Blogging for 14 years

 

I-Stock graphic

 

 It seems like only yesterday when I wrote, 

"Today I took the plunge and decided to make this blog. I guess you could say it is an early New Year's resolution. In addition to sharing my thoughts on this journey, I will post links and information relevant to women diagnosed with ovarian cancer in New Jersey."

It was December 30, 2007, fourteen years ago.

This year as in 2020 meetings and conferences were virtual so many of my posts dealt with what I learned in those virtual meetings. I admit I miss meeting in person the researchers, gynecologic oncologists and advocates I respect and admire. I hope as more people are vaccinated and boosted and omicron lessens we can go back to meeting face to face.

When I looked at my stats for this year, I found my blog was viewed 33,000 times in 2021. My top five most viewed posts in 2021 include:

Let's Chat a 2019 Guide to Tweet Chats

#ASCO  Begins Soon

2021 SGO Virtual Meeting Sunday March 21st 

2021 SGO Virtual Meeting Friday  March 19th Highlights 

It's All About Waiting 

As I look back,  I see that during certain years,  I wrote more frequently than at other times. It seems as my advocacy roles on Review Boards, Data Review Committees, Citizen Scientist Committees, presenting at meetings and moderating the #gyncsm Community with Christina grew, the number of blog posts dropped. I am not sure what 2022 will bring, but  I will continue to strive to stay true to that original statement as long as my followers find the information helpful.

I'll catch you in January with my aspirations for 2022 .

Stay Safe and Stay Well!

Dee

Every Day is a Blessing!

Let's talk about Secondary Cytoreductive Surgery DESKTOP results and more...

As many of you know when I recurred on my liver and spleen, I chose to have surgery followed by chemo. I made that decision after being offered three options.  Option 1 surgery first then chemo ( carbo /taxol). Option 2 chemo first then surgery.  And a clinical trial (GOG 213 ). I chose surgery first followed by chemotherapy.

The question about the benefits of a second surgery on recurrence has been ongoing. Last year at the SGO meeting there was a excellent discussion of the pros and cons given by Dr Gardner and Dr Coleman during the Education Forum. See this blog post . 

Two of the trials that were discussed during the Forum included SOC-1 and GOG-213 .

SOC 1 

"Eligible participants were randomly assigned (1:1)... to undergo secondary cytoreductive surgery followed by intravenous chemotherapy (six 3-weekly cycles of intravenous paclitaxel [175 mg/m²] or docetaxel [75 mg/m²] combined with intravenous carboplatin [area under the curve of 5 mg/mL per min]; surgery group) or intravenous chemotherapy alone (no surgery group)."

Source: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00006-1/fulltext

The reported results showed a median progression-free survival (PFS) of 17.4 months in patients who had surgery and 11.9 months among those who did not have surgery. The trial has not yet reported Overall Survival (OS) numbers. 

Conclusion: "Secondary cytoreduction followed by chemotherapy was associated with significantly longer progression-free survival than was chemotherapy alone in patients with platinum-sensitive relapsed ovarian cancer,..."

GOG 213 

"The GOG-0213 trial is an open-label, phase 3, multicenter, international, randomized clinical trial designed to assess two clinically relevant hypotheses: that bevacizumab added to paclitaxel and carboplatin chemotherapy followed by maintenance bevacizumab improves overall survival (chemotherapy objective) and that secondary surgical cytoreduction in platinum-sensitive, surgically amenable patients improves overall survival (surgical objective)."

Source : https://www.nejm.org/doi/full/10.1056/nejmoa1902626

This study did not show any significant difference in PFS or OS in those who had secondary surgery and those who did not.

Conclusion:

"In this trial involving patients with platinum-sensitive, recurrent ovarian cancer, secondary surgical cytoreduction followed by chemotherapy did not result in longer overall survival than chemotherapy alone."

DESKTOP

 Earlier this month, the DESKTOP trial results was reported in the NEJM.  https://www.nejm.org/doi/full/10.1056/NEJMoa2103294

This trial involved "first re- lapse after a platinum-free interval ... of 6 months or more to undergo secondary cytoreductive surgery and then receive platinum-based chemotherapy or to receive platinum- based chemotherapy alone. Patients were eligible if they presented with a positive Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) score, defined as an Eastern Cooperative Oncology Group performance-status score of 0 (on a 5-point scale, with higher scores indicating greater disability), ascites of less than 500 ml, and complete resection at initial surgery."

In the study the median OS was 53.7 months for those who had surgery and 46.0 months in those that did not have surgery.  Patients with a complete resection (all visible disease removed) had a median overall survival of 61.9 months.

Conclusion: 

"In women with recurrent ovarian cancer, cytoreductive surgery followed by chemotherapy resulted in longer overall survival than chemotherapy alone. "

An editorial written by Drs Gardner and Chi ( also in the NEJM) regarding the DESKTOP trial and the SOC and GOG trials provides an excellent analysis of the differences in trial design, patient selection, quality of surgery and use of bevacizumab. https://www.nejm.org/doi/full/10.1056/NEJMe2116353

I may be biased, since my second surgery has kept me disease free for years, but I hope going forward secondary surgery, where appropriate, is included in all discussions between women with recurrent ovarian cancer and their gynecologic oncologists. 

Thank you Drs Lars Henning (@mdlhenning) and Maria Kfoury (@kfoury) for the Twitter discussion on the DESKTOP results.

Dee

Every Day is a Blessing!

 

Advocacy - the Good and the Loss

Since my last post, my advocacy work has been time consuming but worth it since I felt good about the "work" I was doing. There were two Scientific Review Board meetings, two ASCO Evidence Based Medicine Committee meetings, two #gyncsm chats ( Genetic Testing and Gyn Cancers , Talking to Family and Friends about Cancer and Cancer Risk), two Citizen Scientist Workgroup meetings, a Community Cancer Action Board meeting and support calls for Cancer Hope Network. I also was involved in submitting two journal articles.  I can't wait to share them early next year. 

Those were the good things. But with those comes the sad parts. During a support group meeting in October the moderator asked me why I didn't write about those sad parts.At that time it was too difficult.

I met Nadia through Twitter. In December 2020, she reached out to me via direct message on Twitter.   She had been diagnosed with stage 3 high grade serious ovarian cancer.  Nadia Chaudhri was a neuroscientist in Canada. She taught, had a lab and mentored students. She was married with a young son. We didn't speak too much about treatments except for maintenance therapies. But we did talk about emotional issues. How to find a new way to live after ovarian cancer,  sharing the best times with our loved ones and talking to children about our cancer. In February, she told me the lesion was gone . We talked about savoring that good news. In DMs, we talked how I plot my CA-125's and how much to this day I still get anxious when I need to go for that blood test.

She shared on her public Twitter account about ovarian cancer, her treatments and hospitalizations, and her family. She gained thousands of followers.  In May, she learned her cancer had recurred. In a Tweet , she shared how she told her son she was dying of cancer.  GMA published her story Mom gets outpouring of love from Twitter after revealing she has to tell her son she is dying (https://www.goodmorningamerica.com/wellness/story/mom-outpouring-love-twitter-revealing-son-dying-77674650). In a DM, I shared that my mother passed away when I was young and how I thought that telling her son was a loving act.

In September , Ovarian Cancer Awareness month, she shared her story on the GMA website to raise awareness of symptoms in  Mom dying of ovarian cancer shares what she wants women to know about the deadly disease (https://www.goodmorningamerica.com/wellness/story/mom-dying-ovarian-cancer-shares-women-80167654) . She also raised funds to support underrepresented scholars in her research area.

On October 5th, at the age of 43 Dr Nadia Chaudhri died. 

I read a tweet saying she had passed and sat at my desk and cried. I never met Nadia in person yet her life affected me so, so strongly. I had a hard time explaining to my husband as he saw me crying how a women I only met because we had ovarian cancer could have such an strong affect on me. I still can't explain it except that Nadia was an extraordinary woman. 

Dee

Every Day is a Blessing!

Mixed Feelings During Ovarian Cancer Awareness Month

September is Ovarian Cancer Awareness Month. 

There is so much more information available today for women to learn and be aware of the disease than back in 2005 when I was first diagnosed .Ovarian cancer organizations are doing awareness campaigns and raising funds for research this month and throughout the year. I makes me so happy to see graphics like these on social media. (NOCC, OCRA, Sandy Rollman Ovarian Cancer Foundation, Michigan Ovarian Cancer Alliance and  Norma Leah Ovarian Cancer Initiative. 

 

Don't get me wrong I am so happy there is a month to highlight Gynecologic Cancers and  Ovarian Cancer in particular. But being a survivor during this month can be difficult. It brings a wide range of emotions from happiness to sadness to feelings of anxiety and gratefulness. It doesn't help that September is also the month for my annual visit to see my gyn onc.

It is a time where thoughts of my diagnosis, recurrence and treatments are front and center - every single day. 

It brings back memories of what it felt like to hear I had stage 3 ovarian cancer. I remember the issues I had  recovering from surgery, all the side effects from chemo and trying to find a new way to live as a cancer survivor. I think about feeling good about having a normal CA-125 yet finding out that a  CT scan showed a recurrence. I think about the decision I made to do surgery first and then chemo when I recurred. I think about the time I spent in the hospital when I had a serious reaction to the Carboplatin I took during recurrence.  I think about my feelings while in the hospital when I realized that I could no longer use a treatment that was the best for me. 

I am sad when I think about women who lost their lives to ovarian cancer through these past 16 years as I continued moving forward:

Gail, Lois, Sandy, Grace, Erika, Pamela, Rita Kay, Carol, Jean, Janice, Terry W, Shari...

I think of the women I have spoken to as a peer to peer support person for Cancer Hope Network. There  are some I no longer have to call or email. The connections are strong even if the only thing we had in common was our disease.

I think of my fellow survivors who deal every day with side effects from treatment and fear of recurrence.  There are those who have had multiple recurrences and have had multiple different types of treatment We support each other because we "get it". Thank you to each and every one of them in my little network in NJ and online. 

 I am grateful for the gynecologic oncologists, nurse practitioners, social workers and pharmacist who treat women. And lastly I am grateful for all those researchers who chose to make their life's work understand how ovarian cancer develops and spreads and the best way to treat it. 

So as I work through these feeling during this year's awareness month, I wish you good health. 

Take care,

Dee

Every Day is a blessing! I am blessed to have family by my side through it all.

 

2021 Blogger Challenge - Nancy's Point

As we close in on the unofficial end of summer I am happy to take part in Nancy's blogger challenge. I have been doing it since 2018. 

 2021 Summer Blogging Challenge Questions:

1. Who are you? Tell us your genre, how long you’ve been at it, who or what inspires you or whatever you want us to know.

I wear a number of different hats but for this blog I am a cancer research advocate. I started writing this blog in December of 2007 with the goal of sharing my story as an ovarian cancer survivor. Through the years it has morphed into where I not only share my story but I report on cancer research, clinical trials and share what I learn from oncology conferences I attend.  

 

I am inspired by the researchers who spend years of their lives in search of better treatments and cures for cancer.

2. What’s been your biggest blogging roadblock this year and did you come up with a way to get around it? (If you didn’t, that’s okay too. We’re here to support you.)

Roadblock? Yes, there were quite a few but finding the time is top on the list. I took on the roll of President of my homeowners association so that has taken a big chunk of time every week. I also have commitments on two Boards at my cancer center. Family commitments have started to ramp up again as more folks get vaccinated agains COVID. 

 

In a way with COVID  being center stage for so much of the past year coming up with other topics was a challenge too.

3. What’s something you accomplished with your blog this year that you’re proud of?

I made sure all the links on my resource page were correct. I last did a check in 2019.

4. What are a couple of your best blogging tips?

Be sure to review you post - check links and spelling and grammar. I like to write a post as a draft, leave it for a few hours and come back and reread with fresh eyes. 

 

Keep writing! Even if it is once a month.  You never know who will read what you post. What you share may mean that person has a better day. 

5. How do you handle negative feedback or comments?

How I handle it depends on the type of negative comment. I ignore some. While others I will respond once but only once.

6. Share a link to a favorite post you’ve written RECENTLY (since last year’s challenge perhaps) that you want more people to read.

One hat I wore last year was co-author of a book for women who are diagnosed with ovarian cancer. Read about it here>  http://womenofteal.blogspot.com/2021/07/and-fourth-edition-is-published.html. 

Check below for some of the other blogs that chose to take part in Nancy's challenge:

Dee 

Every Day is a Blessing!

Tips for Tweeting from a Live or Virtual Oncology Conference

Last week, Kim Richardson, fellow cancer advocate, asked me about the template I use when I  report information from cancer meetings and conferences. I realized I had never actually shared the process I use when I Tweet from an ASCO, SGO or OCRA meeting. I concentrate on sharing information on Twitter but feel free to adjust the process a bit if you are disseminating information on other  social media platforms.

Prior to the meeting

Register for the meeting in advance of the meeting, if possible. This will allow you time to download and become familiar with the meeting app, if there is one. Even from year to year you might have to update the app. 

Review the agenda to see which sessions you want to attend. Make yourself a schedule. If the meeting app allows you to create a personal schedule take advantage of that and add sessions to your personal schedule. Or keep a word or excel document listing the date / time / session / presenter name/ trial name . This will make it easier to copy and past the session name, presenter name into a Tweet. Even if sessions conflict,  add them to the app or your list. This way you can listen to those sessions at a later date.

Read abstracts as they become available so you are familiar with the data that will be presented and adjust your schedule as needed.

Set up Tweet Deck or a similar application so that you can follow the meeting #hashtag.  If you don't want to use an app you can use Twitter itself. (Search for the meeting hashtag and look under the "latest" tab.) If the meeting has oncologists live tweeting, such as ASCO Featured Voices, follow them ahead of the meeting. They may list sessions they are important and look forward to attending. Their tweets will show up in your feed or the meeting hashtag's feed too. No need to create original content from all sessions of the meeting.  It is OK to  retweet other reliable researchers tweets. Such as this one from Dr Dizon at #ASCO21

#ASCO21 #gyncsm @omalleygynonc presents mirvetuximab plus bevacizumab (phase 1) in rec on a. I agree: compelling results; sufficient to move forward. While no new safety signals, the tox remains significant: diarrhea (68%) blurred vision (63%) fatigue (58%) severe HTN (13%) pic.twitter.com/GkYVW0kesx

— Don S. Dizon MD 🇬🇺 (@drdonsdizon) June 7, 2021

Day of the meeting

Log into the meeting/app 10 minutes or so before the start of the session. This way if there are updates to the app or the schedule you have time to make adjustments. If you are attending a live meeting try to sit in an area by the presenter or a large screen that will show the presenter's slides.  

Open Twitter and search for the meeting hashtag.  Choose the latest tab. If you are using Tweetdeck or another app make sure the column you created for the meeting app is located in view. ( I follow a few hashtags regularly, so I may have to shuffle the columns around a bit.)

Prepare tweets I copy and past the presenter and session name along with the meeting hashtag and trial name if there is one into a blank tweet. If you are using Twitter, you can add a tweet to the original one so you only have to add the names once and provide more info that what you could fit in 240 characters. If I add tweets, I try to number the tweets 1/4, 2/4 or 1/n.  This is a start of a tweet from this year's ASCO meeting.

Oral Abstract Session

Gynecologic Cancer #ASCO21 #gyncsm 

@rodrocconi Novel GEM vaccine vs placebo

Listen and Compose tweets with pertinent info such such as disease type and trial outcomes or concerns about the trial. I always add #gyncsm to my tweets for gynecologic cancers.

Screen shot interesting slides (if sharing is allowed) to use in Tweets during or after the session has ended. I usually concentrate on trial outcome graphs or conclusion slides.

Oral Abstract Session
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert@rodrocconi novel GEM vaccine vs placebo every 4 weeks maintenance, 91 patients
Gem well tolerated.
Benefit for Homologous Recombination proficient patients pic.twitter.com/eK4OIdt7wi

— Dee Sparacio (@womenofteal) June 7, 2021

If sessions include discussion of a few presentations,  I will try to take a screen shot of the group of scientists discussing the research and comment on any new information. Such as this one from ASCO on HPV vaccination rates.

Dr Pierce #ASCO21 #gyncsm
"Toxic individualism" leading to low HPV vaccination rates in the US.
Need better education on HPV and highlight the benefits of vaccine in reducing cervical cancer rates.
Excellent discussion after presentations Drs Grover, DAs, Pierce pic.twitter.com/549Q2ugaQv

— Dee Sparacio (@womenofteal) June 4, 2021

After the meeting 

Blog or share your tweets on  other platforms . Simple go to the tweet you want to add to your blog and click on the ... in the top right corner. Click on embed tweet. Go to the html page of your blog and paste the text on to the page. 

Let me know if you give any of my steps a try. Plus, I'd love to hear if you have other tips too.

Dee

Every Day is a Blessing

 

A Different Kind of Sweet 16

In 2019, my sister sent me an old photo from my Sweet 16 party. It was a small party at my home with a few friends from high school. In the photo were Kathy, Karen, Patty, Ilene, Mindy and Debbie who were   fellow twirlers and classmates. Everyone in the photo was smiling. I remember it was a fun day. 

Today, July 29th, I celebrate another Sweet 16. 

On this day in 2005, I woke up from surgery to hear my gynecologic oncologist say " I am sorry Dee, you have stage three B ovarian cancer but I will do everything I can to make you well. " I am here writing this blog sixteen years later because of the treatments I received at the Rutgers Cancer Institute of NJ , the care provided by Dr Rodriguez, Dr Gibbon and their team, the support of my family and friends and my faith. 

Today I am thankful for these Sweet 16 years of life. 

Dee

Every Day is a Blessing!

And the Fourth Edition is Published !

In 2005, shortly after my diagnosis,  I picked up the second edition of a book titled 100 Questions and Answers about Ovarian Cancer. I referred to it through out my intial diagnosis and recurrence and used post-it notes to mark important topics. 

In 2015, Dr Dizon asked me to share my voice and experience in the 3rd edition. I was honored to be a part of the publication. 

Fast forward to 2019 the Drs Don Dizon and Vance Broach asked me once again to work on the 4th edition of 100 Questions and Answers about Ovarian Cancer ( Jones & Bartlett Learning).  I was thrill to be part of the updated edition. The book includes the latest information on front line and recurrence treatments including PARP inhibitors, as well as maintenance therapy information and coping strategies. See this on Twitter last Saturday made my day!

A great delivery this morning! The 4th edition of 100 Questions and Answers About Ovarian Cancer. With @womenofteal @VanceBroach TY @JBLearning for the support of this series! And @DrMarkham for the quote! #gyncsm pic.twitter.com/cp3UxVVpQe

— Don S. Dizon MD 🇬🇺 (@drdonsdizon) July 10, 2021

 

The book is available through Jones and Bartlett ( https://www.jblearning.com/catalog/productdetails/9781284183115) or  Amazon (https://www.amazon.com/Questions-Answers-About-Ovarian-Cancer-dp-1284183114/dp/1284183114/ref=dp_ob_title_bk). Be sure to check that it is the  new 4th edition so you get the most up to date information. 

I hope those who read this edition find it as helpful as the 2nd edition was to me.

Dee

Every Day is a Blessing!

#ASCO21 Cancer Disparity Sessions

The theme for this year's ASCO annual meeting was EQUITY: EVERY PATIENT EVERY DAY EVERYWHERE.  I attended a number of sessions including  Equality in Care for All Women: Addressing Disparities in Gynecologic Malignancies and Social Determinants, Not Biology: Time to Reappraise Genetics- Based Theories of Racial/Ethnic Cancer Outcome Disparities and More Than the Patient: Structural Racism and Cancer Disparities.

Here are the tweets I posted during the sessions.

Watching: Intersectionality in Cancer Care w/ Dr Brewer. This is a method to understand how "multiple forms of inequity & disadvantage sometimes compound themselves" gather not only demographic data but social determinant data #ASCO21 #gyncsm

— Dee Sparacio (@womenofteal) June 4, 2021

https://twitter.com/womenofteal/status/1400889490294648837?s=20 

Equality in Care for All Women: Addressing Disparities in Gynecologic Malignancies

#ASCO21 #gyncsm
Botswana : Developed smart phone app with reminders for treatment etc.
HIV status did not impact cervical cancer survival
20% Women < age 40 - Alter screening guidelines?
2/2 pic.twitter.com/ly3DnsO49X

— Dee Sparacio (@womenofteal) June 4, 2021

International Disparities in Gyn cancer
Dr Das #ASCO21 #gyncsm
Low and Mid income countries have lower HPV vaccination rates.
Africa and Asia have highest gyn cancer incidence.#ovca Access to Parps limited in low - Mid income countries pic.twitter.com/IJ7vMQMYHA

— Dee Sparacio (@womenofteal) June 4, 2021

Pierce #ASCO21 #gyncsm
Data supports molecular differences at the tumor level need to invest
There are differences in tumor mutational burden by race.
Immunotherapies GOG3023 Tisodamab Vindontin mostly white women in trial - are responses the same for all? pic.twitter.com/l42J9QvgoO

— Dee Sparacio (@womenofteal) June 4, 2021

Dr Pierce #ASCO21 #gyncsm
"Toxic individualism" leading to low HPV vaccination rates in the US.
Need better education on HPV and highlight the benefits of vaccine in reducing cervical cancer rates.
Excellent discussion after presentations Drs Grover, DAs, Pierce pic.twitter.com/549Q2ugaQv

— Dee Sparacio (@womenofteal) June 4, 2021

Opening Session

.@RheaBoydMD lists ACTIONS to help us become #AntiRacist

1. Create Black Sanctuaries
2. Confront Whiteness#ASCO21 pic.twitter.com/hzg0kVahTU

— Stephanie Graff, MD, FACP (@DrSGraff) June 5, 2021

 

Social Determinants, Not Biology: Time to Reappraise Genetics-Based Theories of Racial/Ethnic Cancer Outcome Disparities 

Prepping for
Social Determinants, Not Biology: Time to Reappraise Genetics-Based Theories of Racial/Ethnic Cancer Outcome Disparities
Robert Timothy Dess, MD
Marvella Elizabeth Ford, PhD
Nestor F. Esnaola, MD#ASCO21 #gyncsm pic.twitter.com/AOCUSU6mBQ

— Dee Sparacio (@womenofteal) June 6, 2021

Robert Timothy Dess, MD
Ed Session Social Determinants, Not Biology: Time to Reappraise Genetics-Based Theories of Racial/Ethnic Cancer Outcome Disparities
Prostate Cancer
Race is a social construct. Treatment Guidelines have race as risk factor. #ASCO21 pic.twitter.com/UpkvB0oH6M

— Dee Sparacio (@womenofteal) June 6, 2021

Social Determinants, Not Biology: Time to Reappraise Genetics-Based Theories of Racial/Ethnic Cancer Outcome Disparities #ASCO21 #gyncsm
Dr Ford: Biological Association of obesity and cancer. SC case I-95 corridor case study most residents are black, > poverty> Cancer rates pic.twitter.com/7bvM4pLdda

— Dee Sparacio (@womenofteal) June 6, 2021

Social Determinants, Not Biology: #ASCO2021 #lcsm
Nestor F. Esnaola
Patient Navigation may be beneficial @OncNav
Southern lung cancer study in progress 2/2 pic.twitter.com/MzCXWpjhLc

— Dee Sparacio (@womenofteal) June 6, 2021

Social Determinants, Not Biology:
Discussion : #ASCO21
Easier to focus on bio than social determinant impacts . What is driving these issues. Esnaola

Limited wi-fi /Techimpacts telehealth. All need access, do patients need help with monthly data/minutes for cell phone. Ford

— Dee Sparacio (@womenofteal) June 6, 2021

 

More Than the Patient: Structural Racism and Cancer Disparities

Education Session
Ansell Matter of Life & Death: The legacy of structural racism.
Gap in mortality from BC in Chicago increased from the 1990's to today 62%.
Inequality in Quality!
Chicago improved quality care and navigate to better treatment pic.twitter.com/fPlbBJCuLr

— Dee Sparacio (@womenofteal) June 8, 2021

Scarlett Lin Gomez Ed session Health Place and Social Justice #ASCO21 @OncoAlert
Prostate CA Higher burden
RESPOND :
higher levels of redlining
Racial bias in mortgage lending
among AA men
What to do: Address Data needs, examine neighborhood context pic.twitter.com/bHv7kEhhgo

— Dee Sparacio (@womenofteal) June 8, 2021

Jennifer J. Griggs
Racism in the Oncology Workforce #ASCO21 #gyncsm
Underepresented groups may be invisible as well as hypervisible
There is fatigue in code switching.
It is hard to not unsee what we see with racism. pic.twitter.com/2s6OUuFVzG

— Dee Sparacio (@womenofteal) June 8, 2021

Digging deeper into More Than the Patient: Structural Racism and Cancer Disparities#ASCO21
We need to mindful about inclusion in the workforce and research- Gomez
We need more Native American oncology providers ( there are only 12 in the US) - Griggs pic.twitter.com/ULRCIggf8R

— Dee Sparacio (@womenofteal) June 8, 2021

 

There are so many areas where we all can improve the care for "every patient everywhere" and these open  and honest discussions can make these needed changes happen.  

 

Dee

Every Day is a Blessing! 

ASCO 2021 Oral Abstract Session - GYN Cancers

I'll begin my coverage of the #ASCO21 Annual  meeting I have been attending virtually with comments and tweets from the Monday June 7th Gyneocologic Cancer Oral Abstract session. 

 

Not all the studies report were "blockbuster", not all provided results the researchers expected but in each and every one of them we - researchers, clinicians and patients learned something. 

 Here is my tweet summary:  

OVARIAN CANCER

PDL1 inhibitor / Neoadjuvant chemo plus Bevacizumab

Oral Abstract Session
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert
Isabelle Laure Ray-Coquard, @CoquardRay
PDL-1 inhibitor w/ NACT for adv #ovca + Bev
Small increase of ORR in CT+P Arm pic.twitter.com/SADhYogHTG

— Dee Sparacio (@womenofteal) June 7, 2021

GINECO neoadj chemo +/- pembro:

💢rate of complete debulking 70% -> 73.8%. (Met primary endpoint but control arm performed better than expected)
💢ORR 62% vs. 73%
📛PFS longer without pembro 20.8 no (vs. 19.3 w/pembro) #gyncsm @OncoAlert pic.twitter.com/w04zccqONv

— Erika Hamilton, MD (@ErikaHamilton9) June 7, 2021

GEM vaccine  (Gemogenovatucel)

Oral Abstract Session
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert@rodrocconi novel GEM vaccine vs placebo every 4 weeks maintenance, 91 patients
Gem well tolerated.
Benefit for Homologous Recombination proficient patients pic.twitter.com/eK4OIdt7wi

— Dee Sparacio (@womenofteal) June 7, 2021

While the GEM tumor vaccine did not improve RFS in the all comers population, women with homologous recombination proficient tumors had RFS and OS benefit from this therapy - will be interesting to see larger studies of this agent in the selected population #ASCO21 #gyncsm pic.twitter.com/CkSlw7Vdaa

— Shannon Westin (@ShannonWestin) June 7, 2021

Bevacizumab 15 months vs 30 months 

Oral Abstract Session
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert
Pfisterer
Bev for 15 months vs 30 months for #ovca, 900 patients
PFS no difference between treatment arms ( 24 months vs 26 months)
15 mo remains STD pic.twitter.com/nSW4i3FuzQ

— Dee Sparacio (@womenofteal) June 7, 2021

It's an #ASCO21 theme in Gyn Cancers - MORE is NOT always better! The additional months of bevacizumab DID NOT improve PFS in advanced #ovariancancer. There was no diff based on residual disease and adverse events were similar b/w both arms. #gyncsm pic.twitter.com/89D7oDMVDc

— Shannon Westin (@ShannonWestin) June 7, 2021

Agent given to highlight tumors with overexpression of folate receptor Alpha during surgery

Oral Ab
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert
Janos Laszlo Tanyi, @Janos
Pafolacianine Sodium injection (OTL38) agent overexpression of folate receptor alpha shows under fluorescence imaging
Demonstrated higher rate of detection and removal of lesions
R0 surgery is goal pic.twitter.com/mNAe9LMknA

— Dee Sparacio (@womenofteal) June 7, 2021

Mirvetuximab plus Bev for recurrent OC

Oral Abstract Session
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert
David M. O'Malley Mirvetuximab +Bev in recurrent #ovca
11.8 month mDOR , 10.6 mo PFS

Combo promising for high FR alpha patients pic.twitter.com/o5TXAUA2i2

— Dee Sparacio (@womenofteal) June 7, 2021

#ASCO21 #gyncsm @omalleygynonc presents mirvetuximab plus bevacizumab (phase 1) in rec on a. I agree: compelling results; sufficient to move forward. While no new safety signals, the tox remains significant: diarrhea (68%) blurred vision (63%) fatigue (58%) severe HTN (13%) pic.twitter.com/GkYVW0kesx

— Don S. Dizon MD 🇬🇺 (@drdonsdizon) June 7, 2021

Adavosertib w and w/out Olaparib

Oral Abstract Session
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert @ShannonWestin EFFORT: adavosertib (Wee1) alone and in combo w/ olarparib in rec OC
80patients,
AD alone and combo -efficacy in PARP resistant OC pic.twitter.com/1TENLsm2dx

— Dee Sparacio (@womenofteal) June 7, 2021

Endometrial Cancer 

Intensive Follow-up after endometrial cancer treatment

Endometrial Cancer
Paolo Zola TOTEM
Oral Abstract Session
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert
1884 enrolled
Intensive follow-up in endometrial cancer does not improve OS. pic.twitter.com/zSnIsksKaG

— Dee Sparacio (@womenofteal) June 7, 2021

mTOR inhibitor and Anastrozole 

Endometrial Cancer
Oral Abstract Session
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert
Heudel VICTORIA
Vistusertib (mTOR inhibitor) + Anastrozole
PFS 5.2 mo combo vs 1.9 mo pic.twitter.com/lEkPQQLyXb

— Dee Sparacio (@womenofteal) June 7, 2021

Pertuzumab and Trastuzumab in uterine cancer patients with ERBB2/ERBB3 

Oral Abstract Session
Gynecologic Cancer #ASCO21 #gyncsm #OncoAlert #TAPUR
Pertuzumab +Trastuzumab in patients w uterine cancer & overexpression,mutation ,amplification
ERBB2/ERBB3 28 patients
PFS 28.1 mo
Anti-tumor activity seen with combo pic.twitter.com/KqlJfuEAur

— Dee Sparacio (@womenofteal) June 7, 2021

 

Over the next few days I'll be sharing tweets from the disparity, plenary ( cervical cancer study)  and poster sessions. Stay tuned. 

Dee

Every Day is a Blessing!

#ASCO21 Begins Soon

 The ASCO Annual meeting runs from June 7, 2021 to June 8, 2021. I am happy to once again attend this meeting which shares cancer research from across the globe. I wish it was in person but once more we will be meeting virtually. 

This year's theme is EQUITY: EVERY PATIENT EVERY DAY EVERY WHERE.

Here is a list of the sessions that relate to Gynecologic Cancer that I hope to attend.

I have also made a list of a  few abstracts of research that I would like to learn more about so I don't miss out on the discussion during the meetings sessions or online. 

ORAL ABSTRACTS  

5502 Oral Abstract Session

Maintenance vigil immunotherapy in newly diagnosed advanced ovarian cancer: Efficacy assessment of homologous recombination proficient (HRP) patients in the phase IIb VITAL trial. Abstract 5502   (Vigil, an autologous tumor cell vaccine transfected with a DNA plasmid encoding GMCSF and bi-shRNA-furin for TGFβ expression control, following frontline platinum-based chemotherapy)

 

5501 Oral Abstract Session

Optimal treatment duration of bevacizumab (BEV) combined with carboplatin and paclitaxel in patients (pts) with primary epithelial ovarian (EOC), fallopian tube (FTC) or peritoneal cancer (PPC): A multicenter open-label randomized 2-arm phase 3 ENGOT/GCIG trial of the AGO Study Group, GINECO, and NSGO (AGO-OVAR 17/BOOST, GINECO OV118, ENGOT Ov-15, NCT01462890). (BEV treatment duration of 15 months remains standard of care vs 30 months)

 

5504

Mirvetuximab soravtansine, a folate receptor alpha (FRα)-targeting antibody-drug conjugate (ADC), in combination with bevacizumab in patients (pts) with platinum-agnostic ovarian cancer: Final analysis  5504

The combination of MIRV with BEV demonstrates impressive anti-tumor activity with durable responses and favorable tolerability in high FRα recurrent ovarian cancer.

5503 Oral Abstract Session

Phase 3, randomized, single-dose, open-label study to investigate the safety and efficacy of pafolacianine sodium injection (OTL38) for intraoperative imaging of folate receptor positive ovarian cancer. intraoperative near-infrared fluores- cence (NIRF) imaging with pafolacianine sodium may offer a novel real-time adjunct to current surgical imaging practice in ovarian cancer surgery. 

5506 Oral Abstract Session

Intensive versus minimalist follow-up in patients treated for endometrial cancer: A multicentric randomized controlled trial (The TOTEM study—NCT00916708). Intensive follow-up in endometrial cancer treated patients showed a weak and uncertain advantage in detecting earlier asymptomatic relapses but did not improve OS, even in HiR patients, nor influenced HRQL.

POSTERS:

5513 Poster Discussion Session 

Evaluation of a RAD51 functional assay in advanced ovarian cancer, a GINECO/GINEGEPS study. RAD51-deficient EOC have im- proved outcome after neoadjuvant platinum. Conversely, the RAD51 assay also identified a small subset of RAD51-high BRCAmut tumors with poor platinum response. Whether this RAD51 functional assay may also predict PARP inhibitor benefit is currently 

 

5519 Poster Discussion Session

Molecular results and potential biomarkers identified from MILO/ENGOT-ov11 phase 3 study of binimetinib versus physicians choice of chemotherapy (PCC) in recurrent low- grade serous ovarian cancer (LGSOC). higher response rates and longer PFS were seen in those patients with LGSOC treated with binimetinib who harbored MAPK mutations, most commonly in KRAS. Somatic tu- mor testing should be routinely performed in patients with recurrent LGSOC to aid in clinical decision making.

5521 Poster Discussion Session

Dendritic cell vaccine (DCVAC) combined with chemotherapy (CMT) in patients with newly diagnosed epithelial ovarian carcinoma (EOC) after primary debulking surgery (PDS): Biomarker exploratory analysis of a phase 2, open-label, randomized, multicenter trial. DCVAC improved PFS and OS outcomes in patients with newly diag- nosed EOC, predominantly in patients with immunologically “cold” tumors, 

 

5544 Poster Session

Nanoanalysis of plasma volatile organic compounds using novel DNA-decorated carbon nanotube vapor sensors to noninvasively distinguish ovarian and pancreatic cancer from benign and control samples. Prescreening test diagnostic approach based on vapor detection of ovarian and pancreatic cancer is achievable.

5548 Poster Session

Circulating tumor DNA as a noninvasive marker of resectability in ovarian carcinomas. ctDNA may be a promising non-invasive marker to assess peritoneal cancer spreading and to predict surgical resectability after neoadjuvant chemotherapy 

5553 Poster Session

Next generation sequencing in ovarian cancer patients: Does personalized medicine improve oncological outcomes? Our study suggests an OS benefit among the NGS tested cohort. We identified Loss of heterozygosity as a prognostic biomarker

 

5552 Poster Session- Disparities

Disparities in ovarian cancer treatment and overall survival according to race: An update. Overall survival remains worse for black patients, regardless of whether their care adhered to NCCN guidelines as defined by our study. This suggests that while receipt of care that is not adherent to NCCN guidelines seems to be negatively associated with overall survival, 

5571 Poster Session- Disparities

Race-related disparities in patterns of uterine cancer recurrence. non-White race is potentially contributory to distant recurrence of uterine can- cer, even when accounting for histopathologic differences, stage at presentation, and other traditional covariates.

Have you looked at the abstracts? Did some catch your eye? Please let me know and tag me ( @womenofteal in a tweet). Please be sure to use #gyncsm when you are tweeting from  the meeting too. 

I'll catch you all up on what I have learned with a few posts about this year's meeting. Stay tuned!

Dee

Every Day is a Blessing!

 

Two Months of Activities and Looking Ahead

Well, where did the last two months go?  I am not sure.  But when I looked at the calendar and it said, May 24th, I thought I really should post to my blog . It has been way too long. 

I was involved in many personal activities as a member of my homeowners association board. It is not an easy process to open a 55+ community pool in NJ in the time of Covid but we are working on it. I also spent lots of time and a few vet visits taking care of my dog. She had a growth removed but is recovering nicely.

 

And on a personal level, I had my second Covid vaccine. HURRAH! And I also I dealt with an ear infection. Yes, adults can still get ear infections.

On the advocacy front, I was so happy to take part in the 40th Anniversary of Cancer Hope Network. They provide one-on-one support for cancer patients and caregivers. I trained as a support volunteer with them in 2007. When I was first diagnosed I spoke to a volunteer. She gave me hope that I could make it to five years. Since then I have had over 50 matches with women who were diagnosed with ovarian cancers or others considering clinical trials.

I also took part in the COSMO (The Collaboration for Outcomes using Social Media in Oncology) Conference. I was part of the The  Patient Engagement in Social Media:When the Doctor is No Longer the Expert panel. It was wonderful speaking about the #gyncsm  cancer community along Tamika Felder, Patricia Anderson, John Novack and Janet Freeman-Daily leaders of other online patient communities and social media leaders. I enjoyed two days interacting with and hearing from cancer Social Media experts like Drs Dizon, Lewis, Durma, Drake, Miller , Painter and others.

You can follow COSMO on Twitter at @COSMONC or the hashtag #COSMOnc. 

On May 12th the #gyncsm community spoke about  Recurrence Secondary Cancer and other Diseases. Check out the highlights on our blog at http://gyncsm.blogspot.com/2021/05/may-12-2021-risk-of-recurrence-second.html.

I am looking forward to  #ASCO21 and hope to highlight the great gyn cancer and disparity research being done. Join me and follow the #gyncsm and #ASCO21 hashtags.

 

Dee

Every Day is a Blessing!

2021 SGO Virtual Meeting Sunday March 21, 2021

I am happy to share with you Tweets that cover the work presented during the last full day session of SGO was on Sunday, March 21, 2021.

One session, Time to Return to the Drawing Board, reported clinical trial results that did not meet their aims. Understanding where a drug or treatment may have failed to provide the results expected is as important as those trials that meet aims.

 Atezolizumab

#SGOMtg Association of BRCA1/2, HRD, and PD-L1 with clinical outcomes in patients receiving atezolizumab vs placebo combined with carbo, paclitaxel, and bev for newly dx
#gyncsm
Landen pic.twitter.com/qIc5j31bHD

— Dee Sparacio (@womenofteal) March 21, 2021

Falretuzumab

#SGOMtg
Phase 2 study to assess the efficacy/safety of farletuzumab in combo with carboplatin plus paclitaxel or carbo plus pegylated liposomal doxorubicin in women w/ low CA125 ( less than 3xs upper level
T. Herzog
Efficacy - no difference
PFS no difference #gyncsm pic.twitter.com/Xq98SqtXS4

— Dee Sparacio (@womenofteal) March 21, 2021

Dr. Herzog presents negative study of addition of farletuzumab (folate receptor alpha mAB) to chemo in pts with platinum sensitive #ovariancancer with CA-125 less than 3x ULN. No improvement in PFS or OS with the addition of the novel agent. #SGOMtg #gyncsm pic.twitter.com/dJq7g8fqSy

— Shannon Westin (@ShannonWestin) March 21, 2021

 

Durvalumab and Trememlimumab

#SGOMtg
Phase II Durvalumab (anti-PDL1)& Tremelimumab (anti-CTLA4) Administered in Combo versus Sequentially for the Treatment of Recurrent PR HGSOC
No diff between arms in PFS
Clear cell histology should be examined
E. Hinchcliff #gyncsm pic.twitter.com/ky6BBP72ZG

— Dee Sparacio (@womenofteal) March 21, 2021

phase II durvalumab and tremelimumab with front-line neoadjuvant chemo in patients with advanced-stage epithelial ovarian cancer
J. Lee
Manageable AEs
NACT increase in CD8T, PDL1 expression#gyncsm pic.twitter.com/iOhbYrcnys

— Dee Sparacio (@womenofteal) March 21, 2021

Additional sessions of interest.

Barriers to Quality of Care - Poster 

Significant barriers and challenges to receipt of quality care in #ovariancancer were identified. How do we raise the bar in access and treatment in this disease? #gyncsm #SGOMtg #sgo2021 pic.twitter.com/t2FJ3PW5Ew

— Sarah Temkin (@temkins) March 22, 2021

Uterine lavage and early detection

GynOnc Fellow Talayeh Ghezelayagh wowed the audience with her featured poster on uterine lavage, a novel early detection method for ovarian cancer. Great Q&A demonstrated her comfort with this high tech genomic study- great mentorship Dr. Rosana Risques.@UWMedicine @UWashOBGYN pic.twitter.com/SR23kC8f0H

— liz swisher (@SwisherLiz) March 21, 2021

Post operative opiods use model 

@BrittDavidsonmd: Development and validation of the Gynecologic Oncology Predictor of Postoperative opioid use (go-pop) model at #SGOMtg I love GO-POP's potential to provide ALL patients with the amount of pain control that they need #SGOPatAdv pic.twitter.com/SpYhoRxIEU

— Annie Ellis (@Stigetta) March 21, 2021

Neuropathy and genetic variants 

Lauren Thomaier presents Genetic variants predictive of chemotherapy-induced peripheral neuropathy symptoms in gynecologic cancer survivors at #SGOMtg Fantastic work to identify patients most at risk of CIPN! Very important! #SGOPatAdv #GYNcsm pic.twitter.com/GCeSoRXWn3

— Annie Ellis (@Stigetta) March 21, 2021

Gross resection and OS / NACT

Great study by @NiteckiRoni showing complete gross resection still remains integral to improving OS and ability to get R0 should inform surgical timing, not number of NACT cycles. @MDAndersonNews @SGO_org #SGO2021 #SGOMtg @RauhHainMD pic.twitter.com/uQAIl0KygU

— Jeffrey How (@jahow514) March 21, 2021

#SGOmtg Surgical Debulking improves survival in high-grade serous carcinoma regardless of platinum sensitivity
N. Cardillo #gyncsm
Retrospective
Optimal surgery is an independent predictor of survival. pic.twitter.com/BpYuZGX4bK

— Dee Sparacio (@womenofteal) March 21, 2021

Partial response or stable disease after neoadjuvant chemotherapy for advanced ovarian cancer-time for surgery or more chemotherapy?
R. Nitecki
Retrospective study , Phys choice more chemo or surgery 2013-2019
residual disease drives survival#SGOMtg #gyncsm pic.twitter.com/VRh51mdXGm

— Dee Sparacio (@womenofteal) March 21, 2021

Vulvar Cancer Studies 

The accuracy of intraoperative frozen section examination of sentinel lymph nodes in squamous cell cancer of the vulva
B. Swift
snl = sentinel lymph nodes #SGOMtg #gyncsm pic.twitter.com/1ddaquo643

— Dee Sparacio (@womenofteal) March 21, 2021

Volume-outcome relationship in vulvar cancer treatment: A Japanese Gynecologic Oncology Group Study

S. Nishio#SGOMtg#gyncsm
>1000 women
no association of hospital volume relationship and PFS pic.twitter.com/0fsEp7Lfnk

— Dee Sparacio (@womenofteal) March 21, 2021

#SGOMtg Vulvar Cancer Research
Pembrolizumab for vulvar squamous cell carcinoma: results from the phase 2 KEYNOTE-158 study
R. Shapira Frommer
Responses independent of PDL-1 status. #gyncsm pic.twitter.com/IJj1eLjdpg

— Dee Sparacio (@womenofteal) March 21, 2021

Endometrial cancer 

Cediranib and Olaparib NRG GY012

Phase II Study Comparing Single-Agent Olaparib, Single Agent Cediranib, and the Combination of Cediranib/Olaparib in Women with Recurrent, Persistent or Metastatic Endometrial Cancer
BJ Rimel NRG GY012 study #SGOMtg
#gyncsm
Did not m pic.twitter.com/YxDK8S565f

— Dee Sparacio (@womenofteal) March 21, 2021

IUD

#SGOMtg
Complete pathological response following levonorgestrel intrauterine device in clinically stage 1 endometrial adenocarcinoma: @AndreasObermair 165 patients
Weight loss may help response. #gyncsm pic.twitter.com/zfh3cc9WiN

— Dee Sparacio (@womenofteal) March 21, 2021

 Enzalutamide

#SGOMtg ENPAC: Phase II trial with safety lead of enzalutamide in combination with paclitaxel and carbofor adv or recurrent endometrioid endometrial adenocarcinoma
Westin #gyncsm health moderator
Andogen receptor expressed in endometroid OC , 35 patients
tolerable. pic.twitter.com/r8ZS9Nfijc

— Dee Sparacio (@womenofteal) March 21, 2021

Here are some articles from various sources that go more into depth about studies discussed at the meeting. 

Medscape article on hormone IUD and endometrial cancer https://www.medpagetoday.com/meetingcoverage/sgo/91740

Vulvar cancer patients with sentinel node micrometastases, radiation therapy (RT) to the groin after local excision led to extremely low rates of recurrence, a phase II trial suggested https://www.medpagetoday.com/meetingcoverage/sgo/86603 

ABV-500 small molecule in OC https://www.medpagetoday.com/meetingcoverage/sgo/91739

 

Thank you so Eisai for supporting patient advocates at the annual meeting . 

Thank you SGO leadership for making us feel welcome and for all the gyn oncs who answered our questions.  

Dee

Every Day is a Blessing!