The following articles appeared in this month's issues of the surveyed journals. Articles that seem to be of most interest to the practicing gynecologic oncologist are included. The journals that are surveyed are New England Journal of Medicine, Journal of Clinical Oncology, Gynecologic Oncology, Cancer, American Journal of Obstetrics and Gynecology, Lancet, Cancer Research, Obstetrics and Gynecology, Journal of the National Cancer Institute, Journal of the American Medical Association. The participants in this program are the active clinical fellows at Memorial Hospital: Bhavana Pothuri, Mario Leitao, Christopher Awtrey, Sarah Ferguson, Alan Schlaerth and Rami Eitan. The managing editor is Douglas Levine. Comments, questions, complaints and suggestions are always welcome, please E-mail us at: VJC@smgo.org or click here.  To subscribe or unsubscribe to the VJC, click here.

Gynecologic Oncology – Mario Leitao

Title: Evaluation of paclitaxel in previously treated leiomyosarcoma of the uterus: a gynecologic oncology group study.

Authors: Donald G. Gallup, John A. Blessing, Willie Andersen and Mark A. Morgan.

Source: Gynecologic Oncology, Volume 89, Issue 1, April 2003, Pages 48-51.

Summary: A phase II trial was conducted to evaluate the efficacy of intravenous paclitaxel in patients with recurrent or advanced leiomyosarcoma of the uterus.  48 of 53 patients were evaluable for toxicity and response. Fifteen had prior irradiation and 39 had prior chemotherapy. Four (8.4%) patients had a complete or partial response and 22.9% had stable disease. Although toxicity was minimal, this regimen demonstrated modest activity in patients with previously treated advanced or recurrent leiomyosarcoma of the uterus.

Click here for abstract from GYN Oncology

Title: Usefulness of 18F-fluorodeoxyglucose positron emission tomography to detect para-aortic lymph nodal metastasis in advanced cervical cancer with negative computed tomography findings.

Authors: W. u C. Lin, Yao C. Hung, Lian S. Yeh, Chia H. Kao, Ruoh F. Yen and Yeh Y. Shen

Source: Gynecologic Oncology, Volume 89, Issue 1, April 2003, Pages 73-76.

Summary: A prospective study was undertaken to evaluate FDG-PET in detecting para-aortic lymph nodal metastasis in patients with locally advanced cervical carcinoma when CT findings were negative.  Retroperitoneal surgical exploration revealed 14 patients with para-aortic lymph nodal metastasis. Two patients had false-negative FDG-PET findings and the other two patients had false-positive FDG-PET findings. 

Overall, FDG-PET imaging had a sensitivity of 85.7%, a specificity of 94.4%, and an accuracy of 92%. When abdominal CT findings are negative, the use of FDG-PET can accurately detect para-aortic lymph nodal metastasis in patients with advanced cervical cancer.

Click here for abstract from GYN Oncology

Journal of Clinical Oncology - Bhavana Pothuri

Title: Combined Intraperitoneal and Intravenous Chemotherapy for Women With Optimally Debulked Ovarian Cancer: Results From an Intergroup Phase II Trial

Authors: Rothenberg, Mace L., Liu, P.Y., Braly, Patricia S., Wilczynski, Sharon P., Hannigan, Edward V., Wadler, Scott, Stuart, Gavin, Jiang, Caroline, Markman, Maurie, Alberts, David S.

Source: J Clin Oncol 2003 21: 1313-1319

Summary: Recent studies evaluating intraperitoneal (IP) chemotherapy have reported a median survival slightly higher those treated with IV chemotherapy. A phase II trial was undertaken to evaluate the feasibility of and 2-year survival rate achieved by the combination of IP paclitaxel, IP cisplatin, and IV paclitaxel in women with optimal stage III ovarian cancer. In 68 evaluable women, the 2-year survival rate was 91%, and the median survival time was 51 months. The majority (96%) of patients experienced toxicity with at least one grade 3 to 4 adverse event during therapy.  Seventy-one percent of patients were able to complete all six cycles. Combined IV and IP chemotherapy with cisplatin and paclitaxel is associated with a very promising 2-year survival rate in women with optimally debulked ovarian cancer. Further randomized trials to determine a survival benefit of IP chemotherapy need to be conducted.

Click here for abstract from JCO

Journal of the National Cancer Institute – Rami Eitan

Nothing of interest this month

Obstetrics and Gynecology – Alan Schlaerth

Click here for 2003 ACM abstracts

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American Journal of Obstetrics and Gynecology – Chris Awtrey

Title: Immunotherapy of human cervical high-grade cervical intraepithelial neoplasia with microparticle-delivered human papillomavirus 16 E7 plasmid DNA.

Authors: Ellen E. Sheets, MD, Robert G. Urban, PhD, Christopher P. Crum, MD, Mary Lynne Hedley, PhD, Joseph A. Politch, PhD, Michael A. Gold, MD, Laila I. Muderspach, MD, Geoffrey A. Cole, PhD, Peggy A. Crowley-Nowick, PhD

Source:  Am J Obstet Gynecol 2003 Apr;188(4):916-26.

Summary: This was a phase I study that was designed to evaluate the safety of the administration of a bacterial expression plasmid encoding a 13 amino acid sequence with high homology to human papillomavirus E7 given to women with CIN 2/3 as diagnosed after colposcopy and biopsy. Fifteen women were evaluated after injection of three different dose of plasmid given weekly for 3 weeks followed by excision in the fourth. The authors noted no adverse events. Importantly 5 women (33%) had a complete response to therapy and 11 developed a HPV-specific T-cell response. Of the five women with a complete response four were noted to develop an HPV specific immunoglobulin A. The authors conclude that the agent, ZYC101 warrants further investigation because of the high response rate without adverse reactions.

Click here for abstract from Am J Ob Gyn

New England Journal of Medicine – Bhavana Pothuri

Nothing of interest this month

Journal of the American Medical Association – Rami Eitan

Cancer – Sarah Ferguson

Nothing of interest this month

Lancet – Chris Awtrey

Nothing of interest this month

Cancer Research – Sarah Ferguson

Nothing of interest this month