28 research outputs found
TP53 status and taxane-platinum versus platinum-based therapy in ovarian cancer patients: A non-randomized retrospective study
<p>Abstract</p> <p>Background</p> <p>Taxane-platinum therapy (TP) has replaced platinum-based therapy (PC or PAC, DNA damaging chemotherapy) in the postoperative treatment of ovarian cancer patients; however, it is not always effective. TP53 protein plays a differential role in response to DNA-damaging agents and taxanes. We sought to define profiles of patients who benefit the most from TP and also of those who can be treated with PC.</p> <p>Methods</p> <p>We compared the effectiveness of PC/PAC (n = 253) and TP (n = 199) with respect to tumor TP53 accumulation in ovarian cancer patients with FIGO stage IIB-IV disease; this was a non-randomized retrospective study. Immunohistochemical analysis was performed on 452 archival tumors; univariate and multivariate analysis by the Cox's and logistic regression models was performed in all patients and in subgroups with [TP53(+)] and without TP53 accumulation [TP53(-)].</p> <p>Results</p> <p>The advantage of taxane-platinum therapy over platinum-based therapy was seen in the TP53(+), and not in the TP53(-) group. In the TP53(+) group taxane-platinum therapy enhanced the probability of complete remission (p = .018), platinum sensitivity (p = .014), platinum highly sensitive response (p = .038) and longer survival (OS, p = .008). Poor tumor differentiation diminished the advantage from taxane-platinum therapy in the TP53(+) group. In the TP53(-) group PC/PAC was at least equally efficient as taxane-platinum therapy and it enhanced the chance of platinum highly sensitive response (p = .010). However, in the TP53(-) group taxane-platinum therapy possibly diminished the risk of death in patients over 53 yrs (p = .077). Among factors that positively interacted with taxane-platinum therapy in some analyses were endometrioid and clear cell type, FIGO III stage, bulky residual tumor, more advanced age of patient and moderate tumor differentiation.</p> <p>Conclusion</p> <p>Our results suggest that taxane-platinum therapy is particularly justified in patients with TP53(+) tumors or older than 53 years. In the group of patients ≤53 yrs and with TP53(-) tumors platinum-based therapy is possibly equally efficient. We provide hints for planning randomized trials to verify these observations.</p
Endometrial cancer
Endometrial cancer is the most common gynecological
malignancy in well-developed countries.
Biologically and clinicopathologically,
endometrial carcinomas are divided into two
types: type 1 or estrogen-dependent carcinomas
and type 2 or estrogen-independent carcinomas.
Type 1 cancers correspond mainly to endometrioid
carcinomas and account for approximately
90 % of endometrial cancers, whereas
type 2 cancers correspond to the majority of the
other histopathological subtypes.
The vast majority of endometrial cancers
present as abnormal vaginal bleedings in
postmenopausal women. Therefore, 75 % of
cancers are diagnosed at an early stage, which
makes the overall prognosis favorable.
The first diagnostic step to evaluate women
with an abnormal vaginal bleeding is the measurement
of the endometrial thickness with
transvaginal ultrasound. If endometrial thickening
or heterogeneity is confirmed, a biopsy
should be performed to establish a definite
histopathological diagnosis.
Magnetic resonance imaging is not considered
in the International Federation of Gynaecology
and Obstetrics staging system. Nonetheless it
plays a relevant role in the preoperative staging of
endometrial carcinoma, helping to define the best
therapeutic management. Moreover, it is important
in the diagnosis of treatment complications,
in the surveillance of therapy response, and in the
assessment of recurrent disease.info:eu-repo/semantics/publishedVersio