Monday, June 10, 2013

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.

Every Day is a Blessing! 

No comments: