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14 results

Gynaecological Cancers
  • Biology and Therapeutics
  • Edited by Sean Kehoe, Richard J. Edmondson, Martin Gore, Iain A. McNeish
  • Published online:
    05 February 2014
    Print publication:
    01 June 2011
  • Gynaecological cancers are categorised as 'rare' diseases, although collectively they affect over 16,000 women each year in the UK alone. There is a lack of real understanding of these conditions compared with other malignancies, possibly owing to their relative rarity when viewed as individual diseases. The 60th RCOG Study Group brought together a range of experts to examine as many biological aspects of gynaecological cancers as possible, including both surgical and non-surgical therapies. This book presents the findings of the Study Group, with contents including:current understanding of the biology of gynaecological cancerstranslation of biology to the clinicstate of the art in imaging and therapycurrent clinical trialsadvances in multimodal therapyindividualised treatment.

  • 18 - Consensus views arising from the 60th Study Group: Gynaecological Cancers: Biology and therapeutics

  • from SECTION 5 - CONSENSUS VIEWS
  • Edited by Sean Kehoe, Richard J. Edmondson, Martin Gore, Iain A. McNeish
  • Book:
    Gynaecological Cancers
    Published online:
    05 February 2014
    Print publication:
    01 June 2011, pp 245-248

  • Summary

    This chapter discusses the biology of and therapeutics for gynaecological cancers such as vulval cancer, cervical cancer and ovarian cancer. The most common type of ovarian cancer, high-grade serous cancer, is characterised by mutation of the p53 (TP53) gene. All women with newly diagnosed high-grade serous ovarian carcinoma should have an accurate family history taken, and be referred for genetic assessment and considered for BRCA1 and BRCA2 mutation testing if appropriate. Within clinical trials, central pathological review is needed when treatment depends on morphological sub-type or other pathological parameters. Functional imaging in multicentre trials should be implemented with strict quality control to ensure standardisation and reproducibility. Evaluation of novel surgical strategies, such as robotics, should occur through well-conducted clinical trials. In surgery for ovarian cancer, whether carried out as a primary or a delayed procedure, the aim should be to remove all visible disease.

  • Preface

  • Edited by Sean Kehoe, Richard J. Edmondson, Martin Gore, Iain A. McNeish
  • Book:
    Gynaecological Cancers
    Published online:
    05 February 2014
    Print publication:
    01 June 2011, pp xi-xii

  • Summary

    The 60th RCOG Study Group focused on gynaecological cancers, a spectrum of cancers affecting over 16000 women each year in the UK alone. There is a lack of real understanding of these conditions compared with other malignancies, possibly owing to their relative rarity when viewed as individual diseases, which can influence the desire to invest in research.

    The objective of the Study Group was to try to examine as many biological aspects of these cancers as possible, including therapies, both surgical and non-surgical. A wide remit, without doubt, and inevitably not all aspects could be covered in the desired detail.

    While a great deal of research is still needed, it is also clear that progress in therapy is occurring, with new agents such as PARP inhibitors targeting specific defects found only in the cancer cell. This is an approach that is opening a new route to therapy besides the normal direct approach to cell destruction. The knowledge that some pathologies previously considered as a primary ovarian disease are in fact of primary fallopian tube origin may not immediately have an effect on patient care but does have implications for research and clinical trials that will ultimately result in better directed therapies.

    Advances in multimodal therapies, imaging and targeted and individualised treatments, as well as the role of surgical approaches, are all also covered in this book.

    Experts from the UK and abroad have dedicated their time to discuss the varied aspects of these malignancies and I am grateful to all involved.

  • 6 - Implications of homologous recombination defectiveness in ovarian cancer

  • from SECTION 2 - THE TRANSLATION OF BIOLOGY TO THE CLINIC
  • Edited by Sean Kehoe, Richard J. Edmondson, Martin Gore, Iain A. McNeish
  • Book:
    Gynaecological Cancers
    Published online:
    05 February 2014
    Print publication:
    01 June 2011, pp 75-82

  • Summary

    This chapter outlines the DNA repair pathways involved in PARP inhibitor sensitivity, how deficiencies in these pathways are exploited by PARP inhibitors and finally how aberrations of these pathways may be identified and thus used as predictive biomarkers for treatment. Evidence suggests that there can be overlap between the pathways under certain circumstances, for instance in repairing DNA crosslink lesions. There is substantial evidence that tumours associated with germline mutations of the BRCA genes are associated with high initial sensitivity to platinum and overall slightly improved outcome compared with other high-grade serous ovarian cancers. DNA repair pathways would appear to be an attractive target for the development of new therapies. Cancer cells are intrinsically and genetically unstable and therefore susceptible to further DNA damage. Accurate biomarkers would allow identification of people with tumours that are not normally recognised to respond to a particular treatment.