A Break for the Land Down Under

Over the next two weeks I will be taking a break from posting to this blog. I am blessed to be joining my son as he presents a paper at a conference in ... drum roll please... Perth, Australia. I am so proud that my  son has the opportunity to present his research at an international conference and happy that he asked me to join him.

I've wanted to visit Australia for as long as I can remember. Maybe it was when I was a little girl and saw photos of my father during World War II in Brisbane and Melbourne. Or maybe it was the stuffed Koala bear that my dad brought back for my mother that made me want to see Koalas and Kangaroos in person. All I know is that right now I've got this unbelievable opportunity join my son and visit the Land Down Under.

I'll be back to posting when I return and I promise not to bore you with too many photos.

Dee
Every Day is a Blessing!

Supreme Court Decides

Justice Thomas read the Supreme Court Decision on the Myriad Genetics Inc. case this morning. The unanimous decision stated that Myriad can not patent naturally occurring isolated genes extracted from the bloodstream .
"... Myriad did not create or alter any of the genetic information encoded in the BRCA1 and BRCA2 genes. The location and order of the nucleotides existed in nature before Myriad found them.  Nor did Myriad create or alter the genetic structure of DNA. "
The opinion went on to say that Myriad probably did create something new when their researchers  created synthetic genes, they call them c-DNA, and they might be patented. The methods to manipulate genes could also be patentable.

Myriad continues to have 20+ patents on the gene testing process. So I wonder if this ruling will open the door for other companies to make a less expensive / easier test for just BRCA1, 2.

From the Myriad Facebook page:" Under the Affordable Care Act, the BRACAnalysis test is considered preventative, and insurance is required to cover 100 percent of the cost for many women. We offer financial assistance to uninsured patients with the greatest need. "


Here are a few good articles on the topic.
http://www.scotusblog.com/2013/06/opinion-recap-no-patent-on-natural-gene-work/

http://www.npr.org/blogs/thetwo-way/2013/06/13/191283148/natural-dna-cannot-be-patented-supreme-court-ruleshttp://www.npr.org/blogs/thetwo-way/2013/06/13/191283148/natural-dna-cannot-be-patented-supreme-court-rules

http://www.bloomberg.com/news/2013-06-13/gene-patents-limited-by-high-court-in-mixed-ruling-for-myriad.html

Comments are welcome.


Dee
Every Day is a Blessing

ASCO from a Distance Part II

I continue to work my way through the ASCO Annual meeting abstracts and news reports. These might be of interest to my readers.

A randomized multicenter phase III study comparing weekly versus every 3 weeks carboplatin (C) plus paclitaxel (P) in patients with advanced ovarian cancer (AOC): Multicenter Italian Trials in Ovarian Cancer (MITO-7) -- European Network of Gynaecological Oncological Trial Groups (ENGOT-ov-10) and Gynecologic Cancer Intergroup (GCIG) trial"
The standard chemotherapy for ovarian cancer is carboplatin(C) and paclitaxel(P) every three weeks. This study compared that standard treatment plan with weekly C & P at lower doses. There were 822 women in the study. The study concluded " Compared to standard CP every 3 weeks, weekly CP did not demonstrate a significant benefit in PFS, but was associated with better QoL and toxicity. " (QoL - quality of life PFS Progression free survival)
I had the standard 3 week C&P when I was first diagnosed. If the weekly treatment were to be offered to me today I think I would choose the extra infusion visits for the better quality of life, less fatigue, neutropenia, low platelets etc.

Phase II study of trabectedin in pretreated patients with recurrent epithelial ovarian cancer (REOC). 
This non-randomized study of 16 women examined the use of single agent Trabectedin in women with recurrent ovarian cancer. Trabectedin is also known as Yondelis and is an agent derived from the sea squirt. It works by cleaving DNA of the tumor cells and cause them to die. It is approved in Europe for soft tissue tumors in platinum sensitive women. Women were given dexamethasone prior to the Trabectedin to reduce toxicity. Although there were no complete responses there were partial responses and stable disease reported. The conclusion was:  "Trabectedin 1.1mg/m2 given as a 3-hour i.v. infusion every 3 weeks was well tolerated and has confirmed a very interesting antitumor activity in this heavily pretreated population and it seems also to be a very tolerable regimen. The co-treatment with dexamethasone improves the safety of Trabectedin by reducing drug-induced myelosuppression and hepatotoxicity. Trabectedin has a manageable toxicity profile, and can be safely administered thanks to its secure action profile also in patients with no other viable therapeutic options.  " Trabectedin was tested with Doxil but was rejected by the FDA due to liver toxicity. I wonder if other drugs combined with Trabectedin or the use of dexamethosone would help move this agent down the  path to approval for recurrent ovarian cancer. 

Here is some interesting research on the psychosocial issues facinc adult vs childhood survivors. 

Psychosocial health in survivors of adult versus childhood cancer. 
This study compared depression, anxiety, post traumatic stress disorder etc in adult and child cancer survivors. They concluded "Survivors of adult onset cancer face a significantly higher amount of psychologic distress, particularly depressive and somatic symptoms, compared to their childhood counterparts and age-expected norms. Analyses are ongoing to evaluate other demographic, disease, and treatment related risk factors that may contribute to this age-related phenomenon in order to develop interventions."I wonder if they will look at the fact that most adults have financial/ work issues to increase their stress.

Dee
Every Day is a Blessing! 

ASCO from a Distance

I've attended the ASCO Annual meeting in person for the past two years. This year I observed from a distance checking on the latest ovarian Cancer news by following ASCO post on Facebook, Tweets by those I follow and the Daily news e-mail. I also checked the online listing of abstracts for ovarian cancer. I've put together a few abstracts I found most interesting.


Randomized, double-blind, phase III trial of pazopanib versus placebo in women who have not progressed after first-line chemotherapy for advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (AEOC): Results of an international Intergroup trial (AGO-OVAR16).
Pazopanib is a multikinase inhibitor and an oral formulation. The 940 patients in the randomized trial were initially diagnosed Stage III or IV and had 5 or more cycles of platinum- taxane chemotherapy. Women who took the pazaponib had an average  Progression Free Survival (PFS) of 5.6 months longer than women give a placebo. Patients did experience some adverse reactions. The Study concluded"Conclusions: Pazopanib maintenance therapy provided a statistically significant and clinically meaningful PFS benefit in patients with AEOC; OS data are not mature. The safety profile of pazopanib in this setting was consistent with its established profile. Clinical trial information: NCT00866697. "

My thoughts: Will the overall survival (OS) for the women in the pazopanib arm correlate to the PFS time? Will OS be 5 months? longer? shorter?
note:After reading a Medpage article and comments, I learned that the 800 mg pill taken daily cost $54 each.

Chemotherapy or upfront surgery for newly diagnosed advanced ovarian cancer: Results from the MRC CHORUS trial 

The first treatment for Ovarian Cancer is normally Primary surgery( PS)  followed by adjuvant platinum-taxane chemotherapy(P-CT). This study compared survival rates for PS/ P-CT versus neoadjuvant chemotherapy (NACT) where chemo is given first and then surgery occurs after there is tumor shrinkage. There were 550 women in the study. The median OS was 22.8 months for PS vs 24.5 months for NACT. They study concluded " NACT was associated with increased optimal debulking, less early mortality and similar survival in this poor prognosis group. CHORUS results are consistent with EORTC55971 and strengthen evidence that NACT is a viable alternative to PS. Clinical trial information: ISRCTN74802813"

My thoughts: Knowing that there are no issues with NACT is important information for doctors to have when they are deciding what is best for their patients.

Comparative effectiveness of treatments for recurrent ovarian cancer.
In the past recurrent OC has been treated with chemotherapy but in some cases secondary cytoreductive surgery has been done (SCS). This study compared survival between chemotherapy vs SCS vs both or neither. There were 1623 women in the study. "Conclusions: Patients with recurrent ovarian cancer treated with both secondary surgery and chemotherapy survive longer than patients treated with either chemotherapy or surgery. Women who are Black, or older at time of recurrence have worse survival. "

My Thoughts:After reading this abstract I am happy I  chose SCS followed by chemotherapy when I recurred in 2008.

I with continue to read through the abstracts and will share more of my favorites in the future.

Dee
Every Day is a Blessing!

A Weekend of Butterflies and Lipstick

This past weekend was great one for survivors in NJ.  The weather was great and the feeling of connectedness to other cancer survivors was strong.

Saturday:
 I attended the Wings of Hope event in honor of National Cancer Survivors Day at the Cancer Support Community-  Central New Jersey in Bedminster. I have participated in CSC-CNJ programs since 2006. The day began with a Walk for Hope.  Origami butterflies purchased to honor or in memory of a loved one diagnosed with cancer were displayed on sheer curtains There were tables of crafts for children, a drumming circle, a basket auction and lots of water and Rita's ice. The sun was bright and the temperatures were in the 80's.

I was thrilled that my two good friends and ovarian cancer survivors Carole Fagella and Lynn Franklin received this year's Spirit of Courage Award for their work as advocates raising awareness of ovarian cancer. Congratulations Carole and Lynn!

Spirit of Courage awardees

Sunday:
The Cancer Institute of NJ's National Cancer Survivors Day Celebration took place at the Hyatt Regency in New Brunswick on Sunday morning.

I was so excited to see so many survivors in the ballroom. And was thrilled that so many oncology nurses and social workers came to celebrate with us.  The event began with a delicious buffet meal and a welcome by the Director of Oncology Nursing Services Janet Gordis-Perez. She introduced the keynote speaker Geralyn Lucas. ( Check out Geralyn's video about getting a mammogram .)

Geralyn Lucas

Geralyn is a seventeen year breast cancer survivor and author of the book Why I Wore Lipstick to my Mastectomy. She told us how she found her "inner cleavage" and described the interaction she had with her cab driver on the way to her mastectomy. She made us laugh and she made us tear up when she invited other breast cancer survivors up to the stage to put on lipstick and share how they celebrate life.

I think this was my forth or fifth time at the CINJ Survivors Day celebration. And the first one where i felt a bit sad at the end.  Last year the ladies from my support group and their caregivers filled a table.This year it was Nick and I and one other ovarian cancer survivor.  I sure do miss Pam, Rita Kay and Ann.

Dee
Every Day is a Blessing!