Oncology Commons^™

The Impact Of Obesity And Adipokines On Breast And Gynecologic Malignancies, Surabhi Tewari, Roberto Vargas, Ofer Reizes

Faculty Scholarship

The link between obesity and multiple disease comorbidities is well established. In 2003, Calle and colleagues presented the relationship between obesity and several cancer types, including breast, ovarian, and endometrial malignancies. Nearly, 20% of cancer-related deaths in females can be accounted for by obesity. Identifying obesity as a risk factor for cancer led to a focus on the role of fat-secreted cytokines, known as adipokines, on carcinogenesis and tumor progression. Early studies indicated that the adipokine leptin increases cell proliferation, invasion, and inhibition of apoptosis in multiple cancer types. As a greater appreciation of the obesity–cancer link has amassed, we …

Efficacy Of Niraparib By Time Of Surgery And Postoperative Residual Disease Status: A Post Hoc Analysis Of Patients In The Prima/Engot-Ov26/Gog-3012 Study, Roisin E O'Cearbhaill, Jose-Alejandro Pérez-Fidalgo, Bradley J Monk, Ignacio Tusquets, Colleen Mccormick, Jose Fuentes, Richard G Moore, Christof Vulsteke, Mark S Shahin, Frédéric Forget, William H Bradley, Sakari Hietanen, David M O'Malley, Anne Dørum, Brian M Slomovitz, Klaus Baumann, Frédéric Selle, Paula M Calvert, Grazia Artioli, Tally Levy, Aalok Kumar, Izabela A Malinowska, Yong Li, Divya Gupta, Antonio González-Martín

Journal Articles

OBJECTIVE: To evaluate the association between surgical timing and postoperative residual disease status on the efficacy of niraparib first-line maintenance therapy in patients with newly diagnosed advanced ovarian cancer at high risk of recurrence.

METHODS: Post hoc analysis of the phase 3 PRIMA/ENGOT-OV26/GOG-3012 (NCT02655016) study of niraparib in patients with newly diagnosed primary advanced ovarian, primary peritoneal, or fallopian tube cancer with a complete/partial response to first-line platinum-based chemotherapy. Progression-free survival (PFS) was assessed by surgical status (primary debulking surgery [PDS] vs neoadjuvant chemotherapy/interval debulking surgery [NACT/IDS]) and postoperative residual disease status (no visible residual disease [NVRD] vs visible residual …

Potential Impact Of Revised Nci Eligibility Criteria Guidance: Prior Malignancy Exclusion In Breast Cancer Clinical Trials, Matthew Perez, Caitlin C Murphy, Sandi L Pruitt, Sawsan Rashdan, Asal Rahimi, David E Gerber

Journal Articles

BACKGROUND: Many individuals with cancer have survived a prior cancer and for this reason may have been excluded from clinical trials. Recent NCI guidance recommends including these individuals, especially when the risk of the prior malignancy interfering with either safety or efficacy endpoints is very low. Using breast cancer as an example, we determined the potential effect this policy change may have on clinical trial accrual.

PATIENTS AND METHODS: We reviewed protocols of NCI-sponsored breast cancer clinical trials activated in 1991 through 2016. We quantified prevalence of prior cancer-related exclusion criteria and assessed the association with trial characteristics using Fisher's …

Impact Of Homologous Recombination Status And Responses With Veliparib Combined With First-Line Chemotherapy In Ovarian Cancer In The Phase 3 Velia/Gog-3005 Study, Elizabeth M Swisher, Carol Aghajanian, David M O'Malley, Gini F Fleming, Scott H Kaufmann, Douglas A Levine, Michael J Birrer, Kathleen N Moore, Nick M Spirtos, Mark S Shahin, Thomas J Reid, Michael Friedlander, Karina Dahl Steffensen, Aikou Okamoto, Vasudha Sehgal, Peter J Ansell, Minh H Dinh, Michael A Bookman, Robert L Coleman

Kimmel Cancer Center Faculty Papers

Objective: In the Phase 3 VELIA trial (NCT02470585), PARP inhibitor (PARPi) veliparib was combined with first-line chemotherapy and continued as maintenance for patients with ovarian carcinoma enrolled regardless of chemotherapy response or biomarker status. Here, we report exploratory analyses of the impact of homologous recombination deficient (HRD) or proficient (HRP) status on progression-free survival (PFS) and objective response rates during chemotherapy.

Methods: Women with Stage III-IV ovarian carcinoma were randomized to veliparib-throughout, veliparib-combination-only, or placebo. Stratification factors included timing of surgery and germline BRCA mutation status. HRD status was dichotomized at genomic instability score 33. During combination therapy, …

Modern Interpretation Of Risk Factors In Breast Cancer Of Women, Oana Denisa Bălălău, Răzvan Valentin Scăunașu, Octavian Gabriel Olaru, Anca Silvia Dumitriu, Stana Paunica, Liliana Florina Andronache, Anca Daniela Stănescu

Journal of Mind and Medical Sciences

Breast cancer is a major public health problem, being the most common cancer diagnosed in women and accounting for more than 1 in 10 new diagnoses of cancer each year. It is the most common neoplasm of women under the age of 40 and the second leading cause of cancer death in this age group, with more frequent detection of pathogenic mutations in breast cancer susceptibility genes. Women with BRCA1 and BRCA2 mutations are about 70% more likely to develop breast cancer. The incidence is rising in most countries and it is expected to have a growing trend in the …

Current Perspectives Of Oncoplastic Breast Surgery In Pakistan, Lubna Mushtaque Vohra, Dua Jabeen, Danish Ali, Syeda Sakina Abidi, Sana Zeeshan, Abida Khalil Sattar

Section of General Surgery

Oncoplastic breast surgery is based on the concept of tumour-specific immediate reconstruction. It combines both local and distant techniques to maintain breast texture, symmetry and cosmesis without compromising oncological outcome. The current narrative review was planned to highlight the current state and future of oncoplastic breast surgery in low- and middle-income countries where its utilisation in surgical practice remains insubstantial because majority of the surgeons who are treating breast cancer are either general surgeons or breast surgeons who do not have expertise in oncoplastic breast surgery or reconstructive surgery. Moreover, scarcity of financial resources, ignorance about oncoplastic breast surgery techniques, …

Diagnostic Accuracy Of Axillary Nodal Ultrasound After Neoadjuvant Chemotherapy In Node-Positive Breast Cancer Patients: A Validation Study, Syeda Sakina Abidi, Lubna Mushtaque Vohra, Asad Ali Kerawala, Imrana Masroor, Muhammad Umair Tahseen

Section of General Surgery

Objective: To determine the accuracy and false negative rate of axillary ultrasound compared to sentinel node biopsy.
Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, from February 1 to March 31, 2021, and comprised data of breast cancer patients who had undergone neo-adjuvant chemotherapy followed by axillary lymph node dissection or axillary disease diagnosed using lymph node biopsy or sentinel lymph node biopsy between January 1, 2016, and December 30, 2020. After receiving neoadjuvant chemotherapy, axillary ultrasound findings were compared with histopathology of lymph nodes. Data was analysed using SPSS 22.
Results: Of the 155 …

Significance Of Pelvic Fluid Observed During Ovarian Cancer Screening With Transvaginal Sonogram, Justin W. Gorski, Charles S. Dietrich Iii, Caeli Davis, Lindsay Erol, Hayley Dietrich, Nicholas J. Per, Emily Lenk Ferrell, Anthony B. Mcdowell, Mckayla J. Riggs, Megan L. Hutchcraft, Lauren A. Baldwin-Branch, Rachel W. Miller, Christopher P. Desimone, Holly H. Gallion, Frederick R. Ueland, John R. Van Nagell Jr., Edward J. Pavlik

Markey Cancer Center Faculty Publications

The primary objective was to examine the role of pelvic fluid observed during transvaginal ultrasonography (TVS) in identifying ovarian malignancy. A single-institution, observational study was conducted within the University of Kentucky Ovarian Cancer Screening trial from January 1987 to September 2019. We analyzed true-positive (TP), false-positive (FP), true-negative (TN), and false-negative (FN) groups for the presence of pelvic fluid during screening encounters. Measured outcomes were the presence and duration of fluid over successive screening encounters. Of the 48,925 women surveyed, 2001 (4.1%) had pelvic fluid present during a TVS exam. The odds ratio (OR) of detecting fluid in the comparison …

Ultrasonographic Visualization Of The Ovaries To Detect Ovarian Cancer According To Age, Menopausal Status And Body Type, Edward J. Pavlik, Emily Brekke, Justin Gorski, Lauren Baldwin-Branch, Rachel Miller, Christopher P. Desimone, Charles S. Dietrich, Holly S. Gallion, Frederick Rand Ueland, John R. Van Nagell, Jr.

Obstetrics and Gynecology Faculty Publications

Because the effects of age, menopausal status, weight and body mass index (BMI) on ovarian detectability by transvaginal ultrasound (TVS) have not been established, we determined their contributions to TVS visualization of the ovaries. A total of 29,877 women that had both ovaries visualized on their first exam were followed over 202,639 prospective TVS exams. All images were reviewed by a physician. While visualization of both ovaries decreased with age, one or both ovaries could be visualized in two of every three women over 80 years of age. Around 93% of pre-menopausal women and ~69% of post-menopausal women had both …

Risk Of Secondary Malignancies In Ovarian Cancer Survivors: 54,305 Patients Analyzed With 40 Years Of Follow-Up, A C. Casper, M W. Parsons, J Chipman, L M. Burt Jr, G Suneja, K A. Maurer, D K. Gaffney

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Factors Impacting Genomic Testing Rates Among Epithelial Ovarian Cancer Patients Across A Large Community-Based Healthcare System, Nicole M. Kretzer, Christopher J. Darus, Nancy Biery, Roshanthi Weerasinghe, Grace Li, Ann Vita, Shwetha Pindikuri, Amy S. Parrish, Charles W Drescher, Fernanda B. Musa

All Podium Presentations

Background: Epithelial ovarian cancer (EOC) accounts for the highest mortality of all gynecological cancers. NCCN guidelines recommend germline and somatic testing for all women with invasive EOC. Despite this recommendation, there is a large diversity in the types of testing patients receive even within a single healthcare system. Reported data of genetic testing for epithelial ovarian cancer (EOC) patients is largely based on patients treated at academic medical centers or patients who participate in clinical trials.

Purpose: This study sought to determine the rates of germline and somatic testing for epithelial ovarian cancer patients and identify factors that impact testing …

Patterns Of Genomic Testing For Epithelial Ovarian Cancer Across A Large Community-Based Health Care Network- A Real World Experience, Nicole M. Kretzer, Fernanda B. Musa, Christopher Darus, Nancy Biery, Roshanthi Weerasinghe, Grace Li, Ann Vita, Shwetha Pindikuri, Amy S. Parrish, Charles W Drescher

All Podium Presentations

Background: NCCN guidelines recommend germline and somatic tumor testing for all women with invasive epithelial ovarian cancer (EOC). Despite this recommendation, testing rates remain low and an optimal strategy to achieve the recommended testing has not been defined.

Purpose: We elected to review the patterns of germline and somatic tumor testing for patients with EOC across a large health care network to identify barriers to testing.

Methods: Clinical, pathologic, demographic and genomic testing (GT) information including involvement of a genetic counselor, specific test(s) ordered, test vendor, test turn-around time, and test results were obtained from the diverse dataset within the …

Frequency Of Homologous Recombination Deficiency In A Large Community-Based Cohort Of Epithelial Ovarian Cancer Cases, Nicole M. Kretzer, Fernanda B. Musa, Christopher Darus, Nancy Biery, Roshanthi Weerasinghe, Grace Li, Ann Vita, Shwetha Pindikuri, Amy S. Parrish, Charles W Drescher

All Podium Presentations

Purpose/Background: Homologous recombination deficiency (HRD) is a useful predictor of treatment response in patients with epithelial ovarian cancer (EOC). Reported data on the frequency of HRD in EOC is largely based on analysis of patients treated at academic medical centers or who participated in clinical trials. We sought to characterize the frequency of HRD based on mutations in homologous recombination repair (HRR) genes, genomic instability (GI) and loss of heterozygosity (LOH) scores in a large community-based cohort of EOC patients who received genomic testing in the context of routine clinical care.

Methods: Information including patient demographic, tumor stage and histology …