Publications by authors named "Shannon N Westin"
Objectives: In patients undergoing interval tumor reductive surgery, a good response to neoadjuvant chemotherapy may limit available tumor for homologous recombination deficiency testing. The objective of this study was to assess whether the chemotherapy response score predicts homologous recombination status.
Methods: We identified patients with advanced epithelial ovarian cancer (diagnosed January 2019 to 20 June 2023) who received neoadjuvant chemotherapy, underwent interval surgery, and for whom a chemotherapy response score was reported (1=no or minimal tumor response, 2=appreciable tumor response, 3=complete or near complete response with no residual tumor).
Article Synopsis
- This review synthesizes research on uterine-conserving treatments for atypical endometrial hyperplasia and grade 1 endometrial carcinoma while identifying gaps in current knowledge.
- The increasing number of younger patients and those with high surgical risk necessitates effective uterine-conserving options, especially since issues like delayed childbearing and obesity continue to rise.
- Hormonal therapy with close monitoring is the primary conservative method, but more studies are needed to determine the best candidates and tailor treatments based on individual needs.
Article Synopsis
- The study aimed to compare the effectiveness and side effects of two chemotherapy regimens, paclitaxel and carboplatin (PC), against bleomycin, etoposide, and cisplatin (BEP) in treating newly diagnosed or recurrent ovarian sex cord-stromal tumors (SCST).
- In a phase II trial involving 63 patients, the analysis showed that PC did not meet the criteria for being as effective as BEP, with a median progression-free survival of 27.7 months for PC compared to 19.7 months for BEP.
- Although PC had fewer serious adverse events (77% vs. 90%), the study concluded that it failed to demonstrate non-inferiority to BE
Endometrial cancer (EC) is the most common gynaecological cancer among women in high-income countries, with both incidence and mortality continuing to increase. The complexity of the management of patients with EC has evolved with greater comprehension of the underlying biology and heterogeneity of this disease. With a growing number of novel therapeutic agents available, emerging treatment regimens seem to have the potential to help to address the concerning trends in EC-related mortality.
View Article and Find Full Text PDFBackground: The efficacy and feasibility of pembrolizumab combined with chemotherapy in frontline management of advanced high-grade epithelial ovarian cancer (EOC) is unknown. Additionally, modification of the tumor microenvironment following neoadjuvant therapy is not well understood.
Methods: In this single-arm phase 2 trial (this study was registered at ClinicalTrials.
On February 6th, 2024, and the Society of Gynecologic Oncology Education Committee co-hosted a webinar about ways to use social media for career enhancement and for dissemination of research. During the discussion, we reviewed:i.how to identify one's goals, target audience, and select a social media platform.
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- Nonsurgical treatments like the levonorgestrel intrauterine device (LIUD) are being explored for managing endometrial atypical hyperplasia (AH) and endometrioid endometrial cancer (EEC), highlighting a need for long-term efficacy data.
- In a study of 43 patients initially responding to LIUD, 39% relapsed, with significant factors for shorter duration of response including younger age and lack of response at the 6-month mark.
- Molecular analysis during the study revealed changes in immune cell populations and pathways involved in relapse, suggesting immune mechanisms play a crucial role in the treatment's effectiveness.
Article Synopsis
- Folate receptor alpha is linked to tumorigenesis in tumors, making it a promising target for therapies, including mirvetuximab soravtansine, an approved monoclonal antibody for treating certain malignancies.
- A study reviewed gynecologic pathology cases over nine months to assess FOLR1 immunohistochemistry (IHC) results, gathering clinical data on patient demographics and tumor characteristics for therapy eligibility.
- Out of 216 cases analyzed, 45.4% tested positive for FOLR1, with mixed results across different tumor types; the majority of positive cases were high-grade serous carcinomas, particularly from tubo-ovarian origins.
Combining an immune checkpoint inhibitor with batiraxcept (AVB-S6-500), an AXL inhibitor that acts via selective binding to growth arrest-specific protein 6 (GAS6), may improve anti-tumor immunity in platinum-resistant ovarian cancer (PROC). This phase 1b trial of durvalumab in combination with escalating doses of batiraxcept enrolled patients with recurrent PROC (NCT04019288). The primary objective was to determine the toxicity profile of the combination.
View Article and Find Full Text PDFPurpose: We aimed to describe RAS mutations in gynecologic cancers as they relate to clinicopathologic and genomic features, survival, and therapeutic implications.
Experimental Design: Gynecologic cancers with available somatic molecular profiling data at our institution between February 2010 and August 2022 were included and grouped by RAS mutation status. Overall survival was estimated by the Kaplan-Meier method, and multivariable analysis was performed using the Cox proportional hazard model.
Article Synopsis
- - The study evaluated the effectiveness of pegsitacianine, a fluorescent imaging agent, in detecting residual disease after cytoreductive surgery (CRS) in patients with peritoneal carcinomatosis, which could enhance long-term survival chances.
- - In a phase II trial, 50 patients received pegsitacianine before surgery, and after CRS, 50% of evaluable patients showed residual disease during examination under near-infrared light.
- - Pegsitacianine was found to be well tolerated, with no serious side effects reported, and helped improve the detection of occult residual disease, indicating its potential utility in surgical procedures.
Background: Intravenous immune checkpoint blockade (ICB) has shown poor response rates in recurrent gynecologic malignancies. Intraperitoneal (i.p.
View Article and Find Full Text PDFObjective: To describe the clinicopathological characteristics and survival outcomes of ovarian neuroendocrine neoplasms from a curated registry.
Methods: This is a retrospective cross-sectional study of patients in our registry with confirmed ovarian neuroendocrine neoplasms. We excluded patients with small cell carcinoma not otherwise specified, small cell hypercalcemic type, and those with neuroendocrine 'features' or 'differentiation.
Endometrial cancer is the most frequent malignant tumor of the female reproductive tract but lacks effective therapy. EphA2, a receptor tyrosine kinase, is overexpressed by various cancers including endometrial cancer and is associated with poor clinical outcomes. In preclinical models, EphA2-targeted drugs had modest efficacy.
View Article and Find Full Text PDFBackground: Few studies have evaluated the role of cytoreductive surgery in patients with recurrent adult granulosa cell tumors of the ovary. Despite a multitude of treatment modalities in the recurrent setting, the optimal management strategy is not known. Cytoreductive surgery offers an attractive option for disease confined to the abdomen/pelvis.
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- Some types of cancers have problems with proteins that are supposed to help with DNA, and this can make them grow badly.
- Researchers tested different cancer cells by blocking certain proteins (PRMT1, PRMT4, and PRMT5) and found this stopped a key protein (ATR) from working properly.
- Combining the blockage of PRMT5 with a type of cancer treatment (PARP inhibitors) was found to help fight tumors without being too harmful to healthy cells.
Background: Single-agent immune checkpoint inhibitors (ICIs) have demonstrated limited responses in recurrent ovarian cancer; however, 30%-40% of patients achieve stable disease. The primary objective was to estimate progression-free survival (PFS) after sequential versus combination cytotoxic T-lymphocyte antigen 4 and programmed death ligand 1 ICIs in patients with platinum-resistant high-grade serous ovarian cancer (HGSOC).
Methods: Patients were randomized to a sequential arm (tremelimumab followed by durvalumab on progression) or a combination arm (tremelimumab plus durvalumab, followed by durvalumab) via a Bayesian adaptive design that made it more likely for patients to be randomized to the more effective arm.
Article Synopsis
- Ovarian cancer treatment is challenging due to advanced diagnosis and high initial chemotherapy response, but survival outcomes are poor.
- Genetic issues like defects in the HRD DNA repair pathway and BRCA1/2 mutations are linked to better responses to PARP inhibitors (PARPi).
- Clinical trials show PARPi significantly improves survival for various ovarian cancer patients, changing treatment approaches and expanding usage into different therapy settings.*
Article Synopsis
- Frontline treatments for advanced ovarian cancer have seen little improvement in cure rates over many years.
- The text emphasizes the need for a multidisciplinary strategy to explore new therapeutic options.
- It highlights the importance of understanding minimal residual disease, which is the phase that contributes to recurring and eventually incurable ovarian cancer.
Article Synopsis
- The study investigates the effectiveness of combining immunotherapy (durvalumab) and chemotherapy (carboplatin/paclitaxel) for advanced or recurrent endometrial cancer, focusing on its benefits for both mismatch repair-deficient (dMMR) and proficient (pMMR) patients.
- In a phase III trial with 718 participants, the results showed significant improvements in progression-free survival (PFS) for both the durvalumab and the durvalumab + olaparib groups compared to the control group.
- Subgroup analyses indicated that both dMMR and pMMR patients, as well as those with PD-L1 positivity, experienced notable PFS benefits, with
Ischemic bowel associated with newly diagnosed patent foramen ovale.
Int J Gynecol Cancer
November 2023
Article Synopsis
- * Recent advances in molecular research and targeted therapies show promise for better outcomes in low-grade serous carcinoma patients, although specifics on its pathogenesis and optimal management are still being explored.
- * An expert panel met in October 2022 to create a consensus document focused on improving diagnosis, treatment, and ongoing research for low-grade serous carcinoma, integrating scientific advancements with patient perspectives to enhance clinical management.
Introduction: NRG/RTOG 1203 compared 3-D conformal radiotherapy (3D CRT) to intensity-modulated radiotherapy (IMRT) in patients with endometrial or cervical cancer requiring post-operative radiotherapy after hysterectomy. The purpose of this study was to report the first quality-adjusted survival analysis comparing the two treatments.
Methods: NRG/RTOG 1203 randomized patients having undergone hysterectomy to either 3DCRT or IMRT.