Gynecologic oncology
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Gynecologic oncology · Nov 2007
Multicenter Study Comparative StudyThe role of multi-modality adjuvant chemotherapy and radiation in women with advanced stage endometrial cancer.
: The optimal adjuvant therapy for women with stages III and IV endometrial cancer following surgical staging and cytoreductive surgery is controversial. We sought to determine the outcome of patients with advanced stage endometrial cancer treated with postoperative chemotherapy+/-radiation to determine whether there was an advantage to combining treatment modalities. ⋯ : Combined adjuvant chemotherapy and radiation was associated with improved survival in patients with advanced stage disease compared to either modality alone. Future clinical trials are needed to prospectively evaluate multi-modality adjuvant therapy in women with advanced staged endometrial cancer to determine the appropriate sequencing and types of chemotherapy and radiation.
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Achieving long-term protection following vaccination is crucial to ensuring that high levels of immunity are maintained within a population while eliminating the need to introduce booster vaccinations. Based on an analysis of the hepatitis B virus vaccine, several factors have been shown to contribute to long-term protection, namely: specific lymphoproliferation, the in vivo humoral response, and immune memory. To ensure protection against persistent human papillomavirus (HPV) infection and the subsequent development of cervical lesions, an effective HPV vaccine must be able to induce strong humoral immune responses. ⋯ Similarly the bivalent HPV vaccine has been shown to induce long-term immunity with >98% seropositivity maintained after 4.5 years of follow-up and geometric mean titres at this time point remaining substantially higher than those noted with naturally acquired infection. Countrywide registration regarding population and health events in a stable population of approximately 25 million makes the Nordic countries an ideal setting for the evaluation of long-term cervical cancer control. Population-based long-term efficacy trials conducted in these countries aim to investigate the long-term efficacy of HPV vaccination with regard to invasive cervical cancer, and the results of these trials are awaited with interest.
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Gynecologic oncology · Nov 2007
Clinical trial endpoints in ovarian cancer: report of an FDA/ASCO/AACR Public Workshop.
The unique characteristics of cancer, particularly issues involving the use of surrogate endpoints in clinical trials, present special challenges in the development of cancer drugs. In response, the U.S. Food and Drug Administration (FDA) has partnered with the American Society of Clinical Oncology, the American Association for Cancer Research, and the American Society of Hematology to conduct public workshops evaluating potential endpoints for drug approvals for the most common tumor types. ⋯ Expert commentary provided by panel members will inform FDA's draft guidance on clinical endpoints for cancer drug approvals and will be discussed at meetings of the FDA's Oncologic Drugs Advisory Committee. FDA intends to develop a set of principles that can be used to define efficacy standards for drugs used to treat ovarian and other cancers.
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Gynecologic oncology · Nov 2007
Comparative StudyManagement of platinum-sensitive recurrent ovarian cancer: a cost-effectiveness analysis.
We wished to compare the cost-effectiveness of three chemotherapy regimens for treatment of recurrent platinum-sensitive ovarian cancer. ⋯ PC appears to be relatively cost-effective compared to C for the treatment of recurrent platinum-sensitive ovarian cancer. GC appears to be less cost-effective compared to PC, with an ICER ten times higher.