Recombinant Human p53 Adenovirus Injection (rAd-p53) Combined with Chemotherapy for 4 Cases of High-grade Serous Ovarian Cancer

2020 ◽  
Vol 20 (4) ◽  
pp. 313-320
Author(s):  
Hui Qu ◽  
Yu Xia ◽  
Xiuqin Li

Background: High-grade serous ovarian carcinoma (HGSOC) is one of the most common ovarian epithelial carcinomas. It is highly invasive, easily recurs after systemic treatment, and has a poor prognosis. Despite many new chemotherapeutic drugs and trials of combinations of different regimens that have been used in treatment attempts, there has been no meaningful progress in the treatment of HGSOC. With the development of gene sequencing technology, gene therapy has become a new direction for tumors treatment. It is reported that the P53 has a very high mutation rate in HGSOC, which provides a theoretical basis for the application of gene therapy in HGSOC patients. Recombinant human p53 adenovirus injection (rAd-p53) is the world's first approved oncology gene therapy drug. Case Report: In this article, we retrospectively analyzed 4 cases of HGSOC patients treated with rAdp53. Three of them were recurrent ovarian cancer, and one was the initial treatment. The treatment method was to apply recombinant human p53 adenovirus injection (rAd-p53) to the lesions for local injection, 72 hours later, the lesions were injected with bleomycin or fluorouracil, and systemic intravenous chemotherapy was performed simultaneously. After rAd-p53 treatment, one of the three relapsed ovarian cancers achieved complete remission(CR), one achieved partial remission (PR), and one was stable disease (SD); the treatment-naive patient was operated after rAd-p53 combined with neoadjuvant chemotherapy and achieved pathological CR. Under the action of various mechanisms of P53, the subsequent tumor treatment showed the characteristics of slow tumor progression, no ascites, and local recurrence. As of the end of follow-up, the OS of 4 patients was 71-120 months. Conclusion: Through the remarkable efficacy of these 4 cases, we can see that the application of rAdp53 combined with chemotherapy can effectively control tumor lesions, prolong the survival time of patients, improve the quality of life of patients, which provide valuable experiences for rAd-p53 treatment in ovarian cancer, promote the further development and progress of gene therapy in this field.

2001 ◽  
Vol 83 (3) ◽  
pp. 549-554 ◽  
Author(s):  
A. Hasenburg ◽  
X.-W. Tong ◽  
D.C. Fischer, Ph.D. ◽  
A. Rojas-Martinez ◽  
C. Nyberg-Hoffman ◽  
...  

Biomolecules ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1711
Author(s):  
Michelle Bilbao ◽  
Chelsea Katz ◽  
Stephanie L. Kass ◽  
Devon Smith ◽  
Krystal Hunter ◽  
...  

Recurrent high-grade serous ovarian cancer (HGSC) is clinically very challenging and prematurely shortens patients’ lives. Recurrent ovarian cancer is characterized by high tumor heterogeneity; therefore, it is susceptible to epigenetic therapy in classic 2D tissue culture and rodent models. Unfortunately, this success has not translated well into clinical trials. Utilizing a 3D spheroid model over a period of weeks, we were able to compare the efficacy of classic chemotherapy and epigenetic therapy on recurrent ovarian cancer cells. Unexpectedly, in our model, a single dose of paclitaxel alone caused the exponential growth of recurrent high-grade serous epithelial ovarian cancer over a period of weeks. In contrast, this effect is not only opposite under treatment with panobinostat, but panobinostat reverses the repopulation of cancer cells following paclitaxel treatment. In our model, we also demonstrate differences in the drug-treatment sensitivity of classic chemotherapy and epigenetic therapy. Moreover, 3D-derived ovarian cancer cells demonstrate induced proliferation, migration, invasion, cancer colony formation and chemoresistance properties after just a single exposure to classic chemotherapy. To the best of our knowledge, this is the first evidence demonstrating a critical contrast between short and prolonged post-treatment outcomes following classic chemotherapy and epigenetic therapy in recurrent high-grade serous ovarian cancer in 3D culture.


2019 ◽  
Vol 29 (5) ◽  
pp. 916-921
Author(s):  
Alicia Smart ◽  
Yu-Hui Chen ◽  
Teresa Cheng ◽  
Martin King ◽  
Larissa Lee

IntroductionTo evaluate clinical outcomes for patients with localized recurrent ovarian cancer treated with salvage radiotherapy.MethodsIn a retrospective single institutional analysis, we identified 40 patients who received salvage radiotherapy for localized ovarian cancer recurrence from January 1995 to June 2011. Recurrent disease was categorized as: pelvic peritoneal (45%, 18), extraperitoneal/nodal (35%, 14), or vaginal (20%, eight). Actuarial disease-free and overall survival estimates were calculated by Kaplan–Meier and prognostic factors evaluated by the Cox proportional hazards model.ResultsMedian follow-up was 42 months. Median patient age was 54 years (range, 27–78). Histologic subtypes were: serous (58%, 23), endometrioid (15%, six), clear cell (13%, five), mucinous (8%, three), and other (8%, three). At the time of salvage radiotherapy, surgical cytoreduction was performed in 60% (24) and 68% (27) had platinum-sensitive disease. Most patients (63%, 25) received salvage radiotherapy at the time of first recurrence. Relapse after salvage radiotherapy occurred in 29 patients at a median time of 16 months and was outside the radiotherapy field in 62%. 18 At 3 years, disease-free and overall survival rates were 18% and 80%, respectively. On multivariate analysis, non-serous histology (hazards ratio 0.3, 95% CI 0.1–0.7) and platinum-sensitivity (hazards ratio 0.2, 95% CI 0.1–0.5) were associated with lower relapse risk. Platinum-sensitivity was also associated with overall survival (hazards ratio 0.4, 95% CI 0.1–1.0). Four patients (10%) were long-term survivors without recurrence 5 years after salvage radiotherapy. Of the five patients with clear cell histology, none experienced relapse at the time of last follow-up.DiscussionPatients with non-serous and/or platinum-sensitive ovarian cancer had the greatest benefit from salvage radiotherapy for localized recurrent disease. Although relapse was common, radiotherapy prolonged recurrence for > 1 year in most patients and four were long-term survivors.


2010 ◽  
Vol 20 (Suppl 2) ◽  
pp. S24-S26 ◽  
Author(s):  
Peter E. Schwartz

Background:OVO5/EORTC 55855, a study punitively refuting the value of CA-125 in the follow-up of ovarian cancer patients, has many deficiencies, including a heterogeneous ovarian cancer patient population, no control of initial treatment regimens, and no control of subsequent surgery or chemotherapeutic management for recurrence. Recent studies suggest a role for prompt surgery in selected cases of recurrent ovarian cancer with CA-125 elevations, a role for tamoxifen in managing rising CA-125 levels in patients without evidence of disease and the use of platinum doublets for treating recurrent platinum-sensitive disease, none of which were incorporated into OVo5/EORTC 55955.Case:A patient with advanced stage ovarian cancer presenting with a CA-125 level of 2000 U/mL, who is initially treated with surgery followed by chemotherapy and has a normal CT scan and normal CA-125 at completion of her initial chemotherapy.Conclusion:This patient remains at a very high risk for recurrence. I would continue to monitor this patient with serial CA-125 levels to identify recurrent cancer and consider initiating treatment before it is clinically obvious.


2019 ◽  
Vol 8 (11) ◽  
pp. 1920 ◽  
Author(s):  
Paik ◽  
Lee ◽  
Lee ◽  
Shin ◽  
Park ◽  
...  

Background: Olaparib maintenance therapy has shown efficacy and tolerability in patients with platinum-sensitive, high-grade serous recurrent ovarian cancer (HSROC) with BRCA1/2 mutation (BRCAm). Our aim was to present real-world experience with olaparib in Korea. Method: We included HSROC patients with BRCAm treated with olaparib maintenance at four institutions in Korea between 2016 and 2018. Medical records were reviewed for clinico-pathologic characteristics, objective response, survival outcomes, and safety. Results: One hundred HSROC patients with BRCAm were included. BRCA1 mutation was present in 71 patients (71.0%), and BRCA2 mutation was present in 23 patients (23.0%). In terms of the best objective response with olaparib maintenance in 53 patients with partial remission from most recent chemotherapy, complete remission occurred in 12 (22.6%) and partial remission in four (7.5%), while 33 patients (62.3%) had stable disease. The 24 month progression-free survival was 42.4%, and 24 month overall survival was 82.1%. Grade 3 or more adverse events were as follows: anemia in 14 patients (14.0%), neutropenia in seven patients (7.0%), thrombocytopenia in two patients (2.0%), oral mucositis in one patient (1.0%), and soft tissue infection in one patient (1.0%). Conclusions: The safety and effectiveness of olaparib maintenance treatment in a real-world study were consistent with those reported in previous clinical trials.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18083-e18083 ◽  
Author(s):  
Sarah M. Belcher ◽  
Susan M. Sereika ◽  
Zan M. Dodson ◽  
Meghan K. Mattos ◽  
Teresa Hagan ◽  
...  

e18083 Background: Women with recurrent ovarian cancer (OC) experience a wide range of cancer- and treatment-related symptoms that negatively impact quality of life (QOL). Studies have reported healthcare disparities by geographic residence related to distance, time, and financial barriers to accessing high quality care. However, no studies have evaluated the impact of residence on symptoms and QOL in women with OC. Therefore, our objectives were to evaluate whether geographic residence (urban versus rural) is associated with symptoms and QOL in a sample of women with recurrent OC. Methods: The Center for Health Equity Research and Promotion conceptual framework guided analyses of baseline GOG-0259 data. We mapped zip codes to RUCA commuter codes and compared sociodemographic and clinical variables between rural and urban groups using two-sample t and chi-square tests. We used MANCOVA, adjusted for age and marital status, to test for associations between residence and symptoms (Symptom Representation Questionnaire) and QOL (Functional Assessment of Cancer Therapy-Ovarian). Results: Rural (n = 122, 25%) and urban (n = 374, 75%) women were similar in all sociodemographic and clinical comparisons except for marital status (83% vs. 70% married, p = .003). Women reported moderate symptom severity (M = 5.5, SD = 2.3) and QOL scores similar to other OC studies (M = 108.4, SD = 19.5). In multi-variate analyses, age and marital status were both associated with symptoms; marital status was associated with QOL. Geographical residence was not associated with either symptoms or QOL. Conclusions: Counter to previous research, there were no symptom or QOL disparities based on geographic residence in this sample. Possible explanations to be explored in future research include a) cooperative group selection bias for women with good access to care regardless of geographic residence and b) protective effects of marital status on symptoms and QOL.


2016 ◽  
Vol 74 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Marcela dos Reis Bigatão ◽  
Fernanda Maris Peria ◽  
Daniela P. C. Tirapelli ◽  
Carlos Gilberto Carlotti Junior

ABSTRACT Objective To evaluate the effectiveness of an educational program on improvement of fatigue and quality of life of patients with high-grade glioma during radiotherapy and chemotherapy treatment. Method This is a longitudinal, experimental study. Twenty-three patients with high-grade glioma were randomly assigned to one of two groups. Both groups completed the Functional Assessment of Cancer Therapy: Fatigue questionnaire and the Beck Depression Inventory, and one of the groups received the educational intervention. The groups did not show any change in quality of life and fatigue in this study, for this reason, the educational program did not present any significant difference. However, there was a significant difference in depressive symptoms during the educational program showing positive evidence for its applicability.


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