods used to detect chromosomal abnormalities and copy number variations in fetuses with CHD. Recently, with the introduction of next-generation sequencing (NGS) in prenatal diagnosis, gene mutations have been identified in cases of CHD. The purpose of this review is to summarize current studies about the genetic cause of fetal CHD, paying particular attention to the application of NGS for fetuses with CHD...
January 2, 2019: Current Opinion in Obstetrics & Gynecology
Arkadius Polasik, Marie Tzschaschel, Fabienne Schochter, Thomas W P Friedl, Brigitte Rack, Andreas Hartkopf, Peter A Fasching, Andreas Schneeweiss, Volkmar Müller, Jens Huober, Wolfgang Janni, Tanja Fehm
PURPOSE OF REVIEW: The possibility of tumor dissemination through the blood system has been known for years. Circulating tumor cells (CTCs) are detectable in the peripheral blood of patients with early as well as metastatic breast cancer. The prognostic relevance of this biomarker has already been described. By the use of repeated blood sampling along the course of disease, CTCs can be monitored in terms of a regular 'liquid biopsy'. This review aims to summarize recent research findings and actual ongoing clinical studies to demonstrate the actual and future relevance of CTCs in daily clinical routine...
December 11, 2018: Current Opinion in Obstetrics & Gynecology
Kelly E McCann
PURPOSE OF REVIEW: Poly-ADP-ribosyl-polymerase (PARP) inhibitors are an increasingly-utilized therapy in women with high-grade serous ovarian carcinoma, but tumor resistance to PARP inhibitor monotherapy is inevitable. RECENT FINDINGS: PARP inhibitors have been most studied in patients with breast and ovarian cancers associated with deleterious germline BRCA1 or BRCA2 mutations, though their role has expanded to include use as maintenance therapy in women with platinum-sensitive high-grade serous ovarian cancer due to the high propensity of such cancers to have defects in DNA repair by homologous recombination...
December 11, 2018: Current Opinion in Obstetrics & Gynecology
Daphne Stewart, Mihaela Cristea
PURPOSE OF REVIEW: Antibody drug conjugates (ADC) are a novel class of cancer therapeutics, delivering cytotoxic therapy directly to cancer cells, and show promise in the management of platinum-resistant ovarian cancer. Herein we summarize the ADC landscape currently in clinical study. RECENT FINDINGS: Mirvetuximab Soravtansine, IMGN853, is an ADC targeting the folate receptor alpha (FRα) and has demonstrated promising single agent activity and a favorable toxicity profile in FRα-positive, platinum-resistant, epithelial ovarian cancer (EOC)...
December 10, 2018: Current Opinion in Obstetrics & Gynecology
Peter A Fasching, Andreas Schneeweiss, Hans-Christian Kolberg, Johannes Ettl, Tanja N Fehm, Friedrich Overkamp, Diana Lüftner
PURPOSE OF REVIEW: Over the last decades the time which is needed to translate a preclinical finding or idea in the clinic has reduced continuously. Especially but not only for breast cancer the number of tested drugs and targeted pathways have increased immensely. In addition, the introduction of immune-oncological treatments has further advanced the possibilities for future treatments. This review focuses on recent developments in the prevention and treatment of breast cancer including results from major clinical trials and recent conferences...
December 5, 2018: Current Opinion in Obstetrics & Gynecology
Malgorzata Banys-Paluchowski, Natalia Krawczyk, Peter Paluchowski
PURPOSE OF REVIEW: Cyclin-dependent kinases (CDK) are key regulatory enzymes that control cell cycle and cell division. In the recent years, new therapeutic options selectively targeting CDK 4 and 6 have shown promising clinical activity in several solid tumors. Since 2015, three CDK 4/6 inhibitors have been approved for treatment of hormone receptor-positive HER2-negative metastatic breast cancer: palbociclib, ribociclib and abemaciclib. These drugs share a common mechanism of action and have been evaluated in studies with a similar design...
December 5, 2018: Current Opinion in Obstetrics & Gynecology
Zenas Chang, Shobhana Talukdar, Sally A Mullany, Boris Winterhoff
PURPOSE OF REVIEW: The present article reviews genomic subtyping of endometrial carcinoma and new molecular markers with therapeutic and prognostic implications. RECENT FINDINGS: Endometrial cancer has historically been classified through histology into endometrioid (type 1) and nonendometrioid (type II, mainly serous) subtypes. Molecular classification through genomic analysis now allows for a major advance in characterization; four distinct subgroups have been identified: polymerase ε (POLE) ultramutated, microsatellite unstable, copy number low/microsatellite stable, and copy number high/'serous-like'...
November 30, 2018: Current Opinion in Obstetrics & Gynecology
Christina Washington, Camille C Gunderson, Kathleen N Moore
PURPOSE OF REVIEW: This review will provide an update of recently presented clinical data as well as discuss ongoing trials focused on the incorporation of poly (ADP-ribose) polymerase inhibitors (PARPi) into the treatment paradigm for ovarian cancer. RECENT FINDINGS: As of this publication, PARPi have indications in many parts of the globe as maintenance therapy following response to platinum-based chemotherapy in the setting of platinum-sensitive recurrence. In addition, in the United States, two PARPi have indications as monotherapy treatment for recurrent ovarian cancer in patients with a BRCA mutation and at least two prior lines of therapy...
November 15, 2018: Current Opinion in Obstetrics & Gynecology
Matthew Cowan, Jonathan B Strauss, Emma L Barber, Daniela Matei
PURPOSE OF REVIEW: This article will provide an opinion on adjuvant treatment of stage I-III endometrial cancer based on existing and evolving evidence. RECENT FINDINGS: For early-stage (I and II) intermediate risk endometrial cancer, vaginal brachytherapy reduces the risk of locoregional relapse. Recent studies have investigated the use of chemotherapy in early stage, high-risk patient population, but did not demonstrate a survival benefit. As such, chemotherapy is only recommended for selected patients at high risk for distant recurrence...
February 2019: Current Opinion in Obstetrics & Gynecology
Gottfried E Konecny, Peter A Fasching
No abstract text is available yet for this article.
February 2019: Current Opinion in Obstetrics & Gynecology
(no author information available yet)
No abstract text is available yet for this article.
February 2019: Current Opinion in Obstetrics & Gynecology
Bruce Schaar, Venkatesh Krishnan, Supreeti Tallapragada, Anita Chanana, Oliver Dorigo
PURPOSE OF REVIEW: To provide an update on cell-based immunotherapies in solid tumors particularly in gynecological cancers. RECENT FINDINGS: Improvements have been made in engineering T cells to overcome the immunosuppressive environment in ovarian cancer. Significant efforts are underway to create 'off the shelf' cell therapies which leverage natural killer (NK) cells and would not rely on engineering a patient's T cells. SUMMARY: Efforts to target solid tumors using cell-based therapies are expanding into cell types other than T cells (NK cells and macrophages) which may have a lower risk of significant side effects and higher efficacy in solid tumors than chimeric antigen receptor T cells...
February 2019: Current Opinion in Obstetrics & Gynecology
Puja S Venkat, Neil Parikh, Phillip Beron
PURPOSE OF REVIEW: Radiation has long been a primary treatment modality in locally advanced gynecologic carcinomas and a tool for palliation of metastatic disease. Here we review advances in imaging and radiation technologies and the corresponding clinical evolution of the role for radiation oncology in the treatment of gynecologic malignancies. RECENT FINDINGS: Advances in MRI are impacting diagnosis, radiation target delineation, planning, treatment delivery, and response assessment...
February 2019: Current Opinion in Obstetrics & Gynecology
Boris Winterhoff, Shobhana Talukdar, Zenas Chang, Jinhua Wang, Timothy K Starr
PURPOSE OF REVIEW: This article discusses the advances, applications and challenges of using single-cell RNA sequencing data in guiding treatment decisions for ovarian cancer. RECENT FINDINGS: Genetic heterogeneity is a hallmark of ovarian cancer biology and underlies treatment resistance. Defining the different cell types present within a single ovarian cancer is difficult, but could ultimately lead to improvements in diagnosis and treatment. Next-generation sequencing technologies have rapidly increased our understanding of the molecular landscape of epithelial ovarian cancers, but the majority of these studies are conducted on bulk samples, resulting in data that represents an 'average' of all cells present...
February 2019: Current Opinion in Obstetrics & Gynecology
Lauren E Stewart, Evelyn Hall, Cassandra L Carberry
PURPOSE OF REVIEW: This article provides an update on the use of cystoscopy at the time of prolapse and incontinence surgery. RECENT FINDINGS: Iatrogenic lower urinary tract injury is a known complication of antiincontinence procedures and surgical repair of pelvic organ prolapse. Intraoperative cystoscopy improves detection of lower urinary tract injuries in women undergoing pelvic floor surgery. The pelvic surgeon has a number of agents available to aid in the cystoscopic visualization of ureteral efflux...
December 2018: Current Opinion in Obstetrics & Gynecology
Erica P Cahill, Paul D Blumenthal
PURPOSE OF REVIEW: To evaluate the literature on repeat use of emergency contraception and pericoital approaches to contraception. RECENT FINDINGS: Women are very interested in an oral, on-demand contraceptive option, were one available. Ulipristal acetate and a combination of levonorgestrel (LNG) and meloxicam (a cyclo-oxygenase-2 inhibitor) both appear to be more effective at disrupting ovulation than LNG alone. Recent advisories from the United Kingdom regarding daily dosing of ulipristal for fibroids emphasize the need for more safety data...
December 2018: Current Opinion in Obstetrics & Gynecology
Wing Kay Fok, Alice Mark
PURPOSE OF REVIEW: Medical abortion offers a well tolerated and effective method to terminate early pregnancy, but remains underutilized in the United States. Over the last decade, 'telemedicine' has been studied as an option for medical abortion to improve access when patients and providers are not together. A number of studies have explored various practice models and their feasibility as an alternative to in-person service provision. RECENT FINDINGS: A direct-to-clinic model of telemedicine medical abortion has similar efficacy with no increased risk of significant adverse events when compared with in-person abortion...
December 2018: Current Opinion in Obstetrics & Gynecology
Paul D Blumenthal
No abstract text is available yet for this article.
December 2018: Current Opinion in Obstetrics & Gynecology
Tatiana Catanzarite, Jasmine Tan-Kim, Shawn Adam Menefee
PURPOSE OF REVIEW: Work-related musculoskeletal disorders (WMSDs) are prevalent among surgeons and result in significant disability. We aimed to review the English-language literature regarding ergonomic risk, prevalence of WMSDs, and unique ergonomic considerations of gynecologic surgery. RECENT FINDINGS: Surgeon WMSDs are prevalent, with rates ranging from 66 to 94% for open surgery, 73-100% for conventional laparoscopy, 54-87% for vaginal surgery, and 23-80% for robotic-assisted surgery...
December 2018: Current Opinion in Obstetrics & Gynecology
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