Phase I trial of selenium plus chemotherapy in gynecologic cancers.

Purpose: Preclinical studies performed in our laboratory have shown that high-dose selenium inhibits the development of carboplatin drug resistance in an ovarian cancer mouse xenograft model. Based on these data, as well as the potential serious toxicities of supranutritional doses of selenium, a phase I trial of a combination of selenium/carboplatin/paclitaxel was designed to determine the maximum tolerated dose, safety, and effects of selenium on carboplatin pharmacokinetics in the treatment of chemo-naive women with gynecologic cancers. Correlative studies were performed to identify gene targets of selenium.

Serial Uterine Artery Embolization for the Treatment of Placenta Percreta in the First Trimester: A Case Report.

Unlabelled: Two patients with placenta percreta underwent uterine artery embolization (UAE) for abnormally invasive placenta (AIP) in the first trimester. Patient 1 had a 9-week cervical ectopic, while Patient 2 had a 9-week cesarean scar pregnancy. Elective termination of pregnancy was performed in both patients.

Benign metastasizing leiomyomatosis of the lungs presenting a miliary pattern.

Benign metastasizing leiomyomatosis is a very rare and significantly interesting pathology of the lungs. It is a challenge to clinicians when presenting a miliary pattern in preoperative radiologic imaging because it could be any other interstitial disease or infectious in etiology such as miliary tuberculosis. We report a case of innumerable tiny nodular densities spread evenly throughout both lungs in a patient with history of hysterectomy for a fibroid uterus.

Phase 2 trial of paclitaxel, 13-cis retinoic acid, and interferon alfa-2b in the treatment of advanced stage or recurrent cervical cancer.

Objective: Overexpression of bcl-2 is a mechanism of drug resistance in cervical cancer. Agents that down-regulate bcl-2 may decrease tumor cell threshold and sensitize tumor cells to chemotherapy. The objective of this multi-institutional phase 2 trial was to evaluate the efficacy and toxicity of paclitaxel and bcl-2 modulators (13-cis retinoic acid and interferon alfa-2b) in patients with advanced-stage or recurrent cervical cancer.

Signal transducers and activators of transcription 3 pathway activation in drug-resistant ovarian cancer.

Purpose: One of the major obstacles in the treatment of ovarian cancer is the development of multidrug resistance. Recent evidence shows that high-grade ovarian cancer often shows activation of the signal transducers and activators of transcription 3 (Stat3) pathway with subsequent transcription of genes that support tumor growth and survival. Less studied is the role of the Stat3 pathway in acquired drug resistance.

Uterine malignant mixed mullerian tumors should not be included in studies of endometrial carcinoma.

Objective: Uterine mixed malignant mullerian tumors (MMMT) have traditionally been excluded from clinical trials of endometrial cancer because of a belief that they are more correctly included in the sarcoma category. Recently, investigators have suggested that uterine MMMTs are actually dedifferentiated epithelial tumors and should be treated as such. The current study was undertaken to compare outcomes, stage for stage, of uterine MMMT with poor prognosis endometrial adenocarcinomas.

Chemosensitization to cisplatin by inhibitors of the Fanconi anemia/BRCA pathway.

Cisplatin resistance occurs, at least in part, through the function of the Fanconi anemia (FA)/BRCA pathway, a DNA-damage response pathway required for repair of cisplatin cross-links. In the current study, we designed a cell-based screening strategy to identify small-molecule inhibitors of the FA/BRCA pathway with the hypothesis that such molecules could restore sensitivity to platinum agents. We identified four inhibitors, including three protein kinase inhibitors (wortmannin, H-9, and alsterpaullone) and one natural compound (curcumin) that inhibit the FA/BRCA pathway.

Psammoma bodies in cervicovaginal cytology specimens: a clinicopathological analysis of 31 cases.

Background: Psammoma bodies in cervicovaginal cytology specimens are associated with malignant and benign conditions. Few studies have evaluated which features distinguish patients with underlying malignancy from those with benign conditions.

Methods: Pathology files were searched for cervicovaginal specimens having psammoma bodies.

Rationale and clinical experience with epidermal growth factor receptor inhibitors in gynecologic malignancies.

The family of epidermal growth factor receptors (EGFRs) is overexpressed in many gynecologic malignancies. Extensive preclinical studies of these receptors demonstrate that they play an important role in supporting the growth of a wide variety of malignancies and that interruption of receptor function or signaling from these receptors leads to inhibition of tumor growth or in certain cases tumor regression. Recently, many therapeutic agents targeting this receptor have entered the clinic and phase II clinical studies have demonstrated activity in lung cancer, colon cancer, and head and neck malignancies.

The follow-up of ovarian cancer.

Few formal guidelines exist regarding the surveillance of patients with epithelial ovarian cancer. The objective of follow-up in patients who have already been treated with primary cytoreductive surgery and first-line chemotherapy is not clear, as recurrent ovarian cancer continues to be a therapeutic dilemma. The vast majority of women with relapses will eventually succumb to their disease.

Palliative surgery for bowel obstruction in recurrent ovarian cancer:an updated series.

Objective: Intestinal obstruction is a frequent sequela of recurrent ovarian cancer. Previous series report median survivals of 3-6 months in patients undergoing surgery for obstruction due to recurrent disease. We analyze a contemporary series of patients to determine if outcomes have changed in patients undergoing palliative surgery.