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...

Myeloid cell networks govern re-establishment of original immune landscapes in recurrent ovarian cancer https://tinyurl.com/47mcxyde Women unfortunate enough to develop a recurrence of ovarian cancer show a range of responses to repeat chemo. This study looks at the immune response to the cancer and the survival outcomes. About half of these women show the presence of tumour infiltrating lymphocytes, (TIL),  suggesting an active cell-mediated immune response. This is associated with better survival. Most of those women also display defective DNA repair with Homologous Recombination Deficiency (HRD). The immune response is stimulated by increased antigen s such as PD-1 , which suggest that immunotherapy with immune checkpoint inhibitors could be of benefit. However, in practice this has not seen to be true. T o understand why this is the case the authors reviewed the immune status of abut 600 patients with ovarian cancer using digital pathology. They subdivided the immune r...

Kinesin superfamily proteins in ovarian cancer: from molecular mechanisms to clinical applications https://tinyurl.com/3d9f6z4v Understanding the cellular changes that occur in ovarian cancer is essential for developing a cure. This review examines the action of microtubule motor proteins, which are crucial for controlling cell division and maintaining normal cell function. In ovarian cancer, one of these motor proteins, called Kinesin, is disrupted. This disruption leads to uncontrolled cell division, metastasis, and chemoresistance. The review highlights that increased intracellular amounts of Kinesin-like proteins are associated with a more aggressive clinical course and a lower survival rate for women with ovarian cancer. The authors suggest that this change in microtubular activity could be a valuable target for precision therapy.

Navigating dual risks: Ovarian cancer prevention and cardiovascular health in patients with hereditary cancer syndromes https://tinyurl.com/3z46f2tp Premature menopause is a health hazard. It has long-term implications for the quality of life and health including ad verse effects on cardiovascular well-being. For women with inherited genetic mutations such as BRCA1&2 this means a dilemma . T hey have a choice of reducing the risk of ovarian cancer by surgical resection of Fallopian tubes and ovaries but need to understand the possible long-term adverse effects. This review article shows the benefits of risk reduction surgery with a decreased risk of ovarian cancer of up to 96%. After surgery there is an immediate menopause . This has been shown to significantly increase the likelihood of cardiovascular disease which is the leading cause of death for women. The risk has been shown to be 2 to 3 times greater when compared to women who experience a normal menopause at the usua...