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Marcela G. Del Carmen - One of the best experts on this subject based on the ideXlab platform.
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investigating the impact of body mass index on intraperitoneal chemotherapy outcomes in ovarian and Fallopian Tube Cancer
International Journal of Gynecological Cancer, 2016Co-Authors: Michelle Davis, Neil S. Horowitz, Emeline M Aviki, Alejandro J Rauhhain, Michael J Worley, Ross S Berkowitz, John O Schorge, Michael G Muto, Rachel Clark Sisodia, Marcela G. Del CarmenAbstract:ObjectivesThe aim of this study was to investigate the impact of body mass index (BMI) on completion, complications, and clinical outcomes of intraperitoneal (IP) chemotherapy in patients with advanced-stage ovarian Cancer.MethodsPatients with optimally cytoreduced International Federation of Gyneco
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Clinical characteristics and outcomes of patients with stage I epithelial ovarian Cancer compared with Fallopian Tube Cancer
American journal of obstetrics and gynecology, 2014Co-Authors: Jose Alejandro Rauh-hain, Olivia W. Foley, Dina Winograd, Carolina Andrade, Rachel M. Clark, Roberto J. Vargas, Emily Hinchcliff, K.m. Esselen, Neil S. Horowitz, Marcela G. Del CarmenAbstract:Objective The purpose of this study was to compare clinical characteristics and survival between patients with stage I epithelial ovarian Cancer and Fallopian Tube Cancer. Study Design We identified women with stage I epithelial ovarian Cancer and Fallopian Tube Cancer who underwent treatment from 2000-2010. Correlation between categoric variables was assessed with χ 2 test. The Kaplan-Meier survival analysis was used to generate overall survival data. Factors predictive of outcome were compared with the use of the log-rank test and Cox proportional hazards model. Results The study group consisted of 385 women with epithelial ovarian Cancer and 43 women with Fallopian Tube Cancer. Patients with Fallopian Tube Cancer had a higher rate of stage IA disease (65% vs 48%; P = .02) and grade 3 tumors (60.4% vs 30.9%; P P P P = .02). The 5-year disease-free survival rates were 100% in women with Fallopian Tube Cancer and 93% in patients with epithelial ovarian Cancer ( P = .04). The 5-year overall survival rates were 100% and 95% for Fallopian Tube Cancer and epithelial ovarian Cancer, respectively ( P = .7). Conclusion We found a higher rate of stage IA, grade 3, and serous carcinoma in Fallopian Tube Cancer. Women with Fallopian Tube Cancer had a higher rate of breast Cancer. There was no difference in overall survival between the groups.
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A phase III study of trabectedin (T) plus pegylated liposomal doxorubicin (PLD) versus PLD for treatment of advanced-relapsed epithelial ovarian, primary peritoneal, or Fallopian Tube Cancer.
Journal of Clinical Oncology, 2014Co-Authors: Robert L. Coleman, Marcela G. Del Carmen, Bradley J. Monk, Roland Elmar Knoblauch, Trilok V. Parekh, Fitzroy Dawkins, Raymond Scott Maul, Youn C. Park, Thomas J. HerzogAbstract:TPS5606 Background: Ovarian Cancer (OVC) is the eighth most common Cancer among women globally, with approximately 60%–70% of cases being diagnosed at an advanced stage (III or IV). Five-year survival rate for advanced stages is under 40%. In a previous pivotal trial, patients with OVC who relapsed after first-line platinum-based chemotherapy (PCT) demonstrated superior progression free survival when treated with the T+PLD combination vs. PLD monotherapy (7.3 vs. 5.8 months; HR = 0.79; p = 0.019). In a subgroup analysis by platinum free interval, T+PLD showed an improved overall survival (OS) for patients with Platinum Free Interval of 6–12 months (HR = 0.64) (J Clin Oncol. 2010 28:3107-14.). Given this demonstrated efficacy, we are conducting a global phase III registration trial to investigate the OS of T+PLD vs. PLD in patients with platinum sensitive epithelial OVC, peritoneal or Fallopian Tube Cancer, in the third-line setting. Methods: In this open-label, active-controlled trial, approximately 670 w...
Nobuo Yaegashi - One of the best experts on this subject based on the ideXlab platform.
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Clinicopathologic features and BRCA mutations in primary Fallopian Tube Cancer in Japanese women.
Japanese journal of clinical oncology, 2018Co-Authors: Shoko Sakurada, Hideki Tokunaga, Yoh Watanabe, Fumiaki Takahashi, Hidekazu Yamada, Kazuhiro Takehara, Nobuo YaegashiAbstract:Objective The present study aimed to clarify the clinicopathological features, including the level of p53 protein expression and BRCA mutations, of primary Fallopian Tube Cancer (PFTC) in Japanese women. Methods A multicenter clinical survey was conducted at three Japanese institutions. Clinical data in patients with PFTC between 1998 and 2016 were collected. Immunohistochemical staining of p53 and BRCA mutation analysis by exome sequence using paraffin-embedded surgical resected specimens were performed. Results A total of 40 patients with PFTC were enrolled in the study. The median age was 58 years (range: 38-78 years); 31 patients were menopausal. Thirty-four (85.0%) patients were diagnosed with serous adenocarcinoma (high grade, 33; low grade, 1). PFTC was classified into ampulla type, fimbriae type and undeterminable type by tumor-occupying lesion; ampulla type and fimbriae type occurred with the same frequency. Among 30 patients with high-grade serous adenocarcinoma, 6 patients showed germline mutations of BRCA1 (stop-gain 4 and frameshift deletion 2) and 2 patients showed germline mutation of BRCA2 (stop-gain 1 and frameshift deletion 1). However, only 1 patient had familial history of breast or ovarian Cancer. Patients with BRCA mutations in the germline were frequently observed in ampulla type and FIGO stage I/II Cancers, but no significant difference in the frequency of p53 overexpression and overall survival was observed. Conclusions Among Japanese patients with PFTC, 26.7% presented with BRCA mutations in the germline. Additionally, p53 was important for the carcinogenesis in Fallopian Tubes, independent of the specific BRCA mutation.
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Japan Society of Gynecologic Oncology guidelines 2015 for the treatment of ovarian Cancer including primary peritoneal Cancer and Fallopian Tube Cancer
International Journal of Clinical Oncology, 2016Co-Authors: Shinichi Komiyama, Mikio Mikami, Satoru Nagase, Masanori Kaneuchi, Hidetaka Katabuchi, Aikou Okamoto, Kiyoshi Ito, Kenichiro Morishige, Nao Suzuki, Nobuo YaegashiAbstract:The fourth edition of the Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian Cancer including primary peritoneal Cancer and Fallopian Tube Cancer was published in 2015. The guidelines contain seven chapters and six flow charts. The major changes in this new edition are as follows—(1) the format has been changed from reviews to clinical questions (CQ), and the guidelines for optimal clinical practice in Japan are now shown as 41 CQs and answers; (2) the ‘flow charts’ have been improved and placed near the beginning of the guidelines; (3) the ‘basic points’, including tumor staging, histological classification, surgical procedures, chemotherapy, and palliative care, are described before the chapter; (4) the FIGO surgical staging of ovarian Cancer, Fallopian Tube Cancer, and primary peritoneal Cancer was revised in 2014 and the guideline has been revised accordingly to take the updated version of this classification into account; (5) the procedures for examination and management of hereditary breast and ovarian Cancer are described; (6) information on molecular targeting therapy has been added; (7) guidelines for the treatment of recurrent Cancer based on tumor markers alone are described, as well as guidelines for providing hormone replacement therapy after treatment.
Peter Kenemans - One of the best experts on this subject based on the ideXlab platform.
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molecular evidence for putative tumour suppressor genes on chromosome 13q specific to brca1 related ovarian and Fallopian Tube Cancer
Journal of Clinical Pathology, 2002Co-Authors: Ans P M Jongsma, Jurgen M J Piek, Ronald P Zweemer, Rene H M Verheijen, J Klein W T Gebbinck, G J Van Kamp, Patricia Shaw, Ian Jacobs, Paul J Van Diest, Peter KenemansAbstract:BACKGROUND/AIMS: Loss of heterozygosity (LOH) on chromosome 13q has been reported to occur frequently in human ovarian Cancer, and indications have been found that chromosome 13 may also play a specific role in the inherited form of ovarian Cancer. The aim of this study was to define regions on chromosome 13 that may harbour additional tumour suppressor genes involved in the tumorigenesis of BRCA1 related ovarian and Fallopian Tube Cancer. MATERIALS/METHODS: DNA extracted from paraffin wax blocks of 36 BRCA1 associated ovarian and Fallopian Tube carcinomas was analysed by LOH polymerase chain reaction using seven highly polymorphic microsatellite markers spanning chromosome 13q. RESULTS: High LOH frequencies were found on loci 13q11, 13q14, 13q21, 13q22-31, 13q32, and 13q32-4, suggesting the presence of putative tumour suppressor genes on the long arm of chromosome 13 that may play a role in the pathogenesis of BRCA1 related ovarian and Fallopian Tube Cancer. LOH patterns appeared to be independent of the type of BRCA1 mutation, stage, and grade. Although in some cases there were indications for loss of larger parts of chromosome 13, in most cases losses were fairly randomly distributed over chromosome 13 with retained parts in between lost parts. Microsatellite instability was found in six cases. CONCLUSION: Several loci on chromosome 13q show high frequencies of LOH in BRCA1 related ovarian and Fallopian Tube Cancer, and may therefore harbour putative tumour suppressor genes involved in the carcinogenesis of this particular type of hereditary Cancer.
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Molecular evidence linking primary Cancer of the Fallopian Tube to BRCA1 germline mutations.
Gynecologic oncology, 2000Co-Authors: Ronald P Zweemer, Ian Jacobs, P. J. Van Diest, R. H. M. Verheijen, Andy Ryan, Johan J.p. Gille, Rolf H. Sijmons, Fred H. Menko, Peter KenemansAbstract:OBJECTIVES: BRCA1 and BRCA2 germline mutations increase the risk of ovarian and breast Cancer. Fallopian Tube Cancer has occasionally been observed in breast-ovarian Cancer families. At our family Cancer clinic we recently encountered two cases of Fallopian Tube Cancer within two families harboring a BRCA1 germline mutation. To study the relationship between Fallopian Tube Cancer and BRCA1 mutations, a histopathological reevaluation and molecular analysis were performed. METHODS: Medical and histopathological reports of the Fallopian Tube Cancer cases as well as archival tissue blocks were retrieved. The histopathological diagnoses were reevaluated. We investigated whether patients with Fallopian Tube Cancer had been carriers of a BRCA germline mutation. In addition we investigated whether loss of the wild-type allele had occurred in the tumor. RESULTS: In 2 of 23 families with a known BRCA1 mutation from our family Cancer clinic, a case of Fallopian Tube Cancer was reported. Histological reevaluation confirmed the diagnosis of Fallopian Tube Cancer in both cases. In one case Fallopian Tube Cancer may have been part of a multifocal primary malignancy. In both patients the presence of a BRCA1 mutation was confirmed in the germline. Furthermore, we showed loss of the wild-type BRCA1 allele in both tumors. CONCLUSIONS: These findings provide the first molecular evidence that Fallopian Tube Cancer may be due to germline mutations in BRCA1. This may have important consequences for the preferred method of prophylactic oophorectomy in BRCA1 mutation carriers.
Barbara A. Goff - One of the best experts on this subject based on the ideXlab platform.
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OCEANS: A Randomized, Double-Blind, Placebo-Controlled Phase III Trial of Chemotherapy With or Without Bevacizumab in Patients With Platinum-Sensitive Recurrent Epithelial Ovarian, Primary Peritoneal, or Fallopian Tube Cancer
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012Co-Authors: Carol Aghajanian, Michael Teneriello, Barbara A. Goff, Stephanie V. Blank, Patricia L. Judson, Amreen Husain, Mika A. Sovak, Lawrence R. NycumAbstract:Purpose This randomized, multicenter, blinded, placebo-controlled phase III trial tested the efficacy and safety of bevacizumab (BV) with gemcitabine and carboplatin (GC) compared with GC in platinum-sensitive recurrent ovarian, primary peritoneal, or Fallopian Tube Cancer (ROC). Patients and Methods Patients with platinum-sensitive ROC (recurrence 6 months after front-line platinum-based therapy) and measurable disease were randomly assigned to GC plus either BV or placebo (PL) for six to 10 cycles. BV or PL, respectively, was then continued until disease progression. The primary end point was progression-free survival (PFS) by RECIST; secondary end points were objective response rate, duration of response (DOR), overall survival, and safety. Results Overall, 484 patients were randomly assigned. PFS for the BV arm was superior to that for the PL arm (hazard ratio [HR], 0.484; 95% CI, 0.388 to 0.605; log-rank P .0001); median PFS was 12.4 v 8.4 months, respectively. The objective response rate (78.5% v 57.4%; P .0001) and DOR (10.4 v 7.4 months; HR, 0.534; 95% CI, 0.408 to 0.698) were significantly improved with the addition of BV. No new safety concerns were noted. Grade 3 or higher hypertension (17.4% v 1%) and proteinuria (8.5% v 1%) occurred more frequently in the BV arm. The rates of neutropenia and febrile neutropenia were similar in both arms. Two patients in the BV arm experienced GI perforation after study treatment discontinuation.
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combined weekly topotecan and biweekly bevacizumab in women with platinum resistant ovarian peritoneal or Fallopian Tube Cancer
Cancer, 2011Co-Authors: Kathryn F. Mcgonigle, Howard G. Muntz, Jacqueline Vuky, Pamela J. Paley, Dan S. Veljovich, Benjamin E. Greer, Barbara A. Goff, Heidi J. Gray, T. W. MalpassAbstract:BACKGROUND: A phase 2 trial was conducted to determine the toxicity and efficacy of combined weekly topotecan and biweekly bevacizumab in patients with primary or secondary platinum-resistant ovarian, peritoneal, or Fallopian Tube Cancer (OC). METHODS: Patients were treated with bevacizumab 10 mg/kg on days 1 and 15 and topotecan 4 mg/m2 on days 1, 8, and 15 of a 28-day cycle until progressive disease (PD) or excessive toxicity. The primary endpoint was progression-free survival (PFS); secondary objectives included overall survival (OS), objective response, and toxicity. RESULTS: Patients (N = 40) received a median of 8 treatment cycles. Toxicity was generally mild or moderate, with neutropenia (18%), hypertension (20%), gastrointestinal toxicity (18%), pain (13%), metabolic toxicity (15%), bowel obstruction (10%), and cardiotoxicity (8%) being the most common grade 3 and 4 adverse events. No bowel perforations, febrile neutropenia, or treatment-related deaths occurred. Median PFS and OS were 7.8 (95% confidence interval [CI], 3.0-9.4) and 16.6 months (95% CI, 12.8-22.9), with 22 (55%) patients progression-free for ≥6 months. Ten (25%) patients had partial response (PR), 14 (35%) had stable disease (SD), and 16 (40%) had PD. Patients treated with 2 prior regimens received greater benefit than patients treated with 1: PR/SD, 78.9% versus 42.9% (P = .03); median PFS, 10.9 versus 2.8 months (P = .08); median OS, 22.9 versus 12.8 months (P = .02). CONCLUSIONS: A weekly topotecan and biweekly bevacizumab combination demonstrates acceptable toxicity and encouraging efficacy in patients with platinum-resistant OC; further study is warranted. Cancer 2011;. © 2011 American Cancer Society.
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Combined weekly topotecan and biweekly bevacizumab in women with platinum‐resistant ovarian, peritoneal, or Fallopian Tube Cancer
Cancer, 2011Co-Authors: Kathryn F. Mcgonigle, Howard G. Muntz, Jacqueline Vuky, Pamela J. Paley, Dan S. Veljovich, Benjamin E. Greer, Barbara A. Goff, Heidi J. Gray, T. W. MalpassAbstract:BACKGROUND: A phase 2 trial was conducted to determine the toxicity and efficacy of combined weekly topotecan and biweekly bevacizumab in patients with primary or secondary platinum-resistant ovarian, peritoneal, or Fallopian Tube Cancer (OC). METHODS: Patients were treated with bevacizumab 10 mg/kg on days 1 and 15 and topotecan 4 mg/m2 on days 1, 8, and 15 of a 28-day cycle until progressive disease (PD) or excessive toxicity. The primary endpoint was progression-free survival (PFS); secondary objectives included overall survival (OS), objective response, and toxicity. RESULTS: Patients (N = 40) received a median of 8 treatment cycles. Toxicity was generally mild or moderate, with neutropenia (18%), hypertension (20%), gastrointestinal toxicity (18%), pain (13%), metabolic toxicity (15%), bowel obstruction (10%), and cardiotoxicity (8%) being the most common grade 3 and 4 adverse events. No bowel perforations, febrile neutropenia, or treatment-related deaths occurred. Median PFS and OS were 7.8 (95% confidence interval [CI], 3.0-9.4) and 16.6 months (95% CI, 12.8-22.9), with 22 (55%) patients progression-free for ≥6 months. Ten (25%) patients had partial response (PR), 14 (35%) had stable disease (SD), and 16 (40%) had PD. Patients treated with 2 prior regimens received greater benefit than patients treated with 1: PR/SD, 78.9% versus 42.9% (P = .03); median PFS, 10.9 versus 2.8 months (P = .08); median OS, 22.9 versus 12.8 months (P = .02). CONCLUSIONS: A weekly topotecan and biweekly bevacizumab combination demonstrates acceptable toxicity and encouraging efficacy in patients with platinum-resistant OC; further study is warranted. Cancer 2011;. © 2011 American Cancer Society.
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Occult Cancer of the Fallopian Tube in BRCA-1 Germline Mutation Carriers at Prophylactic Oophorectomy: A Case for Recommending Hysterectomy at Surgical Prophylaxis
Gynecologic oncology, 2001Co-Authors: Pamela J. Paley, Benjamin E. Greer, Elizabeth M. Swisher, Rochelle L. Garcia, S. Nicholas Agoff, Ksenia L. Peters, Barbara A. GoffAbstract:Abstract Objective. BRCA-1 and BRCA-2 germline mutations increase the risk of ovarian and breast Cancer. Primary Cancer of the Fallopian Tube is rare; however, recent evidence suggests that patients harboring a germline mutation conferring an increased risk of ovarian Cancer may be at risk for Fallopian Tube Cancer as well. We discuss the finding of occult Fallopian Tube Cancer diagnosed at surgical prophylaxis in women harboring BRCA-1 mutations. Methods/Results. Two patients undergoing surgical prophylaxis to address an increase in ovarian Cancer risk were discovered to harbor occult primary Fallopian Tube carcinoma on final pathology review. Mutational analysis confirmed the presence of a deleterious mutation in BRCA-1 in both patients. Conclusion. Currently, consensus opinions regarding ovarian Cancer surgical prophylaxis in gene mutation carriers do not include hysterectomy as part of the preventative procedure. This report as well as a growing number of cases of Fallopian Tube Cancer reported in known BRCA-1 and BRCA-2 mutation carriers has important implications for recommendations regarding surgical prophylaxis in these women.
Richard R. Barakat - One of the best experts on this subject based on the ideXlab platform.
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Effect of perioperative venous thromboembolism on survival in ovarian, primary peritoneal, and Fallopian Tube Cancer.
Gynecologic oncology, 2007Co-Authors: Destin Black, Alexia Iasonos, Hina Ahmed, Dennis S. Chi, Richard R. Barakat, Nadeem R. Abu-rustumAbstract:Abstract Objectives Venous thromboembolism (VTE) affects 15% of Cancer patients and is the second leading cause of death in hospitalized Cancer patients. The purpose of this study was to describe the overall survival of patients with ovarian, primary peritoneal, and Fallopian Tube Cancers treated for VTE within 30 days of initial surgery. Methods We reviewed the medical records of all patients who developed VTE within 30 days of primary surgery for stage I–IV epithelial ovarian, tubal, or primary peritoneal Cancer at our institution from 1/99 to 4/05. Standard statistical tests were used. Results Fifty-seven (10%) of 559 patients developed VTE within 30 days of initial surgery. There were no deaths from VTE within 30 days of surgery. With a median follow-up of 2.8 years (range, 0.11–7.3 years), the median overall survival for the entire cohort was 5.9 years (95% CI, 4.6-NR). The proportion of advanced-stage (III–IV) patients within the VTE group compared to the group with no VTE was higher (90% versus 72%; P =0.0078), as was the proportion of patients with ascites compared to those with none (74% versus 54%; P =0.0045), and the proportion of patients with residual disease >1 cm compared to those with ≤1 cm (37% versus 19%; P =0.0021). On multivariate analysis, advanced stage ( P P =0.0210), and residual disease>1 cm ( P P =0.65). Conclusions Previous studies have shown that a significant number of patients undergoing primary surgery for ovarian Cancer will develop postoperative VTE, especially those undergoing extensive cytoreductive procedures. In this large cohort of patients with ovarian, tubal, or primary peritoneal Cancer, we found no detrimental effects of perioperative VTE on overall survival.
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The safety and efficacy of laparoscopic surgical staging of apparent stage I ovarian and Fallopian Tube Cancers
American journal of obstetrics and gynecology, 2005Co-Authors: Dennis S. Chi, Kathleen N. Moore, Nadeem R. Abu-rustum, Yukio Sonoda, Joseph J. Ivy, Eunice Rhee, Douglas A. Levine, Richard R. BarakatAbstract:Objective To compare the safety and efficacy of laparoscopic staging of ovarian or Fallopian Tube Cancers to staging via laparotomy for epithelial ovarian carcinoma. Study design We performed a case-control study of all patients with apparent stage I adnexal Cancers who had laparoscopic staging from October 2000 to March 2003. The control group consisted of all patients with apparent stage I epithelial ovarian carcinoma who had staging via laparotomy during the same time period. Results Staging was laparoscopic in 20 patients and via laparotomy in 30. There were no differences in mean age and body mass index. There were also no differences in omental specimen size and number of lymph nodes removed. Estimated blood loss and hospital stay were lower for laparoscopy, but operating time was longer. There were no conversions to laparotomy or complications in the laparoscopic group, compared with 3 minor complications in the laparotomy group. Conclusion In this preliminary analysis, it appears that patients with apparent stage I ovarian or Fallopian Tube Cancer can safely and adequately undergo laparoscopic surgical staging.