Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 46
Filter
1.
Front Oncol ; 11: 785102, 2021.
Article in English | MEDLINE | ID: covidwho-1834497

ABSTRACT

BACKGROUND: The present COVID-19 pandemic has tended toward normality. To provide convenient, safe, and effective home treatment programs for patients with recurrent ovarian cancer (ROC), the clinical efficacy and safety of poly (ADP-ribose) polymerase inhibitor (PARPi) (including olaparib, niraparib, and rucaparib) monotherapy as a maintenance treatment for platinum-sensitive ROC were systematically evaluated. METHODS: Numerous electronic databases were systematically searched for randomized controlled trials (RCTs) of PARPi maintenance treatment for ROC that were published before June 2021. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoint was grade 3-4 adverse effects (AEs). After data extraction and the quality evaluation of the included studies, Bayesian network meta-analysis (NMA) was performed using R software. The ability of each treatment was ranked using the surface under the cumulative ranking (SUCRA) curve. RESULTS: The analysis included five studies and 1390 patients. The NMA results demonstrated that compared with the placebo, olaparib and niraparib exhibited significant benefits in the gBRCA-mutated population, and respectively reduced the risk of death by 31% (HR = 0.69, 95% CI: 0.53-0.90) and 34% (HR = 0.66, 95% CI: 0.44-0.99). Olaparib, niraparib, and rucaparib were all found to be very effective in prolonging PFS in patients with ROC. All three PARPi treatments increased the number of grade 3-4 AEs in patients with ROC as compared with the placebo. CONCLUSIONS: Overall, olaparib and niraparib maintenance treatment can significantly prolong the OS of patients with gBRCA mutations. Furthermore, the three investigated PARPi monotherapy maintenance treatments can prolong PFS regardless of BRCA mutation status. Although the incidence of AEs in the treatment groups was found to be significantly higher than that in the placebo group, the patients in the treatment group tolerated the treatment. Home oral PARPi treatment can balance tumor treatment and pandemic prevention and control, and is the most convenient, safe, and effective home treatment method available against the background of the current COVID-19 pandemic. SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/inplasy-2021-6-0033/.

2.
In Vivo ; 36(3): 1337-1341, 2022.
Article in English | MEDLINE | ID: covidwho-1818961

ABSTRACT

BACKGROUND/AIM: The COVID-19 pandemic has significantly influenced the management of oncogynecologic patients in regard to time of diagnosis, to delay of treatment, therapeutic strategy and postoperative complications. The aim of the study was to investigate the impact of preoperative SARS-Cov2 infection on the postoperative outcome after debulking surgery for ovarian cancer. PATIENTS AND METHODS: Between June 2021 and September 2021, 12 patients with antecedents of COVID-19 infection and ovarian cancer were submitted to surgery at "Dr. I. Cantacuzino" Hospital, Bucharest, Romania. Their outcomes were compared to those reported in a similar group of patients submitted to surgery during the same period in the absence of COVID-19 infection. RESULTS: Although preoperative data showed no statistically significant differences between the two groups, intraoperative length and estimated blood loss were higher in the COVID-19 group and so were the postoperative complications, the most commonly encountered ones being reported by wound infection, postoperative hemoperitoneum and pneumonia. However, the differences did not reach statistical significance. CONCLUSION: Preoperative COVID-19 infection seems to slightly increase the risk of postoperative complications after debulking surgery for ovarian cancer.


Subject(s)
COVID-19 , Ovarian Neoplasms , Carcinoma, Ovarian Epithelial , Female , Humans , Ovarian Neoplasms/complications , Ovarian Neoplasms/surgery , Pandemics , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Period , RNA, Viral , Retrospective Studies , SARS-CoV-2
3.
Front Endocrinol (Lausanne) ; 13: 845404, 2022.
Article in English | MEDLINE | ID: covidwho-1809370

ABSTRACT

The borderless transmission of coronavirus remains uncontrolled globally. The uncharted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant reduces the therapeutic efficacy of vaccines against coronavirus disease 2019 (COVID-19). Clinical observations suggest that tumour cases are highly infected with coronavirus, possibly due to immunologic injury, causing a higher COVID-19-related death toll. Presently, screening of candidate medication against coronavirus is in progress. Mogroside V, a bioactive ingredient of Siraitia grosvenorii, has been reported in China to have lung-protective and anticancer effects. The current study used network pharmacology and molecular docking to unlock the potential drug targets and remedial mechanisms of mogroside V against patients with ovarian cancer with COVID-19. We identified 24 related targets of mogroside V in patients with ovarian cancer and COVID-19 and characterised another 10 core targets of mogroside V against COVID-19 ovarian cancer, including Jun, IL2, HSP90AA1, AR, PRKCB, VEGFA, TLR9, TLR7, STAT3, and PRKCA. The core targets' biological processes and signalling pathways were revealed by enrichment analysis. Molecular docking suggested favourable docking between core target protein and mogroside V, including vascular endothelial growth factor A (VEGFA). These findings indicated that mogroside V might be a potential therapeutic agent in the mitigation of COVID-19 ovarian cancer.


Subject(s)
COVID-19 , Ovarian Neoplasms , COVID-19/drug therapy , Female , Humans , Molecular Docking Simulation , Ovarian Neoplasms/drug therapy , SARS-CoV-2 , Triterpenes , Vascular Endothelial Growth Factor A
4.
Curr Oncol ; 29(4): 2835-2847, 2022 Apr 17.
Article in English | MEDLINE | ID: covidwho-1792785

ABSTRACT

This review of the meaningful data from 2021 on cervical, endometrial, and ovarian cancers aims to provide an update of the most clinically relevant studies presented at important oncologic congresses during the year (the American Society of Clinical Oncology (ASCO) Annual Meeting, the European Society for Medical Oncology (ESMO) Congress and the Society of Gynecologic Oncology (SGO) Annual Meeting). Despite the underlying existence of the COVID-19 pandemic, the last year has been notable in terms of research, with significant and promising advances in gynecological malignancies. Several major studies reporting the effects of innovative therapies for patients with cervical, endometrial, and ovarian cancers might change the medical practice in the future.


Subject(s)
COVID-19 , Gynecology , Ovarian Neoplasms , Female , Humans , Medical Oncology , Ovarian Neoplasms/drug therapy , Pandemics
5.
Hum Exp Toxicol ; 41: 9603271221089257, 2022.
Article in English | MEDLINE | ID: covidwho-1789083

ABSTRACT

BACKGROUND: Remdesivir is an anti-viral drug that inhibits RNA polymerase. In 2020, remdesivir was recognized as the most promising therapeutic agents against coronavirus disease 2019 (COVID-19). However, the effects of remdesivir on cancers have hardly been studied. PURPOSE: Here, we reported that the anti-carcinogenic effect of remdesivir on SKOV3 cells, one of human ovarian cancer cell lines. RESEARCH DESIGN: We anlalyzed the anti-carcarcinogenic effect of remdesivir in SKOV3 cells by performing in vitro cell assay and western blotting. RESULTS: WST-1 showed that remdesivir decreased cell viability in SKOV3 cells. Experiments conducted by Muse Cell Analyzer showed that remdesivir-induced apoptosis in SKOV3 cells. We found that the expression level of FOXO3, Bax, and Bim increased, whereas Bcl-2, caspase-3, and caspase-7 decreased by remdesivir in SKOV3 cells. Furthermore, we observed that intracellular reactive oxygen species (ROS) level increased after treatment of remdesivir in SKOV3 cells. Interestingly, cytotoxicity of remdesivir decreased after treatment of N-Acetylcysteine. CONCLUSION: Taken together, our results demonstrated that remdesivir has an anti-carcinogenic effect on SKOV3 cells vis up-regulation of reactive oxygen species, which suggests that remdesivir could be a promising reagent for treatment of ovarian cancer.


Subject(s)
Anticarcinogenic Agents , COVID-19 , Ovarian Neoplasms , Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Anticarcinogenic Agents/pharmacology , Apoptosis , COVID-19/drug therapy , Cell Line, Tumor , Cell Proliferation , Female , Humans , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/genetics , Ovarian Neoplasms/metabolism , Reactive Oxygen Species/metabolism
6.
BMJ : British Medical Journal (Online) ; 377, 2022.
Article in English | ProQuest Central | ID: covidwho-1784795
7.
J Med Case Rep ; 16(1): 119, 2022 Mar 22.
Article in English | MEDLINE | ID: covidwho-1753123

ABSTRACT

PURPOSE: During the severe acute respiratory syndrome coronavirus 2 pandemic, several patient groups are at particular risk. Mortality is higher among cancer patients and may be increased further by thromboembolic events, which are more common in coronavirus 2019 patients according to recent publications. We discuss the association of gynecologic malignancies, Severe acute respiratory syndrome coronavirus 2, and thromboembolism by reporting a case study and summarizing available literature. CASE REPORT: A 71-year-old Caucasian patient with ovarian cancer receiving first-line chemotherapy was diagnosed with deep vein thrombosis and pulmonary embolism. Routine screening revealed infection with severe acute respiratory syndrome coronavirus 2 in absence of specific symptoms. After uneventful recovery, oncologic treatment could be continued a few weeks later. METHODS: We performed a systematic review of the literature on PubMed following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The search included articles ahead of print, published between 1 December 2019 and 1 June 2020. Cross-searches were conducted on all relevant articles. RESULTS: We identified five articles meeting the defined criteria, including two retrospective studies, a review, a position paper, as well as a letter to the editor. CONCLUSION: Cancer patients infected with severe acute respiratory syndrome coronavirus 2 have a relatively poor outcome, which may partially be due to a higher rate of thromboembolic events. Thromboprophylaxis is recommended, and scoring systems are helpful in early detection. In cancer patients with severe acute respiratory syndrome coronavirus 2, individual risk for thromboembolic events should be taken into account when considering interruption versus continuation of antitumoral therapy. However, further data and studies are required.


Subject(s)
COVID-19 , Genital Neoplasms, Female , Venous Thromboembolism , Aged , Anticoagulants/therapeutic use , COVID-19/complications , Female , Genital Neoplasms, Female/complications , Humans , Retrospective Studies
8.
Non-conventional in English | National Technical Information Service, Grey literature | ID: grc-753616

ABSTRACT

Chemo resistance is a major cause of the high mortality of ovarian cancer. For example, although high-grade serous ovarian carcinoma (HGSOC) initially responds well to platinum-based chemotherapy, relapse often occurs with decreased chemotherapeutic sensitivity. Substantial evidence suggests that cancer stem-like cells (CSC) contribute to chemotherapy resistance. Putative epithelial ovarian cancer (EOC) CSCs are typically characterized by increased aldehyde dehydrogenase (ALDH) activity due to concomitant upregulation of the ALDH1A1 gene. It has been demonstrated preclinically that suppression of ALDH activity by ALDH1A1 knock-down sensitizes EOC cells to chemotherapy, demonstrating the functional importance of ALDH activity in EOC chemo resistance. We have furthermore shown that BRD4 (BET) inhibition reduces ALDH activity, thereby eradicating CSCs. The mechanism of suppression of ALDH activity is through down regulation of the ALDH1A1 super-enhancer associated non-coding enhancer RNA (eRNA). Notably, BRD4 genomic locus 19p13.12 is often amplified in HGSOC (~20%), and amplification/overexpression correlates with a poor prognosis in HGSOC patients. Therefore, we hypothesize that BRD4/BET inhibition may overcome chemotherapy resistance, and plan a phase I clinical trial to evaluate the combination of BET inhibitor INCB57643 (Incyte, Inc.) with carboplatin into establish MTD, tolerability, and preliminary efficacy of the combination. We propose embedded correlative science to identify populations most likely to respond to therapy. Our central hypothesis is that platinum resistance can be overcome through eliminating ALDH positive cancer stem-like cells by targetingBRD4 through BET inhibition. The goals of the proposal are: 1) To conduct a Phase I clinical trial of combined BET inhibitor (INCB57643) and carboplatin inpatients with platinum-resistant HGSOC. 2) To identify companion biomarkers that correlate with response to combination therapy in HGSOC patients.

9.
Non-conventional in English | National Technical Information Service, Grey literature | ID: grc-753576

ABSTRACT

High grade serous ovarian cancer typically presents at advanced stage with a median survival of 44 months. Small precursors to this cancer are found in the fallopian tube and likely seed the ovary and peritoneum simultaneously. Early detection is urgently needed and ideally would detect precursor lesions. This award will determine if DNA methylation patterns exhibited in circulating cell-free DNA could be used to detect precursor lesions. During the first year of the award, application for province-wide (Ontario) research ethics approval was submitted to umbrella all 4 participating hospitals. This umbrella approval was obtained;however, we are awaiting final approval from 2 hospitals, which was delayed by the covid-19 shutdown. All research activities were halted (Covid-19 research being the exception) and department staff were redeployed to other hospital activities, causing a back-up of research-related activity. All centres are currently reopening (in stage 2) and study approval should be forthcoming. The Material Transfer Agreements have been started by Sinai Health System and once final REB/IRB approval has been obtained, these will be finalized across the all institutions. Patient samples for use in this study as identified have been secured and we are poised to complete the study once approvals are finalized.

10.
Non-conventional in English | National Technical Information Service, Grey literature | ID: grc-753497

ABSTRACT

We are conducting a study to examine the association between inflammatory markers in peritoneal fluid and driver mutations and immunohistochemical (IHC) markers of cell proliferation and invasiveness in endometriosis tissue. We will also evaluate whether inflammation-related epidemiologic factors and systemic inflammation (e.g., CRP, IL-6 plasma levels) are associated with inflammatory markers in peritoneal fluid. Data and specimens for this study have been previously collected from A2A cohort, a longitudinal cohort of women oversampled for those surgically diagnosed with endometriosis. This project consists of selecting appropriate individuals with peritoneal fluid, endometriosis tissue, blood, and epidemiologic data, accessing samples for biospecimen assays, and conducting analyses. Targeted sequencing is being used to identify our genes of interest, ELISA is being used to measure inflammatory biomarkers in peritoneal fluid and blood, and IHC to assess the tissue expression of selected markers. To date we have conducted the necessary pilot studies to ensure a robust workflow. Currently our work has been paused because of the COVID-19 pandemic and there are no results to present at this time.

11.
Gynecol Oncol ; 165(2): 330-338, 2022 05.
Article in English | MEDLINE | ID: covidwho-1709447

ABSTRACT

OBJECTIVE: The COVID-19-pandemic caused drastic healthcare changes worldwide. To date, the impact of these changes on gynecological cancer healthcare is relatively unknown. This study aimed to assess the impact of the COVID-19-pandemic on surgical gynecological-oncology healthcare. METHODS: This population-based cohort study included all surgical procedures with curative intent for gynecological malignancies, registered in the Dutch Gynecological Oncology Audit, in 2018-2020. Four periods were identified based on COVID-19 hospital admission rates: 'Pre-COVID-19', 'First wave', 'Interim period', and 'Second wave'. Surgical volume, perioperative care processes, and postoperative outcomes from 2020 were compared with 2018-2019. RESULTS: A total of 11,488 surgical procedures were analyzed. For cervical cancer, surgical volume decreased by 17.2% in 2020 compared to 2018-2019 (mean 2018-2019: n = 542.5, 2020: n = 449). At nadir (interim period), only 51% of the expected cervical cancer procedures were performed. For ovarian, vulvar, and endometrial cancer, volumes remained stable. Patients with advanced-stage ovarian cancer more frequently received neoadjuvant chemotherapy in 2020 compared to 2018-2019 (67.7% (n = 432) vs. 61.8% (n = 783), p = 0.011). Median time to first treatment was significantly shorter in all four malignancies in 2020. For vulvar and endometrial cancer, the length of hospital stay was significantly shorter in 2020. No significant differences in complicated course and 30-day-mortality were observed. CONCLUSIONS: The COVID-19-pandemic impacted surgical gynecological-oncology healthcare: in 2020, surgical volume for cervical cancer dropped considerably, waiting time was significantly shorter for all malignancies, while neoadjuvant chemotherapy administration for advanced-stage ovarian cancer increased. The safety of perioperative healthcare was not negatively impacted by the pandemic, as complications and 30-day-mortality remained stable.


Subject(s)
COVID-19 , Endometrial Neoplasms , Ovarian Neoplasms , Uterine Cervical Neoplasms , COVID-19/epidemiology , Cohort Studies , Female , Humans , Pandemics
12.
Int J Gynecol Cancer ; 32(2): 159-164, 2022 02.
Article in English | MEDLINE | ID: covidwho-1593246

ABSTRACT

OBJECTIVE: Given the inconvenience and financial burden of frequent ovarian cancer surveillance and the risks of in-person visits due to COVID-19, which have led to the acceleration of telehealth adaptation, we sought to assess the role of in-person physical examination for the detection of ovarian cancer recurrence among patients enrolled in a routine surveillance program. METHODS: This was a retrospective study of patients initially seen from January 2015 to December 2017 who experienced ovarian cancer recurrence during first clinical remission. Descriptive statistics and bivariate analyses were performed to compare differences in detection methods and in patient and disease characteristics. RESULTS: Among 147 patients who met our inclusion criteria, there were no recurrences detected by physical examination alone. Forty-six (31%) patients had recurrence first detected by tumor marker, 81 (55%) by radiographic scan, 17 (12%) by presentation of new symptoms, and 3 (2%) by biopsies taken during non-oncological surgery. One hundred and eleven patients (75%) had multiple positive findings at the time of recurrence. Of all 147 patients, 48 (33%) had symptoms, 21 (14%) had physical examination findings, 106 (72%) had increases in tumor markers, and 141 (96%) had changes on imaging. CONCLUSIONS: In-person physical examination was not a primary means of detection for ovarian cancer recurrence for any patient. Substituting in-person visits for virtual visits that include patient-reported symptoms, alongside a regular surveillance protocol that includes tumor marker testing and imaging, may be a suitable approach for the detection of ovarian cancer recurrence while also reducing patient inconvenience and risks to health.


Subject(s)
Neoplasm Recurrence, Local/diagnostic imaging , Ovarian Neoplasms/diagnostic imaging , CA-125 Antigen/blood , Female , Humans , Middle Aged , Neoplasm Recurrence, Local/blood , Ovarian Neoplasms/blood , Retrospective Studies , Telemedicine , Tomography, X-Ray Computed
13.
Mol Ther Nucleic Acids ; 27: 718-732, 2022 Mar 08.
Article in English | MEDLINE | ID: covidwho-1586911

ABSTRACT

Drug discovery from plants usually focuses on small molecules rather than such biological macromolecules as RNAs. Although plant transfer RNA (tRNA)-derived fragment (tRF) has been associated with the developmental and defense mechanisms in plants, its regulatory role in mammals remains unclear. By employing a novel reverse small interfering RNA (siRNA) screening strategy, we show that a tRF mimic (antisense derived from the 5' end of tRNAHis(GUG) of Chinese yew) exhibits comparable anti-cancer activity with that of taxol on ovarian cancer A2780 cells, with a 16-fold lower dosage than that of taxol. A dual-luciferase reporter assay revealed that tRF-T11 directly targets the 3' UTR of oncogene TRPA1 mRNA. Furthermore, an Argonaute-RNA immunoprecipitation (AGO-RIP) assay demonstrated that tRF-T11 can interact with AGO2 to suppress TRPA1 via an RNAi pathway. This study uncovers a new role of plant-derived tRFs in regulating endogenous genes. This holds great promise for exploiting novel RNA drugs derived from nature and sheds light on the discovery of unknown molecular targets of therapeutics.

14.
Front Surg ; 8: 740198, 2021.
Article in English | MEDLINE | ID: covidwho-1555708

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) had become a health care event endangering humans globally. It takes up a large number of healthcare resources. We studied the impact of COVID-19 on patients with ovarian cancer by comprehensively analyzing their admissions before and after the epidemic, and made reasonable suggestions to improve their current situation. Methods: We randomly divided the enrolled patients into three groups, PreCOVID-19 Group (PCG) (2019.8.20-2020.1.20), COVID-19 Group (CG) (2020.1.21-2020.6.14), and Secondary Outbreak COVID-19 Group (SOCG) (2020.6.15-2020.10.10). One-way ANOVA and chi-square test were used for analysis. Results: The number of patients from other provinces decreased significantly (p < 0.05). The total hospital stay during the epidemic was substantially more extended (p < 0.05). Before the epidemic, our department performed more open surgery while during the epidemic outbreak, we tended to choose laparoscopy (p < 0.01). We took a longer surgery time (P < 0.05). Patients had significantly less post-operative fever during the epidemic (p < 0.001). Conclusion: During the COVID-19 epidemic, no patient was infected with COVID-19, and no patient experienced severe post-operative complications. We recommend maintaining the admissions of patients with ovarian cancer during the epidemic following the rules: 1. The outpatients must complete a nucleic acid test and chest CT in the outpatient clinic; 2. Maintain full daily disinfection of the ward and insist that health care workers disinfect their hands after contact with patients; 3. Increase the use of minimally invasive procedures, including laparoscopy and robotics; 4. Disinfect the ward twice a day with UV light and sodium hypochlorite disinfectant; 5. Patients need to undergo at least three nucleic acid tests before entering the operating room.

15.
Int J Gynecol Cancer ; 31(5): 658-669, 2021 05.
Article in English | MEDLINE | ID: covidwho-1554526

ABSTRACT

This is a report from the European Society of Gynaecological Oncology State-of-the-Art Virtual Meeting held December 14-16, 2020. The unique 3-day conference offered comprehensive state-of-the-art summaries on the major advances in the treatment of different types of gynecological cancers. Sessions opened with a case presentation followed by a keynote lecture and interactive debates with opinion leaders in the field. The speakers also presented scientific reviews on the clinical trial landscape in collaboration with the European Network of Gynecological Oncological Trial (ENGOT) groups. In addition, the new ESGO-ESRTO-ESP endometrial cancer guidelines were officially presented in public. This paper describes the key information and latest studies that were presented for the first time at the conference.


Subject(s)
Genital Neoplasms, Female/therapy , Gynecology , Medical Oncology , Europe , Female , Humans , Societies, Medical
16.
Int J Surg Case Rep ; 88: 106490, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1487763

ABSTRACT

INTRODUCTION: Ovarian cancer is a gynecological cancer with a very poor prognosis despite the improvement of therapeutic means, of which metastases at the colic level are exceptional. We report an exceptional case which makes it possible to enrich the poor literature published on the subject. CASE PRESENTATION: Through this article, we present a very rare case of colonic metastases from ovarian cancer. Biological monitoring and rectal bleeding allowed this rare secondary location to be discovered. Resection then anastomosis allowed our patient to heal. The objectives of this work are threefold: i), to report this very rare case ovarian metastasis ii), to highlight nulliparity as a risk factor in our patient iii), to report that our therapeutic management interrupted and delayed because of COVID 19. DISCUSSION AND CONCLUSION: Our case report shows that we have to take into consideration this very rare presentation and this even in the absence of true clinical sign. Our work reported also another case of colonic metastasis of a primary ovarian in the very rare case described in the literature and emphasizes the importance of surgical management.

17.
Vaccines (Basel) ; 9(10)2021 Oct 08.
Article in English | MEDLINE | ID: covidwho-1463855

ABSTRACT

OBJECTIVE: Vaccination for SARS-CoV-2 provides significant protection against the infection in the general population. However, limited data exist for cancer patients under systemic therapy. METHODS: In this cohort, we prospectively enrolled cancer patients treated with PARPi as well as healthy volunteers in order to study the kinetics of anti-SARS-CoV-2 antibodies (NAbs) after COVID-19 vaccination. Baseline demographics, co-morbidities, and NAb levels were compared between the two groups. RESULTS: The results of the cohort of 36 patients receiving PARP inhibitors are presented here. Despite no new safety issues being noticed, their levels of SARS-CoV-2 neutralizing antibodies were significantly lower in comparison to matched healthy volunteers up to day 30 after the second dose. CONCLUSIONS: These results suggest that maintaining precautions against COVID-19 is essential for cancer patients and should be taken into consideration for the patients under treatment, while further exploration is needed to reduce the uncertainty of SARS-CoV-2 immunity among cancer patients under treatment.

18.
Med Oncol ; 38(11): 137, 2021 Sep 28.
Article in English | MEDLINE | ID: covidwho-1439757

ABSTRACT

The covid-19 pandemic has impacted the management of non-covid-19 illnesses. Epithelial ovarian cancer (EOC) requires long-duration multidisciplinary treatment. Teleconsultation and shared care are suggested solutions to mitigate the consequences of the pandemic. However, these may be challenging to implement among patients who come from the lower economic strata. We report the disastrous impact of the pandemic on the care of EOC by comparing patients who were treated during the pandemic with those treated in the previous year. We collected the following data from newly diagnosed patients with EOC: time from diagnosis to treatment, time for completion of planned chemotherapy, and proportion of patients completing various components of therapy (surgery and chemotherapy). Patients treated between January 2019 and September 2019 (Group 1: Pre-covid) were compared with those treated between January 2020 and December 2020 (Group 2: During covid pandemic). A total of 82 patients were registered [Group 1: 43(51%) Group 2: 39(49)]. The median time from diagnosis to start of treatment was longer in group 2 when compared to group 1 [31(23-58) days versus 17(11-30) days (p = 0.03)]. The proportion of patients who had surgery in group 2 was lower in comparison to group 1 [33(77%) versus 21(54%) (p = 0.02)]. Proportion of patients who underwent neoadjuvant (NACT) and surgery were fewer in group 2 in comparison to group 1 [9(33%) versus 18(64%) p = 0.002]. Among patients planned for adjuvant chemotherapy, the median time from diagnosis to treatment was longer in group 2 [28(17-45) days, group 1 versus 49(26-78) days, group 2 (p = 0.04)]. The treatment of patients with EOC was adversely impacted due to the COVID-19 pandemic. There was a compromise in the proportion of patients completing planned therapy. Even among those who completed the treatment, there were considerable delays when compared with the pre-covid period. The impact of these compromises on the outcomes will be known with longer follow-up.


Subject(s)
COVID-19/prevention & control , Carcinoma, Ovarian Epithelial/therapy , Neoadjuvant Therapy/methods , Ovarian Neoplasms/therapy , Patient Care/methods , Time-to-Treatment , Aged , COVID-19/epidemiology , Carcinoma, Ovarian Epithelial/diagnosis , Carcinoma, Ovarian Epithelial/epidemiology , Female , Humans , Middle Aged , Neoadjuvant Therapy/trends , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/epidemiology , Pandemics , Patient Care/trends , Retrospective Studies , Time-to-Treatment/trends
19.
Int J Gynecol Cancer ; 31(10): 1363-1368, 2021 10.
Article in English | MEDLINE | ID: covidwho-1370903

ABSTRACT

OBJECTIVE: COVID-19 is a global public health emergency. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological tumors. The Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) performed a survey to evaluate the impact of the COVID-19 pandemic on medical treatment of gynecological cancer, with a focus on chemotherapy and oral treatment with poly(ADP)-ribose polymerase inhibitors (PARP-i). METHODS: The survey consisted of a self-administered online questionnaire, sent via email between November 2020 and January 2021 to all members of MITO group. RESULTS: Forty-nine centers completed the questionnaire. The majority of respondents (83%) use screening tests to determine COVID-19 status in patients who were to undergo chemotherapy or oral medications. All respondents to our survey continued cancer therapy in patients who tested negative for COVID-19 during the pandemic. Seventy-three percent of respondents declared they stopped treatment with chemotherapy or PARP-i only after a positive swab and resumed therapy when negative tests were confirmed. CONCLUSIONS: COVID-19 positivity impacted patterns of treatment in patients diagnosed with ovarian cancer within the MITO group. Further investigations are needed to evaluate whether these modifications influence oncological clinical outcomes.


Subject(s)
Antineoplastic Agents/therapeutic use , COVID-19 Testing/statistics & numerical data , COVID-19/diagnosis , Genital Neoplasms, Female/drug therapy , Poly(ADP-ribose) Polymerase Inhibitors/therapeutic use , Practice Patterns, Physicians'/statistics & numerical data , Withholding Treatment/statistics & numerical data , Administration, Oral , Adult , Aged , COVID-19/complications , COVID-19/prevention & control , Female , Genital Neoplasms, Female/complications , Health Care Surveys , Health Services Accessibility/statistics & numerical data , Humans , Italy , Male , Middle Aged
SELECTION OF CITATIONS
SEARCH DETAIL