New Drug May Slow Advanced Ovarian Cancer

Study found it prolonged remission after chemotherapy almost six months longer than a placebo

By Dennis Thompson

HealthDay Reporter

SATURDAY, June 1 (HealthDay News) -- Women with advanced ovarian cancer stayed in remission almost six months longer when they were treated with the targeted drug pazopanib (Votrient), new German research says.

"Our findings show that we finally have a drug that can maintain control over ovarian cancer growth achieved through initial treatments," study author Dr. Andreas du Bois, a professor of gynecologic oncology at Kliniken Essen-Mitte in Essen, said in a statement. "If pazopanib is approved for ovarian cancer, many patients will experience longer disease-free and chemotherapy-free periods. During this time, the patient keeps control over the disease, instead of the disease having control over patient's life."

The results were to be presented Saturday at the American Society of Clinical Oncology annual meeting, in Chicago. Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.

However, other cancer experts warned against placing too much hope in these early findings.

"I would say that it is intriguing, but I think it's important for the public to know this is not a home run," said Dr. Karen Lu, a professor of gynecologic oncology at the University of Texas MD Anderson Cancer Center, in Houston. "This is an incremental step in the right direction. There did not seem to be a survival advantage. It does increase by 5.6 months, on average, the amount of time a woman does not need to be on chemotherapy, but in terms of prolonging survival or increasing the rate of cure, it doesn't reach that standard."

Advanced ovarian cancer is an aggressive disease with a cure rate of only 20 percent to 25 percent, according to background information in the study. It is often referred to as a "silent killer" because it usually is not detected until it has progressed into its later stages. Two of every three patients with advanced ovarian cancer experience a relapse following successful initial treatment with surgery and chemotherapy.

"Ovarian cancer is a difficult disease to treat," explained Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society. "We don't have effective screening, and women present with more advanced disease."

No targeted therapies are currently approved in the United States for maintenance treatment of ovarian cancer.

Pazopanib, which is taken in pill form, works by blocking the growth of tumors and their blood vessels. The U.S. Food and Drug Administration has already approved its use for the treatment of kidney cancer and soft tissue sarcoma. The drug's maker, GlaxoSmithKline, funded this latest research.

In the study, 940 patients with stage III or IV ovarian cancer received either pazopanib or a placebo daily for 24 months. All patients already had gone through surgery and chemotherapy that successfully prevented the disease from worsening.

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Abdominal 'Chemo Bath' May Extend Survival in Ovarian Cancer Patients

Long-term study found women who received 'intraperitoneal' treatment lived about a year longer

By Denise Mann

HealthDay Reporter

SATURDAY, March 9 (HealthDay News) -- Women with advanced ovarian cancer who receive intense chemotherapy directly into their stomach area may live at least one year longer than women who receive standard intravenous chemotherapy, a new study says.

But this survival edge may come at the expense of more side effects.

"The long-term benefits are pretty significant," said study author Dr. Devansu Tewari, director of gynecologic oncology at the Southern California Permanente Medical Group, in Orange County. "There is no study of ovarian cancer treatments that has shown a greater survival advantage."

Intraperitoneal chemotherapy involves bathing the abdominal area with chemotherapy agents. By contrast, intravenous (IV) chemotherapy is delivered throughout the body via the bloodstream. The U.S. National Cancer Institute currently recommends intraperitoneal therapy for women with ovarian cancer who have had successful surgery to remove the tumor.

The 10-year follow-up data from two studies of nearly 900 women with advanced ovarian cancer will be presented Saturday at the annual meeting of the Society of Gynecologic Oncology, in Los Angeles.

In 2013, more than 22,000 American women will be diagnosed with ovarian cancer, and more than 14,000 will die from the disease, according to the U.S. National Cancer Institute. There are no early screening tests for ovarian cancer, which is why it is often diagnosed when the cancer has already spread outside of the ovaries. For this reason, survival rates tend to be very low.

In the new study, women who received the intraperitoneal treatment were 17 percent more likely to survive longer than those who got IV chemotherapy. On average, women in the intraperitoneal group survived for more than five years, while those who received IV chemotherapy survived for about four years, the study found.

But survival benefits aside, intraperitoneal chemotherapy does confer a greater risk of side effects -- such as abdominal pain and numbness in the hands and feet -- and not all women can tolerate this high concentration of cancer-killing drugs. The drugs are also absorbed more slowly, providing more exposure to the medicine. The same properties that make the intraperitoneal therapy more effective likely play a role in causing more side effects, the researchers said.

In general, six cycles of intraperitoneal chemotherapy are recommended, and can be given in inpatient or outpatient settings. The more cycles the women completed, the greater their survival advantage, the study showed. After five years, close to 60 percent of women who completed five or six cycles of intraperitoneal therapy were still alive, compared with 33 percent of those who completed three or four cycles and 18 percent of those who completed one or two cycles. Women can switch back to IV chemotherapy if the side effects prove too harsh. Still, the researchers said, some intraperitoneal chemotherapy is better than none.

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Pap Test to Detect Ovarian, Endometrial Cancers?

Jan. 9, 2013 -- A new test for ovarian and endometrial cancers looks at cervical fluid obtained during a routine Pap test to detect genetic mutations linked with the cancers.

Although the research is in early stages, the test did well in detecting these cancers, says researcher Yuxuan Wang, a graduate student at the Ludwig Center for Cancer Genetics and Therapeutics at the Johns Hopkins University's Kimmel Cancer Center in Baltimore.

If ongoing research bears out, the new test could someday become a routine screening test, much like the Pap test is for cervical cancer, she says.

"This would not add anything to the current [Pap] procedure," Wang says. "All we do is take part of the sample for DNA testing.''

The cervical fluid collected during a Pap smear contains normal DNA and, if a person has cancer, DNA from those cancer cells.

The researchers used genomic sequencing to pick out the cancerous DNA from the normal DNA.

The study is published in Science Translational Medicine.

Widespread use of the Pap test has reduced deaths from cervical cancer and increased early detection. But finding reliable screening tests for ovarian and endometrial cancers has been elusive.

More than 69,000 U.S. women were expected to get a diagnosis of either ovarian or endometrial cancer in 2012.

If endometrial cancer is suspected, a doctor may order a transvaginal ultrasound. If ovarian cancer is suspected, a doctor may order a blood test that looks for CA-125, a protein found at high levels in some ovarian cancer patients.

Neither test is as reliable as a screening test, the researchers say. The U.S. Preventive Services Task Force and the American Cancer Society do not recommend general routine screening for endometrial or ovarian cancer.

During a Pap test, cells collected from the cervix are examined for signs of cancer. The DNA in the Pap sample may also be examined for human papillomavirus (HPV), which causes cervical cancer.

The cervical fluid collected during the Pap test can also contain cells shed from the ovaries or the uterine lining (the endometrium).

Cancer cells from either the ovaries or endometrium could also be present in the fluid, the researchers say.

In the new study, the researchers determined the most common genetic mutations found in ovarian and endometrial cancers.

"We ended up with 12 genes," Wang says. The test they developed, called the PapGene test, looks for mutations on those 12 genes.

They searched for the mutations in 24 endometrial cancer tissue samples and 22 ovarian cancer tissue samples.

Mutations were found in all 46 samples.

They looked at the Pap test to see if the same mutations were found as they found in the tissue samples.

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