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Tewari KS, Monk BJ. Philip John DiSaia, MD: Available Light & The Origin of Storms. J Obstet Gynaecol Res 2020; 46:959-988. [PMID: 32352218 DOI: 10.1111/jog.14277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 11/29/2022]
Abstract
During a career, which spanned nearly 60 years, Professor Philip J. DiSaia (1937-2018) trailblazed a path forward in academic medicine, which would become the standard by which Departments of Obstetrics and Gynecology and Gynecologic Oncology Divisions and Cancer Centers would be measured throughout the United States, in Europe and Japan. Following his discovery of fetal warfarin syndrome as a resident, DiSaia would serve in the U.S. Navy and successfully compete for an American Cancer Society Grant that would fund his Fellowship in Gynecologic Oncology under the instruction of Dr Felix N. Rutledge at the MD Anderson Hospital and Tumor Institute in Houston, Texas. Dr DiSaia's goal to establish a traditional academic department was realized at the University of California, Irvine, where he remained active in an unprecedented, uninterrupted 42-year run, training many outstanding obstetrician-gynecologists and gynecologic oncologists, future Division Directors, Cancer Center Directors and Department Chairpersons. His dedication to the field and inexhaustible work ethic fueled his many successes in tumor immunology and the clinical trials of the National Cancer Institute's Gynecologic Oncology Group.
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Affiliation(s)
- Krishnansu S Tewari
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of California, Irvine Medical Center, Orange, California, USA
| | - Bradley J Monk
- Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix, Arizona, USA
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Miller DS, Randall ME, Filiaci V. Progress in endometrial cancer: Contributions of the former Gynecologic Oncology Group. Gynecol Oncol 2020; 157:312-322. [PMID: 32014330 DOI: 10.1016/j.ygyno.2020.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/20/2019] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Abstract
For over forty years, the Gynecologic Oncology Group drove progress in treating endometrial cancer. The first decades of investigation began with a meticulous prospective, surgicopathologic staging study that was the platform for development of all subsequent trials. The resultant statistical model of low risk, intermediate risk, and high-risk groups of patients led to trials where therapeutic modalities were best targeted at disease spread. A clear role for chemotherapy was established. It was realized that greater advances might be achieved with the advent of newer anti-neoplastic agents and these agents were subjected to extensive phase II testing. These agents later were integrated into comparison trials for advanced endometrial cancer. Multimodality therapy continues to show promise. Hormonal therapy was thoroughly investigated and led to combination hormonal therapy trials. Newer agents, including biologics are under active study, as well as the potential contribution of modern imaging techniques. Finally, GOG0210 established a repository of clinical specimens with detailed clinical and epidemiologic data from patients with surgically staged endometrial carcinoma. This should provide for a much greater understanding of molecular characteristics associated with risk of endometrial cancer recurrence, clinical and histological characteristics, and epidemiologic factors.
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Affiliation(s)
- David Scott Miller
- University of Texas Southwestern Medical Center at Dallas, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Dallas, TX, United States of America.
| | - Marcus E Randall
- University of Kentucky, Department of Radiation Medicine, 800 Rose Street, Rm. C114D, Lexington, KY 40536 0293, United States of America
| | - Virginia Filiaci
- NRG Oncology Statistical and Data Center, Buffalo, NY, United States of America
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Brooks SE, Carter RL, Plaxe SC, Basen-Engquist KM, Rodriguez M, Kauderer J, Walker JL, Myers TKN, Drake JG, Havrilesky LJ, Van Le L, Landrum LM, Brown CL. Patient and physician factors associated with participation in cervical and uterine cancer trials: an NRG/GOG247 study. Gynecol Oncol 2015; 138:101-8. [PMID: 25937529 DOI: 10.1016/j.ygyno.2015.04.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/25/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to identify patient and physician factors related to enrollment onto Gynecologic Oncology Group (GOG) trials. METHODS Prospective study of women with primary or recurrent cancer of the uterus or cervix treated at a GOG institution from July 2010 to January 2012. Logistic regression examined probability of availability, eligibility and enrollment in a GOG trial. Odds ratios (OR) and 95% confidence intervals (CI) for significant (p<0.05) results reported. RESULTS Sixty institutions, 781 patients, and 150 physicians participated, 300/780 (38%) had a trial available, 290/300 had known participation status. Of these, 150 women enrolled (59.5%), 102 eligible did not enroll (35%), 38 (13%) were ineligible. Ethnicity and specialty of physician, practice type, data management availability, and patient age were significantly associated with trial availability. Patients with >4 comorbidities (OR 4.5; CI 1.7-11.8) had higher odds of trial ineligibility. Non-White patients (OR 7.9; CI 1.3-46.2) and patients of Black physicians had greater odds of enrolling (OR 56.5; CI 1.1-999.9) in a therapeutic trial. Significant patient therapeutic trial enrollment factors: belief trial may help (OR 76.9; CI 4.9->1000), concern about care if not on trial (OR12.1; CI 2.1-71.4), pressure to enroll (OR .27; CI 0.12-.64), caregiving without pay (OR 0.13; CI .02-.84). Significant physician beliefs were: patients would not do well on standard therapy (OR 3.6; CI 1.6-8.4), and trial would not be time consuming (OR 3.3; CI 1.3-8.1). CONCLUSIONS Trial availability, patient and physician beliefs were factors identified that if modified could improve enrollment in cancer cooperative group clinical trials.
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Affiliation(s)
| | - Randy L Carter
- University at Buffalo, NY, United States; NRG Oncology Statistics and Data Management Center, United States; Roswell Park Cancer Institute, Buffalo, NY 14263, United States
| | - Steven C Plaxe
- Gynecologic Oncology, Rebecca and John Moores UCSD Cancer Center, La Jolla, CA 92093, United States
| | - Karen M Basen-Engquist
- Department of Behavioral Science, University of Texas, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Michael Rodriguez
- Gynecologic Oncology, Northern Indiana Cancer Research Consortium, Memorial Hospital, Mishawaka, IN 46545, United States
| | - James Kauderer
- University at Buffalo, NY, United States; NRG Oncology Statistics and Data Management Center, United States; Roswell Park Cancer Institute, Buffalo, NY 14263, United States
| | - Joan L Walker
- Gynecologic Oncology, University of Oklahoma, Oklahoma City, OK 73104, United States
| | | | - Janet G Drake
- Gynecologic Oncology, Waukesha Memorial Hospital, Waukesha, WI 01199, United States
| | | | - Linda Van Le
- Gynecologic Oncology, University of Norton Carolina, Chapel Hill, NC 26588, United States
| | - Lisa M Landrum
- Gynecologic Oncology, University of Oklahoma, Oklahoma City, OK 73104, United States
| | - Carol L Brown
- Office of Diversity Programs in Clinical Care, Research and Training, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, United States
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Brown J, Brady WE, Schink J, Van Le L, Leitao M, Yamada SD, de Geest K, Gershenson DM. Efficacy and safety of bevacizumab in recurrent sex cord-stromal ovarian tumors: results of a phase 2 trial of the Gynecologic Oncology Group. Cancer 2013; 120:344-51. [PMID: 24166194 DOI: 10.1002/cncr.28421] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/15/2013] [Accepted: 08/22/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND The Gynecologic Oncology Group conducted this phase 2 trial to estimate the antitumor activity of bevacizumab and to determine the nature and degree of toxicity in patients with recurrent sex cord-stromal tumors of the ovary. METHODS A prospective, multi-institutional cooperative group trial was performed in women with recurrent, measurable ovarian stromal tumors. Patients were allowed to have unlimited prior therapy, excluding bevacizumab. Bevacizumab 15 mg/kg was administered intravenously on day 1 of every 21-day cycle until patients developed disease progression or adverse effects that prohibited further treatment. The primary endpoint was the response rate (RR). Inhibin A and B levels were measured before each cycle, and the values were examined in relation to response and progression. RESULTS Thirty-six patients were enrolled, and all were eligible and evaluable. Patients received a median of 9 cycles of treatment (range, 2-37 cycles). Six patients (16.7%) had partial responses (90% confidence interval, 7.5%-30.3%), 28 patients (77.8%) had stable disease, and 2 patients (5.6%) had progressive disease. This met the criterion for declaring the regimen active. The median progression-free survival was 9.3 months, and the median overall survival was not reached in during reporting period. Two grade 4 toxicities occurred, including hypertension and proteinuria; and the most common grade 3 toxicities were hypertension (n = 5) and pain (n = 5). Inhibin A and B values were lower in patients who responded to treatment. CONCLUSIONS Bevacizumab has activity in the treatment of recurrent sex cord-stromal tumors of the ovary, and its toxicity is acceptable. Further investigation is warranted.
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Affiliation(s)
- Jubilee Brown
- Department of Gynecologic Oncology and Reproductive Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
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