Risk-Based vs Annual Breast Cancer Screening : The WISDOM Randomized Clinical Trial https://tinyurl.com/mpe28amd Screening women for breast cancer has been a great success . The death rate for women aged 40-70 from breast cancer has been red uced by 45% following the introduction of mammographic screening every two years. However, this has not been without criticism. The high cost and use of otherwise necessar y resources , together with the great number of biopsies and psychological trauma due to cancer anxiety are stated as flaws in the scheme. The WISDOM clinical trial compared personalized care to standard annual screening. In the randomized trial of over 28,000 women , half were assigned to a risk-based arm . In this arm, women were screened based on genetic and individual risk; for example, those at low risk were not assigned to start regular mammography until age 50. This group’s outcomes were compared to a similar-sized cohort assigned to annual screening. The ...

Impact of single-site distant metastases on prognosis in advanced ovarian cancer: a Surveillance, Epidemiology, and End Results population-based study https://tinyurl.com/4neetm9k In general, the presence of a distant metastasis is a bad prognostic indicator for women with ovarian cancer. The 5-year survival rate for these women is about 30%. Distant metastases may occu r in the liver, lungs , bones or brain. This study looks at the different survival outcomes for each site . Using the SEER database , which collects cancer information from the US population , the overall survival for 639 patients was determined . From the information collected the most likely site of distant metastasis is in the liver which was seen in about half of the g roup. Next the lungs ( 40%), bones (5% ) and brain (1%). Survival for all these patients is affected . The least impact is seen for those women with liver disease , which has significantly better survival than other distant metastasis site...

Characteristics and potential predictors of prematurely terminated interventional clinical trials for ovarian cancer in the ClinicalTrials.gov database https://tinyurl.com/55efrnfz Many randomised clinical trials (RCT) do not reach their endpoint with about 25% being terminated for various reasons . This study used data from the Clinical Trials.gov website to disco ver whether this is true for ovarian cancer also. The website records all clinical trials recruiting in the US and World-wide, a listing on this site does not require FDA or NIH approval. During the period 2003-2022 1420 RCTs for ovarian cancer were included. Of these, 21% were terminated early . Mostly this was a result of logistic issues such as recruitment or f unding. About 1/5 th of the terminations w as due to the intervention being non-effective . The RCTs most likely to be terminated tended to be larger trials requiring big numbers of participants and were more likely when the trial was phase 2. A trial ...

Quarter of all ovarian cancer cases linked to endometriosis: expert https://tinyurl.com/vch9rrc9 NewsNation a cable network news service is the leader in US prime-time television being the most-watched service. As such it has a responsibility to ensure that any comment is fact ual and correct. A recent posting stating that 25% of ovarian cancer is associated with endometriosis does not meet this benchmark. Information taken from a large cohort study published in JAMA in July 2024 appears to have been misinterpreted or misunderstood. Endometriosis is associated with ovarian cancer, most notably rare types such as endometrioid and clear cell cancer,  which most often present at an early stage. The cohort study shows the greatly increased risk with infiltrative an d ovarian endometrioma type disease. However, these represent only a very small proportion of the total spectrum of endometriosis. The absolute risk of developing ovarian cancer for women with endometriosis is about...

FDA grants IDE approval for FemBloc nonsurgical permanent birth control https://tinyurl.com/4kmjt2s8 Ovarian cancer mortality and incidence have significantly decreased over the last 20 years. One of the reasons for this is the use of hormonal contraception, meaning fewer lifetime menstrual cycles. Also, resection and ligation of the fallopian tubes as a permanent contraceptive measure has resulted in some protection against ovarian cancer. A new product called FemBloc threatens to disrupt this . Using an innovative outpatient delivery system , a liquid polymer glue is injected into the Fallopian tube causing permanent obstruction , with no ovarian access to the uterine cavity . This device has recently been granted Investigational Device Exemption from the FDA and a phase III clinical trial (FINALE) is currently underway . Preliminary phases of the trial have shown the procedure to be safe with no tubal pregnancy reported. The occlusion of fallopian tubes may be ...

Easy testing for defective DNA repair Olaparib, durvalumab, and cyclophosphamide, and a prognostic blood signature in platinum-sensitive ovarian cancer: the randomized phase 2 SOLACE2 trial https://tinyurl.com/dmncvndv Defective DNA repair causes about half of all ovarian cancer. For those women wh o develop this cancer , and are shown to have the defect , treatment with PARP inhibitors ( PARPi ) will extend progress-free survival (PFS). Identifying these women is costly and unreliable. A new finding obtained from an otherwise inconclusive clinical trial may lead to a che a per and dependable test. The Solace 2 trial sought over a 4-year period to prove that stimulating a n immune response before star t ing conventional therapy would improve PFS for women with advanced high grade serous ovarian cancer (HGSOC) . It is well known that HGSOC depresses immunity , and this accounts for the usual bad outcomes. The trial did not achieve the key indicator, which was 36-week PFS ...

Australian ovarian cancer breakthrough enters human trials https://tinyurl.com/ye245f8f Medicine is full of new words or neologisms. Mostly thes e are produced by PR agencies looking for a memorable brand name for a new drug. Sometimes the new name marks a dramatic shift in medical care. One such is theranostic s a complex noun first used in 1997 to name a marriage of therapy and diagnosis. Theranostics are combinations of antibodies and radiopha rmaceuticals currently being used in the treatment o f prostate cancer and carcinoid. The radi o pharmace utical of choice is lutetium-177 which is a n isotope with a short half-life and an intense Beta emitter. Beta radiation is of high energy with low penetration and highly toxic, Standard systemic brachytherapy with Beta emitters is likely to kill the patient before killing the cancer . The antibody combination targets the radiation to the cancer cell meaning only a low non-fatal dose is required . The antibody is produced ...

Molecular subtypes of human skeletal muscle in cancer cachexia https://tinyurl.com/3y3dun9v Cachexia i s a grave indicator of near death for women with ovarian cancer . It is defined as a weight loss of more than 10% or a BMI of less than 20 in patients with ovarian cancer. Why some patients become cachexic has been a mystery, the weight loss is predominately due to decrease of muscle bulk with associated weakness and impaired mobility . This prospective study involved next-generation genetic sequencing , using muscle biopsy tissue , obtained from 84 patients with cancer, at the time of their ini tial su rgery . The whole muscle RNA signature (RNA ome) s howed t wo distinct subtypes. Only subty pe I patients progressed to cachexia with an inflammatory reaction causing muscle wasting. This breakthrough in und erstanding suggests it may be possible to predict cachexia and employ treatment to prevent it. Also, the differen ce in the RNAome between the two groups may suggest ...

P-P OSSUM Falls Short: Predicting Morbidity in Ovarian Cancer (OC) Cytoreductive Surgery https://tinyurl.com/mrypfj3j Sometimes there are disappointments in the progress of treatment of ovarian cancer. One such is the realisation that predicting the outcome of surgery is more difficult than previously thought. P-POSSUM ( Physiologic and Operative Severity Score for the Study of Mortality and Morbidity) is a commonly used indicator of perioperative risk used for general surgery patients. Based on Age, Previous History of Disease and Blood Test, P-POSSUM has been shown to be a reasonable predictor of peri-operative morbidity and mortality. This has led to a push for this to be used in the management of ovarian cancer seeking to avoid futile surgery for those most at risk. This retrospective study looked at data from 161 patients with ovarian cancer. Peri-operative morbidity occurred in 40% of these women. The predicted risk fro m the POSSUM score was higher at about 60%. Simila...

Barriers and Breakthroughs in Precision Oncology: A National Registry Study of BRCA Testing and PARP Inhibitor Uptake in Women from the National Gynae-Oncology Registry (NGOR) https://tinyurl.com/2dw5xwdj Australia is a wealthy nation with universal health care. Despite this some women with ovarian cancer do not receive best care . This pr o spective study using the National Gynae-Oncology Registry (NGOR), l ooks at the extent of ge netic testing of the BRCA variant and the subsequent chance of PARP inhibitor ( PARPi ) therapy . Survival for women with ovarian cancer has been significantly improved with the introduction of PARPi . This treatment of defective DNA repair is recommended for the approximately 50% of wo men , who demonstrate this on genetic or biomarker testing. Data from the NGOR show a disparity in testing , with older women and women from regional communities being less likely to be tested . A bout 7 0% of women with ovarian cancer in Australia have genet...

Association between childhood adiposity and gyn a ecologic cancers: a mendelian randomi s ation analysis https://tinyurl.com/mr2nah45 Obesity is a major health problem throughout the developed world. Previous studies have shown increased risks of cancer associated with obesity and being obese means worse survival for t hose affected. Determining the level of risk is difficult because of multiple other factors which may mask the effect . This study using the UK geno m e - wide association study data, sough t to determine the association between obesity for girls aged 10 or less with later development of gyn aecological cancers of the ovary, endometrium , and cervix . This was achieved by a process known as mendelian randomisation which seeks to use genetic information in a non- biased randomised way , like a n RCT. Findings from the data showed increased risk of ovarian and endometrial cancer but not for cervical cancer. The latter finding is not surprising in that cerv ical...

Tracking clonal evolution during treatment in ovarian cancer using cell-free DNA https://tinyurl.com/2xtv64nx Drug resistance is the major cause of death from ovarian cancer. Why this occurs is problematic and varies with individuals. This s tudy looks at the evolving genetic mutations which cause previously effective chemo to lose its ability to control the cancer. Using new sequence genetic profiling of circulating tumour DNA , this prospective study followed the course of disease for 18 women with ovarian cancer from diagnosis to recurrence. The main finding was that the genetic clone s which disabled the chemo response w ere present at diagnosis for all these women . This suggests that evolutional preselection is occurring , whereby the environment of chemo promotes the increase in effectiveness of harmful genetic clone s . The authors suggest that understanding this evolutionary effect should lead to a  change in management, alter the environment, and prevent the...