Wednesday, December 26, 2018

NEJM: Maintenance Olaparib in Pts Newly Diagnosed Advanced OC

This article was just released in the latest journal of NEJM. BRCA +Women who have finished standard platinum treatment and surgery and who have had a recurrence are then put on olaparib. In this trial, newly diagnosed BRCA + women discusses the use of olaparib in women who are newly diagnosed.

Here is the abstract from the article. I will also try to include the full link here.



Most women with newly diagnosed advanced ovarian cancer have a relapse within 3 years after standard treatment with surgery and platinum-based chemotherapy. The benefit of the oral poly(adenosine diphosphate–ribose) polymerase inhibitor olaparib in relapsed disease has been well established, but the benefit of olaparib as maintenance therapy in newly diagnosed disease is uncertain.


We conducted an international, randomized, double-blind, phase 3 trial to evaluate the efficacy of olaparib as maintenance therapy in patients with newly diagnosed advanced (International Federation of Gynecology and Obstetrics stage III or IV) high-grade serous or endometrioid ovarian cancer, primary peritoneal cancer, or fallopian-tube cancer (or a combination thereof) with a mutation in BRCA1BRCA2, or both (BRCA1/2) who had a complete or partial clinical response after platinum-based chemotherapy. The patients were randomly assigned, in a 2:1 ratio, to receive olaparib tablets (300 mg twice daily) or placebo. The primary end point was progression-free survival.


Of the 391 patients who underwent randomization, 260 were assigned to receive olaparib and 131 to receive placebo. A total of 388 patients had a centrally confirmed germline BRCA1/2 mutation, and 2 patients had a centrally confirmed somatic BRCA1/2 mutation. After a median follow-up of 41 months, the risk of disease progression or death was 70% lower with olaparib than with placebo (Kaplan–Meier estimate of the rate of freedom from disease progression and from death at 3 years, 60% vs. 27%; hazard ratio for disease progression or death, 0.30; 95% confidence interval, 0.23 to 0.41; P<0.001). Adverse events were consistent with the known toxic effects of olaparib.


The use of maintenance therapy with olaparib provided a substantial benefit with regard to progression-free survival among women with newly diagnosed advanced ovarian cancer and a BRCA1/2 mutation, with a 70% lower risk of disease progression or death with olaparib than with placebo. (Funded by AstraZeneca and Merck; SOLO1 number, NCT01844986.)

Wednesday, December 19, 2018

Cancer Survivorship

This quote from the New England Journal of Medicine, says it best:
"At present, the care of cancer survivors is often an afterthought, tends to be fragmentary, and is not well integrated into the mainstream of cancer care. Also, the best models for providing survivor care remain undefined."

To read the article in its entirety, follow this link

Thursday, November 29, 2018

Sound and Light Could Detect OC Earlier

Researchers have found an innovative way to use sound and light, or photoacoustic, imaging to diagnose ovarian tumors. The method may lead to a promising new diagnostic imaging technique to improve current standard of care for patients with ovarian cancer.
Ovarian cancer claims the lives of more than 14,000 women in the US each year, ranking fifth among cancer deaths in women.
Researchers recently conducted a pilot study using co-registered photoacoustic tomography with ultrasound to evaluate ovarian tumors in 16 patients. The findings appear in Radiology.
“When ovarian cancer is detected at an early, localized stage—stage 1 or 2—the five-year survival rate after surgery and chemotherapy is 70 to 90 percent, compared with 20 percent or less when it is diagnosed at later stages, 3 or 4,” says Quing Zhu, professor of biomedical engineering in the School of Engineering & Applied Science at Washington University in St. Louis and of radiology.
“Clearly, early detection is critical, yet due the lack of effective screening tools only 20-25 percent of ovarian cancers are diagnosed early. If detected in later stages, the survival rate is very low,” Zhu says.

Detailed Look

In their approach, researchers use a transvaginal ultrasound to obtain information about ovarian tumors, but ultrasound lacks accuracy in diagnosis of ovarian masses, Zhu says.
Photoacoustic tomography, however, gives researchers a very detailed look at the tumor’s vasculature, or tumor angiogenesis, and blood oxygen saturation (sO2) by lighting up the tumor’s vasculature bed and allowing for more accurate diagnoses of ovarian masses seen by ultrasound.
Both tumor angiogenesis and tumor sO2 are related to tumor growth, metabolism, and therapeutic response.
For the study, Zhu and her team created a sheath with optical fibers that wrap around a standard transvaginal ultrasound probe. The optical fibers are connected to a laser. Once the probe is inside the patient, Zhu turns the laser on, which shines through the vaginal muscle wall.
With photoacoustic tomography, the light from the laser propagates, the tumor absorbs it, and it generates sound waves, revealing information about the tumor angiogenesis and sO2 inside the ultrasound-visible ovaries. A normal ovary contains a lot of collagen, Zhu says, but an ovary with invasive cancers has extensive blood vessels and lower sO2.

Information and Assurance

The team used two biomarkers to characterize the ovaries: relative total hemoglobin concentration (rHbT), which is directly related to tumor angiogenesis, and mean oxygen saturation (sO2).
They found that the rHbT was 1.9 times higher for invasive epithelial cancerous ovaries, which make up 90 percent of ovarian cancers, than for normal ovaries. The mean oxygen saturation of invasive epithelial cancers was 9.1 percent lower than normal and benign ovaries. All five invasive epithelial cancerous ovaries, including two stage 1 and 2 cancers, showed extensive rHbT distribution and lower sO2.
“Physicians are very excited about this because it might bring significant change into current clinical practice,” Zhu says. “It is very valuable to detect and diagnose ovarian cancers at early stages. It is also important to provide information and assurance to patients that there is no worry about their ovaries, instead of removing a patient’s ovaries.
“This technology can also be valuable to monitor high-risk patients who have increased risk of ovarian and breast cancers due to their genetic mutations. The current standard of care for these women is performing risk reduction surgeries to remove their ovaries at some point, which affects their quality of life and causes other health problems,” Zhu says.
“We are very fortunate to participate in this research endeavor headed by Dr. Zhu,” says Cary Siegel, professor of radiology and chief of gastrointestinal/genitourinary radiology. “This photoacoustic imaging study has great potential to better identify ovarian cancers and may play a valuable role in screening high-risk patients and triaging patients for follow-up imaging or surgical excision.”
These initial results will need to be validated with more patients, Zhu says. The team is applying for funding to conduct a large clinical trial.
The National Institutes of Health and the Center for Strategic Scientific Initiatives at the National Cancer Institute funded the work.
This article was published by Futurity.

Tuesday, November 27, 2018

Merck, Pfizer's Bavencio Misses Ovarian Cancer Trial Endpoints

This article originally appeared in "PharmaTimes" and was written by Selina McKee:
A late-stage study testing Merck KGaA and Pfizer’s PD-L1 antibody Bavencio has failed to meet its primary endpoints in patients with certain forms of ovarian cancer.
The drug was being tested as monotherapy and in combination with pegylated liposomal doxorubicin (PLD), a type of chemotherapy, in the JAVELIN Ovarian 200 trial, but failed to hit overall survival (OS) and progression-free survival (PFS) targets in patients with platinum-resistant or -refractory ovarian cancer compared to PLD alone.
However, signals were observed in the combination arm relative to PLD, and “further analyses of the trial are warranted”, the firms stressed.
Also of note, no new safety signals were observed, with the safety profile for Bavencio (avelumab) found to be consistent with that observed in the overall JAVELIN clinical development programme.
“JAVELIN Ovarian 200 enrolled a high proportion of patients with aggressive, refractory disease that had no response to prior platinum-based chemotherapy, a population known to have disease that is challenging to treat; as such, this group of patients is typically not included in Phase III ovarian cancer trials,” said Chris Boshoff, head of Immuno-Oncology, Early Development and Translational Oncology, Pfizer Global Product Development.
“We initiated the JAVELIN Ovarian 200 trial as the first Phase III study of a checkpoint inhibitor in the platinum-resistant or -refractory setting recognising these patients have the most pressing need for new treatment options. The results speak to the significant challenges these women face.”
“Although OS and PFS did not reach statistical significance, study results indicate potential clinical activity of the combination of avelumab and chemotherapy which will be analysed further,” noted Luciano Rossetti, executive vice president, Global Head of Research & Development at the Biopharma business of Merck KGaA.
In addition to JAVELIN Ovarian 200, the avelumab ovarian cancer clinical development programme includes several ongoing clinical trials investigating the drug in combination with other therapies.
Bavencio is already approved in the US and EU to treat certain patients with metastatic Merkel cell carcinoma, while in the US it is also cleared for locally advanced or metastatic urothelial carcinoma (mUC).
This article was published by PharmaTimes.

Thursday, November 15, 2018

New Study Shows Olaparib Benefits Those Newly Diagnosed

Olaparib (Lynparza), a PARP inhibitor is currently being used in the treatment of recurrent ovarian cancer. This study, recently published in the New England Journal of Medicine, showed that over 66% of women given olaparib in conjunction with standard chemo during the initial treatment of advanced OC had not relapsed after 3 years. The relapse rate is otherwise closer to 70% after 3 years.

The study involved 391 patients who had advanced (Stage 3 or 4) serous, primary peritoneal, endometrioid or fallopian tube OC who had a BRCA 1, 2 or both mutation. These women had either a partial or full response from initial chemo.

The study is being hailed as a "breakthrough" in the treatment of ovarian cancer. To read more about this study, follow this link.

Monday, November 12, 2018

Here It Is: The 2018 Turning the Tide Retreat Unabridged Video!

Many, many thanks to Marissa Fiorucci, studio manager of Ostow Photography, and to Eva Kasell, TTT retreat photographer, for this wonderful, memorable video of our fabulous retreat this year. Sit back and enjoy....

The Clearity Foundation

How would you search for a clinical trial that was based on your location? What if you only wanted a trial that was in a specific phase of development? What if you wanted to find drugs that were specific to platinum resistant recurrences?

Well the answer to these questions and a whole lot more, can be found through The Clearity Foundation.

In my previous entry about the amazing national organization, Steps Through Ovarian Cancer, I mentioned that STOC was a joint venture between two other non-profits. The Clearity Foundation was one of them. It was founded in 2008 by a cancer researcher and ovarian cancer survivor, Dr. Laura Shawver. She wanted to put together a website that helps women and their families understand their diagnosis, reviews the data for treatment options depending on the type of OC, explains how to access clinical trials, provides up-to-date news on the latest treatment developments. It's for patients and physicians.

There's even a great feature about tumor blueprints/molecular profiling. These tumor blueprints help you and your physician select targeted treatment, specific to your type of tumor. Although it doesn't provide guidance on medical treatment, Clearity's staff has expertise in ovarian cancer molecular and cellular biology and can help explain test results for you to discuss with your physician. There is even a financial assistance form for patients to fill out to help cover the cost.

I've signed up for their newsletter to that I can get current information about medical advances in the treatment of various forms of OC. For more information, follow this link.

Saturday, November 10, 2018

Steps through OC - A MUST SEE!

It's rare that I so wholeheartedly encourage OC sisters to check out a website but this one is it! Cindy, from our TTT camp this year, was the first one to point it out on our private FB page and if it wasn't for Donna, I would have missed it completely.

So what is "Steps through Ovarian Cancer"? It's a new, national joint collaboration of two non-profits that offer FREE services for women who have had or still have OC in addition to their families and caregivers.

More than that, as STOC writes on their website, "Steps Through OC is a new, national program offering counseling, patient education, referrals and other free resources."

Every woman is matched with a professional counselor who can help her understand treatment options or get guidance on managing side effects or provide counseling (I believe up to 6 months) for any of the myriad number of reasons we may need it.

Essentially STOC believes that all women with OC and their families should be able to access care. As they write on their website, "We intentionally seek to serve people whose access to safe, affirming, responsive care may be limited by income, geography, language or discrimination of any kind."

I urge you to check them out.

Friday, November 9, 2018

Good News for Women with Clear Cell Ovarian Cancer

The gene that contributes to chemo resistance in clear-cell ovarian cancer has been discovered opening up the door (in the hopefully near future) to possible treatment options. Genes that help prevent this from occurring are known as BCL2 inhibitors. BCL2 inhibitors are currently approved for treatment in lymphoma.

 BCL2 (B-cell lymphoma, 2) is a gene that helps regulate cell death and is over expressed in certain types of cancer: breast, melanoma, prostate, chronic lymphocytic leukemia and lung cancer. Researchers have now linked over-expression of this gene to the development of chemo resistance in clear cell ovarian cancer. 

Clear cell ovarian cancer is linked with a mutation of the ARID1A gene. Downstream to this mutation is where BCL2 plays an important role in developing acquired resistance.  

To find out more about the research done on this, follow this link.

Tuesday, November 6, 2018

Cancer Conference Helps Bring Hope to Rural Maine Communities

Our very own Donna Wiegle attended the recent Downeast Living With Cancer Conference held in Bar Harbor, ME on November 1, 2018.

She was interviewed by WABI TV, Bangor, where she spoke about what the conference offers women and men living with cancer.

To read her interview, follow this link.

Donna, who lives with her husband and 2 dogs on an island off the coast of Maine, runs a small health center and Eldercare Outreach program, which serves a year-round community of 350 residents (~1000 during the summer).  Although she has Stage  3B low-grade serous carcinoma and will always be in treatment, Donna doesn't let that stop her from riding her beloved Harley Davidson motorcycle around New England and Canada.

Monday, November 5, 2018

Cancer Immunotherapy Video from M.D. Anderson Cancer Center

This is an interesting 38 minute video on using viruses to infect and kill cancer cells. It was produced by the Cancer Research Institute.

Dr. James P. Allison is the director of CRI's Scientific Advisory Council. He won the 2018 Nobel Prize in Medicine/Physiology for his research on the immune system's role in treating cancer. He is at the MD Anderson Cancer Center in Houston, TX.

Wednesday, October 31, 2018

TTT 2018 Slideshow

"Improving Cancer Diagnosis and Care" from National Academies Press

This summary is cited from the National Academies Press. To download your free copy, follow this link.

Rapid advances in cancer research, the development of new and more sophisticated approaches to diagnostic testing, and the growth in targeted cancer therapies are transforming the landscape of cancer diagnosis and care. These innovations have contributed to improved outcomes for patients with cancer, but they have also increased the complexity involved in diagnosis and subsequent care decisions.
To examine opportunities to improve cancer diagnosis and care, the National Academies of Sciences, Engineering, and Medicine developed a two-workshop series. The first workshop, held on February 12–13, 2018, in Washington, DC, focused on potential strategies to ensure that patients have access to appropriate expertise and technologies in oncologic pathology and imaging to inform their cancer diagnosis and treatment planning, as well as assessment of treatment response and surveillance. This publication chronicles the presentations and discussions at the workshop.

Free Event re: Recurrent O.C. Sponsored by Tesaro

Drop image here

79 Main Street, Suite 202 • Framingham, MA  01702 • (508) 655-5412 •

Thursday, October 18, 2018

Facebook Live: Immunotherapy & Gynecological Cancers

This is a really exciting video from Dr. Matulonis that Anne alerted me to. Dr. Matulonis is the head of Gynecologic Cancer at Dana Farber.

12th Annual Downeast Living With Cancer Conference

Our dear friend Donna will be attending this conference in Maine. For those of you living in the area, the conference is free of charge and free transportation is available.

Read below to find out  more about the conference and details of how to register.

12 Annual Downeast Living with Cancer Conference set for November 1, 2018                
Bar Harbor, Maine–‘Integrating Science, Wisdom, and Compassion during the Cancer Journey’ is the theme of the 12th Annual Downeast Living with Cancer Conference set to take place on Thursday, November 1, 2018 at the Atlantic Oceanside Hotel & Conference Center in Bar Harbor. This inspiring conference will begin at 9:00 am and run until 3:30 pm, with registration beginning at 8:00 am.
Dr. Rob Rutledge, MD will present two talks, ‘The Body – Mind – Spirit Connection on the Cancer Journey’ and ‘How Understanding Your Brain Can Empower Your Life’. Dr. Rutledge is a Radiation Oncologist in Halifax, Nova Scotia, specializing in breast, prostate and pediatric cancers. He is also an Associate Professor in the Faculty of Medicine at Dalhousie University. He serves as the CEO and Chair of the Healing and Cancer Foundation, a Registered Charity that freely offers educational videos, documentaries, and seminars.
Dr. A. Merrill Garrett, MD will discuss ‘Advances in Technology Lead to Advances in Cancer Care’. Dr. Garrett is Board Certified in Medical Oncology and has been one of the pillars of the treatment team at Cancer Care of Maine for many years. She is currently spearheading the creation of a breast cancer survivorship program at Northern Light Cancer Institute and is seeing oncology patients at Northern Light Maine Coast.
Other event offerings include a patient panel, a caregiver panel, complementary therapies, a complimentary lunch and representatives from various community resources will be offering information throughout the day. The conference is open to cancer survivors, caregivers, family members and all interested community members and is free of charge. Free transportation is available, please call ahead to arrange transportation. You can register here or by calling 207-664-0339.

"Organoids Could Aid Cancer Drug Selection" - news out of DF

A big shout-out to Donna who posted this article from Dana Farber Insight.

Organoids are miniature versions of the tissue or organ they were taken from and therefore replicate faithfully cellular structures.

The key points in this article were:

  • Tests on living 'organoids' created from patients' ovarian cancer cells proved more accurate than DNA sequencing in prediction tumors' sensitivity or resistance to chemotherapy drugs
  • Ovarian cancer organoids were developed from patient tumor samples in just seven to ten days, instead of weeks or months, allowing for rapid, direct tests of drugs and drug combinations.
  • The organoids created in this study were found to contain immune cells, raising the prospect of testing immunotherapy drugs for ovarian cancer, the scientists say.
To read the article in its entirety, follow this link.

Monday, October 15, 2018

2 Studies Look at the Role of Aspirin and NSAIDs in Ovarian Cancer

JAMA Oncology (Oct 2018) and Lancet Oncology (Aug 2018) published research results that dove-tailed each other.

In the Lancet study entitled "Pre-diagnosis and post-diagnosis use of common analgesics and ovarian cancer prognosis (NIH/NIHII): a cohort study", the objective was to determine if regular use of aspirin, non-steroidal anti-inflammatory medications (NSAIDs) or paracetamol before and after diagnosis of epithelial ovarian cancer improved survival.

To do this, they looked at health outcomes from two, very large on-going studies: the Nurses Health Study (NHS) begun in 1976 and the Nurses Health Study II (NHSII), begun in 1989. These two studies rely on completed biennial self-reported questionnaires. Those women who had confirmed StageI-III epithelial OC were included in the study.

The results: "Recent  use of aspirin or non-aspirin NSAIDs, defined as current use in the past 2 years, after diagnosis appears to improve ovarian cancer-specific survival." They go on to say that further research needs to be done to determine timing and dosing and use w/traditional chemotherapies.

The second study was entitled, "Association of Analgesic Use with Risk of Ovarian Cancer in the Nurses' Health Studies." This study examined the use of analgesics in reducing the risk of developing ovarian cancer. Smaller case controlled studies showed correlation and they wanted to see if these results held using much larger samples. What they found was I think, quite interesting.

The use of low dose aspirin reduced the risk of developing ovarian cancer by 23% compared to non-users. However, "current use of nonaspirin NSAIDs was associated with a 19% higher risk of ovarian cancer compared with nonuse."


Saturday, October 13, 2018

Financial Toxicity: A Sad Reality

This article appeared in the American Journal of Medicine, Oct 18th issue.

Sadly, financial toxicity is a reality for many dealing with cancer.

To read the article, follow this link.

Friday, September 28, 2018

Where has the time gone???

Belting out that tune!
Sigh, where does the time go? Here it is, five days after camp ended and every day life keeps intruding on the wonderful memories of this retreat! Many of us are finishing up our work weeks and getting down to life as usual.

But I'll keep posting photos to remind each and every one of you who attended the camp of the wonderful sisterhood we all shared complete with belly laughs, intimate conversations, and fabulous activities.

Mark your calendars for the retreat next year: November 6th-10th, 2019!

Tuesday, September 25, 2018

Teal Ribbon Sneakers

Do you remember the cool sneakers that Anne Evans had on? They were teal ribbon sneakers! I was going to upload the image of them but there would have been a mismatch error trying to link it to this post (https vs http) which would have caused a whole lot of mishap loading the page.

Anyway, Anne sent me the link because so many of you wanted to know where they could get these sneakers. Anne said they were mighty comfy too!  So thanks Anne for forwarding this info to us. Here's the link!

Monday, September 24, 2018

Still in the Glow a Day After the Retreat

After the harvest from a local farm!
I just had to get this quick post off! I'm still in the after-glow of a wonderful retreat. It's so hard to put into words just how nourishing the experience is.

I'll be posting pics of our time there. On the day this picture was taken, we had a full morning of activities: rock wall climbing, archery, ropes course (high up in the trees), facials, yoga, reflexology, massage, stone painting, and if that didn't suit, hanging around the large fireplace drinking tea and chatting!

Afterwards, we all gathered around for the annual raffle. Just in case you're wondering, it's the kind of raffle where EVERYONE gets something - and this is where the donations of gifts are simply amazing. There were a number of gorgeous quilts, a hand woven rug, water color paintings, jewelry, gift baskets etc etc etc. No one walked away unhappy 😎

So stay tuned for most postings!

Friday, September 21, 2018

TTT Ovarian Cancer Retreat 2018, Friday am update 9/21

Kim & Susan
We are having a wonderful time at Camp Kieve for our annual Turning the Tide Ovarian Cancer Retreat. Folks arrived on Wednesday afternoon and here it is, already Friday morning!

I arrived yesterday with Kim, just in time for a wonderfully healthy lunch. We had our annual group photo taken outside which I'll post on line when we get it. It was kind of like herding cats but Donna put on her bossy boots and got us into line!

One of the highlights was our tour around Darmariscotta Lake. We piled into 2 boats with our leaders, Charlie and Henry (thank you guys!!!). Two beautiful dogs (and one baby from another group) also joined us. We got the history of the camp and saw the amazing pristine woods that surround this neck of the lake.

After dinner, our own Katie led us in dance - well it's kind of a stretch calling it "dancing" -  rather it's closer to the intersection of where dancing meets stretching. Amazingly, since I have absolutely no rhythm, she had us all swaying and moving our upper body and feet somehow in unison, to great music. It was delightful!!

Afterwards, those who wanted, joined Patty in a brief meditation before we drifted off either to our rooms or sat by the large fire in the great room to talk.

And that's really the beauty of this camp - it's how we all kind of just magically mix and in the process, get to know each other...and now it's time for my facial.....

ahhh, getting facials

Hi Di!

Walk and Roll(ing)


Sue, keeping us all organized


Melissa, cooking yummy food for us



Carol & Margaret

Thursday, July 26, 2018

Detecting Ovarian Cancer

Searching for Better Detection: The 'Holy Grail' of Ovarian Cancer

Researchers are on the hunt for a better biomarker in ovarian cancer that could detect the disease in earlier stages.
While survival rates among patients with ovarian cancer have increased in recent years thanks to newer and more personalized treatment approaches – including the groundbreaking addition of PARP inhibitors – one major question still remains: How can the disease be detected in its earlier stages?

Sunday, July 15, 2018

A Farewell Gathering for Batoul

Today those of us who could met at Anne & Dick's in Cambridge to say farewell to our dear friend, Batoul who will be returning to Kuwait with her family at the end of August. What can I say except that all of us at TTT will miss Batoul's infectious smile, wonderful sense of humor, the enthusiasm she brings to TTT and to everything she does! Oh and did I mention her fabulous cooking skills and generosity?

Anne as always provided wonderful hospitality by hosting all of us for a terrific pot luck. Dick worked quietly behind the scenes along with Eva, also helped to ensure that everything went smoothly.

Kathy & Bill came down from ME along with Donna and Deirdre. Marilyn & Cathy drove in from VT and  many of our MA contingent also came: Diane, Eva, Peggy, Sue, Paul, Kim, Christine, Debra, Eric, Susan & John, Patti, Devorah & Margaret. It was a great send-off

The food was fabulous (of course) and it was wonderful to catch up with everyone.

Batoul, Mohammad, Abbas and Noah will be returning to Kuwait in August and Batoul will be resuming her full load of teaching come the fall semester. We of course, wish her and her wonderful family all the best and look forward to her visits back here. We love you Batoul!!!

Noah making a scary face

Noah's other scary face