CSN Login
Members Online: 12

Society of Gynecologic Oncologists Conference this week: any abstracts on UPSC?

evertheoptimist
Posts: 140
Joined: Jan 2011

Society of Gynecologic Oncologists are having their annual conference in FL.

I got a link to OVCA (ovarian) related research abstracts. I have yet to see a link to the uterine cancers. and specifically UPSC. Since UPSC behaves just like Ovarian cancer, a lot from the OVCA can shed lifht on UPSC. But, I am still looking for abstracts on UPSC. Did anyone see anything related?

Rewriter's picture
Rewriter
Posts: 494
Joined: Dec 2009

Abstract 11
Uterine Serous Papillary Carcinomas Overexpress
Human Trophoblast Cell Surface Marker
(Trop-2) and are Highly Sensitive to Immunotherapy
with hRS7, A Humanized Anti-Trop-2 Monoclonal
Antibody

A. Santin 1, S. Bellone 1, J. Varughese 1, E. Cocco1, E. Ratner 1, D. Silasi 1, T Rutherford 1, P. Schwartz 1, M. Azodin 1, S. Pecorelli 2

1 Yale University School of Medicine, New Haven, CT, 2 University of Brescia, Brescia, Italy.

Discussant: R. Alvarez, The University of Alabama

evertheoptimist
Posts: 140
Joined: Jan 2011

yes, I just found this one also by going through the conference PDF file. I was not able to get an abstract.

Did you get a content?

Rewriter's picture
Rewriter
Posts: 494
Joined: Dec 2009

No, I did not. However, I noticed Peter Schwartz's name. He was one of the oncologists involved in the 2005 Yale study that led to the first-line treatment for UPSC: 6 rounds of carboplatin/taxol. Following the development of the Yale protocol, women with UPSC fared much better than they had previously.

paris11
Posts: 132
Joined: Oct 2010

SGO: 'Sandwich' Tx Helps in Rare Endometrial Ca

By Charles Bankhead, Staff Writer, MedPage Today
Published: March 08, 2011
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.

Explain that a therapeutic "sandwich" of radiation and chemotherapy, in which chemotherapy is given first and then followed by radiation therapy and then additional chemotherapy, has led to encouraging disease-free survival in patients with uterine papillary serous carcinoma.
ORLANDO -- A therapeutic "sandwich" of radiation and chemotherapy has led to encouraging disease-free survival (DFS) in patients with uterine papillary serous carcinoma (UPSC), data from a single-center experience showed.
Patients with stage III-IV UPSC had a three-year DFS of 54% when treated with six cycles of combination chemotherapy interrupted by two types of radiation therapy. By comparison, historical data have shown a five-year DFS of 5% to 20% in the same type of patients.

Rewriter's picture
Rewriter
Posts: 494
Joined: Dec 2009

for this content, Paris. Where did you find it?

paris11
Posts: 132
Joined: Oct 2010

Go to Kevinmd.com for the complete article.

Connie

evertheoptimist
Posts: 140
Joined: Jan 2011

this is not an apples to apples comparison. The conclusion is SO FLAWED it can't stand any scrutiny from a scientific point of view.

First of all, the DFS of 5%-20% comes from very old data - the kind of data before the era of proper treatment of UPSC. Note that the standard treatment of UPSC with carbo/taxol was not pioneered until 2005 (by Yale doctors mentioned above). And, this protocol resulted in much better outcome for UPSC patients. As such, any recent data showing improved outcome reflects reflect a myriad of better treatment options, and can't be solely attributed to this sandwich method.

Second, the original data that generated 5%-20% had a really weird population characteristics ; as in, the typical patient was 75 year old black woman. Since UPSC was not acknowledged as a separate condition till 1980's, establishment of proper sampling and patient population demographics were properly done for a while. I believe recent data and samples reflect the actual patient population base more accurately. If the earlier data had non-representative samples, and the "typical" patients were fairly old minority members, you can easily imagine that their prognosis was sub optimal compared to general population (whether we like it or not, older minority population (other than Asians) do not have as good an access to the top line medical care - it's a fact).

Third, they are comparing 3 year vs. 5 year survival numbers. Who knows, maybe a large % of women recur between the year 3-5, and thus a steep decline in DFS rate for 5 years. I am not saying this is the case. I am just pointing out all the gigantic holes in this argument.

As a former researcher, I am embarrassed for the people who are making this claim since it's so full of holes and can't withstand even a cursory scrutiny. If I were to attend a presentation like this when I was still operating as a researcher, it would be so tempting to shrewd this presentation to pieces.

Rewriter's picture
Rewriter
Posts: 494
Joined: Dec 2009

I'm not a researcher, but I know enough about the differences in DFS pre- and post-2005 and the atypical populations used in earlier studies to recognize that there are huge holes in this conclusion.

Songflower's picture
Songflower
Posts: 632
Joined: Apr 2009

We need more research. MD Anderson is working on some. It is slow and not well funded. When the weather warms up We should walk naked down the street with our IV bags and scarred bellies. We need help. Diane

paris11
Posts: 132
Joined: Oct 2010

The entire article did not copy. Go to www.kevinmd.com to read. Connie

paris11
Posts: 132
Joined: Oct 2010

By Charles Bankhead, Staff Writer, MedPage Today
Published: March 08, 2011
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Earn CME/CE credit
for reading medical news

Action Points
Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Explain that a therapeutic "sandwich" of radiation and chemotherapy, in which chemotherapy is given first and then followed by radiation therapy and then additional chemotherapy, has led to encouraging disease-free survival in patients with uterine papillary serous carcinoma.
ORLANDO -- A therapeutic "sandwich" of radiation and chemotherapy has led to encouraging disease-free survival (DFS) in patients with uterine papillary serous carcinoma (UPSC), data from a single-center experience showed.
Patients with stage III-IV UPSC had a three-year DFS of 54% when treated with six cycles of combination chemotherapy interrupted by two types of radiation therapy. By comparison, historical data have shown a five-year DFS of 5% to 20% in the same type of patients.

"Toxicities were uncommon and manageable and most occurred after radiation therapy," Mark H. Einstein, MD, of Montefiore Medical Center in New York, said here at the Society of Gynecologic Oncology meeting.

"This regimen should be considered as an arm in future phase III trials in patients with completely resected uterine papillary serous carcinoma."

UPSC accounts for 10% of all endometrial cancers but 40% of deaths from the disease (Curr Opin Obstet Gynecol 2010; 22: 21-29).

Patients with stage I-II endometrioid endometrial cancer have a five-year DFS of 86%, declining to 40% to 50% for stage III and 15% to 20% for stage IV. By contrast, five-year DFS is 74% in patients with stage I-II UPSC, 20% in stage III, and 5% to 10% in stage IV (Gynecol Oncol 2010; 119: 299-304).

Recent studies have suggested that combined therapy improves outcomes in UPSC, said Einstein. However, no consensus exists about the optimal combination strategy.

The adjuvant regimen employed at Montefiore consists of three cycles of paclitaxel-carboplatin chemotherapy, followed by a 45-Gy total dose of external beam radiation therapy (EBRT) to the pelvis, then three weekly applications of brachytherapy at a total dose of 15 Gy, and finally three more cycles of chemotherapy.

Einstein presented data for 72 patients who received at least three cycles of chemotherapy. All had no visible residual disease after surgical resection. The cohort included 65 patients who completed all prescribed therapy.

The patient population had a mean age of 67 and a mean body mass index of 30.7 and was racially and ethnically diverse. The cohort included 14 patients with stage III-IV UPSC.

Among the patients who received three cycles of chemotherapy and the EBRT, those with stage I-II disease had a progression-free survival (PFS) of 65.5 months and overall survival of 76.5 months. Patients with stage III-IV UPSC had a PFS of 25.8 months and overall survival of 35.9 months.

The three-year survival probability was 84% for stage I-II and 50% for stage III-IV.

Collectively, the patients received 435 cycles of chemotherapy. Grade III-IV hematologic toxicity occurred in 27.2% of the cycles. Grade III nonhematologic toxicity occurred in 2.8% of cycles and grade IV in 0.9%. Dose reductions were required in 6% of cycles and dose delays in 8.5%.

The trial had a number of strengths, including a diverse patient population, a high percentage of patients who completed all prescribed therapy, and robust toxicity data, said invited discussant Paola Gehrig, MD, of the University of North Carolina at Chapel Hill.

Moreover, the Montefiore investigators have accumulated one of the largest experiences with UPSC ever reported, she continued. Two Gynecologic Oncology Group phase III clinical trials of endometrial cancer had a combined total of 48 patients with UPSC.

However, Einstein and colleagues needed 10 years to accrue patients and complete the protocol, both the radiation and chemotherapy protocols varied during the course of the study, and the cohort included relatively few patients with stage III-IV disease, Gehrig noted.

"Small patient numbers can lead to underpowered and inaccurate conclusions," Gehrig cautioned.

Ro10's picture
Ro10
Posts: 1362
Joined: Jan 2009

Which street do you recommend we walk down? Do you think we would get someone's attention. I have to add my bald head to the naked body, too. In peace and caring.

I did have the "sandwich treatment" which ended 8/09. I started treatment 2/11 with Taxol/Carbo.

JoAnnDK
Posts: 276
Joined: Jun 2011

Ev, I agree with YOUR conclusion that this sandwich "study" is flawed. Even the report itself says:

"However, Einstein and colleagues needed 10 years to accrue patients and complete the protocol, both the radiation and chemotherapy protocols varied during the course of the study, and the cohort included relatively few patients with stage III-IV disease, Gehrig noted.

"Small patient numbers can lead to underpowered and inaccurate conclusions," Gehrig cautioned."

[Gehrig was an "invited discussant" from UNC Chapel Hill.]

I know that Hopkins is doing UPSC research. My gyn-onc there told me that they have more people in their study than Stanford, Chicago, and UNC combined. You know, I always wanted to be special, but not THIS special! LOL

Subscribe with RSS
About Cancer Society

The content on this site is for informational purposes only. It is not a substitute for professional medical advice. Do not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Use of this online service is subject to the disclaimer and the terms and conditions.

Copyright 2000-2014 © Cancer Survivors Network