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NATIONAL HARBOR, MD. – Parents are now less concerned about whether their daughters are sexually active when weighing whether to vaccinate against human papillomavirus (HPV), compared with just a few years ago.

This shift in parental attitudes can inform physician guidance and shift the HPV vaccination discussion, Anna Beavis, MD, a clinical fellow in gynecologic oncology at Johns Hopkins Medicine, Baltimore, said at the annual meeting of the Society of Gynecologic Oncology.

About 90% of cervical cancer is preventable with the HPV vaccine, but “U.S. vaccination rates are still suboptimal,” putting the United States far behind many other developed countries, Dr. Beavis said.

It’s been shown that the physician recommendation is one of the strongest predictors of whether an adolescent will be immunized against HPV, yet many providers remain reluctant to raise the issue, she said. Discomfort about discussing adolescent sexuality with the teen and with parents has been cited by physicians as a primary barrier.

To evaluate why parents of adolescent girls would opt out of HPV vaccination and to identify whether the reasons had changed over time, Dr. Beavis and her colleagues formulated a study that compared parent responses to a nationwide survey about HPV vaccination given in 2014 to those in 2010.

The study drew from the National Immunization Survey–Teen, a random digit-dialing survey administered by the Centers for Disease Control and Prevention. Only data pertaining to girls aged 13-17 years was included in the analysis, and for the sake of accuracy, only provider-verified responses were used.

Of the 49,345 responses that could be provider verified during the period from 2010 to 2014, 54% had received at least one HPV vaccination. Of the remaining responses, 55% of the parents said they had no intention of vaccinating their daughters.

During this period, vaccination rates have climbed slowly, from a little less than half in 2010 to about 60% in 2014 (test of trend, P less than .001), according to Dr. Beavis.

However, the reasons parents gave for declining vaccination has shifted over time, she said. The primary reason given in 2010 was concern about safety or side effects, followed by the sense that the vaccine was not necessary. These remained the top two reasons in 2014, though they had swapped places.

In 2010, the third most common reason parents gave for declining the HPV vaccination was that their daughters were not sexually active. By 2014, this reason had slid to the bottom of the top five reasons, and now was given by fewer than 10% of parents (test of trend, P less than .01).

This is important information for physicians, Dr. Beavis said in a video interview. If a physician has been reluctant to start the HPV discussion for fear of stepping into awkward territory with parents of teen girls, they should know that it’s significantly less likely that issues of sexuality will be on the parental radar when talking about HPV vaccination.

Looking deeper into the data, the investigators found that white race, younger patient age, and living above the poverty level were risk factors for nonvaccination. This means, Dr. Beavis said, that physicians should consider “developing a targeted HPV message” for families at higher risk of nonvaccination.

“This vaccine message should focus on cancer prevention, necessity, and the safety of the HPV vaccine,” Dr. Beavis said.

She reported having no financial disclosures.

koakes@frontlinemedcom.com

On Twitter @karioakes

NATIONAL HARBOR, MD. – Parents are now less concerned about whether their daughters are sexually active when weighing whether to vaccinate against human papillomavirus (HPV), compared with just a few years ago.

This shift in parental attitudes can inform physician guidance and shift the HPV vaccination discussion, Anna Beavis, MD, a clinical fellow in gynecologic oncology at Johns Hopkins Medicine, Baltimore, said at the annual meeting of the Society of Gynecologic Oncology.

About 90% of cervical cancer is preventable with the HPV vaccine, but “U.S. vaccination rates are still suboptimal,” putting the United States far behind many other developed countries, Dr. Beavis said.

It’s been shown that the physician recommendation is one of the strongest predictors of whether an adolescent will be immunized against HPV, yet many providers remain reluctant to raise the issue, she said. Discomfort about discussing adolescent sexuality with the teen and with parents has been cited by physicians as a primary barrier.

To evaluate why parents of adolescent girls would opt out of HPV vaccination and to identify whether the reasons had changed over time, Dr. Beavis and her colleagues formulated a study that compared parent responses to a nationwide survey about HPV vaccination given in 2014 to those in 2010.

The study drew from the National Immunization Survey–Teen, a random digit-dialing survey administered by the Centers for Disease Control and Prevention. Only data pertaining to girls aged 13-17 years was included in the analysis, and for the sake of accuracy, only provider-verified responses were used.

Of the 49,345 responses that could be provider verified during the period from 2010 to 2014, 54% had received at least one HPV vaccination. Of the remaining responses, 55% of the parents said they had no intention of vaccinating their daughters.

During this period, vaccination rates have climbed slowly, from a little less than half in 2010 to about 60% in 2014 (test of trend, P less than .001), according to Dr. Beavis.

However, the reasons parents gave for declining vaccination has shifted over time, she said. The primary reason given in 2010 was concern about safety or side effects, followed by the sense that the vaccine was not necessary. These remained the top two reasons in 2014, though they had swapped places.

In 2010, the third most common reason parents gave for declining the HPV vaccination was that their daughters were not sexually active. By 2014, this reason had slid to the bottom of the top five reasons, and now was given by fewer than 10% of parents (test of trend, P less than .01).

This is important information for physicians, Dr. Beavis said in a video interview. If a physician has been reluctant to start the HPV discussion for fear of stepping into awkward territory with parents of teen girls, they should know that it’s significantly less likely that issues of sexuality will be on the parental radar when talking about HPV vaccination.

Looking deeper into the data, the investigators found that white race, younger patient age, and living above the poverty level were risk factors for nonvaccination. This means, Dr. Beavis said, that physicians should consider “developing a targeted HPV message” for families at higher risk of nonvaccination.

“This vaccine message should focus on cancer prevention, necessity, and the safety of the HPV vaccine,” Dr. Beavis said.

She reported having no financial disclosures.

koakes@frontlinemedcom.com

On Twitter @karioakes

NATIONAL HARBOR, MD. – Parents are now less concerned about whether their daughters are sexually active when weighing whether to vaccinate against human papillomavirus (HPV), compared with just a few years ago.

This shift in parental attitudes can inform physician guidance and shift the HPV vaccination discussion, Anna Beavis, MD, a clinical fellow in gynecologic oncology at Johns Hopkins Medicine, Baltimore, said at the annual meeting of the Society of Gynecologic Oncology.

About 90% of cervical cancer is preventable with the HPV vaccine, but “U.S. vaccination rates are still suboptimal,” putting the United States far behind many other developed countries, Dr. Beavis said.

It’s been shown that the physician recommendation is one of the strongest predictors of whether an adolescent will be immunized against HPV, yet many providers remain reluctant to raise the issue, she said. Discomfort about discussing adolescent sexuality with the teen and with parents has been cited by physicians as a primary barrier.

To evaluate why parents of adolescent girls would opt out of HPV vaccination and to identify whether the reasons had changed over time, Dr. Beavis and her colleagues formulated a study that compared parent responses to a nationwide survey about HPV vaccination given in 2014 to those in 2010.

The study drew from the National Immunization Survey–Teen, a random digit-dialing survey administered by the Centers for Disease Control and Prevention. Only data pertaining to girls aged 13-17 years was included in the analysis, and for the sake of accuracy, only provider-verified responses were used.

Of the 49,345 responses that could be provider verified during the period from 2010 to 2014, 54% had received at least one HPV vaccination. Of the remaining responses, 55% of the parents said they had no intention of vaccinating their daughters.

During this period, vaccination rates have climbed slowly, from a little less than half in 2010 to about 60% in 2014 (test of trend, P less than .001), according to Dr. Beavis.

However, the reasons parents gave for declining vaccination has shifted over time, she said. The primary reason given in 2010 was concern about safety or side effects, followed by the sense that the vaccine was not necessary. These remained the top two reasons in 2014, though they had swapped places.

In 2010, the third most common reason parents gave for declining the HPV vaccination was that their daughters were not sexually active. By 2014, this reason had slid to the bottom of the top five reasons, and now was given by fewer than 10% of parents (test of trend, P less than .01).

This is important information for physicians, Dr. Beavis said in a video interview. If a physician has been reluctant to start the HPV discussion for fear of stepping into awkward territory with parents of teen girls, they should know that it’s significantly less likely that issues of sexuality will be on the parental radar when talking about HPV vaccination.

Looking deeper into the data, the investigators found that white race, younger patient age, and living above the poverty level were risk factors for nonvaccination. This means, Dr. Beavis said, that physicians should consider “developing a targeted HPV message” for families at higher risk of nonvaccination.

“This vaccine message should focus on cancer prevention, necessity, and the safety of the HPV vaccine,” Dr. Beavis said.

She reported having no financial disclosures.

koakes@frontlinemedcom.com

On Twitter @karioakes

• Robert G. Micheletti, MD, Moderator 
• Jacob Levitt, MD
• Michelle Lowes, MD

The editorial staff of Dermatology News was not involved in developing the video roundtable.

Click here to visit the site

• Robert G. Micheletti, MD, Moderator 
• Jacob Levitt, MD
• Michelle Lowes, MD

The editorial staff of Dermatology News was not involved in developing the video roundtable.

Click here to visit the site

• Robert G. Micheletti, MD, Moderator 
• Jacob Levitt, MD
• Michelle Lowes, MD

The editorial staff of Dermatology News was not involved in developing the video roundtable.

Click here to visit the site

HOUSTON – Use of endovascular mechanical thrombectomy for treating selected patients with acute ischemic stroke surged in U.S. practice following publication of several studies in early 2015 that documented the treatment’s efficacy, in data collected by a large U.S. hospital registry.

During April-June 2016, 3.5% of all acute ischemic stroke patients seen at the nearly 2,000 U.S. hospitals enrolled in the Get With the Guidelines-Stroke program underwent treatment with endovascular thrombectomy, up from the 2% rate at the end of 2014,The new data he reported also showed substantial increases for other measures of thrombectomy use during a roughly 18-month period that followed a flurry of reports in late 2014 and early 2015 that presented clear evidence of the safety and efficacy of thrombectomy for selected ischemic stroke patients. The percentage of hospitals participating in the Get With the Guidelines-Stroke program that performed thrombectomies increased from about a quarter of enrolled hospitals at the end of 2014 to almost a third by mid 2016, and the average quarterly number of endovascular thrombectomy cases at hospitals offering the procedure rose from about 7 during the final 3 months of 2014 to about 12 during July-September 2016, reported Dr. Smith, a neurologist and medical director of the Cognitive Neurosciences Clinic at the University of Calgary (Alta.).

“Before 2015, we saw a slow increase in the use of intra-arterial therapy, but after studies showed it was effective, there was an acceleration in the proportion of hospitals providing this therapy, the number of cases treated at each hospital, and the number of ischemic stroke patients treated,” Dr. Smith said in a video interview. “This shows rapid uptake of endovascular thrombectomy, but we still have a ways to go.”

He estimated that roughly 10%-15% of all U.S. acute ischemic stroke patients are eligible for endovascular thrombectomy based on location of the occluding clot in a large cerebral artery and the time frame when patients appear at a thrombectomy hospital relative to their stroke onset. This suggests that by mid-2016, roughly 20%-33% of U.S. ischemic stroke patients eligible for thrombectomy actually received the treatment.

“I don’t think we should be satisfied until we treat every eligible patient as quickly as we can. We need to move toward 100%,” he said.

The analyses he reported came from data collected on more than 2.4 million ischemic stroke patients treated at more than 2,200 U.S. hospitals participating in the Get With the Guidelines-Stroke program during 2003-2016.

The 2016 data also showed that, while the median thrombectomy annual case volume from mid-2015 to mid-2016 was 32 patients per year at thrombectomy hospitals, about 5% of these centers performed 100 or more cases during this 1-year period, and about 10% performed 10 or fewer thrombectomy cases. “There may be a relationship between case volume and the skill of performing the procedure, and a potential need for a volume minimum for thrombectomy certification to ensure that centers and operators maintain their skills,” Dr. Smith said.

He contrasted the recent pace of thrombectomy uptake with the first few years of routine thrombolytic treatment for the same disease during the mid-1990s, when little uptake occurred. Dr. Smith attributed the more robust penetration of thrombectomy to several factors: the impressive benefit of the treatment, the concurrent reporting of several confirmatory studies, and the stronger acute stroke–care infrastructure now in place, compared with what was available to stroke patients a generation ago.

“It’s encouraging to see such early growth in thrombectomy when thrombolysis lagged for so many years,” Dr. Smith said.

Dr. Smith had no disclosures. Get With the Guidelines-Stroke is a program of the American Heart Association and American Stroke Association using funding provided by several drug companies.

Eric E. Smith, MD, said at the International Stroke Conference, sponsored by the American Heart Association.

mzoler@frontlinemedcom.com

On Twitter @mitchelzoler

HOUSTON – Use of endovascular mechanical thrombectomy for treating selected patients with acute ischemic stroke surged in U.S. practice following publication of several studies in early 2015 that documented the treatment’s efficacy, in data collected by a large U.S. hospital registry.

During April-June 2016, 3.5% of all acute ischemic stroke patients seen at the nearly 2,000 U.S. hospitals enrolled in the Get With the Guidelines-Stroke program underwent treatment with endovascular thrombectomy, up from the 2% rate at the end of 2014,The new data he reported also showed substantial increases for other measures of thrombectomy use during a roughly 18-month period that followed a flurry of reports in late 2014 and early 2015 that presented clear evidence of the safety and efficacy of thrombectomy for selected ischemic stroke patients. The percentage of hospitals participating in the Get With the Guidelines-Stroke program that performed thrombectomies increased from about a quarter of enrolled hospitals at the end of 2014 to almost a third by mid 2016, and the average quarterly number of endovascular thrombectomy cases at hospitals offering the procedure rose from about 7 during the final 3 months of 2014 to about 12 during July-September 2016, reported Dr. Smith, a neurologist and medical director of the Cognitive Neurosciences Clinic at the University of Calgary (Alta.).

“Before 2015, we saw a slow increase in the use of intra-arterial therapy, but after studies showed it was effective, there was an acceleration in the proportion of hospitals providing this therapy, the number of cases treated at each hospital, and the number of ischemic stroke patients treated,” Dr. Smith said in a video interview. “This shows rapid uptake of endovascular thrombectomy, but we still have a ways to go.”

He estimated that roughly 10%-15% of all U.S. acute ischemic stroke patients are eligible for endovascular thrombectomy based on location of the occluding clot in a large cerebral artery and the time frame when patients appear at a thrombectomy hospital relative to their stroke onset. This suggests that by mid-2016, roughly 20%-33% of U.S. ischemic stroke patients eligible for thrombectomy actually received the treatment.

“I don’t think we should be satisfied until we treat every eligible patient as quickly as we can. We need to move toward 100%,” he said.

The analyses he reported came from data collected on more than 2.4 million ischemic stroke patients treated at more than 2,200 U.S. hospitals participating in the Get With the Guidelines-Stroke program during 2003-2016.

The 2016 data also showed that, while the median thrombectomy annual case volume from mid-2015 to mid-2016 was 32 patients per year at thrombectomy hospitals, about 5% of these centers performed 100 or more cases during this 1-year period, and about 10% performed 10 or fewer thrombectomy cases. “There may be a relationship between case volume and the skill of performing the procedure, and a potential need for a volume minimum for thrombectomy certification to ensure that centers and operators maintain their skills,” Dr. Smith said.

He contrasted the recent pace of thrombectomy uptake with the first few years of routine thrombolytic treatment for the same disease during the mid-1990s, when little uptake occurred. Dr. Smith attributed the more robust penetration of thrombectomy to several factors: the impressive benefit of the treatment, the concurrent reporting of several confirmatory studies, and the stronger acute stroke–care infrastructure now in place, compared with what was available to stroke patients a generation ago.

“It’s encouraging to see such early growth in thrombectomy when thrombolysis lagged for so many years,” Dr. Smith said.

Dr. Smith had no disclosures. Get With the Guidelines-Stroke is a program of the American Heart Association and American Stroke Association using funding provided by several drug companies.

Eric E. Smith, MD, said at the International Stroke Conference, sponsored by the American Heart Association.

mzoler@frontlinemedcom.com

On Twitter @mitchelzoler

HOUSTON – Use of endovascular mechanical thrombectomy for treating selected patients with acute ischemic stroke surged in U.S. practice following publication of several studies in early 2015 that documented the treatment’s efficacy, in data collected by a large U.S. hospital registry.

During April-June 2016, 3.5% of all acute ischemic stroke patients seen at the nearly 2,000 U.S. hospitals enrolled in the Get With the Guidelines-Stroke program underwent treatment with endovascular thrombectomy, up from the 2% rate at the end of 2014,The new data he reported also showed substantial increases for other measures of thrombectomy use during a roughly 18-month period that followed a flurry of reports in late 2014 and early 2015 that presented clear evidence of the safety and efficacy of thrombectomy for selected ischemic stroke patients. The percentage of hospitals participating in the Get With the Guidelines-Stroke program that performed thrombectomies increased from about a quarter of enrolled hospitals at the end of 2014 to almost a third by mid 2016, and the average quarterly number of endovascular thrombectomy cases at hospitals offering the procedure rose from about 7 during the final 3 months of 2014 to about 12 during July-September 2016, reported Dr. Smith, a neurologist and medical director of the Cognitive Neurosciences Clinic at the University of Calgary (Alta.).

“Before 2015, we saw a slow increase in the use of intra-arterial therapy, but after studies showed it was effective, there was an acceleration in the proportion of hospitals providing this therapy, the number of cases treated at each hospital, and the number of ischemic stroke patients treated,” Dr. Smith said in a video interview. “This shows rapid uptake of endovascular thrombectomy, but we still have a ways to go.”

He estimated that roughly 10%-15% of all U.S. acute ischemic stroke patients are eligible for endovascular thrombectomy based on location of the occluding clot in a large cerebral artery and the time frame when patients appear at a thrombectomy hospital relative to their stroke onset. This suggests that by mid-2016, roughly 20%-33% of U.S. ischemic stroke patients eligible for thrombectomy actually received the treatment.

“I don’t think we should be satisfied until we treat every eligible patient as quickly as we can. We need to move toward 100%,” he said.

The analyses he reported came from data collected on more than 2.4 million ischemic stroke patients treated at more than 2,200 U.S. hospitals participating in the Get With the Guidelines-Stroke program during 2003-2016.

The 2016 data also showed that, while the median thrombectomy annual case volume from mid-2015 to mid-2016 was 32 patients per year at thrombectomy hospitals, about 5% of these centers performed 100 or more cases during this 1-year period, and about 10% performed 10 or fewer thrombectomy cases. “There may be a relationship between case volume and the skill of performing the procedure, and a potential need for a volume minimum for thrombectomy certification to ensure that centers and operators maintain their skills,” Dr. Smith said.

He contrasted the recent pace of thrombectomy uptake with the first few years of routine thrombolytic treatment for the same disease during the mid-1990s, when little uptake occurred. Dr. Smith attributed the more robust penetration of thrombectomy to several factors: the impressive benefit of the treatment, the concurrent reporting of several confirmatory studies, and the stronger acute stroke–care infrastructure now in place, compared with what was available to stroke patients a generation ago.

“It’s encouraging to see such early growth in thrombectomy when thrombolysis lagged for so many years,” Dr. Smith said.

Dr. Smith had no disclosures. Get With the Guidelines-Stroke is a program of the American Heart Association and American Stroke Association using funding provided by several drug companies.

Eric E. Smith, MD, said at the International Stroke Conference, sponsored by the American Heart Association.

mzoler@frontlinemedcom.com

On Twitter @mitchelzoler

NATIONAL HARBOR, MD. – Maintenance therapy with the first-in-class PARP inhibitor olaparib was associated with a striking improvement in progression-free survival in patients with platinum-sensitive relapsed ovarian cancer and BRCA 1/2 mutation in the randomized, placebo-controlled phase III SOLO2 trial.

Compared with placebo, the tablet formulation of olaparib was associated with investigator-assessed PFS of 19.1 months in 196 patients, compared with 5.5 months in 99 patients who received placebo (hazard ratio, 0.30), Dr. Eric Pujade-Lauraine reported at the annual meeting of the Society of Gynecologic Oncology.

The SOLO2 results were both clinically meaningful and highly statistically significant, said Dr. Pujade-Lauraine of Hopital Hotel-Dieu, Paris.

Active treatment, which involved a twice-daily 300-mg oral dose of olaparib, was well tolerated; 75% of patients completed the study without dose reduction, he noted.

In this video interview, Dr. Pujade-Lauraine discussed the SOLO2 study and findings, which confirmed those of the phase II Study 19. Study 19 looked at olaparib in all-comers with platinum-sensitive relapsed ovarian cancer and involved a different formulation of the drug, which required that patients take 16 capsules each day to achieve a twice-daily dose of 400 mg. Patients with BRCA mutations were found in that study to derive the most benefit from olaparib.

The current findings are practice changing, Dr. Pujade-Lauraine said, concluding that “it is important to test BRCA, and if this test is positive, to offer olaparib in patients who are platinum sensitive.”

sworcester@frontlinemedcom.com

NATIONAL HARBOR, MD. – Maintenance therapy with the first-in-class PARP inhibitor olaparib was associated with a striking improvement in progression-free survival in patients with platinum-sensitive relapsed ovarian cancer and BRCA 1/2 mutation in the randomized, placebo-controlled phase III SOLO2 trial.

Compared with placebo, the tablet formulation of olaparib was associated with investigator-assessed PFS of 19.1 months in 196 patients, compared with 5.5 months in 99 patients who received placebo (hazard ratio, 0.30), Dr. Eric Pujade-Lauraine reported at the annual meeting of the Society of Gynecologic Oncology.

The SOLO2 results were both clinically meaningful and highly statistically significant, said Dr. Pujade-Lauraine of Hopital Hotel-Dieu, Paris.

Active treatment, which involved a twice-daily 300-mg oral dose of olaparib, was well tolerated; 75% of patients completed the study without dose reduction, he noted.

In this video interview, Dr. Pujade-Lauraine discussed the SOLO2 study and findings, which confirmed those of the phase II Study 19. Study 19 looked at olaparib in all-comers with platinum-sensitive relapsed ovarian cancer and involved a different formulation of the drug, which required that patients take 16 capsules each day to achieve a twice-daily dose of 400 mg. Patients with BRCA mutations were found in that study to derive the most benefit from olaparib.

The current findings are practice changing, Dr. Pujade-Lauraine said, concluding that “it is important to test BRCA, and if this test is positive, to offer olaparib in patients who are platinum sensitive.”

sworcester@frontlinemedcom.com

NATIONAL HARBOR, MD. – Maintenance therapy with the first-in-class PARP inhibitor olaparib was associated with a striking improvement in progression-free survival in patients with platinum-sensitive relapsed ovarian cancer and BRCA 1/2 mutation in the randomized, placebo-controlled phase III SOLO2 trial.

Compared with placebo, the tablet formulation of olaparib was associated with investigator-assessed PFS of 19.1 months in 196 patients, compared with 5.5 months in 99 patients who received placebo (hazard ratio, 0.30), Dr. Eric Pujade-Lauraine reported at the annual meeting of the Society of Gynecologic Oncology.

The SOLO2 results were both clinically meaningful and highly statistically significant, said Dr. Pujade-Lauraine of Hopital Hotel-Dieu, Paris.

Active treatment, which involved a twice-daily 300-mg oral dose of olaparib, was well tolerated; 75% of patients completed the study without dose reduction, he noted.

In this video interview, Dr. Pujade-Lauraine discussed the SOLO2 study and findings, which confirmed those of the phase II Study 19. Study 19 looked at olaparib in all-comers with platinum-sensitive relapsed ovarian cancer and involved a different formulation of the drug, which required that patients take 16 capsules each day to achieve a twice-daily dose of 400 mg. Patients with BRCA mutations were found in that study to derive the most benefit from olaparib.

The current findings are practice changing, Dr. Pujade-Lauraine said, concluding that “it is important to test BRCA, and if this test is positive, to offer olaparib in patients who are platinum sensitive.”

sworcester@frontlinemedcom.com

NATIONAL HARBOR, MD. – A large retrospective database study linked the use of vaginal brachytherapy and chemotherapy with improved survival among patients with early-stage uterine papillary serous carcinoma.

The findings offer a degree of clinical guidance on the adjuvant treatment of this relatively rare, aggressive histologic cancer subtype, Stephanie Cham, MD, said during a video interview at the annual meeting of the Society of Gynecologic Oncology.

Large dataset analyses can be especially helpful for exploring the treatment of rare diseases for which clinical trials can be infeasible, said Dr. Cham of Columbia University College of Physicians and Surgeons in New York. To evaluate chemotherapy, vaginal brachytherapy, and whole beam pelvic radiation therapy in stage I and stage II uterine papillary serous carcinoma, she and her associates analyzed the National Cancer Database.

Among 7,325 patients treated between 1998 and 2012, 38% of patients had received chemotherapy, 18% had received external beam radiation, and 20% received brachytherapy, Dr. Cham said. The use of chemotherapy rose significantly over time, regardless of stage (P less than .0001), as did the use of brachytherapy, while the use of external beam radiation decreased.

After the researchers controlled for numerous demographic and clinical variables, chemotherapy was associated with a statistically significant decrease in the risk of death overall (hazard ratio, 0.78; 95% confidence interval, 0.69 to 0.88) and in patients with stage IB (HR, 0.58; 95% CI, 0.44-0.77) or stage II cancer (HR, 0.74; 95% CI, 0.60-0.90). The use of brachytherapy also was associated with significantly improved survival overall (HR, 0.67), in stage IA cancer (HR, 0.67), and in stage II cancer (HR, 0.64).

The survival effect of brachytherapy held up in additional subgroup analyses, Dr. Cham explained. In contrast, external beam radiation therapy was not associated with improved survival overall or in any subgroup, she said. The results highlight the potential use of vaginal brachytherapy in early-stage uterine papillary serous carcinoma, she emphasized.

Dr. Cham cited no funding sources and reported having no conflicts of interest.

NATIONAL HARBOR, MD. – A large retrospective database study linked the use of vaginal brachytherapy and chemotherapy with improved survival among patients with early-stage uterine papillary serous carcinoma.

The findings offer a degree of clinical guidance on the adjuvant treatment of this relatively rare, aggressive histologic cancer subtype, Stephanie Cham, MD, said during a video interview at the annual meeting of the Society of Gynecologic Oncology.

Large dataset analyses can be especially helpful for exploring the treatment of rare diseases for which clinical trials can be infeasible, said Dr. Cham of Columbia University College of Physicians and Surgeons in New York. To evaluate chemotherapy, vaginal brachytherapy, and whole beam pelvic radiation therapy in stage I and stage II uterine papillary serous carcinoma, she and her associates analyzed the National Cancer Database.

Among 7,325 patients treated between 1998 and 2012, 38% of patients had received chemotherapy, 18% had received external beam radiation, and 20% received brachytherapy, Dr. Cham said. The use of chemotherapy rose significantly over time, regardless of stage (P less than .0001), as did the use of brachytherapy, while the use of external beam radiation decreased.

After the researchers controlled for numerous demographic and clinical variables, chemotherapy was associated with a statistically significant decrease in the risk of death overall (hazard ratio, 0.78; 95% confidence interval, 0.69 to 0.88) and in patients with stage IB (HR, 0.58; 95% CI, 0.44-0.77) or stage II cancer (HR, 0.74; 95% CI, 0.60-0.90). The use of brachytherapy also was associated with significantly improved survival overall (HR, 0.67), in stage IA cancer (HR, 0.67), and in stage II cancer (HR, 0.64).

The survival effect of brachytherapy held up in additional subgroup analyses, Dr. Cham explained. In contrast, external beam radiation therapy was not associated with improved survival overall or in any subgroup, she said. The results highlight the potential use of vaginal brachytherapy in early-stage uterine papillary serous carcinoma, she emphasized.

Dr. Cham cited no funding sources and reported having no conflicts of interest.

NATIONAL HARBOR, MD. – A large retrospective database study linked the use of vaginal brachytherapy and chemotherapy with improved survival among patients with early-stage uterine papillary serous carcinoma.

The findings offer a degree of clinical guidance on the adjuvant treatment of this relatively rare, aggressive histologic cancer subtype, Stephanie Cham, MD, said during a video interview at the annual meeting of the Society of Gynecologic Oncology.

Large dataset analyses can be especially helpful for exploring the treatment of rare diseases for which clinical trials can be infeasible, said Dr. Cham of Columbia University College of Physicians and Surgeons in New York. To evaluate chemotherapy, vaginal brachytherapy, and whole beam pelvic radiation therapy in stage I and stage II uterine papillary serous carcinoma, she and her associates analyzed the National Cancer Database.

Among 7,325 patients treated between 1998 and 2012, 38% of patients had received chemotherapy, 18% had received external beam radiation, and 20% received brachytherapy, Dr. Cham said. The use of chemotherapy rose significantly over time, regardless of stage (P less than .0001), as did the use of brachytherapy, while the use of external beam radiation decreased.

After the researchers controlled for numerous demographic and clinical variables, chemotherapy was associated with a statistically significant decrease in the risk of death overall (hazard ratio, 0.78; 95% confidence interval, 0.69 to 0.88) and in patients with stage IB (HR, 0.58; 95% CI, 0.44-0.77) or stage II cancer (HR, 0.74; 95% CI, 0.60-0.90). The use of brachytherapy also was associated with significantly improved survival overall (HR, 0.67), in stage IA cancer (HR, 0.67), and in stage II cancer (HR, 0.64).

The survival effect of brachytherapy held up in additional subgroup analyses, Dr. Cham explained. In contrast, external beam radiation therapy was not associated with improved survival overall or in any subgroup, she said. The results highlight the potential use of vaginal brachytherapy in early-stage uterine papillary serous carcinoma, she emphasized.

Dr. Cham cited no funding sources and reported having no conflicts of interest.

NATIONAL HARBOR, MD. – Next-generation sequencing of high-grade serous ovarian tumor specimens taken during interval debulking identified several mutations that matched those in cell-free DNA (cfDNA), Rebecca C. Arend, MD, said at the annual meeting of the Society of Gynecologic Oncology.

Furthermore, three of four patients whose ovarian cancer recurred had mutations in cfDNA that were previously detected in tumors, said Dr. Arend of the University of Alabama at Birmingham.

Researchers continue to search for ways to spare patients with ovarian cancer from serial biopsies, Dr. Arend noted during a video interview. As part of that work, she and her associates performed longitudinal next-generation sequencing of 50 genes in tumor and plasma specimens from 14 patients with high-grade serous ovarian cancer.

Mutations found only in tumors were relatively consistent before and after neoadjuvant chemotherapy, while mutations found only in cell-free DNA varied substantially.

The researchers also sequenced plasma samples from four patients at cancer recurrence. Three patients had at least one mutation that was previously detected in their tumor sample. Implicated genes included PIK3CA, TP53, KIT, and KDR.

Many studies have sought circulating tumor markers that reliably predict tumor recurrence. When it comes to cfDNA, “we are not there yet,” but the work is worthwhile, Dr. Arend stressed. Sequencing tumor and cfDNA specimens from patients at multiple points during their journey might one day help pinpoint mutations that reliably predict cancer recurrence, sparing patients from repeated biopsies and helping them efficiently enter clinical trials that target their specific mutation, she added.

Dr. Arend cited no funding sources and reported having no conflicts of interest.

NATIONAL HARBOR, MD. – Next-generation sequencing of high-grade serous ovarian tumor specimens taken during interval debulking identified several mutations that matched those in cell-free DNA (cfDNA), Rebecca C. Arend, MD, said at the annual meeting of the Society of Gynecologic Oncology.

Furthermore, three of four patients whose ovarian cancer recurred had mutations in cfDNA that were previously detected in tumors, said Dr. Arend of the University of Alabama at Birmingham.

Researchers continue to search for ways to spare patients with ovarian cancer from serial biopsies, Dr. Arend noted during a video interview. As part of that work, she and her associates performed longitudinal next-generation sequencing of 50 genes in tumor and plasma specimens from 14 patients with high-grade serous ovarian cancer.

Mutations found only in tumors were relatively consistent before and after neoadjuvant chemotherapy, while mutations found only in cell-free DNA varied substantially.

The researchers also sequenced plasma samples from four patients at cancer recurrence. Three patients had at least one mutation that was previously detected in their tumor sample. Implicated genes included PIK3CA, TP53, KIT, and KDR.

Many studies have sought circulating tumor markers that reliably predict tumor recurrence. When it comes to cfDNA, “we are not there yet,” but the work is worthwhile, Dr. Arend stressed. Sequencing tumor and cfDNA specimens from patients at multiple points during their journey might one day help pinpoint mutations that reliably predict cancer recurrence, sparing patients from repeated biopsies and helping them efficiently enter clinical trials that target their specific mutation, she added.

Dr. Arend cited no funding sources and reported having no conflicts of interest.

NATIONAL HARBOR, MD. – Next-generation sequencing of high-grade serous ovarian tumor specimens taken during interval debulking identified several mutations that matched those in cell-free DNA (cfDNA), Rebecca C. Arend, MD, said at the annual meeting of the Society of Gynecologic Oncology.

Furthermore, three of four patients whose ovarian cancer recurred had mutations in cfDNA that were previously detected in tumors, said Dr. Arend of the University of Alabama at Birmingham.

Researchers continue to search for ways to spare patients with ovarian cancer from serial biopsies, Dr. Arend noted during a video interview. As part of that work, she and her associates performed longitudinal next-generation sequencing of 50 genes in tumor and plasma specimens from 14 patients with high-grade serous ovarian cancer.

Mutations found only in tumors were relatively consistent before and after neoadjuvant chemotherapy, while mutations found only in cell-free DNA varied substantially.

The researchers also sequenced plasma samples from four patients at cancer recurrence. Three patients had at least one mutation that was previously detected in their tumor sample. Implicated genes included PIK3CA, TP53, KIT, and KDR.

Many studies have sought circulating tumor markers that reliably predict tumor recurrence. When it comes to cfDNA, “we are not there yet,” but the work is worthwhile, Dr. Arend stressed. Sequencing tumor and cfDNA specimens from patients at multiple points during their journey might one day help pinpoint mutations that reliably predict cancer recurrence, sparing patients from repeated biopsies and helping them efficiently enter clinical trials that target their specific mutation, she added.

Dr. Arend cited no funding sources and reported having no conflicts of interest.