Research News - Jan 2019

A friend, social media guru and breast cancer survivor, Marie Ennis-O'Connor,  writes a weekly post in which she shares blog posts she found interesting from the week before.  In 15 Smart Ways to Drive More Traffic To Your Blog in Medium ( https://medium.com/@JBBC/15-effective-ways-to-drive-more-traffic-to-your-blog-75e1943b88f4) to recommended creating "a weekly round-up post on your blog".  I've been meaning to do this for a while but had trouble deciding what I wanted to share. Should it be journal articles or survivor stories or new resources or events? Earlier this week I decided to concentrate on research news and went to work creating a graphic I could use for these repeating posts.

On the last Wednesday of the month I will provide links to articles on ovarian cancer research and treatments I read during that month.

Here are some interesting articles published in January:

Current strategies for the targeted treatment of high-grade serous epithelial ovarian cancer and relevance of BRCA mutational status

"The recent addition of targeted therapies – anti-angiogenic agents and PARP inhibitors – to the pharmacologic treatments available for ovarian cancer has improved patient outcomes while increasing the available options for the traditionally difficult-to-treat disease."

Overexpression of CCDC69 activates p14^ARF/MDM2/p53 pathway and confers cisplatin sensitivity

"The aim of the study is to explore the relationship between CCDC69 expression and resistance of ovarian cancer cells to cisplatin and reveal the underlying mechanism."

Morbidity and Mortality Rates Following Cytoreductive Surgery Combined With Hyperthermic Intraperitoneal Chemotherapy Compared With Other High-Risk Surgical Oncology Procedures 

"Comparative analysis revealed CRS/HIPEC to be safe, often safer across the spectrum of NSQIP safety metrics when compared with similar-risk oncologic procedures. Patient selection was important in achieving observed outcomes. High complication rates are a misperception from early CRS/HIPEC experience and should no longer deter referral of patients to experienced centers or impede clinical trial development in the United States."

Risk of Malignant Ovarian Cancer Based on Ultrasonography Findings in a Large Unselected Population 

"According to this study, the ultrasonographic appearance of ovarian masses is strongly associated with a woman’s risk of ovarian cancer. Simple cysts are not associated with an increased risk of ovarian cancer, whereas complex cysts or solid masses are associated with a significantly increased risk of ovarian cancer."  

Prevalence of germline pathogenic BRCA1/2 variants in sequential epithelial ovarian cancer cases.

https://www.ncbi.nlm.nih.gov/pubmed/30683677/
"Our study suggests that age at diagnosis, family history of breast and/or ovarian cancer, medical history of breast cancer or a Manchester BRCA Score of ≥15 points are associated with a >10% prevalence of germline pathogenic BRCA1/2 variants in epithelial ovarian cancer.

 

 

Studies Seek to Expand on PARP Inhibitor Success in Ovarian Cancer 

https://www.onclive.com/web-exclusives/studies-seek-to-expand-on-parp-inhibitor-success-in-ovarian-cancer

Where Does Immune Checkpoint Inhibition Fit in Ovarian Cancer Treatment?

http://www.cancernetwork.com/ovarian-cancer/where-does-immune-checkpoint-inhibition-fit-advanced-ovarian-cancer-treatment

If you run across any interesting articles about ovarian cancer research please share them in the comments below or sent them to me in an e-mail.  I will be sure to add them to this page.  Knowledge is Power. (LiveSTRONG)

Dee
Every Day is a Blessing!

 

Medically Underserved Individuals and BRCA Testing Study Results - JAMA article

Knowledge of whether or not you have a hereditary BRCA 1 or 2 mutation can impact the treatment decisions of women diagnosed with breast and ovarian cancer.

Last week, researchers reported the results of an analysis of the Southern Community Cohort Study (JAMA). From 2002-2009 over 49,000 women were recruited to the Southern Community Cohort Study from community health centers in twelve southeastern states. Of those women 2002 had breast, ovarian or both cancers. Of that group 718 (62% black and 33% white; 689 breast cancer and 30 ovarian cancer) were covered by medicare. Sixty-two percent of the women reported an annual income of less than $15,000. Ninety-two of the 718 women would qualify to have Medicare cover the cost of BRCA testing.

Amy Gross, PhD Vanderbilt University reported that of those 92 women only 8 had BRCA testing within five years of diagnosis.  Analysis of the medical records from the twelve states showed that Arkansas, Louisiana, Tennessee, and West Virginia had zero tests.  When data from 2000-2004 was examined it was found that no eligible women were given a BRCA test. Later years showed an increase in testing but in 2010-2014 only ~ 15% received the test. “This testing rate is lower than what I have seen reported in terms of any other study with the same time and eligibility constraints,” Gross said.(VUMC Reporter) The numbers did improve over time

While the sample size is small there could be a few reasons for why the numbers are so low including lack of interest on the part of the patient, lack of referrals for testing by physicians or lack of available resources. The researchers concluded that "novel strategies are needed to ensure that medically underserved women with cancer receive appropriate referral and access to genetic testing."

After reading this report I wonder...
How these numbers from medically underserved individuals compares to women covered by other insurance plans and/or those treated at larger cancer centers during the same time period?

We know that BRCA status is critical in deciding which treatments a women with ovarian cancer provide the most benefit but it also impacts the ability of family members to reduce their risk of breast and ovarian cancer. What can we do to insure that all women diagnosed with epithelial ovarian cancer have access to BRCA genetic testing as recommended by the SGO.

Dee
Every Day is a blessing! 

Resources:
The JAMA article https://jamanetwork.com/journals/jama/article-abstract/2696996
Reuters Article https://www.reuters.com/article/us-health-breastcancer-gene-testing/not-all-women-eligible-for-breast-cancer-gene-tests-are-getting-them-idUSKBN1KZ1RP
VUMC Reporter article http://news.vumc.org/2018/08/14/medically-underserved-women-in-the-southeast-rarely-receive-brca-tests/

News about Anemia drugs- JAMA

When cancer patients experience chemo induced anemia (low hemoglobin levels) they sometimes are prescribed erythropoiesis stimulating agents (ESAs). Two commonly used drugs are called Aranesp from Amgen and Procrit from Johnson & Johnson. Yesterday, the NY Times published a column describing the results of a study printed in JAMA of clinical trials that used those drugs. The study concluded that cancer patients given the ESA's were shown to have decreased survival rates and increased incidence of blood clots.

I took Procrit a few times during my treatment so this article really makes me think about what I would do faced with postponing chemo due to low hemoglobin/red cells. I guess the FDA will have to consider if the risk of taking the drug outweighs what would occur if patients treatments were postponed due to low hemoglobin/ red count.