The HPV vaccine, sold as Gardasil in the U.S., is intended to prevent four strains of the human papillomavirus, the most common sexually transmitted infection in the world. The vaccine also prevents against cervical cancer. While the vaccine represents a significant public health advance, a new article in the Journal of Law, Medicine & Ethics
Full Post: State mandates for HPV vaccination unwarranted and unwise
Results of a phase III, international randomized clinical trial demonstrate a new standard of care for treating advanced ovarian cancer that significantly reduces side-effects and post-operative deaths compared to the previously established treatment course.
The study, presented at the 12th Biennial Meeting of the International Gynecologic Cancer Society (IGCS) in Bangkok in October, has a major impact on many countries where the new standard represents a more practical course of treatment.
The prospective study was presented by Professor Ignace B. Vergote of University Hospital Leuven, EU, on behalf of the European Organization for Research and Treatment of Cancer-Gynaecological Cancer Group (EORTC-GCG) and the National Cancer Institute Canada-Clinical Trial Group (NCIC-CTG).
A total of 718 patients from 60 institutions with advanced ovarian cancer were enrolled in the study. The women were randomized to receive either primary debulking surgery (PDS) prior to receiving six cycles of chemotherapy (329 patients as per protocol), or interval debulking surgery (IDS) performed after three of six cycles of neoadjuvant chemotherapy (339 patients as per protocol). The current treatment guidelines for stage IIIc and IV disease recommend debulking surgery prior to administering chemotherapy. This study represents the first randomized phase III neoadjuvant clinical trial ever reported for ovarian cancer treatment.
“Most women diagnosed with ovarian cancer have advanced stage disease. Surgery before chemotherapy is not a practical course of treatment for patients in many countries because of difficulty scheduling surgery for patients with extensive cancer and associated complications,” said the study’s author, Prof. Vergote. “Because of this trend in treatment, our trial was designed to validate the administration of chemotherapy prior to surgery. In addition to establishing acceptability for this strategy, our study demonstrates fewer complications when chemotherapy is administered prior to surgery.”
The median follow-up for all participants was 4.8 years. Overall survival and progression free survival were similar in both arms of the study, but a statistically significant reduction in complications, including postoperative deaths (2.7 percent in PDS versus .6 percent in IDS) was observed. The PDS arm of the study demonstrated a higher rate of hemorrhage (7 percent versus 1 percent) and blood clots (2.4 percent versus .3 percent).
“It was concluded that in patients with very extensive disease, as included in our study, neoadjuvant chemotherapy followed by interval debulking surgery can be considered as the preferred treatment. However, chemotherapy before surgery should not be used in patients with less than FIGO stage IIIc ovarian cancer, or small IIIc ovarian cancers, as these patients were not well-represented in the study” said Prof. Vergote. “Aggressive debulking surgery to no residual tumor remains the most important prognostic factor, underscoring the importance of a maximal surgical effort whenever the surgery is performed, whether the surgery is performed before or after chemotherapy.”
Worldwide, nearly 200,000 women are diagnosed of ovarian cancer each year and every year, over 100,000 women die of the disease.
http://www.fccc.edu/
--------------------------------------------------------------------------------------------
Related Posts:
Obesity affects health in several ways, but new research shows obesity can have minimal impact on ovarian cancer survival. A study by researchers at the University of Alabama at Birmingham (UAB) Comprehensive Cancer Center found ovarian cancer survival rates are the same for obese and non-obese women if their chemotherapy doses are closely matched to
Full Post: Obesity has minimal impact on ovarian cancer survival
Pancreatic cancer is one of the deadliest and most difficult to treat cancers. Now, in a major step forward, researchers at NewYork-Presbyterian Hospital/Weill Cornell Medical Center have shown that administering radiation therapy prior to surgery nearly doubles survival in pancreatic cancer patients with operable tumors. “Patients who received pre-surgical (neoadjuvant) radiation had almost double the
Full Post: New study on pancreatic cancer survival
A new epidemiological study has found that among women who have never used menopausal hormone therapy, obese women are at an increased risk of developing ovarian cancer compared with women of normal weight. Published in the February 15, 2009 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the research indicates that obesity
Full Post: Obesity raises ovarian cancer risk
A new epidemiological study has found that among women who have never used menopausal hormone therapy, obese women are at an increased risk of developing ovarian cancer compared with women of normal weight. Published in the February 15, 2009 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the research indicates that
Full Post: Study links obesity to elevated risk of ovarian cancer
Systematic use of pelvic lymphadenectomy (removal of the lymph nodes) does not improve disease-free or overall survival in women with early-stage endometrial cancer, according to a randomized trial published online November 25 in the Journal of the National Cancer Institute. The first site of metastasis for endometrial cancer is often the pelvic lymph nodes. However,
Full Post: Pelvic lymphadenectomy does not improve survival in early stage endometrial cancer --------------------------------------------------------------------------------------------
