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Recurrent ovarian

Kathleen G Essel, Kathleen N Moore
Niraparib, an orally available selective inhibitor of poly(adenosine diphosphate-ribose) polymerase (PARP) is the first PARP inhibitor approved for use in patients with ovarian cancer who do not harbor a germline or somatic mutation in the breast cancer gene (BRCA). Overall niraparib is well tolerated and its toxicities, primarily hematologic, are manageable especially with recently released initial dose modification guidelines based on weight and baseline platelet count. The role of niraparib as maintenance following front-line platinum-based chemotherapy as well as in the treatment of recurrent high grade serous ovarian cancer (HGSOC) is an active area of investigation...
June 17, 2018: Expert Review of Anticancer Therapy
Paul DiSilvestro, Angeles Alvarez Secord
Approximately 1% of women in the United States will be diagnosed with epithelial ovarian cancer (EOC) during their lifetime. It is most likely to present at a more advanced stage, requiring aggressive therapeutic measures, and most women will succumb to this illness. Due to advancements in therapy, the oncology community has begun to shift its focus to molecular targeted agents, alternative dosing schedules, and maintenance therapy. Women who achieve a response to initial adjuvant chemotherapy may be candidates for maintenance therapy, with the goal of inducing a lasting remission or prolonging the disease-free interval before recurrence...
June 5, 2018: Cancer Treatment Reviews
Linda R Duska
Surgery plays a critical role in all aspects of the management of ovarian cancer: from comprehensive staging of disease apparently confined to one ovary; to complete removal of advanced disease at the time of presentation; to appropriate surgical management of disease recurrence. As such, the surgeon plays an essential role in the management of this disease throughout its course. Appropriate and aggressive surgical management has been demonstrated in countless publications to improve overall survival from this disease...
June 14, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Yang Shao, Hui Li, Ran Du, Jiao Meng, Gong Yang
Ovarian cancer (OC) is the most lethal gynecological malignancy, with a low 5-year survival rate. Most patients with ovarian cancer are diagnosed in late-stages. A rising number of non-coding RNAs (ncRNAs) have been found to act as key regulators of gene expression by applying novel high-thought methods, such as next generation sequencing (NGS). Non-coding RNAs not only play important roles in carcinogenesis, but also affect the clinical treatment strategies. One of the biggest challenge in OC treatment was chemoresistance, which causes poor prognosis and high recurrence rate after applying traditional remedies...
2018: Journal of Cancer
Sung Bin Park, Min-Jeong Kim, Kyoung Ho Lee, Yousun Ko
OBJECTIVE: To retrospectively evaluate the clinical, pathological, and imaging features of ovarian serous surface papillary borderline tumors (SSPBTs). METHODS: Imaging features were analyzed, including the tumor size, laterality, tumor spread and the presence of ascites. Morphological nature (encased normal ovary, characteristics on MRI) and contrast enhancement (increased flow on Doppler US) were also evaluated. Clinical and pathological features, such as tumor markers (CA 125), treatment methods, outcomes on follow-up, and surgical staging, were analyzed...
June 11, 2018: British Journal of Radiology
Manikandan Lakshmanan, Sameer Gupta, Vijay Kumar, Naseem Akhtar, Arun Chaturvedi, Sanjeev Misra, Kavitha Jain, Sudeep Garg
Malignant germ cell tumors (GCT) of the ovary account for 2-3% of all ovarian neoplasms and occur mostly in the second and third decade of life. Over the past three decades, survival rates for germ cell tumors have dramatically improved, coincident with more aggressive surgical staging and combination chemotherapy. Although there are several studies describing ovarian GCT and fertility-preserving surgery in the western population, there is very little Indian data. We present our experience of germ cell tumor ovary in the Department of Surgical Oncology, King George's Medical University over the last 5 years with special emphasis on treatment outcome and role of fertility preservation surgery...
June 2018: Indian Journal of Surgical Oncology
Ahmed Samy El-Agwany
The second most common epithelial tumor of the ovary is the mucinous tumors, and it constitutes about 8-10% of all ovarian tumors. The recurrence of mucinous cystadenoma is very rare after complete excision. Few cases have been reported. The case presented had initial surgery for adenxal mass diagnosed as mucinous tumor, performed by laparotomy and was followed up. After recurrence, the patient underwent laparoscopic evaluation and bilateral ovarian cystectomy was performed as a fertility preservation for the patient young age...
June 2018: Indian Journal of Surgical Oncology
Edouard J Servy, Laetitia Jacquesson-Fournols, Marc Cohen, Yves J R Menezo
PURPOSE: To evaluate the possibility of correcting metabolic defects in gametes and embryos due to methylene tetra hydrofolate reductase (MTHFR) isoforms C677T and A1298C, by supplementation with 5-methyl THF instead of synthetic folic acid. In these couples, high doses of folic acid lead to UMFA (un-metabolized folic acid) syndrome. METHODS: Thirty couples with fertility problems lasting for at least 4 years, such as recurrent fetal loss, premature ovarian insufficiency, or abnormal sperm parameters, with two thirds of them having failed assisted reproductive technology (ART) attempts were included in this program...
June 7, 2018: Journal of Assisted Reproduction and Genetics
Domenica Lorusso, Elisa Tripodi, Giuseppa Maltese, Stefano Lepori, Ilaria Sabatucci, Giorgio Bogani, Francesco Raspagliesi
Epithelial ovarian cancer is the sixth most common cancer among women worldwide and the first cause of death among gynecological malignancies. Most of the patients present recurrent disease and unfortunately cannot be cured. The unsatisfactory results obtained with salvage chemotherapy have elicited investigators to search for novel biological agents capable of achieving a better control of the disease. In the setting of homologous recombination deficiency, the DNA errors that occur cannot be accurately repaired, and the treatment with poly(ADP-ribose) polymerase (PARP) inhibition results in definitive cell death in a process called synthetic lethality...
2018: Drug Design, Development and Therapy
N Hojo, A L Huisken, H Wang, E Chirshev, N S Kim, S M Nguyen, H Campos, C A Glackin, Y J Ioffe, J J Unternaehrer
To develop effective therapies for advanced high grade serous ovarian cancer (HGSOC), understanding mechanisms of recurrence and metastasis is necessary. In this study, we define the epithelial/mesenchymal status of cell lines that accurately model HGSOC, and evaluate the therapeutic potential of targeting Snai1 (Snail), a master regulator of the epithelial/mesenchymal transition (EMT) in vitro and in vivo. The ratio of Snail to E-cadherin (S/E index) at RNA and protein levels was correlated with mesenchymal morphology in four cell lines...
June 7, 2018: Scientific Reports
Songnan Zhu, Yingjun Zhu, Yabo Liu, Hong Zhang
INTRODUCTION: Hormone therapy is widely used in the treatment of patients with ovarian endometriosis after surgery, and progestin and gonadotropin-releasing hormone (GnRH) are two of the most widely used hormones. This study aimed to compare the outcomes of progestin and GnRH in the treatment of ovarian endometriosis after surgery. METHODS: A total of 399 patients with ovarian endometriosis were included and divided into four groups to receive different treatments...
June 5, 2018: Advances in Therapy
Federica Guffanti, Maddalena Fratelli, Monica Ganzinelli, Marco Bolis, Francesca Ricci, Francesca Bizzaro, Rosaria Chilà, Federica Paola Sina, Robert Fruscio, Michela Lupia, Ugo Cavallaro, Maria Rosa Cappelletti, Daniele Generali, Raffaella Giavazzi, Giovanna Damia
A xenobank of patient-derived (PDX) ovarian tumor samples has been established consisting of tumors with different sensitivity to cisplatin (DDP), from very responsive to resistant. As the DNA repair pathway is an important driver in tumor response to DDP, we analyzed the mRNA expression of 20 genes involved in the nucleotide excision repair, fanconi anemia, homologous recombination, base excision repair, mismatch repair and translesion repair pathways and the methylation patterns of some of these genes. We also investigated the correlation with the response to platinum-based therapy...
May 15, 2018: Oncotarget
Panagiotis A Konstantinopoulos, Ursula A Matulonis
PARP inhibitors have transformed treatment for ovarian cancer, a cancer notable for homologous recombination (HR) deficiencies and aberrant DNA repair, especially high grade serous subtype. PARP inhibitors are now approved for recurrent ovarian cancer as maintenance following response to platinum chemotherapy and BRCA mutated (BRCAm) cancer treatment.
June 5, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Brianna M Lyttle Schumacher, Anne Marie Z Jukic, Anne Z Steiner
OBJECTIVE: To determine the association between antimüllerian hormone (AMH), a measure of ovarian reserve, and miscarriage among naturally conceived pregnancies. DESIGN: Prospective cohort study. SETTING: Not applicable. PATIENT(S): Women (n = 533), between 30 and 44 years of age with no known history of infertility, polycystic ovarian syndrome, or endometriosis who conceived naturally. INTERVENTION(S): None...
June 2, 2018: Fertility and Sterility
Grace Hwei Ching Tan, Claramae Shulyn Chia, Sze Huey Tan, Khee Chee Soo, Melissa Ching Ching Teo
BACKGROUND: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are used in the management of selected peritoneal malignancies. While most patients achieve long-term disease-free survival, there remains a group with early recurrence (ER). We aim to investigate the clinical factors associated with ER. METHODS: A retrospective review of a prospectively maintained database of CRS-HIPEC patients treated between April 2001 and Feb 2016 was performed...
June 5, 2018: International Journal of Clinical Oncology
Clemens Tempfer, Urs Giger-Pabst, Ziad Hilal, Askin Dogan, Günther A Rezniczek
BACKGROUND: Systemic chemotherapy is not effective in patients with peritoneal carcinomatosis (PC) and only a minority of affected patients is eligible for cytoreductive surgery. Intraperitoneal chemotherapy may provide a therapy alternative for these patients. METHODS: We performed a systematic review of clinical and experimental evidence on the safety and efficacy of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in patients with PC and provide clinical recommendations based on the available evidence...
June 4, 2018: Archives of Gynecology and Obstetrics
Prudence A Francis, Olivia Pagani, Gini F Fleming, Barbara A Walley, Marco Colleoni, István Láng, Henry L Gómez, Carlo Tondini, Eva Ciruelos, Harold J Burstein, Hervé R Bonnefoi, Meritxell Bellet, Silvana Martino, Charles E Geyer, Matthew P Goetz, Vered Stearns, Graziella Pinotti, Fabio Puglisi, Simon Spazzapan, Miguel A Climent, Lorenzo Pavesi, Thomas Ruhstaller, Nancy E Davidson, Robert Coleman, Marc Debled, Stefan Buchholz, James N Ingle, Eric P Winer, Rudolf Maibach, Manuela Rabaglio-Poretti, Barbara Ruepp, Angelo Di Leo, Alan S Coates, Richard D Gelber, Aron Goldhirsch, Meredith M Regan
Background In the Suppression of Ovarian Function Trial (SOFT) and the Tamoxifen and Exemestane Trial (TEXT), the 5-year rates of recurrence of breast cancer were significantly lower among premenopausal women who received the aromatase inhibitor exemestane plus ovarian suppression than among those who received tamoxifen plus ovarian suppression. The addition of ovarian suppression to tamoxifen did not result in significantly lower recurrence rates than those with tamoxifen alone. Here, we report the updated results from the two trials...
June 4, 2018: New England Journal of Medicine
Jyoti Roy, Miranda Kaake, Madduri Srinivasarao, Philip S Low
The targeted delivery of chemotherapeutic agents to receptors that are over-expressed on cancer cells has become an attractive strategy to concentrate drugs in cancer cells while avoiding uptake by healthy cells. Luteinizing hormone-releasing hormone receptor (LHRH-R) has attracted considerable interest for this application, since LHRH-R is upregulated in ~86% of prostate cancers, ~80% of endometrial cancers, ~80% of ovarian cancers, and ~50% of breast cancers, but virtually absent from normal tissues. Although LHRH and related peptides have been used to deliver cytotoxic drugs to LHRH-R over-expressing cancer cells, they have suffered from off-target delivery of the therapeutic agents to the liver and kidneys...
May 31, 2018: Bioconjugate Chemistry
Ernest S Han, Wei Wen, Thanh H Dellinger, Jun Wu, Selena A Lu, Richard Jove, John H Yim
Treatment for ovarian cancer remains challenging despite a high initial response rate to first line platinum-taxane treatment. Most patients eventually experience recurrence and require further treatment. Persistent activation of STAT3 is associated with cancer growth and progression and is also involved in cell resistance to platinum and taxane treatment. Targeting JAK/STAT3, therefore, could be a potential novel therapeutic approach for treating advanced and chemoresistant ovarian cancer. We investigated the therapeutic potential of ruxolitinib, a JAK1/JAK2 inhibitor that has been FDA-approved for the treatment of myelofibrosis, to treat ovarian cancer either alone or in combination with conventional chemotherapy agents...
May 11, 2018: Oncotarget
Evgenia Halkia, George Chrelias, Charalambos Chrelias, Jesus Esquivel
Ovarian cancer peritoneal carcinomatosis requires a multimodal-treatment approach. Current treatment considerations are analyzed in this update and include the management of recurrent malignant ascites and the understanding of its pathophysiology, the role of peritoneal washing cytology in detecting peritoneal metastases, capsular invasion and ovarian cancer histologic type, interpretation of pretreatment Ca-125 levels at different time points of ovarian cancer therapeutic management, characteristics of 10-year survivors of high-grade ovarian cancer, and the role of lymphadenectomy in ovarian cancer peritoneal carcinomatosis...
2018: Gastroenterology Research and Practice
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