ANZGOG members regularly publish insights into gynaecological cancers to share their knowledge with the international community of researchers.

The following four publications from our members share game-changing updates in our understanding of gynaecological cancers.

Ovarian cancer

Professor David Bowtell, Peter MacCallum Cancer Centre and Principal Investigator of the Australian Ovarian Cancer Study

Whole-genome characterization of chemoresistant ovarian cancer.

Patients with high-grade serous ovarian cancer (HGSC) have experienced little improvement in overall survival, and standard treatment has not advanced beyond platinum-based combination chemotherapy, during the past 30 years.

To understand the drivers of clinical phenotypes better, here we use whole-genome sequencing of tumour and germline DNA samples from 92 patients with primary refractory, resistant, sensitive and matched acquired resistant disease.

Published in Nature, May 2015

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Endometrial cancer

diana adams

Dr Diana Adams, Campbelltown Hospital and Chair of the ANZGOG Endometrial Tumour Working Group

Has the time come to ask why more oncologists are not prescribing it? It’s something quite different – Exercise!

The benefits of exercise for cancer patients has again caught the attention of public and social media in Australia. Quite often the ABC catalyst programme has sent back patients to their doctors to quiz whether they should be on that drug. This time you or your chemotherapy unit may have noticed patients have been asking to actually add something in and for you to prescribe it!

Published in Oncology News, July 2016

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Cervical cancer

linda mileshkin

Professor Linda Mileshkin, Peter MacCallum Cancer Centre and Chair of ANZGOG Research Advisory Committee

The Cervix Cancer Research Network: A Global Outreach Effort on Behalf of the Gynecologic Cancer InterGroup.

Cervix cancer is a worldwide scourge. It is the second leading cause of cancer deaths in women worldwide with a rate of 728 deaths per day. 87% of cervix cancer deaths occur in low- and middle-income countries, with mortality rates varying 18-fold.1 Even in high-income nations, there has been little improvement in survival rates.2 The last major improvement in cervix cancer was published 15 years ago with the superiority of cisplatin-based chemoradiotherapy to radiotherapy alone.3,4

The Cervix Cancer Research Network (CCRN) developed within the Gynecologic Cancer Intergroup (GCIG) out of a realisation that cervical cancer trials were becoming scarce. While cervical cancer rates are declining in GCIG countries, low- and middle-income countries are coping with large disease burdens. This led to extending trial development beyond GCIG borders to involve a network of accredited, capable centres in other areas of the world. It was envisaged that this could harness local enthusiasm to raise standards of care. The CCRN would provide the infrastructure and support for high quality trials.

Published in the International Journal of Radiation Oncology, Biology, Physics

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Quality of life

Professor Michael Friedlander, Prince of Wales Hospital and member ANZGOG Research Advisory Committee.

Patient-reported outcomes (PRO) in ovarian cancer clinical trials—lost opportunities and lessons learned

Despite increased recognition of the value of including patient-reported outcomes (PROs) as important end points in phase III clinical trials, there has been a lack of pre-specified PRO hypotheses and shortcomings with the analyses and interpretation of PROs in many ovarian cancer trials. This paper discusses and provides examples of the so-called lost opportunities in ovarian cancer trials. These include: (i) no clear pre-specified PRO hypotheses; (ii) PRO end points not included; (iii) insensitive PRO end point selection; (iv) collection of poor-quality PRO data not suitable for analysis; (v) differences in PROs between treatment arms ignored; and (vi) poor reporting quality. We can learn from the past and with relatively little additional effort, improve the collection and interpretation of PRO data in future ovarian cancer trials. The importance of doing so is underpinned by recent initiatives to improve the standard and usefulness of PRO data in clinical trials. These include the Food and Drug Administration (FDA) Guidance for PROs to support labelling claims, the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO MCBS), the International Society for Quality-of-Life Research PRO reporting guidance and the Consolidated Standards of Reporting Clinical Trials (CONSORT)—PRO-extension statement which includes a checklist of recommended items to include in PRO sections of trial protocols. Promoting the importance of hypothesis-driven PROs in ovarian cancer clinical trials will lead to improvements in the design of these trials and the interpretation of their results.

Published in the Annals of Oncology, May 2016

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