Friday, April 29, 2022

Book Review : Medical Bondage - Race, Gender, and the Origins of American Gynecology

 


When I first heard about the book  Medical Bondage - Race, Gender, and the Origins of American Gynecology by Deidre Cooper Owens I added it to my Goodreads list.  I borrowed a copy and finished reading it a few days ago. I highly recommend this book.  It is not an easy book to read. It will make you feel uncomfortable but it is important to understand the issues Black women had in the past being treated and experimented on without any say as to how and what was being done. There was no consent given although in 1833 Beaumont wrote that "consent of the subject is necessary".

The accomplishments of Drs. Mettauer, Sims, Bozeman and others are well known but the fact that  their work was done on women who were poor ,vulnerable, enslaved women or  poor "Blackish" women, such as female Irish immigrants has only been discussed during the past few years.  While women during the 19th century were thought to be "inferior",  Black women were thought to have enhanced reproductive successes and could endure more pain. Scientific racism existed as procedures were done on enslaved women whose owners allowed the procedures or were leased to doctors,  in order to learn how to treat similar conditions in White women.

As I read the book  I thought of the pain I experienced after surgery for ovarian cancer even with access to  pain medications. Imagine going through procedures like ovary removal or fistula repair without being asked, without anesthesia and unclothed. How could the physicians like Sims write about his patient, Lucy, being in agony after a procedure and still think Black women were impervious to pain? I urge you to  read this book. 

I gave this book 4 stars.

Dee
Every day is a Blessing!

 

Wednesday, March 30, 2022

SGO 2022 Annual Meeting Endometrial Cancer

Here are a few studies on endometrial cancer. Be sure to check my Disparities and Equity research post for those studies related to endometrial cancer. 

Phase 2, Two-Stage Study of Letrozole and Abemaciclib in Estrogen Receptor (ER) Positive Recurrent or Persistent Endometrial Cancer – Konstantinopoulos


 

 


EGFL6 is an Important Growth Factor Involved in Endometrial Cancer Tumorigenesis
– A. Garrett

 


 

 

SIENDO/ENGOT-EN5/GOG-3055: A Randomized Phase 3 trial of Maintenance Selinexor Versus Placebo after Combination Platinum-Based Chemotherapy in Advanced or Recurrent Endometrial Cancer –  Vergote 


Ipatasertib, an Oral AKT Inhibitor, in Combination with Bevacizumab Exhibits Anti-Tumorigenic Effects in Pre-clinical Studies for Endometrioid Endometrial Cancer: Endometrial Cancer Molecularly Targeted Therapy Consortium –  M. Newton

 



In Vivo and In Vitro Efficacy of Enhertu in Uterine Serous Carcinoma – Speaker: L. Mutlu


 
Genomic Alterations, Molecularly Targeted Therapy and Race: Real World Data from the Endometrial Cancer Molecularly Targeted Therapy Consortium – A. Alvarez-Secord

 




 
 
Thanks for taking the time to read these SGO meeting posts. 
 
Dee
Every Day is a Blessing! 
 

Tuesday, March 29, 2022

SGO 2022 Annual Meeting Cervical Cancer Studies

As an ovarian cancer survivor, I normally concentrate my posts on ovarian cancer but there were a number of very interesting  cervical cancer and endometrial cancer studies/results presented at the SGO annual meeting. 

This post will focus on the cervical cancer sessions.

Scientific Plenary II: Building Bridges - Pioneering Protocols and Scientific Progress

Patient-Reported Outcomes from the Phase 3 Randomized, Double-Blind, KEYNOTE-826 Trial of Pembrolizumab Plus Chemotherapy Versus Placebo Plus Chemotherapy for the First-Line Treatment of Persistent, Recurrent, or Metastatic Cervical Cancer -  Monk

 

 

Safety and Immunogenicity of Anti PD-L1 (Atezolizumab) Given as an Immune Primer or Concurrently with Extended Field Chemoradiotherapy for Node Positive Locally Advanced Cervical Cancer: an NRG Oncology Trial –  J. Mayadev 


 


Pembrolizumab for Persistent, Recurrent, or Metastatic Cervical Cancer: a Cost-Effectiveness Analysis –  D. Barrington  
 
 
 
 
Scientific Plenary III: Novel Therapeutics: The Expanding Toolbox
 
Efficacy and Safety of Serplulimab (an anti-PD-1 antibody) Combined with Albumin-Bound Paclitaxel in Patients with Advanced Cervical Cancer who Have Progressive Disease or Intolerable Toxicity After First-Line Standard Chemotherapy – J. An
 

 

 
 
 
 
Efficacy and Safety of Cadonilimab, an Anti-PD-1/CTLA4 Bi-Specific Antibody, in Previously Treated Recurrent or Metastatic (R/M) Cervical Cancer: A Multicenter, Open-Label, Single-Arm, Phase II Trial – Speaker: X. Wu


 


Open vs. Minimally Invasive Radical Hysterectomy in Early Cervical Cancer: LACC Trial Final Analysis – R. Ramirez I recalled the initial discussion/ debate on minimally invasive hysterectomy vs open surgery at an ASCO meeting a few years ago. Minimal invasive hysterectomy surgery should not be used.

 


 
 
The next post will report on some endometrial cancer  studies

Dee 
Every Day is a Blessing!


Monday, March 28, 2022

SGO 2022 Annual Meeting - Ovarian Cancer Research

Below find some interesting ovarian cancer research studies I heard at the SGO meeting.

Scientific Plenary II: Building Bridges - Pioneering Protocols and Scientific Progress

Long Term Survival of GOG 252 'Randomized Trial of Intravenous Versus Intraperitoneal Chemotherapy plus Bevacizumab in Advanced Ovarian Carcinoma: An NRG Oncology/GOG Study' J. Walker

 

 What's Next After Bevaciumab Resistance? Targeting Metabolic Vulnerabilities in Ovarian Cancer –  D. Glassman GLSi is a novel therapeutic strategy to treat AVA-resistant ovarian cancer

 

Final Overall Survival Results from SOLO3: Phase III Trial Assessing Olaparib Monotherapy Versus Non-Platinum Chemotherapy in Heavily Pretreated Patients with Germline BRCA1 and/or BRCA2-Mutated Platinum-Sensitive Relapsed Ovarian Cancer –  R. Penson




Investigation of PARP Inhibitor Resistance Through the Analysis of Serially Collected Circulating Tumor DNA (ctDNA) in Ovarian Cancer Patients – Speaker: Y. Kim 

 

Evolution of the Ovarian Cancer Treatment Paradigm, Including Maintenance Treatment, in the US and Europe: A Real-World Chart Review Analysis (2017-2020) – Speaker: K. Moore

 

Knowledge Measure for Ovarian Cancer Research (KnoMOR): Development and Psychometric Testing Results of a Patient-Centered Knowledge Measure – Speaker: L. Meyer

Scientific Plenary II: Building Bridges - Pioneering Protocols and Scientific Progress

OVARIO, A Phase 2 Study of Niraparib + Bevacizumab in Advanced Ovarian Cancer Following Front-Line Platinum-Based Chemotherapy with Bevacizumab: Updated Analysis – Speaker: M. Hardesty

 

 

Prospective, Randomized Trial of Streamlined Genetic Education and Testing for Patients with High Grade Epithelial Ovarian, Fallopian and Peritoneal Cancer – Speaker: R. Previs

 Effectiveness of Platinum-Based Chemotherapy after Progression on Poly ADP Ribose Polymerase (PARP) Inhibitor in Epithelial Ovarian Cancer – Speaker: K. Dugan

Scientific Plenary III: Novel Therapeutics: The Expanding Toolbox

A Novel Combo of Niraparib and Anlotinib in Platinum-Resistant Ovarian Cancer, the Final Efficacy and Safety Report of ANNIE Study, a Phase II, Multi-Center Trial – Speaker: J. Liu , This is a Niraparib and Anlotinib ( kinase inhibitor) combo used in Platinum-Resistant OC (ANNIE Study) Promising combo With tolerable toxicity . PPMD1 mutation may be what leads to resistance in niraparib.


 Updated Results from the Phase 1 Expansion Study of Upifitamab Rilsodotin (UpRi; XMT-1536), a NaPi2b-directed Dolaflexin Antibody Drug Conjugate (ADC) in Ovarian Cancer – D. Richardson


Clinical Outcomes of Ovarian Cancer Patients Treated with the Novel Engineered Cytokine Nemvaleukin Alfa in Combination with the PD-1 Inhibitor Pembrolizumab: Recent Data from ARTISTRY-1 – Speaker: I. Winer

 

Late Breaking Abstracts:

 

Scientific Plenary V: Bullseye! Precision Medicine and Hitting the Right Targets

RNAseq Correlative Biomarkers IFIT1B and VSTM5 Predict Progression Free Survival and Clinical Benefit in a Multi-Site Phase I/II Trial of Olaparib and Tremelimumab for gBRCAm Recurrent Ovarian Cancer –  S. Adams

Turning Cold into Hot: Combination of Pembrolizumab with Bevacizumab and Oral Metronomic Cyclophosphamide Increases Immune Cell Migration into the Tumor Microenvironment in Responding Patients with Recurrent Ovarian Cancer – N. Gaulin



The Role of Mesenchymal Stem Cells in the Ovarian Cancer Precarcinoma Microenvironment – Speaker: T. Orellana

Defining the Impact of Chromobox 2 on the Immune Tumor Microenvironment of High Grade Serous Ovarian Carcinoma –  L. Brubaker

 Stay tuned for a post on Cervical Cancer.

Dee

Every Day is a Blessing! 

Friday, March 25, 2022

SGO 2022 Annual Meeting - Disparities and Equity Research Across Gyn Cancers

The #BreakingBarriers and #BuildingBridges theme of this year's meeting was evident in the presentations on equity and disparities.

Breaking Barriers : Toward Greater Equity in Gyn Oncology Care : Scientific Plenary I

 

Black and Hispanic Patient Representation in NCCN-Recommended Systemic Therapy Regimens for Endometrial Cancer – A. Kulkarni

 

 

Effect of Racism on Cancer Care in Women with Gynecologic Cancers – Speaker: D. Lewis

 

Neighborhood Economic Vulnerability is a Predictor for Patterns of Care and Outcomes for People with Uterine CancerNeighborhood economic vulnerability is a predictor for patterns of care and outcomes for people with uterine cancer

 

Overspending Driven by Dose-Specific Packaging of Lenvatinib for Endometrial Cancer – E. Aviki Financial toxicity of drug packaging for endometrial cancer. 

Distillation Dr Doll “Health equity research requires scientific rigor”

 

 

Do U.S. Screening Guidelines Contribute to Higher Stage and Worse Survival in our Youngest and Oldest Cervical Cancer Patients? C. Sitler

 

 

Impact of Medicaid Expansion on Postoperative Mortality in Women with Gynecologic Cancer: A Difference-in-Difference Analysis – Speaker: S. Huepenbecker

 

 

Health Equity is the Bullseye of the Quadruple Aim: A Social and Moral Imperative – ABOG Speaker: J. Nwando Olayiwola, MD, MPH, FAAFP


 

Focused Plenary Session III: Inequities during the Pandemic and Beyond 

 
Refusal of Gynecologic Cancer Surgery is a Surgical and Oncologic Disparity, Not an Issue of Noncompliance – Speaker: D. Samuel

 

 Socio-Ecological Model of Barriers to Cascade Testing for Hereditary Cancer Syndromes: Systematic Review of the Literature – Speaker: X. Li

 

 Geospatial Approaches for Surveillance of Disparities in Clinical Trial Enrollment – Speaker: J. Gordon

 

 

When Being Insured is Not Enough: The Effect of Insurance Type on Survival in Cervical Cancer – Speaker: C. Kucera

 

 

Race Matters: Disparities in the Use of Maintenance Therapy in Ovarian Cancer (OC) – Speaker: E. Schrader

Thank you Drs Westin, Chino, Ma, Stevens, and Sitler for tweeting their the insights.

 

 Dee

Every Day is a Blessing!

 

Thursday, March 24, 2022

SGO 2022 Annual Meeeting - Rare Gyn Cancers

The rare gynecologic cancers were covered in one Master Class on the first day of the SGO Annual meeting. It took me a bit of time getting back into the swing of tweeting from a live meeting - it has been two years- so most of this post will be from the notes I took instead my Tweets.


NE Tumors of the Cervix – Speaker: M. Frumovitz 
I had not heard of Neuroendocrine gynecologic tumors before this first presentation. Many of the trials for neuroendocrine treatments are basket trials. They are looking at Anti-CTLA-4 and Anti-PdL1 treatments. One that is open now uses Cadonilimab. Patients have used groups on Facebook to share information and crowdfund for research projects. There is a neuroendocrine registry at MDAnderson.
 
Uterine Serous Carcinoma – Speaker: A. Nickles-Fader 
Uterine serous carcinoma is different from endometrial carcinoma in their molecular makeup. USC has high genomic instability , low tumor burden and 90% have TP53 mutations. Minimally invasive surgery is OK for USC. Checking for HER-2 is important. Trials using trastuzumab ( HER-2 inhibitor)  have shown an improvement in PFS ( progression free survival) and OS (Overall survival). Other drugs being tested include Pertuzumab with ERBB2 amplification, Wee inbhibitor Adavosertib, tyrokinase inhbitors and PIKC3A inhibitors and antidrug conjugates.

Germ Cell Tumors – Speaker: L. Frazier
Germ cell tumors are most common in adolescent and young adults. Current treatment with Vinblastine,Bleomycin and a platinum drug causes late side effects. Experts formed MaGIC  https://magicconsortium.com/ to work together.  Current trial includes using carboplatin instead of cisplatin.

Low Grade Serous Ovarian Cancer  – Speaker: R. Grisham 
1000 women a year diagnosed with Low Grade Serous OC.Phase II study of enzalutamide in women who were Andogen receptor+  demonstrated PFS of 4.6 months versus HGSOC with PFS of 1.7 months. In the MILO trial ( recurrent LGSOC, binimetinib)  those with a MAPK mutation had improved outcomes.International Consortium for Low Grade Serous Ovarian Cancer  group established. 
 
Vulvar/Vaginal Melanoma – Speaker: D. Vicus 
1 -3% of all melonomas are mucosal and of those 20% are vaginal/vulvar melanoma . Dasatinib trial for recurrent disease had 7.5 months PFS . AntiPDL-1 being studied. February 2022 study AO91903 w/ nivulomab opened. 

Vulvovaginal Melanoma or Vulvar and Vaginal Melanoma: Can These Tumors be Considered The Same? – Speaker: A. Wilhite 



Debate: Should Gynecologic Cancer Trials be Conducted Based on Histology or Molecular Features? (Histology) – Speaker: J. Brown 
GOG established a Rare Tumor committee in 2005. Basket umbrella trials might be best. 

 

Debate: Should Gynecologic Cancer Trials be Conducted Based on Histology or Molecular Features? (Basket) – Speaker: I. Ray-Coquard 

 GOG-3051 Bouquet enrolling 



Innovative Biostatistical Designs for Overcoming Logistical Barriers – Speaker: M. Krailo 
Interesting presentation on using historic data in rare cancer clinical trials. 

 

Clear Cell Carcinoma/ARID1a/PI3K – Speaker: S. Gaillard & L. Shih 
Ovarian Clear Cell Caricinoma is underrepresented in clinical trials.ARID1a deletion and PIK3CA mutation found in OCCC. 
Glutumase over expression is seen in recurrent clear cell.



DNA Methylating Drug Temozolomide Sensitizes ARID1A-Mutated Tumors to PARP Inhibitors – Speaker: T. Wang 
ARID1a knock out cells are more sensitive to Temozolomide and PARPi. 

Bridging the Translational Interface in Rare Ovarian Cancers: Endometrioid Ovarian Cancer – Speaker: C. Gourley & R. Hollis 
Endometrioid OC makes up about 11% of all ovarian cancer cases. University of Edinburgh has set up an ovarian cancer database for endometriod OC.  TP53 and CTNNB1 are most prevelant mutations



Ovarian and Uterine Carcinosarcoma Cell Lines Show Preclinical Sensitivity to BAY 1895344, a Novel Ataxia-Telangiectasia and Rad3-related (ATR) Kinase Inhibitor – D. Manavella 
Carcinosarcomas are agressive cell types. This was a Cell line study using  Elimusertib (BAY-1895344), a selective ATR kinase inhibitor. 40% of ovarian carcinosarcoma have an HRD signature
 

 

The session ended with a panel of patient advocates, J. Ludemann, K. Richardson, S. Madsen, L. Laughlin talking about the needs of patients and additional clinical trials being designed for rare gyn cancers.

Next up Disparities and Equity Research Across Gyn Cancers. That post will be reports of various presentations over the days of the conference. 


Dee

Tuesday, March 22, 2022

Planning My SGO 2022 Meeting Posts, Observations and Thank you's


 

I am back from my first ever, in-person SGO 2022 Annual Meeting. This meeting was solely gynecologic cancer research but covered a range of topics - from mouse studies to the use of FDA approved drugs , from disparities in treatment of endometrial cancer to the impact of  packaging's impact on financial toxicity. And in my opinion each and every study was valuable. I will report on these topics over the next few days.

Rare Gyn Cancers
Disparities and Equity Research Across Gyn Cancers 
Ovarian Cancer
Endometrial Cancer 
Cervical Cancer
 
Making connections and reconnecting at meetings is an important part of the in-person meeting. For example,  I had a chance to chat with Dr Fiona Simpkins and Dr Sarah Adams. A few years ago, while I was on the Board of the Kaleidoscope of Hope Ovarian Cancer Foundation, these gyn oncs received grants from the Foundation. Seeing them present their research and lead sessions at a national meeting made me smile. To all the foundations raising funds to support ovarian cancer research,  your grants are making a significant difference in the careers of the scientists you support. Please continue your support.

I would like to thank Annie Ellis, survivor and advocate extraordinaire, for her guidance about attending the meeting in person and for gathering advocates and patients attending the meeting so that we could network with each other. I also want to thank the SGO President, Dr Yamada and Meeting Chairs, Dr Adams ( yes the same Dr Adams supported by the KOH grant)  and Dr Nickles Fader for the outstanding meeting and for including patients / advocates on panels.  And finally thank you to each and every gyn cancer researcher, fellow and resident for the work you do.

Stay tuned for my meeting blog posts. 
 
Dee
Every Day is a Blessing!