Showing posts with label PARP inhibitors. Show all posts
Showing posts with label PARP inhibitors. Show all posts

Thursday, June 8, 2023

ASCO23 Day 3 :Parp Inhibitors & Late Breaking Abstract session

While there were fewer gynecologic cancer sessions on Day 3, Sunday June 4th there were two important sessions regarding the use of PARP inhibitors and trial results for a drug to teat  platinum resistant ovarian cancer drug which may be change practice.

Parp Inhibitor Optimal Selection and Toxicity Management 

Dr Tew - Status updates on Parp use


Dr Friedlander- Real World Experience in Managing PARP Toxicities 


 


 


 Susan Feinberg  (FORCE) - Living on a PARPi 


 


Late Breaking Abstract Session  
Mirvetixumab in Folate Receptor Alpha positive platinum resistant ovarian cancer

I wish I had been able to be in the room when this session took place. I could feel the excitement from the Tweets being posted.  This is the first trial to show overall survival benefit in platinum resistant ovarian cancer! This is practice changing. 

 Here is a slide of the overall survival  MIRV 16.46 months vs investigator choice of treatment 12.75 months.


 Stop by tomorrow for highlights from my last day of ASCO - Day 4 . 


Dee

Every Day is a Blessing

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Monday, April 3, 2023

SGO Annual Mtg 2023 Highlights : Ovarian Cancer

I've gathered together some interesting Tweets about ovarian cancer research studies from the SGO 2023 Annual Meeting.

Botensilimab An Fc-engineered recombinant human immunoglobulin (Ig) G1 monoclonal antibody and Balstilimab a PD-1 inhibitor 

Additional information  https://www.cancernetwork.com/view/botensilimab-plus-balstilimab-yields-enduring-responses-in-r-r-ovarian-cancer

 

SOLAR Trial olaparib (Lynparza) with selumetinib (Koselugo) in patients with RAS-mutant gynecologic malignancies

Find additional information at https://www.onclive.com/view/dr-westin-on-outcomes-of-the-solar-trial-in-ras-mutant-gynecological-malignances


SOLO 1 trial results - 7 year overall survival reported

Additional information may be found at https://www.onclive.com/view/dr-mathews-on-maintenance-olaparib-in-ovarian-cancer

 

NOVA trial Recurrent ovarian cancer - Niraparib (Zejula) did not produce a statistically significant overall survival (OS) benefit compared with placebo.  

 

Minimally invasive surgery vs open surgery

 

Neoadjuvant olaparib - improved surgical outcomes 

 For additional information see https://www.onclive.com/view/neoadjuvant-olaparib-proves-feasible-aids-optimal-resection-in-brca-mutant-ovarian-cancer

mirvetuximab soravtansine-gynx (Elahere)

Steroid eye drops followed by lubricating eye drops and regular visits to an ophthalmologist should be scheduled . For more information see https://www.onclive.com/view/dr-matulonis-on-the-management-of-mirvetuximab-soravtansine-related-toxicities-in-fr-ovarian-cancer

venous thromboembolism (VTE)

 

For additional information see https://www.medpagetoday.com/meetingcoverage/sgo/103793

If you would like to share additional ovarian cancer studies presented at SGO 2023 please mention in the comment section below. Thanks.

Stop by tomorrow to read Tweets that highlighted studies on equity, diversity at the meeting.

 

Dee
Every Day is a Blessing! 

 

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Sunday, March 17, 2019

SGO Annual Meeting - Saturday 3/16

Saturday SGO Meeting:

I wish I had been able to hear the SGO Presidential speech by Dr. Agnes Binagwaho (@agnesbinagwaho) .



Financial Toxicity



Genetic Testing
PARP Inhibitors


Cancer Disparity

Leadership - Dr Parkham Zambia


Thank you Yvette WilliamsBrown (@MYvetteWB), Ali Saiz, MD (@AllisonSaizMD), Shannon Westin (@ShannonWestin), Ross Harrison (@RossFH), Erin Stevens (@erinstevensmd), BJ Rimel (@BJRimelMD) and Annie Ellis (@Stigetta) for taking the time to tweet from the meeting.

Dee
Every Day is a Blessing!
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Wednesday, January 30, 2019

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:

"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."

"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!
 

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Tuesday, June 5, 2018

#ASCO18 Twitter Highlights June 4, 2018

Many gyn cancer research topics as well as survivorship issue  were covered on Monday at the ASCO Annual Meeting.

If you were at the meeting and think I missed any important developments please share a link to it in my comments section below.

Genetics / Genetics Counseling




Risk Reducing Surgery




CA-125


Endometriosis and Cannibis Treatment
Mindfulness

Neuropathy


Patient Reported Outcomes- Pain
Enodmetrial Cancer- Posters

Ovarian Cancer - Posters

Fertility Preservation

Metformin in Cancer Treatment

HIPEC

Palliative Care

Recurrent Ovarian Cancer

Neoadjuvant Chemotherapy - OC

 Further details may be found at 
https://meetinglibrary.asco.org/record/160515/abstract

Cediranib and Olaparib for recurrent OC
Further info may be found at
https://meetinglibrary.asco.org/record/160525/abstract


Thank you to all the researchers , advocates, and cancer centers who tweeted from this year's Annual Meeting.

Dee
Every Day is a Blessing!


 
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Monday, March 26, 2018

#SGOmtg Twitter Highlights - Research Highlights Saturday March 24, 2018

Here are a few highlights from the  SGO meeting from Saturday March 24, 2018. Tweets of physicians and advocates I follow concentrated on:
LACK OF GYN CANCER CLINICAL TRIALS



OPIOID USE


IMPROVED OS OF MINORITY PATIENTS IN CLINICAL TRIALS



EVEROLIMUS/LETROZOLE IN ENDOMETRIAL CANCER


GOG244 LYMPHEDEMA STUDY


COST AND PARP MAINTENANCE


CHECK POINT INHIBITOR SIDE EFFECTS



SENTINEL LYMPH NODE IDENTIFICATION

 It was exciting for me to see an advocate - Meg Gaines - present at the meeting. We are making progress.
Thank you SGO, Amir Jazaeri, Rick Boulay MD, Kian Behbakht, Nicole D. Fleming MD, Shannon Westin, Erin Stevens, Joshua Garrett Cohen,  and Annie Ellis for tweeting from the meeting.


Dee
Every Day is a Blessing!
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Tuesday, September 19, 2017

Day 19 A Month of Teal: Treatments for Recurrence - Chemotherapy/ targeted therapies

Depending on how your disease presents itself on recurrence you may be offered surgery, chemotherapy or a clinical trial. I was offered surgery and chemotherapy or a clinical trial. A majority of women will have chemotherapy but I strongly urge women to consider a clinical trial.

 Below is a list of drugs you may be offered:

Chemotherapy Drugs for Recurrence platinum sensitive:
  • Cisplatin or carboplatin + paclitaxel 
  • Carboplatin + gemcitabine
  • Carboplatin + pegylated liposomal doxorubicin
  • Carboplatin + epirubicin
  • Cisplatin + doxorubicin + cyclophosphamide  ( recurrence 12+yrs)

Carboplatin and Taxol are considered the standard for first time platinum sensitive recurrence

Chemotherapy Drugs for Recurrence Platinum Resistant
  • Paclitaxel
  • Topetecan
  • Gemcitabine
  • Pegylated liposomal doxorubicin
  • Pegylated liposomal doxorubicin + trabectedina 
  • Etoposide
  • Hexamethylmelamine (Altretamine)
  • Irinotecan
  • Oxaliplatin
  • Vinorelbine
  • Fluorouracil and capecitabine
  • Tamoxifen
  • Pemetrexed
  • Bevacizumab
  • The U.S. Food and Drug Administration has approved the use of bevacizumab ( Avastin)  in combination with pegylated liposomal doxorubicin, paclitaxel, or topotecan.  Two trials OCEANS and AURELIA showed the improvement in PFS ( progression free survival).
  • Olaparib (PARP inhibitor)- maintenance (9/12/17 FDA Approval) / after 3 or more chemotherapy treatments and a BRCA mutation (2014 FDA approval)
  • Rucaparib ( BRCA mutations, 2 or more chemotherapy treatments, 2016)
  • Niraparib(Maintenance therapy BRCA mutation not required)

 For additional information about each of these treatments and evidence for their use  please see
https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq#link/_789 
https://www.cancer.gov/news-events/cancer-currents-blog/2017/fda-olaparib-ovarian-cancer-maintenance?cid=eb_govdel

or the NCCN guideline page
https://www.nccn.org/patients/guidelines/ovarian/index.html#63/z 

Dee
Every Day is a Blessing ! 

 

 
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Thursday, September 14, 2017

Day 14 A Month of Teal: Chemotherapy on Initial Diagnosis

The section below is an excellent description of the chemotherapy drugs used for ovarian cancer. It can be found in full on the  Cancer.net website sponsored by ASCO.

Ovarian, Fallopian Tube, and Peritoneal Cancer: Treatment Options

"Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ 
ability to grow and divide. Chemotherapy is given by a gynecological oncologist or a medical oncologist, a doctor who specializes in treating cancer with medication.
Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).
A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.
Most of the chemotherapy options described below apply to epithelial ovarian cancer, as well as fallopian tube cancer and peritoneal cancer. The type of the chemotherapy used depends on several factors.
  • Adjuvant chemotherapy. This is done to destroy cancer remaining after surgery. This treatment typically consists of carboplatin (Paraplatin) given with paclitaxel (Taxol) or docetaxel (Docefrez, Taxotere) intravenously (IV), which is through the vein. Most of these drugs are given every 3 weeks. 
    Another approach is called “dose-dense” chemotherapy. This is when the drugs are giving weekly instead of every 3 weeks. Some studies show that using dose-dense paclitaxel with carboplatin may improve survival rates compared to giving the drugs every 3 weeks. Talk with your doctor about which scheduling option is best for your situation. (The  recent ICON 8 study reported on at #ESMO17 found no difference in survival between dose dense and every 3 week chemotherapy http://www.esmo.org/Conferences/ESMO-2017-Congress/Press-Media/Press-Releases/ICON8-Trial-Reaffirms-Standard-Dosing-in-Ovarian-Cancer-Chemo)


    In addition, a third way to give adjuvant chemotherapy is to infuse it directly into the abdomen. This is called intraperitoneal or “IP” chemotherapy. This approach can be considered for women with stage III disease after a successful surgical debulking procedure. In previous studies, IP treatment was more effective when compared to intravenous treatment on the every 3-week schedule.

    Studies comparing dose-dense (weekly) IV chemotherapy with carboplatin and paclitaxel to IP chemotherapy with the same drugs show similar outcomes. Doctors are discussing whether the more intense IV approach can replace the use of IP chemotherapy.

    With each of these approaches, doctors consider a variety of factors, such as age, kidney function, and other existing health problems.

    Research studies are underway to see if additional medications, such as PARP inhibitors, should be used. Several studies have evaluated whether adding bevacizumab (Avastin), which is an anti-vascular or “blood vessel growth blocking” antibody, to standard chemotherapy following initial surgery is helpful. In general, bevacizumab used for ovarian cancer has prolonged the time in some patients before the cancer returns; see Latest Research."


    Additional information on chemotherapy may be found on these pages:
    https://www.nccn.org/patients/guidelines/ovarian/index.html 
    http://www.foundationforwomenscancer.org/types-of-gynecologic-cancers/ovarian/chemotherapy/
    Dee
    Every Day is a Blessing!

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Friday, September 21, 2012

OC Awareness #21 - HIgh Grade Serous subtypes

The article

Profiles of genomic instability in high-grade serous ovarian cancer predict treatment outcome



appeared in a recent issue of Clinical Cancer Research. Researchers at Dana Farber using a process called single nucleotide polymorphism (SNP) arrays were able to examine single units in the genetic code of tumor cells of high grade serous ovarian cancer ( HGSOC) . HGSOC cells have many genetic abnormalities including missing or extra chromosomes and  On examination the HGSOC fell into three groups based on abnormalities or loss of heterozygosity ( LOH). (Heterozygosity is having dissimilar pairs of genes.) One group had a high level of LOH and a loss of chromosome 13. The researchers found that patients in this group were slow to develop resistance to chemotherapy drugs and also were found to have the longest progression free survival.

A good review of the study can be found at
http://www.healthcanal.com/cancers/32333-Researchers-identify-three-subtypes-high-grade-serous-ovarian-cancer.html

Dee
Every Day is a Blessing!


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Tuesday, June 12, 2012

ASCO - Parp Inhibitor and BRCA Mutation Studies

Part Three of my ASCO Report.

 Parp inhibitors (which inhibit the enzyme  poly ADP ribose polymerase) have been found in some cases to be effective in women with BRCA1 and 2 mutations. There have even been a few studies where the inhibitor was found to be effective in women without the mutation.

The Parp inhibitor abstract and BRCA 1& BRCA 2 abstract  were part of an ASCO Poster Session, while the last study was part of an Oral Abstract session I attended.

Abstract 5068
A phase II study of pazopanib in recurrent or persistent ovarian (EOC), peritoneal (PPC), or Fallopian tube cancer (FTC): A Spanish Ovarian Cancer Group (GEICO) study.

This Spanish study was discontinued early since the clinical benefit number was not reached due to the lack of activity of Pazopanib.

Abstract 5066
Effect of BRCA mutation on prognosis in patients with ovarian cancer: A systematic review and meta-analysis.

This poster was a review of over 2000 studies and confirmed the hypothesis that a BRCA mutation is a prognostic ( predicting the outcome)  factor in patients with ovarian cancer. Those women with BRCA mutations had better survival than the control group (women without the mutation). There was slightly longer survival for those with BRCA 2 mutations than BRCA1 . The researchers suggested that was due to a different nature of the dysfunction of these two genes.


Abstract 5001

Olaparib plus paclitaxel plus carboplatin (P/C) followed by olaparib maintenance treatment in patients (pts) with platinum-sensitive recurrent serous ovarian cancer (PSR SOC): A randomized, open-label phase II study.


This abstract was discussed by Dr Oza at the Oral Abstract session on Saturday. The study involved women with recurrent disease. Olaparib is an oral Parp Inhibitor drug.
Conclusion:  Patients with platinum sensitive recurrent serous ovarian cancer who took the parp inhibitor olaparib along with carboplatin and placitaxel followed by olaparib maintenance had some improvement in progression free survival (median 2.6 months) compared to patients treated with carboplatin and paclitaxel online.

It should be noted that earlier this year Astra Zeneca ( the maker of Olaparib) decided not to produce Olaparib for maintenance therapy of serous ovarian cancer.

Dee
Every Day is a Blessing!
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Friday, May 20, 2011

ASCO Preview - Two interesting Studies

The ASCO meeting abstracts are posted online. Here are two studies highlighted on Cancer.net.

Long-Term Treatment with Olaparib May Help Treat Recurrent Ovarian Cancer

This PARP inhibitor is effective in extending the progression-free survival of recurrent patients with an inherited version of a DNA deficiency as well as a non-inherited version. Interesting study. I can't wait to hear more about olaparib. Here is a Med-Page link that explains the study further.


Screening Does Not Reduce Deaths from Ovarian Cancer for the General Population

This large ( 80,000 particpant) study highlights the need for further research to find a a screening test for the general public for ovarian cancer. CA-125 and Ultrasound together to screen for the disease did not reduce mortality numbers.

Dee
Every Day is a Blessing!

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