RESUMEN
OBJECTIVE: To review the current status of large phase academic clinical trials for women with ovarian cancer, address cross-cutting issues, and identify promising areas for future collaboration. METHODS: In May 2009, the Gynecologic Cancer Intergroup, which represents 19 Cooperative Groups conducting trials for women with gynecologic cancer, and the US National Cancer Institute convened a Clinical Trials Planning Meeting. RESULTS: The topics covered included the impact of new developments in cancer biology upon molecular targets and novel agents, pharmacogenomics, advances in imaging, the potential benefit of diet and exercise to reduce the risk of recurrence, academic partnership with industry, statistical considerations for phases 2 and 3 trials, trial end points, and symptom benefit and health-related quality-of-life issues. The clinical trials discussed spanned the spectrum of ovarian cancer from initial diagnosis, staging, and cytoreductive surgery to consolidation chemotherapy, and treatment of recurrent disease. CONCLUSIONS: Ongoing and effective collaboration with industry, government, and patients aims to ensure that the most important scientific questions can be answered rapidly. We encourage women with ovarian cancer and their oncologists to consider participation in the academic clinical trials conducted by the member groups of the Gynecologic Cancer Intergroup.
Asunto(s)
Centros Médicos Académicos , Ensayos Clínicos como Asunto , Neoplasias de los Genitales Femeninos/diagnóstico , Neoplasias de los Genitales Femeninos/terapia , Femenino , Humanos , Cooperación Internacional , National Cancer Institute (U.S.) , Estados UnidosAsunto(s)
Antineoplásicos , Ensayos Clínicos como Asunto , Inhibidores de Proteínas Quinasas , Quinazolinas , Antineoplásicos/uso terapéutico , Biomarcadores de Tumor/metabolismo , Receptores ErbB/efectos de los fármacos , Receptores ErbB/metabolismo , Clorhidrato de Erlotinib , Humanos , Inhibidores de Proteínas Quinasas/uso terapéutico , Quinazolinas/uso terapéuticoAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ensayos Clínicos como Asunto , Derivación y Consulta , Rabdomiosarcoma/terapia , Niño , Preescolar , Ensayos Clínicos Fase I como Asunto , Ensayos Clínicos Fase II como Asunto , Ensayos Clínicos Fase III como Asunto , Humanos , Estudios Multicéntricos como Asunto , Ensayos Clínicos Controlados Aleatorios como AsuntoAsunto(s)
Ensayos Clínicos como Asunto , Inhibidores Enzimáticos/farmacología , Inhibidores Enzimáticos/uso terapéutico , Piridinas/farmacología , Piridinas/uso terapéutico , Ribonucleótido Reductasas/antagonistas & inhibidores , Tiosemicarbazonas/farmacología , Tiosemicarbazonas/uso terapéutico , Ciclo Celular , Daño del ADN , Esquema de Medicación , Inhibidores Enzimáticos/administración & dosificación , Humanos , Neoplasias/tratamiento farmacológico , Piridinas/administración & dosificación , Ribonucleótido Reductasas/farmacología , Tiosemicarbazonas/administración & dosificaciónAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ensayos Clínicos como Asunto , Niño , Protección a la Infancia , Germinoma/tratamiento farmacológico , Humanos , Linfoma no Hodgkin/tratamiento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Retinoblastoma/tratamiento farmacológico , Sarcoma/tratamiento farmacológicoAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ensayos Clínicos Fase II como Asunto , Ensayos Clínicos Fase III como Asunto , Neoplasias Colorrectales/tratamiento farmacológico , Ensayos Clínicos Fase II como Asunto/métodos , Ensayos Clínicos Fase III como Asunto/métodos , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Derivación y Consulta , Análisis de SupervivenciaAsunto(s)
Papillomaviridae/inmunología , Papillomaviridae/patogenicidad , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus , Neoplasias del Cuello Uterino/prevención & control , Neoplasias del Cuello Uterino/virología , Vacunas de ADN/inmunología , Vacunas Virales/inmunología , Ensayos Clínicos como Asunto , Femenino , Humanos , Neoplasias del Cuello Uterino/mortalidadAsunto(s)
Ensayos Clínicos como Asunto , Neoplasias/tratamiento farmacológico , Quinonas/uso terapéutico , Rifabutina/análogos & derivados , Rifabutina/uso terapéutico , Benzoquinonas , Proteínas HSP90 de Choque Térmico/antagonistas & inhibidores , Humanos , Lactamas Macrocíclicas , Proteínas Serina-Treonina Quinasas/antagonistas & inhibidores , Quinonas/farmacología , Rifabutina/farmacologíaRESUMEN
Carcinoma of the prostate is the second leading cause of male cancer-related death in the United States. Better indicators of prostate cancer presence and progression are needed to avoid unnecessary treatment, predict disease course, and develop more effective therapy. Numerous molecular markers have been described in human serum, urine, seminal fluid, and histological specimens that exhibit varying capacities to detect prostate cancer and predict disease course. However, to date, few of these markers have been adequately validated for clinical use. The purpose of this review is to examine the current status of these markers in prostate cancer and to assess the diagnostic potential for future markers from identified genes and molecules that display loss, mutation, or alteration in expression between tumor and normal prostate tissues. In this review we cite 91 molecular markers that display some level of correlation with prostate cancer presence, disease progression, cancer recurrence, prediction of response to therapy, and/or disease-free survival. We suggest criteria to consider when selecting a marker for further development as a clinical tool and discuss five examples of markers (chromogranin A, glutathione S-transferase pi 1, prostate stem cell antigen, prostate-specific membrane antigen, and telomerase reverse transcriptase) that fulfill some of these criteria. Finally, we discuss how to conduct evaluations of candidate prostate cancer markers and some of the issues involved in the validation process.