Avastin may help Ovarian Cancer Patients

http://www.cancernetwork.com/ovarian-cancer/content/article/10165/1739232?GUID=F465BF3C-0BD5-404E-A2A8-C0BF422F4322&rememberme=1

Oncology NEWS International. Vol. 19 No. 11

 

Bevacizumab offers new hope to ovarian cancer patients

By FRAN LOWRY | December 4, 2010

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Results of ICON7 trial will influence discussion of treatment options between oncologists and patients.

Early results from the ICON7 trial suggest that adding bevacizumab (Avastin) to standard chemotherapy in women with newly diagnosed ovarian cancer reduces the risk of disease progression during the first year of treatment.

The findings from the large, multicenter, phase III trial were announced at ESMO 2010 by ICON7 lead investigator Timothy J. Perren, MD, a consultant medical oncologist at Leeds Teaching Hospitals NHS Trust, UK.

Ovarian cancer initially responds very well to surgical treatment and chemotherapy, but the benefit is short lived, Dr. Perren said. "More than half of the patients go on to develop recurrent disease from which they will eventually die, despite our best current treatment," he explained. "For the women we have included in the ICON7 trial, the average time to development of recurrent disease is about 18 months and the average survival time is about three and a half years."

Bevacizumab has been shown to improve outcomes in breast and colon cancer. To see whether it worked in ovarian cancer, the ICON7 investigators randomized 1,528 women (median age, 57 years) with high-risk early- or advanced-stage epithelial ovarian cancer, primary peritoneal cancer, or fallopian tube cancer to one of two treatment regimens after their surgery.

Women in the control arm were randomized to six cycles of standard chemotherapy (carboplatin AUC 6 and paclitaxel 175 mg/m2) alone given once every three weeks. Women in the research arm of the trial were randomized to the same chemotherapy regimen given concurrently with bevacizumab (7.5 mg/kg) for six cycles, followed by maintenance bevacizumab for 12 additional cycles (abstract LBA4).

At 12 months, the risk of developing further progression of ovarian cancer was reduced by 15% when compared with the risk of progression seen with chemotherapy treatment alone. The effect of bevacizumab was strongest at 12 months, but then fell over time. Overall, the median progression-free survival in the control arm was 17.3 months vs 19 months in the research arm (P = .0041), Dr. Perren reported. Bevacizumab appeared to have a stronger effect in patients with a particularly poor prognosis, he added.

Dr. Perren also noted that the drug was well tolerated by the patients, with high blood pressure as the most common adverse event related to bevacizumab. Eighteen percent of the patients required antihypertensive medication. In comparison, 2% of women in the standard chemotherapy arm developed high blood pressure necessitating treatment.

The results from ICON7 support the findings of the Gynecologic Oncology Group (GOG 218) trial that were announced in June at the 2010 American Society of Clinical Oncologymeeting, Dr. Perren said (ASCO abstract LBA1).

"This is the first new drug in first-line treatment since the mid-1990s to show an improvement in outcome for ovarian cancer so it is a very big step forward," he said. "The results of ICON7 and GOG 218 will undoubtedly influence the discussions patients have with their oncologists, but probably more than that, it is going to influence the next generation of clinical trials. It is not possible to ignore these data."

Psychologist moved me to January...Christmas thoughts

Feeling sleepy literally right now, so I hope I don't bore anyone.  Good day to you.

My psychologist cancelled today because she is ill, and they won't let her work in that condition.  The cancer center has high infection control procedures, so I'm just hoping she gets better soon.  This though has thrown me a bit of a curve ball.

My next appointment is Jan 5th 2011.  I'll be paying full price for the consult, and I really didn't want to do that.  My deductible is $2500, so I'll be spending money no matter what until I reach that number, it's just a downer.

I'm not sure yet if I need regular visits, or if a free local support group will suffice.  So I may just skip the psychologist altogether and see how things go with voc rehab.

Part of my depression is that I have no job waiting for me.  The down economy scares me so I am relying heavily on help from voc rehab.  I don't even have a dress or suit to wear to an interview.

I stick to my beliefs that there are no accidents and need to keep my faith clear and strong.  I just need a little help, a little nudge, a little more energy, and the right place to work.

I did my 20 minutes of quick exercise activity, felt good.  I just ran in place and did some aerobic movements to get the blood pumping.  My arthritis is acting up, the soles of my feet hurt..............but can't let that stop me.

I'm so excited for Christmas, still need a special gift for mom.

I'M TRYING TO  LIVE AS IF THIS IS MY LAST CHRISTMAS.  So I'm wanting to get out the cards, and presents to special people.  I guarantee you members of my family are frustrated because they don't want me to spend any money, they just want me to save my change.  I am so grateful to have such a protective family and they are right, I should save all my money.

But this Christmas was not too expensive, really.  I have total faith that God is taking care of me.  It's going to be OK.  I will not be a drain on my family and will be able to take care of myself.............

But at the same time, what if this is my last Christmas?  I could have a relapse before next Christmas and it's possible treatment won't work.  So today is the day to give, not waiting until I'm earning more money.

That's the problem living in NED land.  Nobody can give me any solid answers so I can't make any solid plans or decisions.

Christmas is the most special holiday for me.  I love Christmas.  Easter is hard for me, I just really get emotional, and it's just not the same.  It's a greater joy, on Easter, but the week before Easter and Lent is a lot of work and inner soul searching.

So Christmas is just joyous and a time for freely giving.  I just want to give what I can.

Love you.

Merry Christmas

Good News

Hi,

I am so relieved that my CA125 is still at 10.  My pelvic exam went well too.  I'm feeling more secure with this news and am ready to see my psychologist tomorrow.  It's weird, I still feel depressed, and tired, but less heavy than before.  This is the life of being NED (no evidence of disease).  You live in blocks of time, until the next test.

So for now I will relish the joy of this good news.  Have a beautiful day.

God Bless and Merry Christmas

The holidays

Merry Christmas everyone.  This is the time of year for joy, love, forgiveness and peace.  This Christmas season is so different from last year, and I'm glad.  I get to enjoy shopping.  I also get to reflect more on God's blessings.  My online ovarian cancer group lost another sister today, so sad.  The grace is that she is at peace, and no longer in pain.

Everyday we lose a dear sister, it's just so difficult to understand sometimes.  I feel a thousand emotions all the time.

For me, I am really wanting to make the most of it.  I'm putting more thought into my little gifts and really really praying that everyone just has fun.  I want to hear more laughter than ever before.  I am so lucky that I have such an amazing family.  By the way, I was happy to send Christmas cards to my surgeon, oncologist and favorite chemo nurse.  I didn't get to do that last year, I was too out of it, really.  If you know someone on Chemo, offer to help them with cards and thank yous.........it will really help them.

I have four doctors appointments in the next 5 day run.  I will find out tomorrow the results of my latest CA125. I will also see my psychologist on Friday for the first time.  Monday I get my hearing checked and have another appointment with vocational rehab.  I'm very fortunate to have these opportunities.

I finally got my new glasses, which I really needed. I couldn't read a book without a magnifying glass....sigh.

I'll be posting more as we get closer to Christmas and fill you in on the results of my appointments.

My main message today is that we only have a few days left before we celebrate the birth of our Lord Jesus Christ.  Everyone in the world needs to have a chance to smile and feel true love.  Jesus does love us all, and allow Him to comfort you during this time of great celebration.

God's Blessings to all!

Doctors can be real #1 idiots

I belong to an online support group for people effected by ovarian cancer.  Members consist of patients, caregivers, incognito health professionals, friends, spouses, family etc.  Most of the members are female patients.  Its fairly common that at some point you learn that many women on the site mention that their ovarian cancer was completely missed altogether or just very difficult to diagnose.  I have a new friend who had the worst gynecologist ever it seems.

Doc is a friend of her husband, and I think that because of that, he didn't show this woman the respect she deserved.  She had been going back and forth and back and forth to him, literally telling him that her symptoms sounded like ovarian cancer and he refused to do a CA125 blood test.

He kept telling her it was menapause, or it was fibroids, or it was this or that or whatever.  He did the same to her that my gyno did to me.  He said she was too young to have ovarian cancer and laughed it off.

I was fuming mad when  I had read it, and wrote back a little about myself and our common experiences.  She "friended" me and we e-mailed a little more.

MY FRUSTRATION IS THAT IF A WOMAN SAYS TO HER GYNOCOLOGIST OR PCP THAT SHE WANTS A CA125, AND SHE HAS SOME SIGNS OF OVARIAN CANCER, WHO IS THIS DOC TO DENY THE TEST??????????????  WHO IS HE/SHE TO PLAY GOD?????????

If I would have know the symptoms of ovarian cancer before I was diagnosed, I would have paid for the blood test myself, screw my doctor!  I'm totally serious.  Every woman should have the right to have this test.  I KNOW THE CA125 IS NOT TOTALLY RELIABLE, BUT IF YOU HAVE OTHER SYMPTOMS, THE TEST SHOULD BE DONE, PERIOD.

This could literally save a life!  Do they teach medical students about ovarian cancer?  Have they just given up on us?  Why are they so complacent to just let it get to stage IIIC?  My friends doctor kept telling her it was pointless anyway because if they found it later it would be too late anyway!

What an ass.

I try not to use profanity, but really.  She could have had early stage ovarian cancer treated and not live her remaining life in fear.  Instead she was treated as an advanced stage patient, and even being NED/remission, her chances of recurrence are incredibly high.  So are mine.  We think about it all the time.

I don't want to live the rest of my life worrying about recurrence, and I am getting help in this area.  I want to be happy.  I want to be joyous and loving and happy and fun to be around.

At the same time I want to create a huge punching bag that has all the names of the docs who have negligently allowed women to advance into later stages of ovarian cancer, and give all those women a chance to pounce!

Thats the problem.  Underneath all this healing simmers ever so slowly a burning anger that this could have been prevented.  I have forgiven almost all of my doctors, except for two.  I'm close to forgiving them.

I'm hoping to finish that by Christmas.  The docs are just plain idiots, and really don't listen to their patients.  We can't continue to allow this to keep happening.  We just cant.

Be Love and God Bless