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Despite remarkable advances in the knowledge of molecular biology and treatment, ovarian cancer remains the leading cause of death from gynecologic cancer. In the last decade, there have been important advances both in systemic and surgical treatment. However, there is no doubt that the incorporation of PARP inhibitors as maintenance after the response to platinum-based chemotherapy, first in recurrent disease and recently also in first line, will change the natural history of the disease.The objective of this guide is to summarize the current evidence for the diagnosis, treatment, and follow-up of ovarian cancer, and to provide evidence-based recommendations for clinical practice.
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Carcinoma Epitelial do Ovário/diagnóstico , Carcinoma Epitelial do Ovário/terapia , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/terapia , Antineoplásicos Imunológicos/uso terapêutico , Bevacizumab/uso terapêutico , Carcinoma Epitelial do Ovário/patologia , Quimioterapia Adjuvante/métodos , Ensaios Clínicos Fase III como Assunto , Procedimentos Cirúrgicos de Citorredução/métodos , Feminino , Humanos , Quimioterapia de Manutenção/métodos , Oncologia , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias/métodos , Neoplasias Ovarianas/patologia , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Sociedades Médicas , EspanhaRESUMO
In the original version of this article Figure 1 was shown incorrectly. The correct Figure 1 is shown here.
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Because of advances in the understanding of histological and molecular characteristics in ovarian cancer, it is now possible to recognize the existence of five subtypes, which in turn has allowed a more refined therapeutic approach and better design of clinical trials. Each of these five subtypes has specific histological features and a particular biomarker expression, as well as mutations in different genes, some of which have prognostic and predictive value. CA125 and HE4 are examples of ovarian cancer biomarkers used in the diagnosis and follow-up of these malignancies. Currently, somatic or germinal mutations on BRCA1 and BRCA2 genes are the most important biomarkers in epithelial ovarian cancer having prognostic and predictive value. This article will review the histological and molecular characteristics of the five subtypes of ovarian cancer, describing the most important biomarkers and mutations that can guide in diagnosis, screening and tailored treatment strategy.
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Biomarcadores Tumorais/análise , Neoplasias Epiteliais e Glandulares/diagnóstico , Neoplasias Ovarianas/diagnóstico , Carcinoma Epitelial do Ovário , Feminino , HumanosRESUMO
Endometrial cancer (EC) is the most common gynecological cancer in developed countries. Most patients are diagnosed at an early stage with a low risk of relapse. However, there is a group of patients with a high risk of relapse and poor prognosis. Despite the recent publication of randomized trials, the adjuvant treatment of high-risk EC is still to be defined and there are many open questions about the best approach and the right timing. Unfortunately, the survival of metastatic or recurrent EC is short, due to the poor results of chemotherapy and the lack of a second line of treatment. Advances in the knowledge of the molecular abnormalities in EC have permitted the development of promising targeted therapies.
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Neoplasias do Endométrio/terapia , Quimioterapia Adjuvante/métodos , Feminino , Humanos , Radioterapia Adjuvante/métodosRESUMO
Abstract: Ecuador is considered the fishing capital of the Southeastern tropical Pacific with more than 900 native species. Cichlasoma festae represents an economic important freshwater species of much local use. Thus, in this study, our goal was to characterize this fish species during juvenile stages, as the first step for its conservation and valuation, and also for the preparation of proposals for sustainable rural development and formulation of plans for environmentally responsible fisheries management. The study lasted 25 weeks and was undertaken in the ictiohidrographic area of Province of Los Rios, which accounts for 35 % of native fish species in Ecuador. Weekly, the individual biometric parameters total length (L), body width (BW) and body depth (BD) of 90 juveniles of C. festae were measured. Growth was determined using non-linear biological regression models. The average standard length varied between 6.30 cm and 12.25 cm and the average weight varied between 4.99 and 35.71 g. The length-weight relationship was best fit by the equation lnW = -3.92 + 2.96 ln(L), and the species presented negative allometric growth. Finally, the best fit for the growth of C. festae was the Von Bertalanffy's model where L∞ = 19.758 cm, k = 0.028 cm week-1 and t0 = -14.463 week-1. We concluded that to support sustainable and reliable fisheries production studies, the growth record from length may be obtained with standard methods as those evaluated in this study, or may be obtained with new safer tools such as photogrammetry. Rev. Biol. Trop. 65 (3): 1185-1193. Epub 2017 September 01.
Resumen: Ecuador se considera la capital pesquera del Pacífico tropical suroriental con más de 900 especies nativas. Cichlasoma festae representa una importante especie de agua dulce de gran uso local. Por lo tanto, en este estudio, nuestro objetivo fue caracterizar esta especie durante la etapa juvenil, como primer paso para su conservación y valoración, así como para la preparación de propuestas para el desarrollo rural sostenible y la formulación de planes para una gestión pesquera ambientalmente responsable. El estudio duró 25 semanas y se llevó a cabo la zona ictiohidrográfica de la Provincia de Los Ríos, que representa el 35 % de las especies nativas en Ecuador. Semanalmente, se midieron los parámetros biométricos individuales longitud total (L), ancho corporal (BW) y profundidad corporal (BD) de 90 juveniles de C. festae. El crecimiento se determinó utilizando modelos de regresión biológicos no lineales. La longitud media estándar varió entre 6.30 y 12.25 cm y el peso promedio varió entre 4.99 y 35.71 g. La relación longitudpeso se ajustó a la ecuación lnW = -3.92 + 2.96 ln(L), y la especie presentó crecimiento alométrico negativo. Finalmente, el mejor ajuste para el crecimiento de C. festae fue el modelo de Von Bertalanffy donde L∞ = 19.758 cm, k = 0.028 cm week -1 y t0 = -14.463 week -1. Concluimos que el registro de crecimiento de la longitud podría estar asociado a la fotogrametría como una herramienta para el desarrollo de una producción pesquera sostenible y segura.
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Allele frequency distribution and statistical parameters of forensic efficiency concerning the Investigator Argus X-12 kit (Qiagen, Hilden, Germany) were determined in a total sample of 641 unrelated Mexican females, including two Mestizo-admixed- populations (n=309) and seven Amerindian groups (n=332) from the main regions of the country. Most of the 12 X-STRs were in agreement with Hardy-Weinberg expectations in all nine Mexican populations. The power of discrimination in females (PD) and Median exclusion chance for trios (MECT) and duos (MECD) of this genetic system based on X-STRs were >99.99%. Although Mexican populations showed significant pairwise differentiation, a closer relationship was evident between Amerindian groups and nearby Mestizos, in agreement with historical records, previous genetic studies, and X-linked inheritance pattern expectations.
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Impressões Digitais de DNA , Frequência do Gene , Genética Populacional , Indígenas Norte-Americanos/genética , Feminino , Humanos , México , Repetições de MicrossatélitesRESUMO
Despite remarkable advances in the knowledge of molecular biology and treatment, ovarian cancer (OC) is the first cause of death due to gynecological cancer and the fifth cause of death for cancer in women in Spain. The aim of this guideline is to summarize the current evidence and to give evidence-based recommendations for clinical practice.
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Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/terapia , Guias de Prática Clínica como Assunto , Feminino , Humanos , EspanhaRESUMO
Cervical cancer (CC) is the second most common cancer worldwide, strongly linked to high-risk human papilloma virus infection. Although screening programs have led to a relevant reduction in the incidence and mortality due to CC in developed countries, it is still an important cause of mortality in undeveloped countries. Clinical stage is still the most relevant prognostic factor. In early stages, the primary treatment is surgery or radiotherapy, whereas concomitant chemo-radiotherapy is the conventional approach in locally advanced stages. In the setting of recurrent or metastatic CC, for the first time ever, the combination of chemotherapy plus bevacizumab prolongs the overall survival beyond 12 months. Therefore, this regimen is considered by most of the oncologist a new standard of care for metastatic/recurrent CC.
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Guias de Prática Clínica como Assunto/normas , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/terapia , Ensaios Clínicos como Assunto , Terapia Combinada , Gerenciamento Clínico , Detecção Precoce de Câncer , Feminino , Humanos , Oncologia , Estadiamento de Neoplasias , Prognóstico , Sociedades MédicasRESUMO
Ovarian cancer is the leading cause of death due to gynecological cancer and the 5th cause of death for cancer in women in Europe. Optimal management of patients with ovarian cancer needs the participation of a well-trained multidisciplinary team. In the last few years, we have observed a significant improvement in the knowledge of the molecular biology of the different histotypes of ovarian cancer that will probably change our standard of care in the forthcoming years. In this Guideline, we summarize the most current evidence for the medical management of ovarian cancer.
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Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/terapia , Feminino , HumanosRESUMO
In 2006, under the auspices of The Spanish Research Group for Ovarian Cancer (Spanish initials GEICO), the first "Treatment Guidelines in Ovarian Cancer" were developed and then published in Clinical and Translational Oncology by Poveda Velasco et al. (Clin Transl Oncol 9(5):308-316, 2007). Almost 6 years have elapsed and over this time, we have seen some important developments in the treatment of ovarian cancer. Significant changes were also introduced after the GCIG-sponsored 4th Consensus Conference on Ovarian Cancer by Stuart et al. (Int J Gynecol Cancer 21:750-755, 2011). So we decided to update the treatment guidelines in ovarian cancer and, with this objective, a group of investigators of the GEICO group met in February 2012. This study summarizes the presentations, discussions and evidence that were reviewed during the meeting and during further discussions of the manuscript.
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Neoplasias Ovarianas/terapia , Conferências de Consenso como Assunto , Feminino , Guias como Assunto , Humanos , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia , EspanhaRESUMO
BACKGROUND: The present study aimed to provide updated data on anaemia prevalence and management in cancer patients undergoing systemic therapy in Spain. METHODS: This was a multicenter, observational, cross-sectional study performed in 2008. Eligible patients were ≥18 years, with non-myeloid malignancies treated with systemic therapy [chemotherapy (CT), hormonal therapy or immunotherapy]. Anaemia was defined according to WHO as haemoglobin (Hb) < 12 g/dL. RESULTS: The study included 214 patients with a median age of 63 years (range 20-91), 58 % women, 73 % with solid tumours, and 79 % with advanced disease. CT was used in 91 % of patients (26 % with platinum compounds), hormonal therapy in 8.5 %, and immunotherapy in 8.5 %. In our study, 48.1 % of patients [95 % confidence interval (CI) 45.2-58.6] showed anaemia (31 % symptomatic): 42.0 % mild (10 ≤ Hb ≤ 11.9 g/dL), 5.6 % moderate (8 ≤ Hb ≤ 9.9 g/dL), and 0.5 % severe (Hb < 8 g/dL). A higher prevalence was observed in patients treated with CT (51 vs. 20 %, p = 0.01), platinum-based CT (70 vs. 47 %, p = 0.01) or palliative CT (61 vs. 39 %, p = 0.003). Anaemia was also more frequent in patients with more than three lines of CT (83 %) and in the fourth or subsequent CT cycle (58 %). Management in the previous 4 weeks in patients with anaemia was: 62 % did not receive treatment (92 % mild), 24 % received erythropoiesis-stimulating agents (ESAs), 14 % received iron and 8.7 % received transfusion. CONCLUSIONS: In Spanish hospitals, about half of patients with non-myeloid malignancies undergoing systemic therapy fulfilled anaemia criteria (87 % mild). Approximately two-third of patients with anaemia do not receive specific treatment and ESA use is below current guidelines.
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Anemia/etiologia , Neoplasias da Mama/complicações , Neoplasias Gastrointestinais/complicações , Hematínicos/uso terapêutico , Neoplasias Hematológicas/complicações , Neoplasias Pulmonares/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/tratamento farmacológico , Anemia/epidemiologia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/terapia , Terapia Combinada , Estudos Transversais , Feminino , Seguimentos , Neoplasias Gastrointestinais/mortalidade , Neoplasias Gastrointestinais/terapia , Inquéritos Epidemiológicos , Neoplasias Hematológicas/mortalidade , Neoplasias Hematológicas/terapia , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prevalência , Prognóstico , Espanha/epidemiologia , Taxa de Sobrevida , Adulto JovemRESUMO
Y-linked markers are suitable loci to analyze genetic diversity of human populations, offering knowledge of medical, forensic, and anthropological interest. In a population sample of 206 Mestizo males from western Mexico, we analyzed two binary loci (M3 and YAP) and six Y-STRs, adding to the analysis data of Mexican Mestizos and Amerindians, and relevant worldwide populations. The paternal ancestry estimated in western Mexican-Mestizos was mainly European (60-64%), followed by Amerindian (25-21%), and African ( approximately 15%). Significant genetic heterogeneity was established between Mestizos from western (Jalisco State) and northern Mexico (Chihuahua State) compared with Mexicans from the center of the Mexican Republic (Mexico City), this attributable to higher European ancestry in western and northern than in central and southeast populations, where higher Amerindian ancestry was inferred. This genetic structure has important implications for medical and forensic purposes. Two different Pre-Hispanic evolutionary processes were evident. In Mesoamerican region, populations presented higher migration rate (N(m) = 24.76), promoting genetic homogeneity. Conversely, isolated groups from the mountains and canyons of the Western and Northern Sierra Madre (Huichols and Tarahumaras, respectively) presented a lower migration rate (N(m) = 10.27) and stronger genetic differentiation processes (founder effect and/or genetic drift), constituting a Pre-Hispanic population substructure. Additionally, Tarahumaras presented a higher frequency of Y-chromosomes without Q3 that was explained by paternal European admixture (15%) and, more interestingly, by a distinctive Native-American ancestry. In Purepechas, a special admixture process involving preferential integration of non-Purepecha women in their communities could explain contrary genetic evidences (autosomal vs. Y-chromosome) for this tribe.
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Cromossomos Humanos Y/genética , Variação Genética , Genética Populacional , Indígenas Norte-Americanos/genética , Análise de Variância , População Negra/genética , Frequência do Gene , Marcadores Genéticos/genética , Geografia , Haplótipos/genética , Humanos , Masculino , México , População Branca/genéticaRESUMO
Ovarian and cervical cancers are significant health problems. This article provides an update in selected management topics. Paclitaxel and platinum derivatives are the first-line treatment for patients with advanced disease. In selected patients, intraperitoneal chemotherapy has been associated with improved survival but the broad applicability of this strategy is limited by issues of toxicity and feasibility. Management of patients with recurrent disease is based on a number of factors and includes surgery in selected cases, platinum-based chemotherapy for patients with platinum-sensitive disease and other agents such as topotecan and pegylated liposomal formulation of doxorubicin for patients with platinum-resistant disease. In cervical cancer, the most significant issue/event is the demonstration of superior survival with topotecan and cisplatin compared to cisplatin alone. Finally, new agents such as epidermal growth factor receptor inhibitors and antiangiogenic agents are being currently tested in these settings.
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Antineoplásicos/uso terapêutico , Carcinoma/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias do Colo do Útero/tratamento farmacológico , Inibidores da Angiogênese/uso terapêutico , Cisplatino/uso terapêutico , Receptores ErbB/metabolismo , Feminino , Humanos , Injeções IntraperitoneaisRESUMO
Cervical cancer is a virus-induced disease that is caused by the integration of high-risk infecting human papillomaviruses (HPV) in the host genome. For this reason, the carcinogenesis process of cervical cancer is associated to the expression of the viral oncogenic proteins E6 and E7. These proteins are capable of inactivating p53 and pRb, which induces a continuous cell proliferation with the increasing risk of accumulation of DNA damage that eventually leads to cancer. Moreover, cervical cancer can be prevented by prophylactic HPV vaccines; their molecular characteristics and mechanism of action are reviewed. Ultimately, new molecular targets for cervical cancer like proteasome, the EGFR family and IGF family are exposed.
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Neoplasias do Colo do Útero/virologia , Alphapapillomavirus/fisiologia , Feminino , Humanos , Biologia Molecular , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero/prevenção & controleRESUMO
National and international specialists have met with the aim of writing down the guidelines for the treatment of epithelial ovarian cancer (in the Spanish Castilian language). These guidelines are based on the International Consensus that was published in English in the Annals of Oncology in 2005. This condition is the leading cause of death from gynaecological cancer in western countries. Its low rate of survival, barely 30% at 5 years, is above all due to late diagnosis and inappropriate surgery, so emphasis is put on these aspects. After describing the methodology for early detection and a scheme of surgical diagnostic procedures in view of the staging of an ovarian mass, the following therapeutic strategies will be recommended: cytoreductive surgery together with platinum chemotherapy under normal conditions, and also in the case of relapse. Likewise, very recent models of treatment focused on molecular targets are presented, and a broad section on methodology of clinical assays. As for this, co-operation among groups is crucial in order to make the conclusions of these studies valid for the development of new therapies.
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Neoplasias Ovarianas/terapia , Feminino , Humanos , Recidiva Local de NeoplasiaRESUMO
OBJECTIVE: The objective was to define the toxicity and activity of weekly docetaxel administered with a short course of estramustine and enoxaparine in patients with hormone-resistant prostate cancer (HRPC). PATIENTS AND METHODS: Twenty-four patients were treated with the next regimen: weekly docetaxel 36 mg/m(2) iv for three consecutive weeks every 28 days, and estramustine 280 mg three times a day for three consecutive days beginning the day before docetaxel (days 1-3, 8-10 and 15-17). In order to prevent thromboembolic events, 40 mg of subcutaneous enoxaparine was administered daily sc on the same days as estramustine. Primary endpoints were: toxicity, especially the presence of thromboembolic events, PSA response rate and response in measurable disease. Secondary endpoints were: time to PSA progression and overall survival. RESULTS: Nineteen of 24 patients (79.1%, 95% CI 71-87%) had a PSA response = or >50%. Four of the eleven patients with measurable disease had a partial response. The median time to PSA progression was 7 months (CI 95%: 6.5-9) and the median survival was 19 months (IC 95%: 11-24). Toxicity was manageable with no treatment- related mortality. Only two patients had grade 4 neutropenia. Two patients had thrombotic events, one deep venous thrombosis and one stroke. The main grade 3 non-haematologic toxicity was diarrhoea and asthenia, both in 25% of patients. CONCLUSIONS: Weekly docetaxel with a short course of estramustine and enoxaparine is active and tolerable in HRPC patients. The observed incidence of thrombosis was lower than previously reported but the association of enoxaparine was not enough to completely prevent the thromboembolic events.
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Anticoagulantes/administração & dosagem , Antineoplásicos/administração & dosagem , Enoxaparina/administração & dosagem , Estramustina/administração & dosagem , Neoplasias da Próstata/tratamento farmacológico , Taxoides/administração & dosagem , Idoso , Antineoplásicos Hormonais/uso terapêutico , Docetaxel , Esquema de Medicação , Resistencia a Medicamentos Antineoplásicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do TratamentoRESUMO
The 15 AmpF/STR Identifiler loci (D8S1179, D21S11, D7S820, CSF1PO, D3S1358, TH01, D13S317, D16S539, D2S1338, D19S433, vWA, TPOX, D18S51, D5S818 and FGA) were analyzed in the sample of 180 unrelated autochthonous healthy adults born in Meztitlán City from the valley of Metztitlán (Estado de Hidalgo, México). The agreement with Hardy-Weinberg equilibrium was confirmed for all loci. From the forensic point of view, the heterozygosity value, power of discrimination and the a priori chance of exclusion were calculated.