Saturday, October 24, 2020

Prestigious Award Given to Dana Farber to Study Treatment Resistance in OC

Dana-Farber/Harvard Cancer Center (DF/HCC) has been awarded a $12 million grant from the National Cancer Institute (NCI) to bring promising ovarian cancer research from the laboratory to clinical practice. The highly competitive Specialized Programs of Research Excellence (SPORE) grant will help fund three research studies on overcoming the problem of treatment resistance in ovarian cancer and enable DF/HCC- affiliated institutions to build on recent therapeutic advances in this disease. The principal investigators of the SPORE grant are Alan D’Andrea, MD, director of the Susan F. Smith Center for Women's Cancers at Dana-Farber Ursula Matulonis, MD, chief of the Division of Gynecologic Oncology at Dana-Farber and David Spriggs, MD Director of Gynecologic Oncology Program at MGH Cancer Center. 

“Through the Ovarian Cancer SPORE of the DF/HCC, several of the most urgent questions in ovarian cancer therapy will be addressed,” said Alan D’Andrea, MD. “We are grateful to the National Cancer Institute for recognizing the combined expertise of the DF/HCC institutions and providing the resources to further advance the significant therapeutic progress made in this disease in recent years.”

Ovarian cancer is the most lethal gynecological malignancy in the United States, with less than half of newly diagnosed women surviving more than five years. Because no effective screening measures exist for ovarian cancer, the disease is often diagnosed in an advanced stage, when it is difficult to treat successfully.

The three research projects supported by DF/HCC Ovarian Cancer SPORE seek to translate scientists’ growing understanding of treatment resistance in ovarian cancer into new therapeutic approaches.

  • New classes of drugs known as PARP inhibitors, which hamper cells’ ability to repair damaged DNA, are increasingly used to treat women newly diagnosed with ovarian cancer as well as those whose disease has recurred following standard treatment. These agents have changed the standard of care for many women with ovarian cancer and represent a major advance in the treatment of the disease. However, many patients eventually develop resistance to PARP inhibitors. The first research project supported by the SPORE grant will include clinical trials of drug combinations designed to extend the  effectiveness of PARP inhibitors.

  • The SPORE funding will also support the development and study of a novel neoantigen vaccine trial for ovarian cancer patients. The personalized vaccine will be designed to recognize cancer-specific proteins, called neoantigens, that are present on an individual’s cancer cells but not on normal cells. Used in conjunction with immunotherapy drugs known as a checkpoint inhibitors, such a vaccine could “steer” the immune system to a direct assault on the cancer cells.

  • The third project will address patients with recurrent or drug-resistant high-grade serous ovarian cancer or low-grade serous cancer. The SPORE funds will support research into novel combinations, such as a BCL inhibitor and a MEK inhibitor, and will look for biomarkers of drug activity.

"Our focus will be on new ovarian cancer therapies for which laboratory research provides evidence of their effectiveness," said Ursula Matulonis, MD. "Physician-researchers across the DF/HCC institutions will work collaboratively to test and develop the next generation of agents that we can deliver to our patients and ultimately improve outcomes. This is a very important collaborative grant for us.”

Additional components of the SPORE in Ovarian Cancer include a Developmental Research Program (DRP) and a Career Enhancement Program (CEP) as well as four core facilities to support the research: Administrative, Pathology, Biostatistics, and Organoids, Model Systems, and Biomarkers. 

The Specialized Programs of Research Excellence is a cornerstone of the NCI’s efforts to promote collaborative, interdisciplinary translational cancer research. SPORE grants involve both basic and clinical/applied scientists working together and support projects that will result in new and diverse approaches to the prevention, early detection, diagnosis, and treatment of human cancers.

The DF/HCC SPORE in Ovarian Cancer includes DF/HCC researchers from the Dana-Farber Cancer Institute, Massachusetts General Hospital (MGH), Brigham and Women’s Hospital, Beth Israel Deaconess Hospital, and Harvard Medical School (HMS).


 

Thursday, October 22, 2020

Scholarships for Women Affected by OC

 

I just found out about this from an email from The Clearity Foundation about scholarships for women who have been financially impacted by ovarian cancer. After all, who hasn't been impacted? The scholarships are for $6,000 but only three will be awarded. :(  Still, here's the article for those interested......

The Make A Difference Scholarship, made possible by a partnership between The Clearity Foundation and Select Justice, is a scholarship that offers women and others who have been directly impacted by ovarian cancer a chance to have renewed opportunities and receive a financial reward that helps advance them in their next steps.

Through the Make A Difference Scholarship, Select Justice will award $6,000 for the 2021 academic year to three lucky recipients. This partnership with The Clearity Foundation not only offers hope to those impacted by ovarian cancer — but it also offers them exciting opportunities for a tomorrow that’s filled with promise.

Monday, October 12, 2020

New Agents and Immunotherapy In the Works for OC

 

OncLive recently published an article about a new treatment currently in clinical trials. Antibody drug conjugates (ADCs) work by targeting the cancer cell directly. Essentially, a toxic payload is attached to an antibody that seeks out a very specific molecule called Folate receptor alpha (FRa). This molecule is found in large numbers in ovarian epithelial cancers.

Immunotherapy, whether using a single or combination drug has had some mixed results and there are studies currently underway.

To read more about these newer treatment options and the clinical trials that are underway, follow this link.

Monday, October 5, 2020

2020 TTT Virtual Retreat: Personal Thoughts

What an incredible weekend we just had with our condensed, TTT virtual retreat! Sure, we understand that nothing beats being together at Camp Kieve but boy, this was one heck of a retreat filled with fun activities (juggling anyone?), self-facials, self-massages, art projects, yoga, music & movement, foot soaks and plenty of time to meet in our virtual "tea room" for more intimate conversations.

In addition, our social worker Barbara led us in great discussions whose topics were selected from participant suggestions. More than anything, the committee who planned this year's retreat was focused on doing everything possible to maintain the intimacy and strengthen the bonds that previous retreat goers so value. With that in mind, the retreat still limited the number of women who could attend despite it being virtual. In this way, large and small break-out sessions were manageable and allowed everyone to get the chance to participate and feel a part of the group.

 Each woman received an enormous bag full of items to be used for each session plus plenty of surprise gifts - hand knitted winter hats, note cards, snacks, etc. (really too numerous to name) and all the items needed to do our own facials led by the fantastic women from Elizabeth Grady in Boston who instructed us on how to apply all our different creams and toners. (Oh my god - what a delightful treat that was!)

As I reflect on this past weekend what is a standout for me is how this wonderful group of women easily and quickly embraced, listened to and supported each other. Having been diagnosed w/advanced OC 5 years ago (and still going strong), I can personally attest to how isolating it was to get the diagnosis. This is a terrible disease but I couldn't ask for a better group of women around me. As a veteran of the retreat, there is nothing more important and fulfilling than to embrace and support newly diagnosed women. We are in this together...


 

Saturday, October 3, 2020

Trying to Avoid Sugar? Try These Perfect Protein Energy Balls/"Brownie" Snacks

 

Again, a big shout-out to Christine C. for this recipe! Below, I've included a similar recipe that uses only 3 ingredients: raw almonds (can use other favorite nuts), majool dates and cacao powder.

 

Ingredients

·       1 1/2 cup almonds (or other nuts) I use peanuts

·       1 cup pitted medjool dates

·       1 tbsp coconut oil

·       1 tbsp cacao powder

·       1 tbsp protein powder 

·       1 tbsp chia seeds I use 2 tbsp

Instructions

·       Blend nuts in a food processor.

·       Add remaining ingredients to the food processor and blend until you get a smooth mixture.

·       Roll into little balls and store in the fridge or freezer.

 

This can be doubled and stored in the freezer (I put them on wax paper in a pyrex container)

Here's a variation on this from the cookbook, "Deliciously Ella" by Ella Woodward 

Ingredients

2 cups of raw almonds (or cashews or peanuts or even assorted raw nuts)

20 pitted Mejool dates (I buy them w/pits and then take them out b/c I find that the pitted ones are drier. The more sticky they are, the better the mixture holds together.)

3 TB of cacao powder (not coco powder b/c of it contains sugar)

Instructions

  • Blend nuts in a food processor
  • Add remaining ingredients and blend well
  • Spread into a rectangular, freezer proof dish, then place in the freezer for an hour. 

Cut into brownie-sized pieces and enjoy!

ps - I keep my "brownies" in the freezer  or the refrigerator rather store them at room temp.

 

Trying to Avoid Sugar? Try this Avocado Chocolate Mousse Recipe.


 What a great virtual TTT retreat weekend we are having! Today, the last day, we are wrapping up and I do want to take the time to thank everyone who has participated and presented - but I'll write something separately about that later.

In our breakout rooms, Christine C. talked about this amazing avocado mousse recipe that I'd like to share with everyone. What makes this recipe so special is that for those of you who want to avoid sugars, this is a wonderful option. I didn't share the picture because of potential copyright infringement but when I make this myself, I'll post my picture.

So here's the recipe courtesy of Christine C. Many thanks Christine!!!!

Ingredients:

1 ripe avocado (peeled and pitted)

1 Cup frozen banana slices (sit out for a few minutes to partially thaw)

¾-1 Cup milk or oral supplement (oat milk, almond milk, soy, etc.)

1-2 scoops vanilla-flavored protein powder

2-3 Tablespoons cacao powder (can use unsweetened cocoa powder)

Agave, maple syrup or honey to taste (optional)

 

Directions:

1.   Blend all ingredients with an immersion hand blender or food processor.

2.   As needed, add more liquid for a thinner consistency.

3.   Transfer mousse to a storage container and cover.

4.   Keep leftover mousse in the refrigerator for no more than one day.

 

Note:  BiPro Protein Powder:  tested by NSF, a 3rd party testing company for purity of ingredients.


Wednesday, August 5, 2020

Can a Statin Lower Risk for Ovarian Cancer?

                              
The connection between the use of statins and risk reduction for ovarian cancer has been the subject of research going back at least a decade (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910322/ ). Most recently, Kala Visvanathan, M.D., MHS, professor of epidemiology ad oncology at Johns Hopkins, presented her findings at the American Association for Cancer Research (Virtual) Annual Meeting.

The study analyzed data from a Finnish national cancer registry along with prescription drug claims for over 10,000 women between 1995 and 2015. The researchers found that women with all subtypes of ovarian cancer had a lower mortality rate if they took statins. 

Although more research needs to be done, statins are very well tolerated and inexpensive and may prove to be part of the armament of treatment protocols at some point in the future.

To read more about this study, follow this link.


Wednesday, July 15, 2020

2020 TTT Virtual Retreat Forms Are Available Here

A letter from Anne Tonachel, the founder of Turning-the-Tide Ovarian Cancer Retreats. To access the forms from this website, go to the "2020 Retreat Info" section shown above. You will be able to download the forms there.


Turning the Tide Ovarian Cancer Retreats
2020 Virtual Retreat
Thursday, October 1 to Saturday, October 3 
 Registration Opens July 15  

Dear friends, old and new,  
            Turning the Tide (TTT) welcomes you to apply to our first virtual retreat. Registration opens on July 15 and all the paperwork is enclosed.
Before the COVID-19 pandemic, our retreats have always taken place at a camp in Maine. This year we have called on the ingenuity and generosity of an amazing group of women, many of whom have attended past retreats, to create a virtual event that honors the most important lessons of the Maine camp. Above all, we will create an environment embodying both joy and reflection to create deep and lasting bonds of support among us as we together face the physical, logistical, emotional and spiritual burdens of an ovarian cancer diagnosis. 
This three-day online space is one that you should treat in the same way that you would carve out time away from home and work to spend in Maine, time to rest, time to share and time to strengthen your resilience. At home you will need a place of privacy for yourself so that each woman attending will feel safe to say whatever she needs to talk about with the group. It is vital that your attention to the retreat be sacred, and that you plan to attend the opening, the discussion gatherings, the closing, and as many of the self-care, arts and exercise classes as possible, as the most important gift you will receive by attending the retreat is the kinship of women facing the same challenges as you and looking for wisdom to move forward,. 
To ensure that the virtual retreat maintains the powerful intimacy of the Maine retreat, there will be a limit to the number of applicants we can accept. There is also a sliding-scale registration fee; however, our policy is that no woman is ever turned away for financial reasons and scholarships are readily available.
            We are excited to welcome both old and new participants to TTT and encourage you to send us your application as soon as registration opens on July 15.

                                                                        Yours,

                                                                        Anne Tonachel

Monday, July 6, 2020

Early Phase 1 Study Shows Promise for Platinum-Resistant Epithelial OC

Good news for women who have platinum-resistant OC and who have had 5 previous types of treatment.

The drug, STRO-002 is a combination antibody-drug conjugate, meaning it combines an antibody with chemo to deliver the medication directly to the cancer cell, hopefully eliminating some adverse side effects associated with off-targeting.

The results were presented at 2020 AACR Virtual Meeting of April 27-28.

Phase1 has been successfully completed which means that the toxic range of the medication has been established and now, Phase 2, will determine the recommended dose. OncLive conducted an interview with one of the lead investigators. Follow this link to the full article.

Friday, July 3, 2020

MGH: Part II - A Guide to Understanding Clinical Trials

Here is Part II of the MGH "A Guide to Understanding Clinical Trials".

Since the start of the SARS-COV-2 (COVID-19) outbreak, scientists have repeatedly advocated for the use of well-structured clinical trials in testing new treatments for the disease. But what does a well-structured trial look like?
In part one of this series, we discussed how clinical trials are set up. In part two, we highlight a few key components to look for when reading about the latest research and clinical trials, because they are not created equal.
Maurizio Fava, MD, Psychiatrist-in-Chief at Massachusetts General Hospital and Director of the Division of Clinical Research of the Mass General Research Institute, stresses the “importance of well-designed studies and clinical trials, as today’s clinical research will help us improve the standard of care of the future. This is absolutely critical for conditions such as COVID-19, given the need to develop ways to both prevent it and treat it.”
Here are a few things to look for to ensure that results are as accurate as possible:

Sample size: The number of patients/participants studied

The number of people involved in a clinical trial is critical because scientists are basing the success of the treatment on how it affects the participants involved. These insights that get applied to an entire population, so ensuring they are as accurate as possible is important for everyone’s safety. 
For example, a treatment that appears to work well in a sample of 20 participants may not work as well when that pool is expanded to hundreds or thousands of participants.
Keep in mind, a small sample size may also make key differences harder to spot and may not be representative of or applicable to a larger population. If a study is done on a small homogenous group with similar demographics (age, health status, ethnicity, gender, etc.), there is no telling how it could affect other demographics.

Placebo: An inactive substance given in the place of a treatment

Placebos are used when there is no existing standard of care to test a new treatment against. They are typically designed to look like the medication that is being tested but do not have a therapeutic effect. 
Testing a new treatment against a placebo gives researchers something to compare their results to and helps to eliminate bias in patient-reported outcomes.

Randomization: Assigning treatments to participants at random

Randomization is the process of randomly assigning patients to either the treatment or control group without considering underlying factors such as disease state, age, weight or medical history.
For example, if all young participants receive an experimental treatment and get better, while all older participants receive standard treatment and fare worse, it would be difficult to prove the experimental treatment was the sole cause of improvement, because age could play a role. 
However, if the experimental treatment was distributed to all participants at random and the health of the experimental group improved (regardless of age), it would be easier to draw more accurate conclusions.

Peer review: A process in which experts in the same field objectively review a scientific study before publication

Peer review is a vetting process that allows impartial subject matter experts who were not involved in the study to review research before it is published. It is critical to scientific discovery because it helps validate and improve the quality of research.
There are some cases where scientists will opt to publish their findings in a non-peer reviewed journal because it is faster and easier than going through the peer review process, but this also means there is potential for errors and findings may not be accepted by the broader scientific community.
Non-peer reviewed studies have become increasingly popular, so when reading about scientific findings or new study results, it is important to check where those results have been published.

Blinded studies: Studies that withhold treatment information from patients or researchers to reduce bias

There are two types of blinded studies: single-blind and double-blind.
  • Single-blind: Researchers know if participants are receiving the treatment or the placebo/standard of care, but participants do not. This helps reduce participant bias by limiting the “placebo effect”—a form of unconscious bias that can sometimes lead people to feel better after believing they have been given a new treatment, even if it was an inert substance or standard treatment.
  • Double-blind: Neither participants nor the researchers know who is receiving treatment. This is considered the “gold standard” in clinical trials because it helps reduce participant and researcher bias. With both groups having little information to influence their perspective, the study is likely to produce more accurate results.
One of the first high profile clinical trials for hydroxychloroquine as a potential treatment for COVID-19 received sharp criticism from the scientific community due to several issues with its structure. 
Critics were quick to point out that the sample size was small with just 42 participants, the control and treatment group participants did not appear to be randomly selected and several negative patient outcomes were excluded from the results.
Two additional studies from The Lancet and The New England Journal of Medicinewere also recently retracted. Findings gathered from The Lancet study were called into question when the scientific community noticed homogenous patient data and potential issues with the statistical analyses. Researchers leading The New England Journal of Medicine study were forced to retract their study when they could not validate their supporting research.
As we move forward and learn of new findings from researchers working to uncover the mechanisms behind disease, it is important to ask questions and critically examine the supporting research before accepting new findings as facts.

Thursday, June 25, 2020

MGH: A Guide to Understanding Clinical Trials" Part 1

Although this article is not specific to ovarian cancer, "A Guide to Understanding Clinical Trials" is important info for all of us.

Published on the MassGeneral website, I am including the full text below. This is part 1.

When a new disease such as COVID-19 is discovered, it is up to doctors and scientists to investigate how the disease behaves so treatments can be developed and tested.
There are numerous clinical trials for COVID-19 therapeutics across the globe, and results from these trials (often uncontrolled and published in non-peer reviewed journals) are being released on a regular basis.
With all of the new information coming out so rapidly, it can be confusing to understand what these results mean. The Mass General Research Institute is providing a resource to explain how clinical trials work and share what makes for a strong clinical trial with clear and promising results.

What are clinical trials and why are they important?

Clinical trials are scientific studies designed to test the safety and usefulness of new medical interventions such as treatments, devices, preventative care, screening or diagnostic procedures, and more.
They are crucial to the advancement of strong science and patient care because, if well-designed, they can validate the performance of an intervention under controlled circumstances to ensure it is safe, effective and provides measurable benefits to patients.

How do they work?

Scientists typically conduct research on a disease or potential treatment for several years to lay a foundation for a clinical trial. During this time, they are gathering as much information as possible to learn about how a disease behaves, what it does to the body, which populations are at risk for it and what may be potential targets for treatment. Research can move into the next phase, called preclinical or translational research, once enough promising and validated reproducible data have been generated to justify further testing.
Preclinical trials are the first opportunity to see how a treatment may work in specific non-human models. In this stage, scientists must follow strict guidelines to test their interventions in vitro (in a petri dish or test tube) or in vivo (in a living organism such as an animal model) before moving on to human trials. If the findings are promising, investigators must fill out the necessary paperwork and get approval so the study can move onto a Phase I clinical trial.

What happens in the four phases of clinical trials?

According to the Federal Drug Administration (FDA), there are four phases of clinical trials that each inform decisions made in the next phase:
  • Focus: Establishing the safety and correct dosage of a treatment
  • Time frame: Typically lasts several months
  • Sample size: 20-100 participants who are either healthy or have the targeted condition
  • Bottom line: Designed to understand how the treatment and dosage are tolerated within the human body