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1.
Introduction: The landscape of poly (ADP-ribose) polymerase (PARP) inhibition in ovarian cancer is rapidly evolving and becoming increasingly complex. Ovarian cancer is leading therapeutic innovation by providing the proof of concept for DNA repair as a target. Three different PARP inhibitors have now received approvals in the US and Europe in different indications. Subtle but crucial differences can be found among the licensed indications for each PARP inhibitor in terms of histology, type of BRCA mutation (germline and/or somatic), number of prior lines of chemotherapy and whether the indication is in the treatment or maintenance settings.

Areas covered: We review the latest clinical data regarding the PARP inhibitor rucaparib in ovarian cancer, provide an update on the evolving landscape of PARP inhibition in ovarian cancer, and summarize avenues of ongoing and future research.

Expert opinion: All eligible patients should be offered a PARP inhibitor. SOLO1 trial results demonstrated an unprecedented benefit maintenance with PARP inhibitors in first line. Results from trials evaluating PARP inhibitors as maintenance in first line regardless of BRCA status and from trials evaluating combinatorial strategies are eagerly awaited.  相似文献   

2.

Aims

To examine the influence of pre-existing psychiatric disorder on the choice of treatment in patients with gynaecological cancer.

Materials and methods

The analyses were based on all patients who underwent surgical treatment for endometrial, ovarian or cervical cancer who were registered in the Danish Gynecological Cancer Database in the years 2007–2014 (3059 patients with ovarian cancer, 5100 patients with endometrial cancer and 1150 with cervical cancer). Logistic regression model and Cox regression model, adjusted for relevant confounders, were used to estimate the effect of pre-existing psychiatric disorder on the course of cancer treatment. Our outcomes were (i) presurgical oncological treatment, (ii) macroradical surgery for patients with ovarian cancer, (iii) radiation/chemotherapy within 30 days and 100 days after surgery and (iv) time from surgery to first oncological treatment.

Results

In the group of patients with ovarian cancer, more patients with a psychiatric disorder received macroradical surgery versus patients without a psychiatric disorder, corresponding to an adjusted odds ratio of 1.24 (95% confidence interval 0.62–2.41) and the chance for having oncological treatment within 100 days was odds ratio = 1.26 (95% confidence interval 0.77–2.10). As for patients with endometrial cancer, all outcome estimates were close to unity. The adjusted odds ratio for oncological treatment within 30 days after surgery in patients with cervical cancer with a history of psychiatric disorder was 0.20 (95% confidence interval 0.03–1.54).

Conclusions

We did not find any significant differences in the treatment of ovarian and endometrial cancer in patients with pre-existing psychiatric diagnoses. When it comes to oncological treatment, we suggest that increased attention should be paid to patients with cervical cancer having a pre-existing psychiatric diagnosis.  相似文献   
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4.
卵巢未成熟畸胎瘤43例综合治疗疗效分析   总被引:3,自引:0,他引:3  
为探讨不同手术方式及化疗方法对卵巢未成熟畸胎瘤的疗效及相关影响因素,对43例卵巢未成熟畸胎瘤患者进行回顾性分析。手术方式分为:保守性手术(患侧附件、大网膜切除术+盆、腹腔腹膜结节切除术+盆腔淋巴结清扫术)及根治性手术(全子宫、双附件及大网膜切除术_肿瘤细胞减灭术+盆腔淋巴结清扫术)。术后采用VAC(长春新碱,阿霉素,环磷酰胺)方案、BEP(博莱霉素或平阳霉素,足叶乙叉甙,顺铂或卡铂)方案或VBP(长春新碱,博莱霉素或平阳霉素,顺铂或卡铂)方案进行联合化疗。患者5年生存率根治性手术为44.4%,保守性手术为64.0%,差异无显著性。VAC方案与BEP(或VBP)方案的5年生存率分别为33.3%和77.3%(P<0.01)。疗程数≥4患者的5年生存率为73.9%,明显高于疗程数<4患者的38.9%(P<0.05)。认为对于有生育要求的卵巢未成熟畸胎瘤患者,可仅行保守性手术,术后辅以联合化疗。BEP(或VBP)方案对患者长期生存率的改善明显优于VAC方案。术后化疗的疗程数与疗效有关,对长期生存率的影响较明显。  相似文献   
5.
评估控制性卵巢刺激中预测卵巢反应性的指标   总被引:1,自引:0,他引:1  
在辅助生育技术的实施中,控制性卵巢刺激(COS)方案是根据患者情况确定的,在用药剂量和启动时间的掌握上非常重要。由于卵巢本身反应性或基础状态的不同,不同年龄及不同病因的患者有着极大的差异,用量适当可避免因启动剂量过大造成卵巢过度剌激(OHSS),或剂量过少造成低反应,卵泡  相似文献   
6.
7.
目的探讨缺氧条件对卵巢癌细胞Caov-3体外黏附和迁移能力的影响。方法在常氧和缺氧条件下培养卵巢癌细胞Caov-3,分别用四甲基偶氮唑蓝(MTT)比色法和细胞迁移试验测定常氧和缺氧条件下培养的Caov-3细胞体外黏附和迁移能力。结果缺氧条件下,Caov-3细胞在Matrigel和纤维连接蛋白Fn基质上黏附数量增加,黏附促进率分别为17.1%和15.2%,与常氧条件下比较有显著性差异(P<0.05)。缺氧条件下,Caov-3细胞在Matrigel基质上迁移距离增大,分别为258.8±19.5μm和331.3±24.4μm,迁移促进率为28.0%,与常氧条件下比较有显著性差异(P<0.05)。结论缺氧环境对卵巢癌细胞Caov-3体外黏附和迁移具有明显的促进作用。  相似文献   
8.
This study was aimed at assessing the outcome of in-vitro fertilization(IVF) and embryo transfer in patients with polycystic ovariansyndrome (PCOS). The results of IVF and embryo transfer in PCOSpatients (PCOS group, 78 cycles of 26 patients) were comparedwith those of a control group (423 cycles in 202 patients withoutmale factor; age and ovarian stimulation protocol were matched).Although the pregnancy rate per transfer was not different inthe two groups of patients (25 versus 34%, PCOS versus controlgroup), the PCOS group had a significantly lower pregnancy rateper follicle aspiration (19 versus 31%, P < 0.05). A notableresult was a significantly higher incidence of embryo transfercancellations in the PCOS group (22 versus 8%, P < 0.01),which resulted from unpredictable failure of either oocyte recoveryor fertilization. The incidence of unexplained complete failureof fertilization was significantly higher in the PCOS group(18 versus 5%, P < 0.01). These results may reflect a reducedquality of the oocytes in the PCOS group, and there was a subgroupof PCOS patients who repeatedly produced poor results of treatment.Although the ovarian stimulation regimen best suited to PCOSpatients remains to be determined, special care should be takenduring ovarian stimulation, especially when the PCOS patientshad experienced unexplained failure of oocyte recovery or fertilizationin the previous treatment cycle(s).  相似文献   
9.
目的:探讨人卵巢癌标本中,肿瘤转移抑制基因nm23-H1编码蛋白NDPK-A表达的临床意义及其与预后的关系。方法:应用免疫组织化学抗生蛋白链菌素-过氧化酶结合(S-P)法,检测58例人卵巢癌标本中nm23-H1蛋白水平。结果:nm23-H1蛋白的表达与患者手术时是否有淋巴结及大网膜转移相关(P〈0.05),但原发灶与转移灶间的阳性表达率相差不显著;与患者术后生存时间密切相关(P〈0.01),术后生  相似文献   
10.
BACKGROUND: Acne is a multifactorial disease exhibiting distinct clinical presentations. Among them, the catamenial type is a matter of concern for young women. Some oral contraceptives may help without, however, clearing the skin condition. AIM: The present open study aimed at evaluating the effect of overnight applications of a paste made of petrolatum,15% zinc oxide and 0.25% miconazole nitrate. METHOD: The split-face trial was conducted in 35 women. A non-medicated cream was used as control. Clinical evaluations and biometrological assessments on cyanoacrylate follicular biopsies were performed monthly for 3 months. Comedometry and the density in autofluorescent follicular casts were used as analytical parameters. In addition, the five most severe cases at inclusion were tested at the completion of the study for follicular bacterial viability using dual flow cytometry. RESULTS: Compared with baseline and to the control hemi-face, the medicated paste brought significant improvement of acne. The number of papules and their redness were reduced beginning with the first treatment phase. A reduction in the follicular fluorescence was yielded beginning with the second treatment phase. The ratios between injured and dead bacteria, on the one hand, and live bacteria, on the other hand were significantly increased at completion of the study. CONCLUSION: A miconazole paste applied for 1 week at the end of the ovarian cycle has a beneficial effect on catamenial acne.  相似文献   
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