Navigation Links
New Clues to Treating Ovarian Cancer Relapse
Date:10/1/2010

By Amanda Gardner
HealthDay Reporter

THURSDAY, Sept. 30 (HealthDay News) -- New research finds that women with ovarian cancer relapse who start chemotherapy as soon as levels of a biomarker for the cancer rise don't live significantly longer than women who wait until symptoms begin to reappear.

Blood levels of the marker, known as CA125, often precede the reappearance of symptoms in an ovarian cancer relapse, but there has been some debate on the usefulness of monitoring CA125 levels.

"I think the main outcome of this study is going to be to give people confidence that we're not compromising anybody's treatment [if we delay chemotherapy]," said Dr. Andrew Berchuck, director of the division of gynecologic oncology at Duke University Medical Center in Durham, N.C.

And the test cost is miniscule (about $50) compared to tens of thousands of dollars for many other tests, he added.

When the results of the study were first released at a large cancer gathering, The Society of Gynecologic Oncologists issued a statement saying that "although there may not presently be a major survival advantage to the use of CA125 monitoring for earlier diagnosis of recurrence, patients and their physicians should still have the opportunity to choose this approach as integral to a philosophy of active management that includes participation in trials of novel therapies. Other patients, particularly those with a less robust performance status, might be more suitable for watchful waiting with an emphasis on quality of life."

This paper, the first randomized trial to look at the timing of chemo in women with recurring ovarian cancer, appears in the Oct. 2 issue of The Lancet, a special themed issue on cancer.

The study involved 529 women who were in remission from ovarian cancer and who were having their CA125 levels checked every three months.

Participants were randomized either to have chemotherapy early (as soon as CA125 levels doubled to twice the upper limit of normal) or later (when symptoms appeared).

Survival was about the same in both groups: 25.7 months in those who were treated early and 27.1 months in those treated later, the researchers reported.

But many of the patients in the study relapsed earlier than average, suggesting that they might have higher-risk disease, meaning one more resistant to chemotherapy, said Dr. Robert A. Burger, professor of surgical oncology and director of the Women's Cancer Center at Fox Chase Cancer Center in Philadelphia.

"In this therapy-resistant subgroup, it may be reasonable to hold off on treatment until patients become symptomatic or to treat with a non-toxic agent, such as tamoxifen, or to enroll such patients in a clinical trial evaluating biologic therapies rather than cytotoxics," he said. "This trial has not answered the question for patients who relapse at 12 months or later."

Burger also pointed out there are differences in patterns of care and the availability of a wider range of drugs to treat ovarian cancer in the United States than in Europe on average. Also, treatments have improved since the study was conducted.

In the study, however, quality of life was found to be much higher among those who started chemo only after symptoms of the cancer's recurrence, something Berchuck has seen in his own practice.

"I've had patients with CA125 levels going up and I know it, but I try to tell them we can't cure cancer and there's no evidence that treating sooner is better so they should just stay on a chemo holiday with the knowledge that they will have to go back at some point. They'll have improved quality of life," he explained.

Berchuck said he himself would rather know CA125 levels, even if women don't want the results passed on, "so I know what's going on with the disease. The key thing is not the CA125 levels, it's what you do with the information."

"For the first time, women can be given evidence-based advice and can make informed choices about follow-up," the researchers wrote in the study. "The results of this trial suggest that they can opt to forgo routine CA125 monitoring if their disease is in complete remission after first-line treatment."

Burger added, "Patients and their physicians should still have the opportunity to choose CA125 monitoring as a philosophy of active management."

Another study in the same issue of the journal found that the chemotherapy drug cabazitaxel allowed men with metastatic prostate cancer who have not responded well to other therapies to survive a median 2.4 months longer than docetaxel.

And a third study found that adding the monoclonal antibody rituximab to chemotherapy extended the lives of patients with chronic lymphocytic leukemia.

More information

The U.S. National Cancer Institute has more on ovarian cancer.

SOURCES: Andrew Berchuck, M.D., director, division of gynecologic oncology, Duke University Medical Center, Durham, N.C.; Robert A. Burger, M.D., professor of surgical oncology, section of gynecologic oncology and director, Women's Cancer Center, Fox Chase Cancer Center, Philadelphia; Oct. 2, 2010, The Lancet


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Hurts so good -- neural clues to the calming effects of self-harm
2. Long-Term Type 1 Diabetes Survivors Give Clues to the Disease
3. More Clues To Fibromyalgia Pain
4. Gene Mutation Offers Clues to Tamoxifen-Blood Clot Link
5. New Clues for Treating Ulcerative Colitis
6. Gene Mutations Offer Clues to Autoimmune Disorders
7. Cysts hold clues to pancreatic cancer
8. Tracking PSA Test Results Over Time Gives Clues to Cancer
9. New Clues to Treating Immune System Disorders
10. New Clues to Treating an Aggressive Breast Cancer
11. Pigs Yield Clues to Cystic Fibrosis-Related Lung Disease
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
New Clues to Treating Ovarian Cancer Relapse
(Date:4/29/2016)... ... 29, 2016 , ... Our bodies are bombarded daily by environmental and lifestyle ... these stressors is to adopt a more healthful diet, but too many people think ... certified Holistic Nutritionist and the creator of the Newport Beach Cleanse and 14-Day Eating ...
(Date:4/29/2016)... ... April 29, 2016 , ... The White House ... their loans, more information about their loan terms and accounts, and more protections ... debt, including federal and private loans, has reached $1.3 trillion, with 43 million ...
(Date:4/29/2016)... ... ... Spine Team Texas, a comprehensive spine physician group specializing in the treatment of ... invited to be a featured speaker at the Texas Society of the American College ... , Dr. R. Scott McPherson, a physical medicine and rehabilitation specialist, will speak ...
(Date:4/29/2016)... ... 29, 2016 , ... The Gluten-Free Certification Program (GFCP), in ... the launch of the GFCP Scoop in response to consumer demand ... the GFCP Scoop site is to keep the gluten-free community updated ...
(Date:4/29/2016)... Beverly Hills, CA (PRWEB) , ... April 29, 2016 , ... ... distributor of devices and products for the head and neck/ear, nose and throat specialty, ... Safety Device , The KOTLER NASAL AIRWAY™ is a newly patented safety ...
Breaking Medicine News(10 mins):
(Date:4/27/2016)... 2016 At the Sachs CEO ... a Phase 2 clinical study of its lead drug ... cochlear implantation (CI) surgery. This large, placebo-controlled, double-blind, phase ... Germany and France . ... the time of surgery. "Despite advances in cochlear implant ...
(Date:4/26/2016)... , April 26, 2016 Hill-Rom Holdings, Inc. ... a management presentation at the Deutsche Bank 41 st ... 2:50 p.m. EDT. You are invited to listen ... http://ir.hill-rom.com/events.cfm or access it directly at http://edge.media-server.com/m/p/mr4uxgas . ... hour after conclusion of the live event and accessible at ...
(Date:4/26/2016)... April 27, 2016 Research and ... Molecular Diagnostics Market 2016-2020" report to their offering. ... ,The global molecular diagnostics market is projected to grow ... Molecular diagnostics is a technique that involves ... molecular level to detect changes in biochemical pathways. The ...
Breaking Medicine Technology: