Ovarian and fallopian tube cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2014
The most important favourable prognostic factors at presentation in ovarian cancer patients include earlier disease stage, smaller residual tumour following primary cytoreductive surgery, good performance status, absence of ascites, a younger age, histological subtype other than mucinous/clear cell carcinoma and a well-differentiated tumour. Historically, grade was believed to be of limited significance. However, initial findings in stage I ovarian cancer suggested that patients with high-grade ovarian cancer, including those with clear cell histology, are the ones that most benefit from adjuvant platinum chemotherapy. Over the past 5 years, the new classification of common ovarian cancer subtypes into low and high grade has also impacted management. The low grade tumours are indolent and relatively resistant to cytotoxic therapy whereas the high grade tumours are the most common subtype that are characterized by transient chemo-sensitivity with shorter progression-free intervals leading eventually to the patient’s death through chemo-resistant disease. Retrospective data have demonstrated that the outcome from ovarian cancer is improved if surgery is performed by gynaecological cancer surgeons (above). If all treatment is given in a cancer centre the survival of ovarian cancer now approaches 50% at 10-years follow-up. With respect to the stage, the survival for stages I, II, III and IV disease is 92%, 55%, 22% and 6%, respectively.
Nutraceutical’s Role in Proliferation and Prevention of Gynecological Cancers
Sheeba Varghese Gupta, Yashwant V. Pathak in Advances in Nutraceutical Applications in Cancer, 2019
According to the American Cancer Society, ovarian cancers are the cause for more deaths among all gynecological cancers. Ovarian cancers are classified as per the cell types they originate from: about 90% from epithelial cells, 5% from stromal cells, and less than 5% from germ cell. Estrogen by hormone replacement therapy and smoking tobacco are one of the major causes for epithelial ovarian cancer. Estrogen by hormone replacement therapy and smoking tobacco are one of the major causes for epithelial ovarian cancer, especially in individuals who are carrier of mutant BRCA1/BRCA2 genes [9]. Current line of treatment for ovarian cancer is treatment by using surgery and targeted therapy. Radiotherapy is not much significant, while chemotherapy consists of paclitaxel combined with carboplatin, bleomycin, cisplatin, etoposide, bevacizumab, docetaxel, liposomal doxorubicin, gemcitabine, and topotecan [10].
Ovarian, Fallopian Tube, and Primary Peritoneal Cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2020
The most significant risk factors for ovarian cancer are age and a family history of the disease. The odds ratio for ovarian cancer in first-degree and second-degree relatives of ovarian cancer cases, compared with controls, is 3.6 and 2.9, respectively. Epidemiological studies have suggested that the risk of ovarian cancer is associated with ovulation, in that early onset of menarche and late menopause are associated with a slightly higher risk of ovarian cancer, whereas pregnancy, the contraceptive pill, and tubal ligation reduce risk. Nulliparity and infertility are associated with increased risk. There is an increased risk of developing borderline ovarian tumors in women who undergo in vitro fertilization treatment. There is also evidence that prolonged use of hormone replacement therapy is associated with a small increased risk of ovarian cancer. The use of perineal talc is now largely discounted as a cause of ovarian cancer, whereas tobacco smoking appears to increase the risk of mucinous tumours. There is an association between body mass index and ovarian cancer risk. Endometriosis is associated with an increased risk of clear cell and endometrioid histotypes. Dietary intake and consumption of alcohol are not associated with epithelial ovarian cancer.
MicroRNA and Long Non-Coding RNA in Ovarian Carcinoma: Translational Insights and Potential Clinical Applications
Published in Cancer Investigation, 2016
Reliable biomarkers for the detection of early ovarian carcinoma are currently unavailable. MicroRNA and long non-coding RNA may be important in cancer initiation and progression by regulating gene expression through post-transcriptional mechanisms. MicroRNAs, such as miR-26a and miR-132, have been investigated as novel biomarkers for diagnosis, prognosis, monitoring of therapeutic response, and therapeutic targets in ovarian carcinomas. Some long non-coding RNAs, such as H19 and UCA1, may be involved in the pathogenesis of ovarian carcinomas. MicroRNA and long non-coding RNA have potential clinical utility in the diagnosis of ovarian cancer and predicting prognosis, metastasis, recurrence, and response to therapy.
Sushi Domain Containing 2 (SUSD2) inhibits platelet activation and binding to high-grade serous ovarian carcinoma cells
Published in Platelets, 2018
Tyson W. Lager, Jessica J. Roetman, Jacob Kunkel, Megan Thacker, Jordan N. Sheets, Kristi A. Egland, Cecelia M. Miles, Mark K. Larson, Jennifer A. A. Gubbels
Platelets play a central role in primary hemostasis affecting tumor survival and metastases. Tumors induce platelets to aggregate and bind to the cancer cells, resulting in protection from immune surveillance and often leading to thrombocytosis. In ovarian cancer (OvCa), one-third of patients present with thrombocytosis, a diagnosis that correlates with shorter survival. SUSD2 (SUShi Domain containing 2), a type I transmembrane protein, shown to inhibit metastatic processes in high-grade serous ovarian carcinoma (HGSOC), is expressed on endothelial cells and thus may influence platelet reactivity. As such, we hypothesized that SUSD2 levels in ovarian cancer-derived cell lines influence platelet activation. We incubated OvCa non-targeting (NT) and SUSD2 knockdown (KD) cell lines with labeled platelets and quantified platelet binding, as well as GPIIb/IIIa integrin activation. The role of GPIIb/IIIa in tumor cell/platelet interaction was also examined by measuring cell–cell adhesion in the presence of eptifibatide. We found that platelets exposed to OvCa cells with low SUSD2 expression display increased tumor cell-platelet binding along with an increase in GPIIb/IIIa receptor activation. As such, platelet activation and binding to HGSOC cells was inversely correlated with the presence of SUSD2. This represents one of the first tumor proteins known to provide differential platelet interaction based on protein status.
Review of the use of topotecan in ovarian carcinoma
Published in Expert Opinion on Pharmacotherapy, 2004
Ovarian cancer is the fifth leading cause of cancer deaths in women. The majority of patients present with advanced disease and relapse after first-line platinum-based chemotherapy; therefore, many proceed to treatment with salvage chemotherapy. Currently available treatment options are generally no longer curative in the relapse setting; hence, the emphasis of treatment is towards disease control and palliation of symptoms. There are several agents available for the treatment of relapsed ovarian carcinoma, of which topotecan is one of the most widely studied and characterised. This review aims to evaluate the role of topotecan in the management of this disease by considering the properties of the compound, the clinical efficacy in Phase II and III studies, its role in first- and second-line treatment and alternative dosing strategies to overcome toxicity.
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