Monday, February 24, 2020

Crispr Technology Used in First Human Study

Crispr technology has been around for several years. Essentially, Crispr is a “cut-and-paste” tool used in gene editing – especially useful when scientists have pinpointed specific disease-causing genes. 

Fast forward to a very small study (3 people) released this week from the University of Pennsylvania and Stanford research teams that has cleared the first hurdle related to safety. 

These cancer patients received their own genetically modified T cells – to make them more powerful hunters and killers of cancer cells. The T-cells were bathed in a special growing solution until they had increased to about a 100 million at which time they were infused back into the patient. The biggest concern was that once these cells were released back into the body, would they be too hyper-active, that is, trigger a massive deadly immune response. Instead, these gene edited immune cells lived and appeared to fit right back into the body’s immune system.

Results have been mixed: of the three patients, one woman with multiple myeloma died seven months after receiving the treatment and the other two, another with multiple myeloma and a man with sarcoma, have had their cancers return. A few other trials are getting underway. Overall, this promises to be an invaluable tool perhaps used in conjunction with other therapies. 

To read more about this particular research, follow this link

To read more about Crispr technology, read this article.

Friday, February 21, 2020

Ovarian Cancer Thriver Seminar: The Julie Fund

A shout out to Betsy who sent me this information today about this seminar scheduled for April 4, 2020 from 8:30am to 2:00pm at the Wyndham Boston Beacon Hill.

The seminar is FREE to women and their caregivers and includes lunch.

The topics, presented by the gyn/onc doctors from MGH - who I can't speak highly enough about - cover biology, surgery, personalized medicine, immunotherapy, advances in management of disease recurrence/clinical trials and other relevant and interesting topics.

Of course, there will also be time for Q&A. Parking is only $5 for all attendees with validation.

To register for this free event, follow this link.

Monday, February 17, 2020

Genetic Links to Ovarian Cancer

I stumbled across this interesting and informative   website during a recent on-line search. Published by the National Institutes of Health (NIH)/Genetics Home Reference section, the article gives a basic overview of the origins, frequency, causes, inheritance patterns, diagnosis and treatment options etc. of ovarian cancer.

What makes this website unique are the sidebars associated with each section providing informational links. For example, one link connects to a new page explaining why some genetic conditions are found more often in particular ethnic groups. There were also over 20 additional links to further resources.

To find out more about this website, follow this link.

Monday, February 10, 2020

Endometriosis Appears to Have No Effect on Ovarian Cancer Outcomes, But More Research Needed, Study Says

This was a small study that examined the link between endometriosis and ovarian cancer. It appeared on the Clearity Foundation website.

Endometriosis does not seem to significantly affect ovarian cancer prognosis and survival in patients of reproductive age, a small study suggests.

However, more research is needed to identify factors associated with the progression of endometriosis to cancer and also to identify women who would benefit from more aggressive endometriosis treatment.
Ovarian cancer risk factors include a number of variables, such as age, weight, menstrual history, pregnancy history, smoking, inheritance of certain mutations, and benign gynecological conditions, including endometriosis.
Specific risk incidences vary depending on the type of cancer, but according to a study published in The Lancet, overall, endometriosis was estimated to increase ovarian cancer risk by nearly 50%.
However, it remains unclear whether there is a meaningful clinical difference between ovarian cancer in a person with endometriosis (endometriosis-associated ovarian carcinoma, EAOC) and the same type of cancer in a person without endometriosis (non-endometriosis-associated ovarian cancer, non-EAOC).
This is of particular interest in younger individuals, since age itself is independently associated with different ovarian cancer prognoses (younger age seems to be a prognostic factor for improved survival). Moreover, endometriosis is most common in people between 25 and 35 years old, according to the authors of the study.
The researchers analyzed medical records of people 40 years of age or younger who were treated for ovarian cancer at the Peking Union Medical College Hospital in China between 2006 and 2017.
Specifically, the researchers compared cases of EAOC, comprising either ovarian endometrioid carcinoma (OEC) or ovarian clear cell carcinoma (OCCC), with non-EAOC cases.
The studied group included 94 people with ovarian cancer — 40 with endometriosis (EAOC group) and 54 without (non-EAOC group). All of them were treated surgically; most also received chemotherapy.
In terms of outcomes, “a total of 77 (81.9%) patients were alive with no evidence of residual tumour at the time of the last visit, 4 (4.3%) patients were alive with the recorded disease, and 13 (13.8%) were dead of the recorded disease. There were no obvious differences between the two groups in terms of these variables,” the researchers wrote.
Further statistical analyses demonstrated that endometriosis was not significantly associated with an altered risk of disease progression or death. Another factor was, most notably, whether there was residual disease after initial treatment.
On the whole, there were “no differences in clinicopathological [disease-causing] or prognostic features,” between ovarian cancer in people with or without endometriosis, according to the researchers.
There was one exception: painful periods, or dysmenorrhea, which was reported by a much higher percentage of people with endometriosis than without (45% vs. 3.7%). But, the researchers said, this “is a typical symptom of patients with endometriosis,” and, as a result, most likely isn’t tied to the ovarian cancer.
This was a fairly small study of patients treated at a single center, so the results shouldn’t be generalized yet — there is still a need for further research to understand both endometriosis and ovarian cancer, and the intersection of both diseases.
“Endometriosis is not an independent prognostic predictor in patients with OCCC and OEC when age is confined to under 40 years. It is premature to consider ovarian cancers arising from endometriosis as a distinct entity,” the researchers concluded.
“This analysis also suggests that reproductive-aged women with early-stage OEC and OCCC should be offered conservative treatment,” they said. “Future research should focus on the identification of factors that are associated with the malignant transformation of endometriosis and how to identify women for whom more definitive endometriosis treatment would be appropriate to prevent ovarian cancer.”

Monday, February 3, 2020

Weekly Dose-Dense Chemo Not Recommended in First-Line Epithelial Ovarian Cancer Treatment

This article, by Matthew Fowler was orginally published published by the Clearity Foundation.

Weekly dose-dense paclitaxel as a frontline treatment for patients with epithelial ovarian cancer was not found to significantly improve progression-free survival (PFS) compared to the standard 3-weekly chemotherapy, according to results from the ICON8 study published in The Lancet.1

The results of the ICON8 trial show that it is feasible to deliver weekly dose-dense paclitaxel in combination with either 3-weekly or weekly carboplatin in the first-line treatment of high-risk ovarian cancer,” Andrew Clamp, PhD, of The Christie NHS Foundation Trust, and colleagues wrote. “However, neither of these regimens is associated with an improvement in survival outcomes compared with standard 3-weekly carboplatin–paclitaxel treatment in the predominantly European population treated on this trial.”
The phase III ICON8 trial randomly assigned predominantly European women with newly diagnosed International Federation of Gynecology and Obstetrics stage IC–IV epithelial ovarian cancer to 3 groups.
1,566 women from June 2011 to November 2014 were recruited for treatment as a part of the ICON8 study. In this 3 arm trial, patients in group 1 received carboplatin AUC5 or AUC6 and 175 mg/m2paclitaxel once every 3 weeks; patients in group 2 received carboplatin as in group 1 and dose-fractionated 80 mg/m2paclitaxel weekly; and patients in group 3 received carboplatin AUC2 and 80 mg/m2paclitaxel weekly.
Primary endpoints for the study were PFS and overall survival (OS). Both groups 2 and 3 were individually compared with group 1 (control group) to determine primary endpoint results. Secondary endpoints included safety, quality of life, and health economics.
The median PFS was 17.7 months for the control group (group 1), 20.8 months in group 2, and 21.0 months in group 3.
After a 9-month cross-analysis of the results, the study determined there was no significant difference between the groups with regards to quality of life. As for toxic effects, both group 2 and group 3 treatments were associated with increased instances of grade 3 or higher toxic effects, but these effects were deemed “uncomplicated.”
“Although most patients were able to complete 6 chemotherapy cycles, both weekly treatments were associated with more treatment modifications and a higher incidence of grade 3 or higher toxic effects,” stated in a press issued by the European Society for Medical Oncology (ESMO). “Although grade 3 or 4 toxic effects increased with weekly treatment, these effects were predominantly uncomplicated.”2
The population included both patients who underwent primary cytoreductive surgery (IPS) and those who chose delayed primary cytoreductive surgery (DPS) options. The results from each of these populations also stood as a secondary point of intrigue for the researchers. No significant relationship between surgical decision and treatment schedule was detected.
The ICON8 study was a large, international process including a variety of different patient variables, including demographic, surgery selection and treatment schedule. The study also yielded an 85% chemotherapy completion rate, allowing for valuable results to be drawn from the process. Even more, although the results did not yield a positive development for European women, the weekly-dose treatment can still be an option for Japanese women with epithelial ovarian cancer, who previously demonstrated a superior benefit to the regimen.2
“Weekly dose-dense paclitaxel treatment could still be considered as a first-line treatment option for Japanese women with epithelial ovarian cancer,” said in an ESMO press release. “But the weekly dose-dense paclitaxel should not be recommended as a component of first-line epithelial ovarian cancer treatment for women of non-Japanese ethnic origin.”
Two further studies have been done analyzing weekly dose-dense chemotherapy treatment within the lifetime of the ICON8 study, but the researchers recommend even more investigation into this treatment among different ethnic groups.
This article was published by Cancer Network.