Validation of the KELIM score as a predictor of response to neoadjuvant treatment in patients with advanced high grade serous ovarian cancer https://tinyurl.com/4vebw3w8            One of the many unresolved questions about ovarian cancer is; why do some women survive better than others? This study suggests that an objective measurement of the rapidity of response to chemo may provide a guide as to who will do well.          As part of the standard care for high-grade ovarian cancer, most women have chemotherapy before surgery, known as neoadjuvant therapy (NACT). . The response to NACT is measured by the reduction of the CA125 antigen; this is elevated in about 90% of epithelial ovarian cancers.          A retrospective trial for 217 patients with ovarian cancer showed that the rate of elimination of CA125 (KELIM) from serum is related to survival....

Improving LGBTQ+ Inclusivity in Ovarian Cancer Care https://tinyurl.com/yx5schcr            Equity and inclusion are fundamental for good health care. It is clear that there is bias against the diverse LGBTQ+ community in cancer care and also a perception by members of the community that they will be discriminated against when they seek medical assistance.          This article by the CEO of the world ovarian cancer coalition seeks to address these issues. Education is needed to explain that the use of oral contraceptives, pregnancy and breast-feeding are protective against ovarian cancer. Non-heterosexual women are therefore disadvantaged. Risk reduction surgery may be appropriate, but needs careful discussion and understanding.          Failure to include diverse minority groups in cancer research, most notably in the design of clinical trials, is...

DNA methylation and transcriptomic features are preserved throughout disease recurrence and chemoresistance in high grade serous ovarian cancers https://tinyurl.com/4yvhprf7            Progress in the treatment of ovarian cancer is slow and often occurs in small steps. This study uses whole genome data to show the genetic signature of ovarian cancer is unchanged after recurrence.          Previously it was thought that recurrence of ovarian cancer is due to resistance to chemotherapy, as a result of a yet to be described genetic mutation. This small study suggests that this is not the case.          Whole genome sequencing was obtained from 28 women, with data before treatment and after recurrence.. No change likely to cause resistance was detected; suggesting that resistance and recurrence of ovarian cancer is pre-determined at presentation. As who...

Independent and joint associations of weightlifting and aerobic activity with all-cause, cardiovascular disease and cancer mortality in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial   https://tinyurl.com/bdzkstr9            Often data obtained from one trial has other uses. The Prostate, Lung, Colorectal and Ovarian Cancer screening trial (PLCO) involved 1.5 million people, over a period of 13 years, with the aim of demonstrating the benefit of screening. No survival benefit for ovarian cancer was found.          Analysis of the data continues, it is seen that moderate to vigorous physical exercise is associated with a significant (32%) lower risk of all-cause mortality. Adding weight training to the exercise routine did not significantly improve the benefit.          Although the exercise routines improved overall mortality...

  Measure of CA-125 Elimination May Guide Interval Debulking Surgery Selection in High-Grade Serous Ovarian Cancer https://tinyurl.com/mpwbajh2            Change in treatment for cancer often occurs when conventional treatment protocols are challenged. Ovarian cancer survival is  determined by the completeness of initial surgical excision. It is now usual for this surgery to be preceded by chemo in a procedure called neoadjuvant therapy (neo).          This article looks at whether all patients who have neo need to have surgery, measuring the speed at which the marker; CA125 is eliminated, shown by testing blood serum. The rate of elimination is called KELIM, the patient group (254 women), fell into two groups those who had high KELIM (90 women, i.e. good responders), and those who did not.          For patients with high KELIM, debulking ...

Common Chemotherapy Drugs Seem to Increase Hearing Loss in Adults https://tinyurl.com/mr48a9jd            One of the more significant side effects of chemo is neuropathy. Peripheral neuropathy with loss of function and pain is well recognised and may be an inevitable consequence of chemotherapy as part of the initial treatment of ovarian cancer.          Less well recognised and often not considered is cranial neuropathy, where the cranial nerves are damaged. For the auditory nerve this damage presents as hearing loss and often tinnitus.           Data from a study looking at survivors of cancer who had chemo found that 70% had significant hearing loss, with hearing below the 50 th  percentile for any frequency. Similarly 40% reported tinnitus with ringing in the ears for longer than 10 minutes. Despite the high incidence of hearing loss o...

Genomic and epigenomic BRCA alterations predict adaptive resistance and response to platinum-based therapy in patients with triple-negative breast and ovarian carcinomas https://tinyurl.com/5xw4248z            One of the unsolved issues in ovarian cancer is why some patients are resistant to the normal chemotherapy regime. This article suggests that epigenetic alteration may be a cause.          Epigenetic change occurs when chemical effects such as methylation cause structural deformity to DNA. The effects of this change to the BRCA gene are similar to mutation. Both groups with BRCA alteration, either due to mutation or epigenetics, have a good response to chemo.          Exposure of the epigenetically changed BRCA gene to platinum chemo may cause reversal to normal BRCA status. It is suggested that adaption to the effects of chemo in this way can...