Management of women with surgically staged 1 uterine papillary serous cancer.

Objective. To review the management and outcomes of women with surgically staged 1 UPSC. Methods.

Phase II study of temsirolimus in women with recurrent or metastatic endometrial cancer: a trial of the NCIC Clinical Trials Group.

Purpose: Phosphatase and tensin homolog (PTEN) is a tumor suppressor gene, and loss of function mutations are common and appear to be important in the pathogenesis of endometrial carcinomas. Loss of PTEN causes deregulated phosphatidylinositol-3 kinase/serine-threonine kinase/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling which may provide neoplastic cells with a selective survival advantage by enhancing angiogenesis, protein translation, and cell cycle progression. Temsirolimus, an ester derivative of rapamycin that inhibits mTOR, was evaluated in this setting.

Temsirolimus in combination with carboplatin and paclitaxel in patients with advanced solid tumors: a NCIC-CTG, phase I, open-label dose-escalation study (IND 179).

Background: The purpose of the study was to assess the safety, tolerability, recommended phase II dose (RPTD), and preliminary antitumor activity of the combination of carboplatin-paclitaxel (Taxol)-temsirolimus.

Materials And Methods: Patients with solid malignancies suitable for carboplatin-paclitaxel (CP) chemotherapy and two or less prior lines of chemotherapy received 15, 20, or 25 mg of temsirolimus per week with CP given every 21 days. Thirty-eight eligible patients were entered into six dose levels with the first two levels administering temsirolimus on days 8 and 15 and the subsequent four dose levels switching to days 1 and 8 temsirolimus administration.

Phase II study of erlotinib in recurrent or metastatic endometrial cancer: NCIC IND-148.

Purpose: Epidermal growth factor receptor (EGFR) overexpression is common in endometrial cancers and may have a major role in tumor growth and progression. Erlotinib is an orally active, selective inhibitor of EGFR tyrosine kinase activity.

Patients And Methods: A multinomial design two-stage phase II study was performed to evaluate single-agent activity of erlotinib in women with advanced endometrial cancer with recurrent or metastatic disease who were chemotherapy naïve and had received up to one line of prior hormonal therapy.

Evaluation of postoperative pain control for women undergoing surgery for gynaecologic malignancies.

Objectives: (1) To compare the benefits of epidural analgesia and patient-controlled analgesia (PCA) in the management of postoperative pain in women with gynaecologic malignancies,and (2) to understand issues related to the delivery of pain control strategies.

Methods: A retrospective cohort study, based on chart review, was conducted of all women with gynaecologic malignancies who received either PCA or epidural analgesia at the Henderson Division of Hamilton Health Sciences, Hamilton, Ontario, from May 20, 1999, to July 17, 2001. Both objective (i.

Gastrointestinal stromal tumor presenting as a recurrent vaginal mass.

Gastrointestinal stromal tumors are CD117 (c-Kit)-positive mesenchymal neoplasms with histologic and ultrastructural features of the interstitial cell of Cajal. While tumors outside of the gastrointestinal tract have been described, to our knowledge the case we present is the first such case in the vagina. We describe a 75-year-old woman with a recurrent vaginal gastrointestinal stromal tumor without apparent rectal involvement.

Desmoplastic small round cell tumor presenting in the ovaries: report of a case and review of the literature.

Desmoplastic small round cell tumor is a recently recognized clinical entity with specific morphologic, immunocytochemical, and genetic features. Though this tumor is mostly described to involve serosal surfaces, we report a case with ovarian involvement. The clinical presentation and differential diagnoses as well as the treatment including aggressive surgical debulking and multiagent chemotherapy are discussed.

A comparison of two prophylactic regimens for hypersensitivity reactions to paclitaxel.

Objective: The aim of this study was to compare the rates of hypersensitivity reactions to paclitaxel with the conventional prophylactic regimen of two doses of oral corticosteroids and a modified regimen of a single dose of intravenous corticosteroid.

Methods: This was a retrospective historical cohort study assessing the rates of hypersensitivity reactions in patients receiving paclitaxel for ovarian or primary peritoneal carcinoma at the Hamilton Regional Cancer Centre from 1996 to 2000. Until 1998, all patients received the conventional prophylactic regimen consisting of two doses of oral dexamethasone (20 mg), 12 and 6 h prior to paclitaxel.

Weekly intravenous methotrexate with folinic acid for nonmetastatic gestational trophoblastic neoplasia.

Objective: The objective of this study was to determine the complete response rate to weekly intravenous methotrexate at 100 mg/m(2) with folinic acid for patients with nonmetastatic gestational trophoblastic neoplasia.

Methods: From 1988 to 1999, 22 women with nonmetastatic gestational trophoblastic neoplasia were treated with weekly intravenous methotrexate with folinic acid at the Hamilton Regional Cancer Centre. Complete response was defined as the attainment of a serum beta-hCG level <5 IU/L for 3 consecutive weeks.

Reversal of suppression of lymphokine-activated killer cells by transforming growth factor-beta in ovarian carcinoma ascitic fluid requires interleukin-2 combined with anti-CD3 antibody.

Ascitic fluid from human ovarian carcinoma (AF) has been shown to inhibit IL-2-induced lymphokine-activated killer (LAK) cell generation from peripheral blood mononuclear cells (PBMC) resulting from the presence of biologically active transforming growth factor-beta (TGF-beta). A 50% concentration of AF completely suppressed the LAK response to 100 units IL-2/ml and only partial reversal (less than 50%) could be achieved by increasing the IL-2 concentration to 1000 units/ml. We evaluated the ability of tumor necrosis factor-alpha (TNF-alpha, 1-1000 ng/ml) and anti-CD3 antibody (alpha-CD3, 1-100 ng/ml) to reverse AF-mediated suppression of IL-2-stimulated LAK generation.

A rapid and simple method for the purification of tumor cells from ascitic fluid of ovarian carcinoma.

Rapid isolation of tumor cells growing in clumps from the ascitic fluid of patients with ovarian carcinoma was achieved by harvesting cells from ascitic fluid and subsequently passing them over a 30-microns nylon mesh filter. Single cells and small cell aggregates passed through the mesh, and large cell clumps that had not passed through the filter were isolated by backwashing. Morphologically, the cells in the clumps consisted almost entirely of tumor cells.

Phase II study of mitomycin C and 5 fluorouracil in platinum resistant ovarian cancer.

Fourteen patients with relapsing ovarian cancer were treated with Mitomycin C (Mit C) and 5 Fluorouracil (5-FU). All but one patient (one responder) were defined as platinum resistant. The drug dosaging was Mit C 10 mg/m2 IV day 1 every 6 weeks, and 5-FU 500 mg/m2 IV days 1-3, every 3 weeks.

Two phase I studies of carboplatin dose escalation in chemotherapy-naive ovarian cancer patients supported with granulocyte-macrophage colony-stimulating factor.

Recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF) may reduce myelosuppression and, thus, allow dose escalation of certain chemotherapeutic agents. We conducted two sequential phase I trials of escalating doses of carboplatin and a fixed dose and schedule of rHuGM-CSF in ovarian cancer patients who had not previously had chemotherapy, i.e.

Prognostic significance of positive peritoneal cytology in endometrial carcinoma.

A retrospective review of 280 patients with endometrial carcinoma who had peritoneal cytologic examination done at the time of laparotomy was undertaken. A positive cytologic finding was the only manifestation of extrauterine disease in 16 patients (6%). Four (25%) of these patients had a recurrence.