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Pelvic malignancies in older patients: New drugs in the elderly?
S22
J O U RN A L OF GE RI A T RI C O NC OL O G Y 3 ( 2 01 2 ) S 1 0 –S2 5
As an example, there is no doubt that a 92-year old demented patient with prostate carcinoma, tongue carcinoma, hairy cell leukemia, and who is incapable of communicating and eating by himself, with no advanced directives would be considered frail; however, what if the family requests surgery? radiation therapy? chemotherapy? immunotherapy? Should the patient be denied modern therapeutic means on the basis of its obvious frailty? The question here remains unanswered. 1
Not all the biographies were available at time of printing.
doi:10.1016/j.jgo.2012.10.163
F29 Improving outcomes in elective surgery1 J.K. Dhesi. Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London, UK With changes in demographics, in surgical and anaesthetic techniques and in patient expectations, increasing numbers of older people are undergoing elective surgery. Although it is well established that this group has much to gain in terms of morbidity and mortality, it is also recognised that older people remain more likely to ‘fail the pre-assessment’ (not have surgery) than younger people, and furthermore those who do have surgery have higher rates of post-operative complications. From a geriatrician's perspective, opportunities to improve outcomes after elective surgery are being missed. First, at the pre-assessment stage; the prevalent model is for the patient to be assessed by a surgical nurse or doctor, with no specific expertise in optimising the patient. This occurs despite the wealth of evidence demonstrating improved outcomes if comorbidities (such as anaemia, cardiac disease, respiratory disease, diabetes etc.) are appropriately assessed and treated. Second at the peri-operative stage, the anaesthetist sees the patient on the day of surgery, with limited information from the pre-assessment clinic, and is less likely to adjust peri-operative care to improve outcome in older patients. Third, at the postoperative stage, medical care is provided by junior surgical staff, with advice from on-call teams, lacking in expertise in management of older people with multiple comorbidities. Proactive care of older people undergoing surgery (POPS) provides an alternative model, with an elderly care team involved throughout the surgical journey. In this talk I will expand on this model and describe some of the interventions and benefits. 1
Methods: A perioperative protocol based on fast-track surgery principles and techincal modifications of the surgical techinque was applied to bladder cancer patient candidates for etherotopic bladder substitution. Our protocol included pre-, intra-, and post-operative interventions. The technical variations of the modified Indiana Pouch tecnique were focused on the intestinal anastomosis to restore bowel continuity, the ureterocolonic anastomoses, and the capacity of the reservoir. Results: From 2003 and 2010, 68 consecutive patients partecipated in the study. Two patients died due to surgical complications (2.9%). Overall, 24 of 68 patients experienced complications (35.3%). Surgery was needed under general anaesthesia for 7 patients (10.2%) and under local anaesthesia for 4 (5.9%). Medical complications were encountered in 13 of 68 patients (19.1%). According to Clavien grading, complications were grade 5 in 2 patients, grade 4 in 2 patients, grade 3b in 5 patients, grade 3a in 4 patients, grade 2 in 9 patients and grade 1b in 2 patients (see Table 1). A limitation of our series is that patients were recruited at a single urologic centre and were operated by a single surgeon. Findings need validation. Conclusions: Progress in the perioperative management of major surgery and technical refinements can contribute to reduced complications. In addition, the use of objective reporting tools will facilitate comparison of studies.
Table 1 Postoperative complications.
Not all the biographies were available at time of printing.
doi:10.1016/j.jgo.2012.10.164 1
Major surgical: pts n°
Clavien grade pts n°
Death 2 Dehiscence intestinal anastomosis 1 Jejunal cannula displacement 1 Uretero-colonic anastomosis stricture 1 Ureteral stone 1 Afferent ileal limb re-alignment 1
V2 III b 5
Minor surgical: Wound dehiscence 3 Stoma mucosal prolapse 1
III a 4
Major medical Myocardial infarction 1 Sepsis 1
IV 2
Minor medical Cl. Difficilis colitis 2 Urinary infection 1 Delirium 4 Failure to thrive 2 Permanent catheter 2 Total 24
II 9
Id2 Total 24
Not all the biographies were available at time of printing.
Pelvic Malignancies in Older Patients doi:10.1016/j.jgo.2012.10.165 F30 Surgical excision and recontruction for bladdder cancer1 Massimo Maffezzini. Department of Urology, E.O. Ospedali Galliera, Genova, Italy Purpose of the study: The population of patients aged 75 years , or more, has increased in the last decades. As a consequence, an increase of age related diseases as cancer and chronic illnesses is currently observed. As an example, about 35% of patient candidates to radical cystectomy at presentation have one or more co-morbidities putting the patients at increased risk of peri-operative complications. Our purpose was to reduce the complications of radical cystectomy and intestinal urinary reconstruction for bladder cancer.
F31 Pelvic malignancies in older patients: New drugs in the elderly?1 H. Boyle. Medecine department, Centre Léon Bérard, 28 rue Laënnec 69008 Lyon, France Pelvic tumours occur frequently in the elderly. Several new drugs have been developed in the last few years. Among them, there are new hormonal therapies for prostate cancer such as abiraterone acetate and enzalutamide.1,2 There are also new chemotherapy drugs such as cabazitaxel in prostate cancer,3 vinflunine in bladder cancer,4,5 pegylated liposomal doxorubicin6–8 and trabectidin in
J O U RN A L OF GE RI A T RI C O NC OL O G Y 3 ( 2 01 2 ) S 1 0 –S2 5
ovarian cancer9. Bevacizumab has also been approved for ovarian cancer.10–12 The two new hormonal therapies were studied in similar trials, in men with metastatic castration resistant prostate cancer, after docetaxel.1,2 Median age was 69 years (range 41–95). More than a quarter of the patients were over 75. The overall survival benefit seen in the whole group was found in the subgroup analysis of patients over 65 too. Toxicity with abiraterone was mainly related to its minerlocorticoid effect (hypertension, fluid retention and hypokalemia). This should be carefully monitored. The main side effects of enzalutamide are fatigue, nausea and hot flushes. It seems that these 2 drugs can be used in elderly patients. Cabazitaxel, a novel taxane, was compared to mitoxantrone in patients with metastatic castration resistant prostate cancer and showed an improvement in overall survival (OS).3 Less than 20% were older than 75. Sub-group analysis shows a benefit also in patients ≥65 years. However toxicity is more important than with docetaxel (neutropenic fever, diarrhoea, fatigue) and the use of this drug may be difficult in older patients. Vinflunine was compared to best supportive care in patients with advanced urothelial carcinomas after a platinum based regimen.4 More than half of the patients were younger than 65. Vinflunine provides a 2-month prolongation in median survival. Toxicity was frequent: neutropenia, thombocytopenia, nausea, constipation, asthenia, abdominal pain and stomatitis. Based on data from phase I trials, it is recommended to start vinflunine at lower dose in patients over 75.5 Pegylated liposomal doxorubicin (PLD) in association with carboplatin was compared to carboplatin + paclitaxel in first line (MITO-2) or in recurrent ovarian carcinoma (CALYPSO).6,7 Median age was young in both trials (57 and 60.5 years). The subgroup analysis of the 16% of patients older than 70 enrolled, in the noninferiority CALYPSO trial, shows no difference in progression free survival (PFS) between the 2 regimens and less toxicity with the PLD regimen.8 These results are similar to those in the whole trial. Trabectidin was also studied in recurrent ovarian cancer in combination with PLD.9 No benefit was seen in patients older than 65, despite a PFS and OS benefit in the whole study group. Bevacizumab has been recently approved for ovarian cancer. It was studied in first line or at relapse.10–12 Median age in the trials was less than 65. The benefit in PFS seen in the whole trials was seen in every age sub-group. However toxicity is a concern. Despite elderly patients having been enrolled in the trials, the routine use of these drugs in the general elderly population is not easy and should be taken carefully. Specific trials are still needed. References [1] de Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L, Chi KN, Jones RJ, Goodman Jr OB, Saad F, Staffurth JN, Mainwaring P, Harland S, Flaig TW, Hutson TE, Cheng T, Patterson H, Hainsworth JD, Ryan CJ, Sternberg CN, Ellard SL, Fléchon A, Saleh M, Scholz M, Efstathiou E, Zivi A, Bianchini D, Loriot Y, Chieffo N, Kheoh T, Haqq CM, Scher HI, COU-AA-301 Investigators. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med May 26 2011;364(21):1995–2005. [2] Scher HI, Fizazi K, Saad F, Taplin ME, Sternberg CN, Miller MD, de Wit R, Mulders P, Chi KN, Shore ND, Armstrong AJ, Flaig TW, Fléchon A, Mainwaring P, Fleming M, Hainsworth JD, Hirmand M, Selby B, Seely L, de Bono JS, the AFFIRM Investigators. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med Aug 15 2012. [3] de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I, Gravis G, Bodrogi I, Mackenzie MJ, Shen L, Roessner M, Gupta S, Sartor AO, TROPIC Investigators. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet Oct 2 2010;376(9747):1147–1154.
[4]
[5] [6]
[7]
[8]
[9]
[10]
[11]
[12]
1
S23
Bellmunt J, Théodore C, Demkov T, Komyakov B, Sengelov L, Daugaard G, Caty A, Carles J, Jagiello-Gruszfeld A, Karyakin O, Delgado FM, Hurteloup P, Winquist E, Morsli N, Salhi Y, Culine S, von der Maase H. Phase III trial of vinflunine plus best supportive care compared with best supportive care alone after a platinum-containing regimen in patients with advanced transitional cell carcinoma of the urothelial tract. J Clin Oncol Sep 20 2009;27(27):4454–4461. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR__Product_Information/human/000983/WC500039604.pdf Pignata S, Scambia G, Ferrandina G, Savarese A, Sorio R, Breda E, Gebbia V, Musso P, Frigerio L, Del Medico P, Lombardi AV, Febbraro A, Scollo P, Ferro A, Tamberi S, Brandes A, Ravaioli A, Valerio MR, Aitini E, Natale D, Scaltriti L, Greggi S, Pisano C, Lorusso D, Salutari V, Legge F, Di Maio M, Morabito A, Gallo C, Perrone F. Carboplatin plus paclitaxel versus carboplatin plus pegylated liposomal doxorubicin as first-line treatment for patients with ovarian cancer: the MITO-2 randomized phase III trial. J Clin Oncol Sep 20 2011;29(27):3628–3635. Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E, Gebski V, Heywood M, Vasey PA, Volgger B, Vergote I, Pignata S, Ferrero A, Sehouli J, Lortholary A, Kristensen G, Jackisch C, Joly F, Brown C, Le Fur N, du Bois A. Pegylated liposomal doxorubicin and carboplatin compared with paclitaxel and carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol Jul 10 2010;28(20):3323–3329. Kurtz JE, Kaminsky MC, Floquet A, Veillard AS, Kimmig R, Dorum A, Elit L, Buck M, Petru E, Reed N, Scambia G, Varsellona N, Brown C, Pujade-Lauraine E, Gynecologic Cancer Intergroup. Ovarian cancer in elderly patients: carboplatin and pegylated liposomal doxorubicin versus carboplatin and paclitaxel in late relapse: a Gynecologic Cancer Intergroup (GCIG) CALYPSO sub-study. Ann Oncol Nov 2011;22(11):2417–2423. Monk BJ, Herzog TJ, Kaye SB, Krasner CN, Vermorken JB, Muggia FM, Pujade-Lauraine E, Lisyanskaya AS, Makhson AN, Rolski J, Gorbounova VA, Ghatage P, Bidzinski M, Shen K, Ngan HY, Vergote IB, Nam JH, Park YC, Lebedinsky CA, Poveda AM. Trabectedin plus pegylated liposomal doxorubicin in recurrent ovarian cancer. J Clin Oncol Jul 1 2010;28(19):3107–3114. Perren TJ, Swart AM, Pfisterer J, Ledermann JA, PujadeLauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM, ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med Dec 29 2011;365(26):2484–2496. Burger RA, Brady MF, Bookman MA, Fleming GF, Monk BJ, Huang H, Mannel RS, Homesley HD, Fowler J, Greer BE, Boente M, Birrer MJ, Liang SX, Gynecologic Oncology Group. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med Dec 29 2011;365(26):2473–2483. Aghajanian C, Blank SV, Goff BA, Judson PL, Teneriello MG, Husain A, Sovak MA, Yi J, Nycum LR. OCEANS: a randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinumsensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J Clin Oncol Jun 10 2012;30(17):2039–2045.
Not all the biographies were available at time of printing.
doi:10.1016/j.jgo.2012.10.166
J O U RN A L OF GE RI A T RI C O NC OL O G Y 3 ( 2 01 2 ) S 1 0 –S2 5
As an example, there is no doubt that a 92-year old demented patient with prostate carcinoma, tongue carcinoma, hairy cell leukemia, and who is incapable of communicating and eating by himself, with no advanced directives would be considered frail; however, what if the family requests surgery? radiation therapy? chemotherapy? immunotherapy? Should the patient be denied modern therapeutic means on the basis of its obvious frailty? The question here remains unanswered. 1
Not all the biographies were available at time of printing.
doi:10.1016/j.jgo.2012.10.163
F29 Improving outcomes in elective surgery1 J.K. Dhesi. Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London, UK With changes in demographics, in surgical and anaesthetic techniques and in patient expectations, increasing numbers of older people are undergoing elective surgery. Although it is well established that this group has much to gain in terms of morbidity and mortality, it is also recognised that older people remain more likely to ‘fail the pre-assessment’ (not have surgery) than younger people, and furthermore those who do have surgery have higher rates of post-operative complications. From a geriatrician's perspective, opportunities to improve outcomes after elective surgery are being missed. First, at the pre-assessment stage; the prevalent model is for the patient to be assessed by a surgical nurse or doctor, with no specific expertise in optimising the patient. This occurs despite the wealth of evidence demonstrating improved outcomes if comorbidities (such as anaemia, cardiac disease, respiratory disease, diabetes etc.) are appropriately assessed and treated. Second at the peri-operative stage, the anaesthetist sees the patient on the day of surgery, with limited information from the pre-assessment clinic, and is less likely to adjust peri-operative care to improve outcome in older patients. Third, at the postoperative stage, medical care is provided by junior surgical staff, with advice from on-call teams, lacking in expertise in management of older people with multiple comorbidities. Proactive care of older people undergoing surgery (POPS) provides an alternative model, with an elderly care team involved throughout the surgical journey. In this talk I will expand on this model and describe some of the interventions and benefits. 1
Methods: A perioperative protocol based on fast-track surgery principles and techincal modifications of the surgical techinque was applied to bladder cancer patient candidates for etherotopic bladder substitution. Our protocol included pre-, intra-, and post-operative interventions. The technical variations of the modified Indiana Pouch tecnique were focused on the intestinal anastomosis to restore bowel continuity, the ureterocolonic anastomoses, and the capacity of the reservoir. Results: From 2003 and 2010, 68 consecutive patients partecipated in the study. Two patients died due to surgical complications (2.9%). Overall, 24 of 68 patients experienced complications (35.3%). Surgery was needed under general anaesthesia for 7 patients (10.2%) and under local anaesthesia for 4 (5.9%). Medical complications were encountered in 13 of 68 patients (19.1%). According to Clavien grading, complications were grade 5 in 2 patients, grade 4 in 2 patients, grade 3b in 5 patients, grade 3a in 4 patients, grade 2 in 9 patients and grade 1b in 2 patients (see Table 1). A limitation of our series is that patients were recruited at a single urologic centre and were operated by a single surgeon. Findings need validation. Conclusions: Progress in the perioperative management of major surgery and technical refinements can contribute to reduced complications. In addition, the use of objective reporting tools will facilitate comparison of studies.
Table 1 Postoperative complications.
Not all the biographies were available at time of printing.
doi:10.1016/j.jgo.2012.10.164 1
Major surgical: pts n°
Clavien grade pts n°
Death 2 Dehiscence intestinal anastomosis 1 Jejunal cannula displacement 1 Uretero-colonic anastomosis stricture 1 Ureteral stone 1 Afferent ileal limb re-alignment 1
V2 III b 5
Minor surgical: Wound dehiscence 3 Stoma mucosal prolapse 1
III a 4
Major medical Myocardial infarction 1 Sepsis 1
IV 2
Minor medical Cl. Difficilis colitis 2 Urinary infection 1 Delirium 4 Failure to thrive 2 Permanent catheter 2 Total 24
II 9
Id2 Total 24
Not all the biographies were available at time of printing.
Pelvic Malignancies in Older Patients doi:10.1016/j.jgo.2012.10.165 F30 Surgical excision and recontruction for bladdder cancer1 Massimo Maffezzini. Department of Urology, E.O. Ospedali Galliera, Genova, Italy Purpose of the study: The population of patients aged 75 years , or more, has increased in the last decades. As a consequence, an increase of age related diseases as cancer and chronic illnesses is currently observed. As an example, about 35% of patient candidates to radical cystectomy at presentation have one or more co-morbidities putting the patients at increased risk of peri-operative complications. Our purpose was to reduce the complications of radical cystectomy and intestinal urinary reconstruction for bladder cancer.
F31 Pelvic malignancies in older patients: New drugs in the elderly?1 H. Boyle. Medecine department, Centre Léon Bérard, 28 rue Laënnec 69008 Lyon, France Pelvic tumours occur frequently in the elderly. Several new drugs have been developed in the last few years. Among them, there are new hormonal therapies for prostate cancer such as abiraterone acetate and enzalutamide.1,2 There are also new chemotherapy drugs such as cabazitaxel in prostate cancer,3 vinflunine in bladder cancer,4,5 pegylated liposomal doxorubicin6–8 and trabectidin in
J O U RN A L OF GE RI A T RI C O NC OL O G Y 3 ( 2 01 2 ) S 1 0 –S2 5
ovarian cancer9. Bevacizumab has also been approved for ovarian cancer.10–12 The two new hormonal therapies were studied in similar trials, in men with metastatic castration resistant prostate cancer, after docetaxel.1,2 Median age was 69 years (range 41–95). More than a quarter of the patients were over 75. The overall survival benefit seen in the whole group was found in the subgroup analysis of patients over 65 too. Toxicity with abiraterone was mainly related to its minerlocorticoid effect (hypertension, fluid retention and hypokalemia). This should be carefully monitored. The main side effects of enzalutamide are fatigue, nausea and hot flushes. It seems that these 2 drugs can be used in elderly patients. Cabazitaxel, a novel taxane, was compared to mitoxantrone in patients with metastatic castration resistant prostate cancer and showed an improvement in overall survival (OS).3 Less than 20% were older than 75. Sub-group analysis shows a benefit also in patients ≥65 years. However toxicity is more important than with docetaxel (neutropenic fever, diarrhoea, fatigue) and the use of this drug may be difficult in older patients. Vinflunine was compared to best supportive care in patients with advanced urothelial carcinomas after a platinum based regimen.4 More than half of the patients were younger than 65. Vinflunine provides a 2-month prolongation in median survival. Toxicity was frequent: neutropenia, thombocytopenia, nausea, constipation, asthenia, abdominal pain and stomatitis. Based on data from phase I trials, it is recommended to start vinflunine at lower dose in patients over 75.5 Pegylated liposomal doxorubicin (PLD) in association with carboplatin was compared to carboplatin + paclitaxel in first line (MITO-2) or in recurrent ovarian carcinoma (CALYPSO).6,7 Median age was young in both trials (57 and 60.5 years). The subgroup analysis of the 16% of patients older than 70 enrolled, in the noninferiority CALYPSO trial, shows no difference in progression free survival (PFS) between the 2 regimens and less toxicity with the PLD regimen.8 These results are similar to those in the whole trial. Trabectidin was also studied in recurrent ovarian cancer in combination with PLD.9 No benefit was seen in patients older than 65, despite a PFS and OS benefit in the whole study group. Bevacizumab has been recently approved for ovarian cancer. It was studied in first line or at relapse.10–12 Median age in the trials was less than 65. The benefit in PFS seen in the whole trials was seen in every age sub-group. However toxicity is a concern. Despite elderly patients having been enrolled in the trials, the routine use of these drugs in the general elderly population is not easy and should be taken carefully. Specific trials are still needed. References [1] de Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L, Chi KN, Jones RJ, Goodman Jr OB, Saad F, Staffurth JN, Mainwaring P, Harland S, Flaig TW, Hutson TE, Cheng T, Patterson H, Hainsworth JD, Ryan CJ, Sternberg CN, Ellard SL, Fléchon A, Saleh M, Scholz M, Efstathiou E, Zivi A, Bianchini D, Loriot Y, Chieffo N, Kheoh T, Haqq CM, Scher HI, COU-AA-301 Investigators. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med May 26 2011;364(21):1995–2005. [2] Scher HI, Fizazi K, Saad F, Taplin ME, Sternberg CN, Miller MD, de Wit R, Mulders P, Chi KN, Shore ND, Armstrong AJ, Flaig TW, Fléchon A, Mainwaring P, Fleming M, Hainsworth JD, Hirmand M, Selby B, Seely L, de Bono JS, the AFFIRM Investigators. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med Aug 15 2012. [3] de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I, Gravis G, Bodrogi I, Mackenzie MJ, Shen L, Roessner M, Gupta S, Sartor AO, TROPIC Investigators. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet Oct 2 2010;376(9747):1147–1154.
[4]
[5] [6]
[7]
[8]
[9]
[10]
[11]
[12]
1
S23
Bellmunt J, Théodore C, Demkov T, Komyakov B, Sengelov L, Daugaard G, Caty A, Carles J, Jagiello-Gruszfeld A, Karyakin O, Delgado FM, Hurteloup P, Winquist E, Morsli N, Salhi Y, Culine S, von der Maase H. Phase III trial of vinflunine plus best supportive care compared with best supportive care alone after a platinum-containing regimen in patients with advanced transitional cell carcinoma of the urothelial tract. J Clin Oncol Sep 20 2009;27(27):4454–4461. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR__Product_Information/human/000983/WC500039604.pdf Pignata S, Scambia G, Ferrandina G, Savarese A, Sorio R, Breda E, Gebbia V, Musso P, Frigerio L, Del Medico P, Lombardi AV, Febbraro A, Scollo P, Ferro A, Tamberi S, Brandes A, Ravaioli A, Valerio MR, Aitini E, Natale D, Scaltriti L, Greggi S, Pisano C, Lorusso D, Salutari V, Legge F, Di Maio M, Morabito A, Gallo C, Perrone F. Carboplatin plus paclitaxel versus carboplatin plus pegylated liposomal doxorubicin as first-line treatment for patients with ovarian cancer: the MITO-2 randomized phase III trial. J Clin Oncol Sep 20 2011;29(27):3628–3635. Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E, Gebski V, Heywood M, Vasey PA, Volgger B, Vergote I, Pignata S, Ferrero A, Sehouli J, Lortholary A, Kristensen G, Jackisch C, Joly F, Brown C, Le Fur N, du Bois A. Pegylated liposomal doxorubicin and carboplatin compared with paclitaxel and carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol Jul 10 2010;28(20):3323–3329. Kurtz JE, Kaminsky MC, Floquet A, Veillard AS, Kimmig R, Dorum A, Elit L, Buck M, Petru E, Reed N, Scambia G, Varsellona N, Brown C, Pujade-Lauraine E, Gynecologic Cancer Intergroup. Ovarian cancer in elderly patients: carboplatin and pegylated liposomal doxorubicin versus carboplatin and paclitaxel in late relapse: a Gynecologic Cancer Intergroup (GCIG) CALYPSO sub-study. Ann Oncol Nov 2011;22(11):2417–2423. Monk BJ, Herzog TJ, Kaye SB, Krasner CN, Vermorken JB, Muggia FM, Pujade-Lauraine E, Lisyanskaya AS, Makhson AN, Rolski J, Gorbounova VA, Ghatage P, Bidzinski M, Shen K, Ngan HY, Vergote IB, Nam JH, Park YC, Lebedinsky CA, Poveda AM. Trabectedin plus pegylated liposomal doxorubicin in recurrent ovarian cancer. J Clin Oncol Jul 1 2010;28(19):3107–3114. Perren TJ, Swart AM, Pfisterer J, Ledermann JA, PujadeLauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM, ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med Dec 29 2011;365(26):2484–2496. Burger RA, Brady MF, Bookman MA, Fleming GF, Monk BJ, Huang H, Mannel RS, Homesley HD, Fowler J, Greer BE, Boente M, Birrer MJ, Liang SX, Gynecologic Oncology Group. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med Dec 29 2011;365(26):2473–2483. Aghajanian C, Blank SV, Goff BA, Judson PL, Teneriello MG, Husain A, Sovak MA, Yi J, Nycum LR. OCEANS: a randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinumsensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J Clin Oncol Jun 10 2012;30(17):2039–2045.
Not all the biographies were available at time of printing.
doi:10.1016/j.jgo.2012.10.166