James Lacey, Jr, PhD
Division of Cancer Etiology
Department of Population Science
City of Hope
Mark Wakabayashi, MD
Clinical Associate Professor of Surgery
Department of Surgery
Chief, Gynecologic Oncology Surgery
City of Hope
New Agents in Gynecologic Cancers
Robert Morgan, Jr, MD, FACP
Director, Continuing Medical Education
Gynecologic Oncology/Peritoneal Malignancy Program
City of Hope
Release date: October 29, 2010
Expiration date: October 28, 2011
Estimated time to complete activity: 1.5 hours
This program has been designed for medical oncologists, gynecologic oncologists, and other medical professionals who treat patients with gynecologic cancers.
Ovarian cancer is the most deadly of gynecologic cancers, accounting for more than 55% of all gynecologic cancer deaths. Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States and the country’s fifth most common cause of cancer mortality in women. In 2009, there were more than 21,000 new diagnoses and nearly 15,000 deaths from this neoplasm in the United States.. Ovarian cancer is the eighth most common cancer among women, excluding non-melanoma skin cancers, and it accounts for about 3% of all cancers in women and ranks fifth in cancer deaths. A woman's risk of having invasive ovarian cancer during her lifetime is about 1 in 71, and her chance of dying from it is about 1 in 95.
The incidence rate of ovarian cancer has been slowly declining over the past 20 years, even though it is difficult to detect early. Approximately 3 in 4 women with ovarian cancer will survive at least one year after diagnosis, with almost half (46%) of women with ovarian cancer still living at least 5 years after diagnosis. If ovarian cancer is found and treated before it has spread outside the ovary, the 5-year survival rate is 93%. However, less than 20% of all ovarian cancer is found at this early stage. In general, the ovarian cancer survival rate will depend on the type (ovarian epithelial, ovarian germ cell, low malignant germ cell) and stage (I, II, III, IV) of ovarian cancer, a woman's age and general health, and whether the cancer has recently been diagnosed or has recurred.
Despite encouraging recent data on both diagnostics and therapeutics, treatment of ovarian cancer remains a challenge, with many clinical debates remaining. The resolution of these debates will greatly impact the interdisciplinary approach to ovarian cancer treatment. The National Comprehensive Cancer Network (NCCN) recently updated the NCCN Clinical Practice Guidelines for Oncology™ for Ovarian Cancer to reflect the addition of two preferred combination regimens for a specific cohort of patients based on data from recent clinical research studies. However, although improvements in therapy have occurred, first-line chemotherapy fails to provide response rates in more than 20 percent of patients and approximately 40 percent to 50 percent of women who do experience a response to initial treatment relapse within two years. Also, current treatment for late-stage ovarian cancer has a very poor response rate and the toxic side effect profiles of cytotoxic agents limit their usage. Because ovarian cancer has few early symptoms, one of the major gaps is most patients are not diagnosed until the disease has progressed to an advanced stage, which contributes to the high mortality rate. This is because early stage ovarian cancer symptoms may not appear or be noticed or symptoms (ie, bloating, indigestion, diarrhea, constipation and others) may be vague and associated with many common and less serious conditions. Most importantly, there has been no effective test for early detection.
It is critical for medical oncologists, gynecologic oncologists, and other caregivers to be more aware of the issues and understand the newly available data to support optimal clinical decision-making. This activity has been designed to meet the identified learning gaps in treatment of gynecologic cancers.
At the conclusion of this educational activity, participants should be able to:
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of City of Hope and Carden Jennings Publishing Co., Ltd. City of Hope is accredited by the ACCME to provide continuing medical education for physicians.
City of Hope designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
The City of Hope adheres to ACCME Essential Areas, Standards for Commercial Support, and Policies regarding industry support of continuing medical education. Disclosure of the commercial relationships of everyone in a position to control content of an educational activity will be made at the activity. Speakers are also required to openly disclose discussion of any off-label, experimental, or investigational use of drugs or devices in their presentations.
The following City of Hope National Medical Center CME Committee members/planners have indicted they have nothing to disclose: Lucille Leong, MD, Crystal Saavedra, Anna Pawlowska, MD, Karl Gaal, MD, Mary Mendelsohn, Jo Hanson, Christina Eckhart, Khanh Nguyen, MD, Paul Lin, MD, and Teresa Ball.
The following CME Committee Members/planners have indicated a conflict with the following corporate organizations:
Any potential conflicts relative to the previous disclosure have been resolved.
The employees of CJP Medical Communications have no financial relationships to disclose.
In accordance with the ACCME’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of everyone in a position to control content of an educational activity. A relevant financial relationship is a relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears below:
This activity has been developed through independent educational grants received from Pfizer, Ethicon Endosurgery, and Centocor Ortho Biotech.
There are no fees for participating in this CME activity. To receive credit during the period October 29, 2010 to October 28, 2011, participants must (1) read the learning objectives and disclosure statements, (2) study the educational activity, (3) complete the posttest, and (4) complete the activity evaluation form, including the certificate information section.
The posttest can be accessed at the end of the activity. Please e-mail any questions to firstname.lastname@example.org.
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