GCIG Rare Tumour Brainstorming Day
|
|
- Alexis Atkins
- 5 years ago
- Views:
Transcription
1 GCIG Rare Tumour Brainstorming Day Relatively (Not So) Rare Tumours Adenocarcinoma of Cervix Keiichi Fujiwara, Ros Glasspool Benedicte Votan, Jim Paul
2 Aim of the Day To develop at least one clinical trial in adenocarcinoma of cervix. Consider the methodologies for studying relatively rare cancers
3 Key Points Difference between adenocarcinoma and squamous cell carcinoma of the cervix Individualization of the therapy
4 Histological Types of Cervical Carcinoma Squamous Cell Carcinoma 75% Adenocarcinoma 20-25% Adenosquamous cell carcinoma Others Small Cell Clear Cell etc
5 Epidemiology of Cervical Adenocarcinoma In creased infection of HPV-16 and HPV-18 (80%) HPV-18 infection (50%) SCC 15% Poorer prognosis than SCC 10-20% difference in 5-year survival rate Larger Tumor Size Higher LN Mets More ovarian mets/peritoneal dissemination Lower sensitivity to RT?
6
7 JSGO 2013 Clinical Stage +
8 Pathology of Cervical Adenocarcinoma Macroscopic 50% - exophytic or polypoid 15% - No visible tumor Subtypes Mucinous Endometrioid Serous Clear cell Upregulated Gene Expression CEACAM5, TACSTD1, S100P, MSLN PIK3CA (25%), KRAS (17.5%)
9 Treatment for Cervical Adenocarcinoma: Current Consensus NCCN Guideline Not separated from SCC Early Stages Surgery Locally Advanced Stages ChemoRT Metastatic or Recurrent Disease Chemotherapy
10 Unanswered Questions Need Clinical Trials 1. Is AC more or less radiosensitive than SCC? 2. Does the prognosis of AC differ? 3. Is uterine preservation possible? 4. What is the recommended CCRT regimen? 5. Is neoadjuvant chemotherapy followed by RH is beneficial for patients with locally advanced AC? 6. What therapy can be used for the control of distant metastasis? 7. Which are the potential molecular target drug candidates?
11 Treatment for Cervical Adenocarcinoma Consensus with Controversial Points Adenocarcinoma in Situ Simple hysterectomy or conization for fertility preservation (FP) Stage IA1 Simple hysterectomy Conization or cylinderectomy for FP Stage IA2 Type B radical hysterectomy with LNDX
12 Conservative Surgery Concept Study format: observational 5y follow-up Eligibility: AIS, IA1 Pts wishing to preserve fertility Pre/postop. workup including HPV testing Treatment: cervical conization (free margins) Country-based centralized pathology review (slides & blocks)
13 Treatment for Cervical Adenocarcinoma Consensus with Controversial Points Stage IB/II Radical Hysterectomy or ChemoRT for tumor size < 2 cm ChemoRT for tumor size > 4 cm Pre-therapeutic aortic nodal staging by laparoscopy before RT Neoadjuvant chemotherapy followed by radical hysterectomy
14 Treatment for Cervical Adenocarcinoma Consensus with Controversial Points Stage IIIA-IVA ChemoRT Pre-therapeutic aortic nodal staging by laparoscopy before RT Systemic chemotherapy with cisplatin/carboplatin and paclitaxel Stage IVB and Metastatic Disease Platinum with paclitaxel or docetaxel with Bevacizumab
15 Unanswered Questions Need Clinical Trials 1. Is AC more or less radiosensitive than SCC? 2. Does the prognosis of AC differ? 3. Is uterine preservation possible? 4. What is the recommended CCRT regimen? 5. Is neoadjuvant chemotherapy followed by RH is beneficial for patients with locally advanced AC? 6. What therapy can be used for the control of distant metastasis? 7. Which are the potential molecular target drug candidates?
16 How Can we Answer these Questions? Studying rare sub-types of common tumours Include them in general trials Meta-analysis of sub group in several general trials Enhance the numbers of the sub-group Sub-type specific trials Umbrella trials including different anatomical or histological types in different arms of a common protocol
17 What we can learn from on-going trial? Study for NACT-Surgery vs CCRT EORTC55994 Role of Systemic Chemotherapy in addition to CCRT INTERLACE OUTBACK RTOG-0724 Antiangiogenesis Trial GOG240 CIRCCA ENGOT-cx/BGOG-cx
18 NACT-RH Expanding currently on-going EORTC Trial of NACT-RH vs CCRT after analyzing adenocarcinoma subpopulation
19 Concurrent Chemotherapy JGOG Proposal to add paclitaxel to cisplatin for the CCRT chemo-regimen.
20 Survival Curves of the FIGO IIIB Cervical Adenocarcinoma, 19 institutes in Japan Survival Curves of the FIGO IIB - IIIB Cervical Adenocarcinoma, University of the Ryukyus, Okinawa, Japan 20.2 % CCRT using CDDP alone (n=8) 5-yr OS 25.0% RT (n=14) 5-yr OS 15.4% CCRT using CDDP (n=20) no CCRT (n=41) 5-yr OS 15.8% 23.4% p Niibe Y, et al. Jpn J Clin Oncol 2010;40:795-9 Nagai Y, et al. Anticancer Res 2012;32:1475-9
21 External beam radiotherapy (50Gy/25Fr. 40Gy- center shield) High-dose rate brachytherapy (point A dose 18Gy/3Fr.) CDDP 50 mg/m 2 tri-weekly + PTX 50 mg/m 2 weekly OS Central DFS Nagai Y, et al. Anticancer Res 2012;32:1475-9
22 CCRT for Advanced Cervical Adenocarcinoma; CCRT-TP vs. CCRT-P CCRT-TP (n=9) CCRT-P (n=7) Recurrence rate 33% (3/9) 71% (5/7) Umayahara, et al. Int J Gynecol Cancer 2009;19:723-7 Recommendation dose CDDP 30 mg/m 2, weekly OS Median (months) PFS Median (months) 40(5-72) 21(3-40) 40(0-72) 4(1-27) PTX 50 mg/m 2, weekly Tanigawa T, et al., Abstract of the 50 th Annual Meeting of Japan Society of Clinical Oncology
23 Schema Cervical adenocarcinoma, FIGO IIIA, IIIB, IVA 術 Histologically confirmed adenocarcinoma, and adenosquamous carcinoma age; PS 0-1 no paraaortic lymphnode enlargement Randomization Control Arm CCRT-P CDDP 40 mg/m 2 weekly Treatment Arm CCRT-TP CDDP 30 mg/m 2 weekly PTX 50 mg/m 2 weekly
24 Endopoint Primary endpoint: 5-yr OS Secondary endpoints: 1) Completion rate (radiotherapy, chemotherapy) 2) Adverse events (early, and late) 3) 5-yr PFS 4) 5-yr local PFS 5) 5-yr distant PFS
25 Statistical Considerations α error (bilateral) 5% β error 20% Estimated 5Y OS Control Arm (P-CCRT) 20% Estimated 5Y OS Experimental Arm(TP-CCRT) 35% Estimated accrual per year 36 (inside Japan only) HR Accrual Duration 6.5 years Control Arm (P-CCRT) 120 Experimental Arm(TP-CCRT) 120
26 Discussion Points for JGOG Concept Including large (>7 cm) IB2, IIB disease To increase accrual Challenges Difference of radiation dose Will be managed by stratification Run in phase I for US-Europe dose of RT? Integration of systemic chemotherapy after CCRT Second randomization Using paclitaxel + carboplatin x4 cycles Tissue collection Need logistic setup under GCIG leadership
27 Unanswered Questions Need Clinical Trials 1. Is AC more or less radiosensitive than SCC? 2. Does the prognosis of AC differ? 3. Is uterine preservation possible? 4. What is the recommended CCRT regimen? 5. Is neoadjuvant chemotherapy followed by RH is beneficial for patients with locally advanced AC? 6. What therapy can be used for the control of distant metastasis? 7. Which are the potential molecular target drug candidates?
28 PI3K pathway Which Target? PIK3CA mutations 25% of AC and 38% in SCC*. Associated with poor prognosis Combine with other tumour types with high rates of PI3K activation in an umbrella trial? Angiogenesis GOG 240 CIRCCa ENGOT-Cx/BGOG-cxI Targeting HPV Ongoing vaccine trial of ADXS in recurrent cervical cancer (GOG). *Wright, Alexi A; Howitt, Brooke E; Myers, Andrea P; et al. Cancer 119: 21, p
29 Targeted Therapy Randomized discontinuation trial multiple tumour types in an umbrella design analyse results by molecular phenotype as well as by anatomical site/histology
30 CR/PR Experimental Experimental Randomise SD Prog/ Lack of tolerance Standard for tumour type
31 Proposed Trials for AC Cervix Metanalysis of on-going trials for systemic chemotherapy Amendment by reviewing the proportion of AC potentially extending the recruitment of AC Conservative Surgery Trial New CCRT Regimen Trial with secondary randomization for adjuvant chemotherapy Randomized discontinuation trial for target therapy in AC cervix.
32 Questions?
Chemotherapy for Cervical Cancer. Matsue City Hospital Junzo Kigawa
Chemotherapy for Cervical Cancer Matsue City Hospital Junzo Kigawa Introduction Worldwide, cervical cancer is the second most common cancer in women and affects 530,000 new patients and 275,000 deaths.
More informationManagement of high risk early cervical cancer - a view of surgeon Dan DY Kim, M.D., Ph.D.
Management of high risk early cervical cancer - a view of surgeon Dan DY Kim, M.D., Ph.D. Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
More informationUPDATE IN THE MANAGEMENT OF INVASIVE CERVICAL CANCER
UPDATE IN THE MANAGEMENT OF INVASIVE CERVICAL CANCER Susan Davidson, MD Professor Department of Obstetrics and Gynecology Division of Gynecologic Oncology University of Colorado- Denver Anatomy Review
More informationGynecologic Cancer InterGroup Cervix Cancer Research Network. Management of Cervical Cancer in Resource Limited Settings.
Management of Cervical Cancer in Resource Limited Settings Linus Chuang MD Conflict of Interests None Cervical cancer is the fourth most common malignancy in women worldwide 530,000 new cases per year
More informationUpdate on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer
Update on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer Nicoletta Colombo, MD University of Milan-Bicocca European Institute of Oncology Milan, Italy NACT in Cervical Cancer NACT Stage -IB2 -IIA>4cm
More informationEvolving Treatment Strategies for Cervical Cancer
Evolving Treatment Strategies for Cervical Cancer Nadeem Abu-Rustum, MD Memorial Sloan Kettering Cancer Center Evolving Treatment Strategies 1. Surgery 2. Radiation 3. Chemotherapy Incidence of cervix
More information17 th ESO-ESMO Masterclass in clinical Oncology
17 th ESO-ESMO Masterclass in clinical Oncology Cervical and endometrial Cancer Cristiana Sessa IOSI Bellinzona, Switzerland Berlin, March 28 th, 2018 Presenter Disclosures None Cervical Cancer Estimated
More informationreceive adjuvant chemotherapy
Women with high h risk early stage endometrial cancer should receive adjuvant chemotherapy Michael Friedlander The Prince of Wales Cancer Centre and Royal Hospital for Women The Prince of Wales Cancer
More informationChapter 8 Adenocarcinoma
Page 80 Chapter 8 Adenocarcinoma Overview In Japan, the proportion of squamous cell carcinoma among all cervical cancers has been declining every year. In a recent survey, non-squamous cell carcinoma accounted
More informationChun-Chieh Wang, MD and Feng-Yuan Liu, MD/ Prof. Chyong-Huey Lai, MD
Concept/trial design presentation A Phase 2 Trial of Pembrolizumab Combined with Chemoradiation for Patients with [ 18 F]-FDG PET/CT-defined Poor-prognostic Cervical Cancer Chun-Chieh Wang, MD and Feng-Yuan
More informationAdjuvant Therapies in Endometrial Cancer. Emma Hudson
Adjuvant Therapies in Endometrial Cancer Emma Hudson Endometrial Cancer Most common gynaecological cancer Incidence increasing in Western world 1-2% cancer deaths 75% patients postmenopausal 97% epithelial
More informationGCIG Cervix Committee: Sunday, November 17, 2013, 10:30 a.m. 12:00 noon Room 2+3, UCL Education Centre, London, UK.
GCIG Cervix Committee: Sunday, November 17, 2013, 10:30 a.m. 12:00 noon Room 2+3, UCL Education Centre, London, UK. Satoru Sagae (JGOG) Bradley Monk (GOG) Bill Small (RTOG) President elect Publications:
More informationLocally advanced disease & challenges in management
Gynecologic Cancer InterGroup Cervix Cancer Research Network Cervix Cancer Education Symposium, February 2018 Locally advanced disease & challenges in management Carien Creutzberg Radiation Oncology, Leiden
More informationGCIG Cervix Committee: Chicago, USA May 30th Satoru Sagae (JGOG) Bradley Monk (GOG)
GCIG Cervix Committee: Chicago, USA May 30th 2013 Satoru Sagae (JGOG) Bradley Monk (GOG) Conflict of Interest Disclosures CURRENT ACTIVE/NEAR ACTIVATION RANDOMIZED TRIALS WITH GCIG PARTICIPATION: Wellcome
More informationARROCase: Locally Advanced Endometrial Cancer
ARROCase: Locally Advanced Endometrial Cancer Charles Vu, MD (PGY-3) Faculty Advisor: Peter Y. Chen, MD, FACR Beaumont Health (Royal Oak, MI) November 2016 Case 62yo female with a 3yr history of vaginal
More informationQuimio Radioterapia en Cancer de Cervix
Quimio Radioterapia en Cancer de Cervix HIGINIA R. CÁRDENES PROFESSOR RADIATION ONCOLOGY CLINICAL DIRECTOR SCHNECK CANCER CENTER Worldwide incidence of cervical cancer 2014, 12.360 cases Global incidence
More informationBEATcc Trial: ENGOT-Cx10 / GEICO 68-C / JGOG1084. GCIG Meeting
BEATcc Trial: ENGOT-Cx10 / GEICO 68-C / JGOG1084 GCIG Meeting Ana Oaknin, MD PhD Head of Gynecologic Cancer Program. Vall d Hebron Institute of Oncology(VHIO). Vall d Hebron University Hospital. GEICO
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Carcinoma of the Uterine Cervix
THIS DOCUMENT North of Scotland Cancer Network Carcinoma of the Uterine Cervix UNCONTROLLED WHEN PRINTED DOCUMENT CONTROL Prepared by A Kennedy/AG Macdonald/Others Approved by NOT APPROVED Issue date April
More informationStage IB1 (2-4 cm) Cervical cancer treated with Neoadjuvant chemotherapy followed by fertility Sparing Surgery (CONTESSA) Dre Marie Plante
Stage IB1 (2-4 cm) Cervical cancer treated with Neoadjuvant chemotherapy followed by fertility Sparing Surgery (CONTESSA) Dre Marie Plante Neo-Adjuvant Chemotherapy and Conservative Surgery in Cervical
More informationRESEARCH ARTICLE. Kuanoon Boupaijit, Prapaporn Suprasert* Abstract. Introduction. Materials and Methods
RESEARCH ARTICLE Survival Outcomes of Advanced and Recurrent Cervical Cancer Patients Treated with Chemotherapy: Experience of Northern Tertiary Care Hospital in Thailand Kuanoon Boupaijit, Prapaporn Suprasert*
More informationChapter 5 Stage III and IVa disease
Page 55 Chapter 5 Stage III and IVa disease Overview Concurrent chemoradiotherapy (CCRT) is recommended for stage III and IVa disease. Recommended regimen for the chemotherapy portion generally include
More informationRadiotherapy & Cervical Cancer Dr Mary McCormack Consultant Clinical Oncologist University College Hospital, London,UK
Lead Group Log Radiotherapy & Cervical Cancer Dr Mary McCormack Consultant Clinical Oncologist University College Hospital, London,UK Cervical Cancer treatment Treatment planning should be made on a multidisciplinary
More informationA phase II study of weekly paclitaxel and cisplatin followed by radical hysterectomy in stages IB2 and IIA2 cervical cancer AGOG14-001/TGOG1008
A phase II study of weekly paclitaxel and cisplatin followed by radical hysterectomy in stages IB2 and IIA2 cervical cancer AGOG14-001/TGOG1008 NCT02432365 Chyong-Huey Lai, MD On behalf of Principal investigator
More informationENDOMETRIAL CANCER Updated Apr 2017 by: Dr. Jenny Ko (Medical Oncologist, Abbotsford Cancer Centre)
ENDOMETRIAL CANCER Updated Apr 2017 by: Dr. Jenny Ko (Medical Oncologist, Abbotsford Cancer Centre) Source: UpToDate 2017, ASCO/CCO/Alberta provincial guidelines, NCCN Reviewed by: Dr. Sarah Glaze (Gynecologic
More informationCarcinosarcoma Trial rial in s a in rare malign rare mali ancy
Carcinosarcoma Trials in a rare malignancy BACKGROUND Rare and highly aggressive epithelial malignancies Biphasic tumors with epithelial and mesenchymal components Uterine carcinomas (UCS) uncommon with
More informationAdjuvant Chemotherapy
State-of-the-art: standard of care for resectable NSCLC Adjuvant Chemotherapy JY DOUILLARD MD PhD Professor of Medical Oncology Integrated Centers of Oncology R Gauducheau University of Nantes France Adjuvant
More informationTargeted Agents as Maintenance Therapy. Karen Kelly, MD Professor of Medicine UC Davis Cancer Center
Targeted Agents as Maintenance Therapy Karen Kelly, MD Professor of Medicine UC Davis Cancer Center Disclosures Genentech Advisory Board Maintenance Therapy Defined Treatment Non-Progressing Patients Drug
More informationNon-small Cell Lung Cancer: Multidisciplinary Role: Role of Medical Oncologist
Non-small Cell Lung Cancer: Multidisciplinary Role: Role of Medical Oncologist Vichien Srimuninnimit, MD. Medical Oncology Division Faculty of Medicine, Siriraj Hospital Outline Resectable NSCLC stage
More informationThoracic and head/neck oncology new developments
Thoracic and head/neck oncology new developments Goh Boon Cher Department of Hematology-Oncology National University Cancer Institute of Singapore Research Clinical Care Education Scope Lung cancer Screening
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX Site Group: Gynecology Cervix Author: Dr. Stephane Laframboise 1. INTRODUCTION 3 2. PREVENTION 3 3. SCREENING AND
More informationCombined Modality Therapy State of the Art. Everett E. Vokes The University of Chicago
Combined Modality Therapy State of the Art Everett E. Vokes The University of Chicago What we Know Some patients are cured (20%) Induction and concurrent chemoradiotherapy are each superior to radiotherapy
More informationCo-Chairs Helen J MacKay and Diane Provencher On behalf of the OV21/PETROC Investigators CCTG, NCRI (UK), GEICO and SWOG
OV21/PETROC: A Randomized Gynecologic Cancer Intergroup (GCIG) Phase II Study of Intraperitoneal (IP) vs. Intravenous (IV) Chemotherapy Following Neoadjuvant Chemotherapy and Optimal Debulking Surgery
More informationPrognostic factors and treatment outcome after radiotherapy in cervical cancer patients with isolated para-aortic lymph node metastases
Original Article J Gynecol Oncol Vol. 24, No. 3:229-235 pissn 2005-0380 eissn 2005-0399 Prognostic factors and treatment outcome after radiotherapy in cervical cancer patients with isolated para-aortic
More informationPERIOPERATIVE TREATMENT OF NON SMALL CELL LUNG CANCER. Virginie Westeel Chest Disease Department University Hospital Besançon, France
PERIOPERATIVE TREATMENT OF NON SMALL CELL LUNG CANCER Virginie Westeel Chest Disease Department University Hospital Besançon, France LEARNING OBJECTIVES 1. To understand the potential of perioperative
More informationTratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón
Tratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón Santiago Ponce Aix Servicio Oncología Médica Hospital Universitario 12 de Octubre Madrid Stage III: heterogenous disease
More informationDe-Escalate Trial for the Head and neck NSSG. Dr Eleanor Aynsley Consultant Clinical Oncologist
De-Escalate Trial for the Head and neck NSSG Dr Eleanor Aynsley Consultant Clinical Oncologist 3 HPV+ H&N A distinct disease entity Leemans et al., Nature Reviews, 2011 4 Good news Improved response to
More informationLung Cancer Epidemiology. AJCC Staging 6 th edition
Surgery for stage IIIA NSCLC? Sometimes! Anne S. Tsao, M.D. Associate Professor Director, Mesothelioma Program Director, Thoracic Chemo-Radiation Program May 7, 2011 The University of Texas MD ANDERSON
More informationTable Selected Clinical Trials of Anti-Angiogenesis Therapy in Gynecologic Malignancies
Table Selected Clinical Trials of Anti-Angiogenesis Therapy in Gynecologic Malignancies Uterus Study N Eligibility Regimen RR (No. of Responses) Median OS Grade 3/4 Toxicities Nimeiri et al[42] Total:
More informationChemotherapy or Observation in Stage I-II Intermediate or High Risk Endometrial Cancer
Find Studies About Studies Submit Studies Resources About Site Chemotherapy or Observation in Stage I-II Intermediate or High Risk Endometrial Cancer The safety and scientific validity of this study is
More informationHYPERTHERMIA in CERVIX and VAGINA CANCER. J. van der Zee
HYPERTHERMIA in CERVIX and VAGINA CANCER J. van der Zee ESTRO 2006 Deep hyperthermia in Rotterdam HYPERTHERMIA in CERVIX and VAGINA CANCER ESTRO 2006 Hyperthermia and radiotherapy in primary advanced cervix
More informationBackground. TAP, Paclitaxel + Doxorubicin + Cisplatin
A randomized phase II study of paclitaxel/carboplatin/bevacizumab, paclitaxel/carboplatin/temsirolimus and ixabepilone/carboplatin/bevacizumab as initial therapy for measurable stage III or IVA; stage
More informationManagement of Cervical Cancer in Resource Limited Settings
Management of Cervical Cancer in Resource Limited Settings Linus Chuang MD MPH MS Professor, Gynecologic Oncology Icahn School of Medicine at Mount Sinai New York NY 84% of incidence and death occur in
More informationCurrent state of upfront treatment for newly diagnosed advanced ovarian cancer
Current state of upfront treatment for newly diagnosed advanced ovarian cancer Ursula Matulonis, M.D. Associate Professor of Medicine, HMS Program Leader, Medical Gyn Oncology Dana-Farber Cancer Institute
More informationFoROMe Lausanne 6 février Anita Wolfer MD-PhD Cheffe de clinique Département d Oncologie, CHUV
FoROMe Lausanne 6 février 2014 Anita Wolfer MD-PhD Cheffe de clinique Département d Oncologie, CHUV Epithelial Ovarian Cancer (EOC) Epidemiology Fifth most common cancer in women and forth most common
More informationRTWG - Carcinosarcoma. Max Parmar, Jane Bryce, Andreas Poveda, Amit Oza
RTWG - Carcinosarcoma Max Parmar, Jane Bryce, Andreas Poveda, Amit Oza Overview Background Questions urgent and timely investigations? Proposed Approach Regulatory Solutions Output Carcinosarcomas Background
More informationCURRENT STANDARD OF CARE IN NASOPHARYNGEAL CANCER
CURRENT STANDARD OF CARE IN NASOPHARYNGEAL CANCER Jean-Pascal Machiels Department of medical oncology Institut I Roi Albert II Cliniques universitaires Saint-Luc Université catholique de Louvain, Brussels,
More informationYukiharu Todo 1, Hidemichi Watari 2. Abstract
Review Article on Cervical Cancer Concurrent chemoradiotherapy for cervical cancer: background including evidence-based data, pitfalls of the data, limitation of treatment in certain groups Yukiharu Todo
More informationHypofractionated RT in Cervix Cancer. Anuja Jhingran, MD
Hypofractionated RT in Cervix Cancer Anuja Jhingran, MD Hypofractionated RT in Cervix Cancer: Clinicaltrials.gov 919 cervix trials 134 hypofractionated RT trials Prostate, breast, NSCLC, GBM 0 cervix trials
More informationCombined modality treatment for N2 disease
Combined modality treatment for N2 disease Dr Clara Chan Consultant in Clinical Oncology 3 rd March 2017 Overview Background The evidence base Systemic treatment Radiotherapy Future directions/clinical
More information3/8/2014. Case Presentation. Primary Treatment of Anal Cancer. Anatomy. Overview. March 6, 2014
Case Presentation Primary Treatment of Anal Cancer 65 year old female presents with perianal pain, lower GI bleeding, and anemia with Hb of 7. On exam 6 cm mass protruding through the anus with bulky R
More informationConcurrent chemoradiotherapy with low-dose daily cisplatin for high risk uterine cervical cancer: a long-term follow-up study
Original Article J Gynecol Oncol Vol. 24, No. 2:108-113 http://dx.doi.org/10.3802/jgo.2013.24.2.108 pissn 2005-0380 eissn 2005-0399 Concurrent chemoradiotherapy with low-dose daily cisplatin for high risk
More informationStage III Non-Small Cell Lung Cancer, Is There Any Progress? HARMESH R NAIK, MD. KARMANOS CANCER INSTITUTE 2/24/99
Stage III Non-Small Cell Lung Cancer, Is There Any Progress? HARMESH R NAIK, MD. KARMANOS CANCER INSTITUTE 2/24/99 Introduction 1/3 of the total lung cancer cases few patients are cured with single modality
More informationEnterprise Interest None
Enterprise Interest None Cervical Cancer -Management of late stages ESP meeting Bilbao Spain 2018 Dr Mary McCormack PhD FRCR Consultant Clinical Oncologist University College Hospital London On behalf
More informationAdjuvant Therapy in Locally Advanced Head and Neck Cancer. Ezra EW Cohen University of Chicago. Financial Support
Adjuvant Therapy in Locally Advanced Head and Neck Cancer Ezra EW Cohen University of Chicago Financial Support This program is made possible by an educational grant from Eli Lilly Oncology, who had no
More informationAlgorithms for management of Cervical cancer
Algithms f management of Cervical cancer Algithms f management of cervical cancer are based on existing protocols and guidelines within the ESGO comunity and prepared by ESGO Educational Committe as a
More informationNew Paradigms for Treatment of. Erminia Massarelli, MD, PHD, MS Clinical Associate Professor
New Paradigms for Treatment of Head and Neck cancers Erminia Massarelli, MD, PHD, MS Clinical Associate Professor City of Hope Disclosure Statement Grant/Research Support frommerck Bristol Grant/Research
More informationMolly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010
LSU HEALTH SCIENCES CENTER NSCLC Guidelines Feist-Weiller Cancer Center Molly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010 Initial Evaluation/Intervention: 1. Pathology Review 2. History and Physical
More informationRTOG Lung Cancer Committee 2012 Clinical Trial Update. Wally Curran RTOG Group Chairman
RTOG Lung Cancer Committee 2012 Clinical Trial Update Wally Curran RTOG Group Chairman 1 RTOG Lung Committee: Active Trials Small Cell Lung Cancer Limited Stage (Intergroup Trial) Extensive Stage (RTOG
More informationKe Hu, Weiping Wang, Xiaoliang Liu, Qingyu Meng and Fuquan Zhang *
Hu et al. Radiation Oncology (2018) 13:249 https://doi.org/10.1186/s13014-018-1197-5 RESEARCH Open Access Comparison of treatment outcomes between squamous cell carcinoma and adenocarcinoma of cervix after
More informationGynecologic Cancer InterGroup Cervix Cancer Research Network. The SHAPE Trial
Gynecologic Cancer InterGroup Cervix Cancer Research Network The SHAPE Trial Comparing radical hysterectomy and pelvic node dissection against simple hysterectomy and pelvic node dissection in patients
More informationGOG212: Taxane Maintenance
GOG212: Taxane Maintenance Epithelial Ovarian or Primary Peritoneal Cancer Optimal or Suboptimal Cytoreduction Clinical C with normal CA125, no symptoms, normal CT Primary Carboplatin and Paclitaxel (or
More information3/25/2019. Rare uterine cancers ~3% Leiomyosarcoma Carcinosarcoma (MMMT) Endometrial Stromal Sarcomas Aggressive tumors High Mortality Rates
J. Anthony Rakowski D.O., F.A.C.O.O.G. MSU SCS Board Review Coarse Rare uterine cancers ~3% Leiomyosarcoma Carcinosarcoma (MMMT) Endometrial Stromal Sarcomas Aggressive tumors High Mortality Rates Signs
More informationCervical Cancer 3/25/2019. Abnormal vaginal bleeding
Cervical Cancer Abnormal vaginal bleeding Postcoital, intermenstrual or postmenopausal Vaginal discharge Pelvic pain or pressure Asymptomatic In most patients who are not sexually active due to symptoms
More informationMedicinae Doctoris. One university. Many futures.
Medicinae Doctoris The Before and The After: Can chemotherapy revise the trajectory of gastric and esophageal cancers? Dr. David Dawe MD, FRCPC Medical Oncologist Assistant Professor Disclosures None All
More informationClinical statistics of gynecologic cancers in Japan
J Gynecol Oncol. 2017 Mar;28(2):e32 pissn 2005-0380 eissn 2005-0399 Review Article Clinical statistics of gynecologic cancers in Japan Wataru Yamagami, 1,7 Satoru Nagase, 2,7 Fumiaki Takahashi, 3 Kazuhiko
More informationHitting the High Points Gynecologic Oncology Review
Hitting the High Points is designed to cover exam-based material, from preinvasive neoplasms of the female genital tract to the presentation, diagnosis and treatment, including surgery, chemotherapy, and
More informationImmune Therapy in Clear Cell Ovarian Cancer (ITICC) Hal Hirte Canadian Cancer Clinical Trials Group
Immune Therapy in Clear Cell Ovarian Cancer (ITICC) Hal Hirte Canadian Cancer Clinical Trials Group Results of Phase II Study of Durvalumab and Tremelimumab in recurrent clear cell ovarian cancer Trial
More informationPre- Versus Post-operative Radiotherapy
Postoperative Radiation and Chemoradiation: Indications and Optimization of Practice Dislosures Clinical trial support from Genentech Inc. Sue S. Yom, MD, PhD Associate Professor UCSF Radiation Oncology
More informationEndometrial Cancer. Incidence. Types 3/25/2019
Endometrial Cancer J. Anthony Rakowski DO, FACOOG MSU SCS Board Review Coarse Incidence 53,630 new cases yearly 8,590 deaths yearly 4 th most common malignancy in women worldwide Most common GYN malignancy
More informationCervix Cancer Committee Tuesday, Nov.10, 2015, 3F Room, Jikei University, Tokyo
Cervix Cancer Committee Tuesday, Nov.10, 2015, 1:30p.m. 3:30 p.m. 3F Room, Jikei University, Tokyo Satoru Sagae (JGOG) Bradley Monk (GOG) Harmonization Liaisons: Hiltz (Ops), Reuss (Stats) AGENDA Published/
More informationOptimal sequencing in treatment muscle invasive bladder cancer : oncologists. Phichai Chansriwong, MD Ramathibodi Hospital, Mahidol University
Optimal sequencing in treatment muscle invasive bladder cancer : oncologists Phichai Chansriwong, MD Ramathibodi Hospital, Mahidol University Slide 2 Presented By Andrea Apolo at 2018 Genitourinary Cancers
More informationCervix Cancer Research Network
Cervix Cancer Research Network GCIG: General Assembly November, 2015 Chair: David Gaffney Steering Committee: Henry Kitchener, Sang Young Ryu, Bill Small, Carien Creutzberg, D. Thinh, Anuja Jhingran, Linda
More informationClinical Trials. Ovarian Cancer
1.0 0.8 0.6 0.4 0.2 0.0 < 65 years old 65 years old Events Censored Total 128 56 184 73 35 108 0 12 24 36 48 60 72 84 27-10-2012 Ovarian Cancer Stuart M. Lichtman, MD Attending Physician 65+ Clinical Geriatric
More informationIs the Neo-adjuvant Approach Better than Adjuvant Approach? Comparative Levels of Evidence: Randomized Trials
Is the Neo-adjuvant Approach Better than Approach? Virginie Westeel University Hospital Besançon, France Perspectives in Lung Cancer Amsterdam, 5-6 March 2010 Comparative Levels of Evidence: Randomized
More informationRisk group criteria for tailoring adjuvant treatment in patients with endometrial cancer : a validation study of the GOG criteria
Risk group criteria for tailoring adjuvant treatment in patients with endometrial cancer : a validation study of the GOG criteria Suk-Joon Chang, MD, Hee-Sug Ryu MD Gynecologic Cancer Center Department
More informationTwo Cycles of Chemoradiation: 2 Cycles is Enough. Concurrent Chemotherapy / RT Regimens
1 Two Cycles of Chemoradiation: 2 Cycles is Enough Heather Wakelee, M.D. Assistant Professor of Medicine, Oncology Stanford University Concurrent Chemotherapy / RT Regimens Cisplatin 50 mg/m 2 on days
More informationTarceva Trial EORTC 55041
Tarceva Trial EORTC 55041 Primary Chemotherapy Tarceva consolidation 2 years Control Patients closed / 835 Leading Participating EORTC AGO-AUSTRIA, ANZGOG, GINECO, MRC/NCIC, MANGO Randomised trial on Erlotinib
More informationENDOMETRIAL CANCER. Endometrial cancer is a great concern in UPDATE. For personal use only. Copyright Dowden Health Media
For mass reproduction, content licensing and permissions contact Dowden Health Media. UPDATE ENDOMETRIAL CANCER Are lymphadenectomy and external-beam radiotherapy valuable in women who have an endometrial
More informationEndometrial Cancer. Saudi Gynecology Oncology Group (SGOG) Gynecological Cancer Treatment Guidelines
Saudi Gynecology Oncology Group (SGOG) Gynecological Cancer Treatment Guidelines Endometrial Cancer Emad R. Sagr, MBBS, FRCSC Consultant Gynecology Oncology Security forces Hospital, Riyadh Epidemiology
More informationbreast and OVARIAN cancer
breast and OVARIAN cancer DR DAVID FENNELLY CONSULTANT MEDICAL ONCOLOGIST ST VINCENT S UNIVERSITY HOSPITAL DUBLIN HOW RELEVANT IS ONCOLOGY IN MEDICINE TODAY? Cancer is the second leading cause of death
More informationJacqui Morgan March 6, 2019
Jacqui Morgan March 6, 2019 Case 1 25yo, G2P1 Here for WWE, no problems, healthy, needs refill on OCPs. Pap- Abnormal Glandular Cells-NOS Now What?? Case 1 Colposcopy What findings? Case 1 ECC Cervical
More informationIndex. B Bilateral salpingo-oophorectomy (BSO), 69
A Advanced stage endometrial cancer diagnosis, 92 lymph node metastasis, 92 multivariate analysis, 92 myometrial invasion, 92 prognostic factors FIGO stage, 94 histological grade, 94, 95 histologic cell
More informationLung Cancer Non-small Cell Local, Regional, Small Cell, Other Thoracic Cancers: The Question Isn t Can We, but Should We
Lung Cancer Non-small Cell Local, Regional, Small Cell, Other Thoracic Cancers: The Question Isn t Can We, but Should We Edward Garon, MD, MS Associate Professor Director- Thoracic Oncology Program David
More informationCUrative Radiotherapy to the primary tumor vs. best supportive care in patients with initially metastatic Cervical carcinoma (CURE-C trial)
CUrative Radiotherapy to the primary tumor vs. best supportive care in patients with initially metastatic Cervical carcinoma (CURE-C trial) EORTC ROG-GCG-QLG Study coordinator Igor Sirák, M.D., Ph.D Department
More informationHeterogeneity of N2 disease
Locally Advanced NSCLC Surgery? No. Ramaswamy Govindan M.D Co-Director, Section of Medical Oncology Alvin J Siteman Cancer Center at Washington University School of Medicine St. Louis, Missouri Heterogeneity
More informationChemo-radiotherapy in non-small cell lung cancer. HARMESH R NAIK, MD. September 25, 2002
Chemo-radiotherapy in non-small cell lung cancer HARMESH R NAIK, MD. September 25, 2002 Epidemiology Estimated 170000 new cases Estimated 157,000 deaths Second commonest cancer diagnosis in men and women
More informationClinical Trials in Transoral Endoscopic Head &Neck Surgery ECOG3311 and RTOG1221. Chris Holsinger, MD, FACS Bob Ferris, MD, PhD, FACS
Clinical Trials in Transoral Endoscopic Head &Neck Surgery ECOG3311 and RTOG1221 Chris Holsinger, MD, FACS Bob Ferris, MD, PhD, FACS 1 Disclosure I have no conflicts of interest to disclose 2 Robotic H&N
More informationCervical CA: What is Advanced Stage? If the tumor is early stage but >4cm (IB2 or IIA2), it is often treated as advanced stage (category 1) but also h
PROGRAMA 2 Taller Internacional Multidisciplinario de Cancer de Mama y Cuello Uterino Racional del tratamiento combinado con Quimioterapia e Irradiación. Resultados en Cáncer de Cérvix avanzado Higinia
More informationSAMO MASTERCLASS Bern, Prof. C. Sessa IOSI - Bellinzona
SAMO MASTERCLASS Bern, 13.09.2014 Gynecological cancers Prof. C. Sessa IOSI - Bellinzona Epithelial ovarian cancer Epidemiology Fourth most common cause of female mortality Incidence 13/100 000 woman/yr
More informationRole of Surgery in Cervical Cancer & Research Questions
Role of Surgery in Cervical Cancer & Research Questions Arb-aroon Lertkhachonsuk, M.D., Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Role of surgery in cervical cancer
More informationStaging. Carcinoma confined to the corpus. Carcinoma confined to the endometrium. Less than ½ myometrial invasion. Greater than ½ myometrial invasion
5 th of June 2009 Background Most common gynaecological carcinoma in developed countries Most cases are post-menopausal Increasing incidence in certain age groups Increasing death rates in the USA 5-year
More informationGCIG Cervix Committee: Chicago William Small Jr. Satoru Sagae Bradley Monk
GCIG Cervix Committee: Chicago 2012 William Small Jr. Satoru Sagae Bradley Monk Conflict of Interest Disclosures Closed Trials GOG 240 and Active Trials Gynecologic Oncology Group Cervical Cancer Update
More informationThe PARADIGM Study: A Phase III Study Comparing Sequential Therapy (ST) to Concurrent Chemoradiotherapy (CRT) in Locally Advanced Head and Neck Cancer
The PARADIGM Study: A Phase III Study Comparing Sequential Therapy (ST) to Concurrent Chemoradiotherapy (CRT) in Locally Advanced Head and Neck Cancer Robert I. Haddad, Guilherme Rabinowits, Roy B. Tishler,
More informationThe following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only.
The following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only. If you have any ques7ons, please contact Imedex via email at:
More informationFertility-sparing surgery in young patients with cervical cancer
Fertility-sparing surgery in young patients with cervical cancer Pr Catherine Uzan Chef de service Chirurgie et cancérologie gynécologique et mammaire, Pitié Evaluation BEFORE surgery Cancer: stage, type
More informationThe Effect of Treatment Time in Locally Advanced Cervical Cancer in the Era of Concurrent Chemoradiotherapy
The Effect of Treatment Time in Locally Advanced Cervical Cancer in the Era of Concurrent Chemoradiotherapy Suisui Song, MD 1 ; Sonali Rudra, MD 1 ; Michael D. Hasselle, MD 2 ; Paige L. Dorn, MD 1 ; Loren
More informationEGFR inhibitors in NSCLC
Suresh S. Ramalingam, MD Associate Professor Director of Medical Oncology Emory University i Winship Cancer Institute EGFR inhibitors in NSCLC Role in 2nd/3 rd line setting Role in first-line and maintenance
More informationInvasive Cervical Cancer: Squamous Cell, Adenocarcinoma, Adenosquamous
Note: If available, clinical trials should be considered as preferred treatment options for eligible patients (www.mdanderson.org/gynonctrials). Other co-morbidities are taken into consideration prior
More informationJemal A, Siegel R, Ward E, et al: Cancer statistics, CA: Cancer J Clin 59(4):225-49, 2009
Ovarian cancer 2010-22,500 cases diagnosed per year in the United States and 16,500 deaths per year1. - Most patients are diagnosed in late stages; no screening test exists. - Pathology: 4 different types
More informationManagement of Squamous Cell Cancer of the Esophagus: Surgery Should Follow Chemo + RT
Management of Squamous Cell Cancer of the Esophagus: Surgery Should Follow Chemo + RT David H. Ilson, MD, PhD Gastrointestinal Oncology Service Memorial Sloan Kettering Cancer Center Disclosure Consulting
More information