Researchers identify patterns that predict ovarian cancer relapse https://tinyurl.com/bp5u7kp3 Every now and then something new pops up that has the potential to completely change the way we look at disease. One such is the ability to examine the spatial  structure of ovarian cancer. By this is meant the 3D  distribution  o f  B cells, plasma cells, tertiary lymphoid tissues and cancer associated fibroblasts .  This is possible due to advances in genetic sequencing techniques which allow multi-cell detail . Using this technique, samples from 42 patients with ovarian cancer were analysed.  When the immune response enabled a good spatial  appearance ,  with plasma cells and other components in  proximity  and inter twined with cancer ce l ls ,  those  patients had better survival and less likely recurrence of cancer. This is early work with great promise of further progress in cancer therapy.

Cancer Stage Compared with Mortality as End Points in Randomized Clinical Trials of Cancer Screening.  A  Systematic Review and Meta-Analysis https://tinyurl.com/7wh75xhy One of the white hopes for cancer prevention is population screening. It is hoped that cancer can be avoided or detected ear ly in those who have a genetic predisposition. The NHS in the U K  have  commenced  a large clinical trial called Galleri. In th is trial  140,000 people have been tested using the multi cancer early  detection  ( MCED)  test,  with a similar control group who are not te sted. The purpose of the trial is to  determine  whether cancer survival can be improved.  Unfortunately,  the  design of the trial is flawed with the endpoints being diagnosis of stage III/IV  cancer, instead of the normal endpoints of progress-free or overall survival. This retrospective review  sought  to compare the  mortality ...

Fewer Than Half of Drugs Granted Accelerated Approval Demonstrated Benefit Within 5 Years   https://tinyurl.com/33hfxxkx   Increasingly new cancer drugs, thought by the FDA to show enough evidence of improved outcomes , navigate a short cut in the approval process , with accelerated approval allowing clinical use.   This study looks at 129 such drugs and reviews the benefit after 5 years, with correlation to confirmatory trials.   Results from the study suggest that the majority (67%) of these drugs do not improve survival or the quality of life . Despite this many of these drugs received full unqualified approval later.   The Authors suggest that informed consent should be obtained prior to use of the drugs in this category of accelerated approval , and that confirmatory trials should be undertaken before the limited approval is extended or converted.    

Is routine appendectomy beneficial in the management of ovarian cancer? https://tinyurl.com/3zpxrbpx It has been  common practice  for the appendix to be removed at the time of  initial  surgery for ovarian cancer. The reason being to avoid  subsequent  appendicitis . On occasions, this may be  deemed  inappropriate, either due to advanced age or  complex surgical  presentation . This retrospective survey looked at 136 patients who had their appendix removed.  40% of patients ,  with high grade epithelial ovarian cancer ,  had  evidence of metastasis of the cancer to the appendix. Removal of the appendix is helpful for staging of the disease and complete resection  of ovarian cancer.