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Gynecologic Oncology Research and Practice

Nancy Innocentia Ebu
Background: The burden of HIV and cervical cancer is concentrated in sub-Saharan Africa. Women with HIV are more likely to have persistent HPV infection leading to cervical abnormalities and cancer. Cervical cancer screening seems to be the single most critical intervention in any efforts to prevent cervical cancer. The purpose of this study was to determine the socio-demographic factors influencing intention to seek cervical cancer screening by HIV-positive women in the Central Region of Ghana...
2018: Gynecologic Oncology Research and Practice
Hanoon P Pokharel, Neville F Hacker, Lesley Andrews
Background: Gynaecological cancers may be the sentinel malignancy in women who carry a mutation in BRCA1 or 2, a mis-match repair gene causing Lynch Syndrome or other genes. Despite published guidelines for referral to a genetics service, a substantial number of women do not attend for the recommended genetic assessment. The study aims to determine the outcomes of systematic follow-up of patients diagnosed with ovarian or endometrial cancer from Gynaecologic-oncology multidisciplinary meetings who were deemed appropriate for genetics assessment...
2018: Gynecologic Oncology Research and Practice
Rachel Grisham, Bonnie Ky, Krishnansu S Tewari, David J Chaplin, Joan Walker
Combretastatin A4-phosphate (CA4P) is a vascular-disrupting agent (VDA) in clinical development for the treatment of ovarian and other cancers. In contrast to antiangiogenic agents, such as bevacizumab, which suppress the development of new tumor vasculature, VDAs target established tumor vasculature. These differing but complementary mechanisms of action are currently being explored in clinical trials combining CA4P and bevacizumab. Clinical experience to date has highlighted an important need to better understand the cardiovascular adverse events of CA4P, both alone and in combination with antiangiogenic agents, which can also be associated with cardiovascular adverse events...
2018: Gynecologic Oncology Research and Practice
Daniel Asfaw Erku, Adeladlew Kassie Netere, Amanual Getnet Mersha, Sileshi Ayele Abebe, Abebe Basazn Mekuria, Sewunet Admasu Belachew
Background: In Ethiopia, cervical cancer is ranked as the second most common type of cancer in women and it is about 8 times more common in HIV infected women. However, data on knowledge of HIV infected women regarding cervical cancer and acceptability of screening is scarce in Ethiopia. Hence, the present study was aimed at assessing the level of knowledge of about cervical cancer and uptake of screening among HIV infected women in Gondar, northwest Ethiopia. Methods: A cross sectional, questionnaire based survey was conducted on 302 HIV infected women attending the outpatient clinic of University of Gondar referral and teaching hospital from March 1 to 30, 2017...
2017: Gynecologic Oncology Research and Practice
Vicky Makker, Angela K Green, Robert M Wenham, David Mutch, Brittany Davidson, David Scott Miller
Endometrial cancer is the most common gynecologic malignancy in the United States, accounting for 6% of cancers in women. In 2017, an estimated 61,380 women were diagnosed with endometrial cancer, and approximately 11,000 died from this disease. From 1987 to 2008, there was a 50% increase in the incidence of endometrial cancer, with an approximate 300% increase in the number of associated deaths. Although there are many chemotherapeutic and targeted therapy agents approved for ovarian, fallopian tube and primary peritoneal cancers, since the 1971 approval of megestrol acetate for the palliative treatment of advanced endometrial cancer, only pembrolizumab has been Food and Drug Administration (FDA)-approved for high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR) endometrial cancer; this highlights the need for new therapies to treat advanced, recurrent, metastatic endometrial cancer...
2017: Gynecologic Oncology Research and Practice
Mekonnen Sisay, Dumessa Edessa
Poly (ADP-ribose) polymerases (PARPs) are an important family of nucleoproteins highly implicated in DNA damage repair. Among the PARP families, the most studied are PARP1, PARP2 and PARP 3. PARP1 is found to be the most abundant nuclear enzyme under the PARP series. These enzymes are primarily involved in base excision repair as one of the major single strand break (SSB) repair mechanisms. Being double stranded, DNA engages itself in reparation of a sub-lethal SSB with the aid of PARP. Moreover, by having a sister chromatid, DNA can also repair double strand breaks with either error-free homologous recombination or error-prone non-homologous end-joining...
2017: Gynecologic Oncology Research and Practice
Tran N Le, Rachel E Harvey, Christine K Kim, Jubilee Brown, Robert L Coleman, Judith A Smith
Background: While many of these agents have been compared in prospective clinical trials, the gemcitabine/platinumbased regimens have not been compared in a prospective, randomized clinical trial. While bothgemcitabine/carboplatin and gemcitabine/cisplatin have a similar ORR in separate clinical trials, the tworegimens have never been directly been compared. With overlapping dose-limiting toxicity of thrombocytopenia, the gemcitabine/carboplatin regimen has been challenging to employ in the clinical setting in previously treated ovarian cancer patients and is often associated with treatment delays and/or dose reductions...
2017: Gynecologic Oncology Research and Practice
Jill K Alldredge, Ramez N Eskander
Clear cell carcinoma and endometrioid adenocarcinoma are histologic subtypes of ovarian and uterine cancer that demonstrate unique clinical behavior but share common underlying genomic aberrations and oncogenic pathways. ARID1A mutations are more frequently identified in these tumors, in comparison to other gynecologic histologies, and loss of ARID1A tumor suppressor function is thought to be an essential component of carcinogenic transformation. Several therapeutic targets in ARID1A mutated cancers are in development, including EZH2 inhibitors...
2017: Gynecologic Oncology Research and Practice
Amsalu Degu, Peter Njogu, Irene Weru, Peter Karimi
BACKGROUND: Although cervical cancer is preventable, it is still the second leading cause of cancer deaths among women in the world. Further, it is estimated that around 5-10% of hospital admissions are due to drug related problems (DRPs), of which 50% are avoidable. In cancer therapy, there is an immense potential for DRPs due to the high toxicity of most chemotherapeutic regimens. Hence, this study sought to assess DRPs among patients with cervical cancer at Kenyatta National Hospital (KNH)...
2017: Gynecologic Oncology Research and Practice
Matthew Schlumbrecht, John Siemon, Guillermo Morales, Marilyn Huang, Brian Slomovitz
BACKGROUND: Preparation in the business of medicine is reported to be poor across a number of specialties. No data exist about such preparation in gynecologic oncology training programs. Our objectives were to evaluate current time dedicated to these initiatives, report recent graduate perceptions about personal preparedness, and assess areas where improvements in training can occur. METHODS: Two separate surveys were created and distributed, one to 183 Society of Gynecologic Oncology candidate members and the other to 48 gynecologic oncology fellowship program directors...
2017: Gynecologic Oncology Research and Practice
Thomas J Herzog, Bradley J Monk
BACKGROUND: Therapy for advanced epithelial ovarian cancer (OC) includes first line platinum/taxane-containing chemotherapy and re-treatment with platinum-containing regimens for disease recurrence in patients likely to respond again. Single-agent, non-platinum, cytotoxic agents are commonly used to treat patients resistant to platinum retreatment, but these agents are associated with dose-limiting toxicities and response rates below 20%. MAIN BODY: Recent advances have led to novel targeted treatments for recurrent OC that offer opportunities to improve response rates and prolong progression-free intervals...
2017: Gynecologic Oncology Research and Practice
Brandon-Luke L Seagle, Emily S Miller, Anna E Strohl, Anna Hoekstra, Shohreh Shahabi
BACKGROUND: To determine the cost-effectiveness of transversus abdominis plane block with liposomal bupivacaine (TAP) compared to oral opioids alone for acute postoperative pain after laparoscopic hysterectomy for early endometrial cancer. METHODS: A cost-effectiveness analysis using a decision tree structure with a 30.5 day time-horizon was used to calculate incremental cost-effectiveness ratio (ICER) values per quality-adjusted life-year (QALY). Base-case costs, probabilities, and QALY values were identified from recently published all-payer national database studies, 2017 Medicare fee-schedules, randomized trials, institutional case series, or assumed, when published values were not available...
2017: Gynecologic Oncology Research and Practice
Paula S Lee, Samantha Kempner, Michael Miller, Jennifer Dominguez, Chad Grotegut, Jessie Ehrisman, Rebecca Previs, Laura J Havrilesky, Gloria Broadwater, Sarah C Ellestad, Angeles Alvarez Secord
BACKGROUND: Due to the significant morbidity and mortality associated with placenta percreta, alternative management options are needed. Beginning in 2005, our institution implemented a multidisciplinary strategy to patients with suspected placenta percreta. The purpose of this study is to present our current strategy, maternal morbidity and outcomes of patients treated by our approach. METHODS: From 2005 to 2014, a retrospective cohort study of patients with suspected placenta percreta at an academic tertiary care institution was performed...
2017: Gynecologic Oncology Research and Practice
Brett Miles, Howard P Safran, Bradley J Monk
Survival of patients with advanced, recurrent, or metastatic human papillomavirus (HPV)-associated cancer is suboptimal despite the availability of various treatment modalities. The recently developed bacterial vector Listeria monocytogenes (Lm) activates innate and adaptive immune responses and is expected to offer immunologic advantages. Axalimogene filolisbac (AXAL or ADXS11-001) is a novel immunotherapeutic based on the live, irreversibly attenuated Lm fused to the nonhemolytic fragment of listeriolysin O (Lm-LLO) and secretes the Lm-LLO-HPV E7 fusion protein targeting HPV-positive tumors...
2017: Gynecologic Oncology Research and Practice
Brett A Miles, Bradley J Monk, Howard P Safran
Immune responses to the facultative intracellular bacterium Listeria monocytogenes (Lm) are robust and well characterized. Utilized for decades as a model of host-disease immunology, Lm is well suited for use as an immunotherapeutic bacterial vector for the delivery of foreign antigen. Genetic modification of Lm has been undertaken to create an attenuated organism that is deficient in its master transcriptional regulator, protein-related factor A, and incorporates a truncated, nonhemolytic version of the listeriolysin O (LLO) molecule to ensure its adjuvant properties while also preventing escape of the live organism from the phagolysosome...
2017: Gynecologic Oncology Research and Practice
Dorcas Obiri-Yeboah, Yaw Adu-Sarkodie, Florencia Djigma, Kafui Akakpo, Ebenezer Aniakwa-Bonsu, Daniel Amoako-Sakyi, Jacques Simpore, Philippe Mayaud
[This corrects the article DOI: 10.1186/s40661-017-0041-1.].
2017: Gynecologic Oncology Research and Practice
Bradley J Monk, Warner K Huh, Julie Ann Rosenberg, Ira Jacobs
OBJECTIVE: Bevacizumab is an important component in the treatment of various cancers, and despite guidelines recommending its use in both ovarian and cervical cancer, patient access to bevacizumab and other angiogenesis inhibitors is limited. Biosimilars are large, structurally complex molecules that are intended to be highly similar to, and treat the same condition(s) as, an existing licensed or approved (reference) biologic, with no clinically meaningful differences in purity, potency and safety...
2017: Gynecologic Oncology Research and Practice
Radoslav Chekerov, Philipp Harter, Stefan Fuxius, Lars Christian Hanker, Linn Woelber, Lothar Müller, Peter Klare, Wolfgang Abenhardt, Yoana Nedkova, Isil Yalcinkaya, Georg Heinrich, Harald Sommer, Sven Mahner, Pauline Wimberger, Dominique Koensgen-Mustea, Rolf Richter, Gülten Oskay-Oezcelik, Jalid Sehouli
BACKGROUND: Palliative systemic treatment in elderly gynaecological cancer patients remains a major challenge. In recurrent ovarian cancer (ROC), treosulfan an active alkylating drug showed similar cytotoxicity whether as oral (p.o.) or intravenous (i.v.) application. The aim of this innovative trial was to evaluate the preference of elderly patients (≥65 years) for p.o. or i.v. chemotherapy focusing compliance, outcome, toxicities, and geriatric aspects as secondary endpoints. METHODS: Patients with ROC had the free choice between treosulfan i...
2017: Gynecologic Oncology Research and Practice
Dorcas Obiri-Yeboah, Yaw Adu-Sarkodie, Florencia Djigma, Kafui Akakpo, Ebenezer Aniakwa-Bonsu, Daniel Amoako-Sakyi, Simpore Jacques, Philippe Mayaud
BACKGROUND: Modern cervical cancer screening increasingly relies on the use of molecular techniques detecting high-risk oncogenic human papillomavirus (hr-HPV). A major challenge for developing countries like Ghana has been the unavailability and costs of HPV DNA-based testing. This study compares the performance of careHPV, a semi-rapid and affordable qualitative detection assay for 14 hr-HPV genotypes, with HPV genotyping, for the detection of cytological cervical squamous intraepithelial lesions (SIL)...
2017: Gynecologic Oncology Research and Practice
Melissa K Frey, Bhavana Pothuri
Until recently our knowledge of a genetic contribution to ovarian cancer focused almost exclusively on mutations in the BRCA1/2 genes. However, through germline and tumor sequencing an understanding of the larger phenomenon of homologous recombination deficiency (HRD) has emerged. HRD impairs normal DNA damage repair which results in loss or duplication of chromosomal regions, termed genomic loss of heterozygosity (LOH). The list of inherited mutations associated with ovarian cancer continues to grow with the literature currently suggesting that up to one in four cases will have germline mutations, the majority of which result in HRD...
2017: Gynecologic Oncology Research and Practice
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