Objective To assess the clinical efficacy, safety and cost-effectiveness of topotecan for recurrent epithelial ovarian cancer. Methods We searched MEDLINE (1966 to 2005), EMbase (1989 to 2004), CancerLit (1996 to 2003), CBMdisc (1978 to 2005), CNKI (1994 to 2005), The Cochrane Library (Issue 3, 2005), The National Research Register, and the Health Technology Assessment Database (HTA). Relevant journals were also handsearched. The search was conducted on December 31, 2005. Randomize controlled trials (RCTs) comparing topotecan versus other agents for recurrent epithelial ovarian cancer were included. The quality of the eligible trials was assessed by two reviewers independently. Meta-analysis was performed. Results Four RCTs met the inclusion criteria, and the methodological quality was either level A or B. When used as second-line chemotherapy for recurrent ovarian cancer, there was no significant difference in remission rate between topotecan and paclitaxel or pegylated liposomal doxorubicin (PLD). The clinical benefit rate of topotecan was higher than that of paclitaxel or PLD. Myelosuppression was more frequent in patients in the topotecan group than those in the PLD or paclitaxel group, but it was not severe. As to cost-effectiveness analysis, topotecan was better than PLD. Conclusions The standard regimen of topotecan (intravenous 1.5 mg/m2/d for 5 consecutive days) is recommended for use in platinum-resistant and refractory ovarian cancer.
Objective
To estimate the diagnostic value of mesothelin in ovarian cancer.
Methods
PubMed, The Cochrane Library, CBM, CNKI and WanFang Data databases were searched from inception to October 2016 to collect relevant diagnostic accuracy studies of mesothelin in ovarian cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Statistical analysis was performed using Meta-Disc 1.4, Stata 12.0 and RevMan 5.2 softwares. The pooled sensitivity, specificity and diagnostic odds ratio were calculated, the summary receiver operating characteristic curve (SROC) was drawn and the area under the curve (AUC) was calculated.
Results
Seventeen studies involving 2 052 patients were included. The pooled sensitivity, specificity, DOR were 0.63 (95%CI 0.60 to 0.67), 0.92 (95%CI 0.90 to 0.93) and 26.62 (95%CI 14.96 to 47.38), respectively. The AUC and Q index were 0.915 1 and 0.847 8, respectively.
Conclusion
The current evidence indicates that mesothelin has high specificity and low sensitivity, which can’t be used alone as a biomarker for the detection of ovarian cancer, but should be combined with other biomarkers.
Objective To use a meta-analysis method to establish quantitatively the association between the HER-2/neu gene amplification/enhanced protein expression status and the 5-year post-operative survival rate or median survival time in women with epithelial ovarian carcinoma. Methods We searched and screened Chinese and English literature published since 1989 to collect all retrospective cohort studies on the prognostic significance of HER-2/neu status in this population. The survival data were analyzed using Ludwig’s centered signed rank and the DerSimonian-Laird method. Results In total, 25 studies involving 3 251 patients were included. HER-2/neu was positive in 27.1% (95%CI 0 to 54.8%) of patients, which was not related to the pathological stage, type or grade of epithelial ovarian carcinoma. In HER-2/neu positive cases, the median survival time was shortened by 0.65 years, and the 5-year survival rate was lowered. The hazard ratio (HR) for mortality was 1.22 (95%C 1.09 to 1.36). By subgroup analysis, HER-2/neu protein expression was found to be most significant in prognostic assessment. Patients with a b positive value of HER-2/neu had an increased HR for the 5-year survival; and platinum-based chemotherapy was demonstrated to be less effective in HER-2/neu positive ovarian carcinoma. Conclusion In gynecological oncology, it is reasonable to measure HER-2/neu as a routine pathological marker to predict a patient’s prognosis and to determine the most appropriate adjuvant chemotherapy regimen.
Extracellular matrix (ECM) has been implicated in tumor progress and chemosensitivity. Ovarian cancer brings a great threat to the health of women with a significant feature of high mortality and poor prognosis. However, the potential significance of matrix stiffness in the pattern of long non-coding RNAs (lncRNAs) expression and ovarian cancer drug sensitivity is still largely unkown. Here, based on RNA-seq data of ovarian cancer cell cultured on substrates with different stiffness, we found that a great amount of lncRNAs were upregulated in stiff group, whereas SNHG8 was significantly downregulated, which was further verified in ovarian cancer cells cultured on polydimethylsiloxane (PDMS) hydrogel. Knockdown of SNHG8 led to an impaired efficiency of homologous repair, and decreased cellular sensitivity to both etoposide and cisplatin. Meanwhile, the results of the GEPIA analysis indicated that the expression of SNHG8 was significantly decreased in ovarian cancer tissues, which was negatively correlated with the overall survival of patients with ovarian cancer. In conclusion, matrix stiffening related lncRNA SNHG8 is closely related to chemosensitivity and prognosis of ovarian cancer, which might be a novel molecular marker for chemotherapy drug instruction and prognosis prediction.
ObjectiveTo systematically review the effectiveness and safety of intraperitoneal hyperthermic perfusion chemotherapy (IHPC) for ovarian cancer, so as to provide references for clinical practice and studies.
MethodsWe electronically searched PubMed, EMbase, The Cochrane Library (Issue 6, 2013), Web of Science, WanFang Data, CBM, VIP and CNKI for randomized controlled trials (RCTs) about IHPC vs. intravenous chemotherapy (IC) for ovarian cancer from the inception of the databases to June 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Then meta-analysis was performed using RevMan 5.1 software.
ResultsA total of 10 RCTs involving 723 patients were included. The results of meta-analysis showed that the IHPC group was superior to the IC group in clinical efficiency (OR=4.02, 95%CI 2.85 to 5.68, P < 0.000 01), clinical benefit response (OR=3.41, 95%CI 2.13 to 5.45, P < 0.000 01), recurrence and metastasis rates (OR=0.29, 95%CI 0.20 to 0.42, P < 0.000 1), and overall survival rates (OR=3.30, 95%CI 1.82 to 5.99, P < 0.000 1). In the aspect of safety, no significant difference was found in bone marrow suppression, hemoglobin reduction, nausea and vomiting between two groups.
ConclusionIHPC for ovarian cancer can improve clinical efficiency, clinical benefit response and overall survival rates, and reduce recurrence and metastasis rates; and it is also safe for patients.
ObjectivesTo systematically review the efficacy of Chinese herbal medicine (CHM) combined with chemotherapy for ovarian cancer.MethodsCNKI, VIP, WanFang Data and PubMed databases were searched to collect randomized controlled trials on the CHM combined with chemotherapy for ovarian cancer from inception to March 31st, 2018. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsThirteen studies were included. Meta-analysis showed that, CHM combined with chemotherapy group was superior to the chemotherapy alone group in effective rate of TCM syndrome (RR=1.72, 95%CI 1.46 to 2.03, P<0.00.000 1), effective rate of tumor change (RR=1.40, 95%CI 1.21 to 1.63,P<0.000 01), physical condition score (MD=9.19, 95%CI 5.89 to 12.48,P<0.000 01), tumor markers (MD=–18.00, 95%CI –20.62 to –1.538,P<0.000 01), leukocyte reduction (RR=0.67, 95%CI 0.58 to 0.77,P<0.000 01), granulocy tedepletion (RR=0.67, 95%CI 0.55 to 0.81,P<0.000 1), thrombocytopenia (RR=0.55, 95%CI 0.45 to 0.69,P<0.000 01), and digestive tract reaction (RR=0.66, 95%CI 0.50 to 0.87,P=0.004).ConclusionsThe current evidence shows that CHM combined with chemotherapy is superior to chemotherapy alone in the treatment of ovarian cancer. Due to limited quality and quantity of included studies, the above conclusions are required to be verified by more high-quality studies.
Objective
To investigate the effects and underlying mechanisms of human pituitary tumor-transforming gene 1 (hPTTG1) small interfering RNA (siRNA) on apoptosis of ovarian cancer cell line A2780.
Methods
hPTTG1 siRNA was transfected into A2780 with lipofectamine (the hPTTG1 siRNA group), and the normal group and the negative control group were set up. Detections were conducted 48 hours after transfection: the interfering efficiency of hPTTG1 mRNA was measured by real-time polymerase chain reaction, the expression of survivin gene and survivin protein was examined by semiquantitative reverse transcriptase-polymerase chain reaction and Western blot, cell apoptosis was detected by DNA fragmentation gel electrophoresis and propidium iodide staining kit, and the activity of caspase-3 was assayed by caspases colorimetric assay kit.
Results
The expression of hPTTG1 mRNA was expressly inhibited after hPTTG1 siRNA transfection. DNA ladder was observed in the hPTTG1 siRNA group. The apoptotic rate of hPTTG1 siRNA transfection in the hPTTG1 siRNA group was (17.53±2.17)%, higher than those in the normal group and the negative control group [(8.97±1.56)% and (9.64±1.31)%, respectively], with statistically significant differences between them (P<0.05). The expression levels of survivin mRNA and survivin protein were down-regulated. The activity of caspase-3 was raised.
Conclusions
siRNA targeting hPTTG1 could induce apoptosis of A2780 by inhibition of survivin expression and activation of caspase-3. It may be a potential target for gene therapy of ovarian cancer.
High-grade serous ovarian cancer has a high degree of malignancy, and at detection, it is prone to infiltration of surrounding soft tissues, as well as metastasis to the peritoneum and lymph nodes, peritoneal seeding, and distant metastasis. Whether recurrence occurs becomes an important reference for surgical planning and treatment methods for this disease. Current recurrence prediction models do not consider the potential pathological relationships between internal tissues of the entire ovary. They use convolutional neural networks to extract local region features for judgment, but the accuracy is low, and the cost is high. To address this issue, this paper proposes a new lightweight deep learning algorithm model for predicting recurrence of high-grade serous ovarian cancer. The model first uses ghost convolution (Ghost Conv) and coordinate attention (CA) to establish ghost counter residual (SCblock) modules to extract local feature information from images. Then, it captures global information and integrates multi-level information through proposed layered fusion Transformer (STblock) modules to enhance interaction between different layers. The Transformer module unfolds the feature map to compute corresponding region blocks, then folds it back to reduce computational cost. Finally, each STblock module fuses deep and shallow layer depth information and incorporates patient's clinical metadata for recurrence prediction. Experimental results show that compared to the mainstream lightweight mobile visual Transformer (MobileViT) network, the proposed slicer visual Transformer (SlicerViT) network improves accuracy, precision, sensitivity, and F1 score, with only 1/6 of the computational cost and half the parameter count. This research confirms that the proposed algorithm model is more accurate and efficient in predicting recurrence of high-grade serous ovarian cancer. In the future, it can serve as an auxiliary diagnostic technique to improve patient survival rates and facilitate the application of the model in embedded devices.
Objective To assess the clinical effectiveness and safety of paclitaxel liposomes and carboplatin for ovarian cancer. Methods The databases such as The Cochrane Library, PubMed, EMBASE, CNKI and CBM were searched to collect all randomized control trials (RCTs) about the clinical effectiveness and safety of paclitaxel liposomes and carboplatin for ovarian cancer. Literatures were screened according to the inclusive and exclusive criteria, the data were extracted, the methodological quality of the included studies was assessed in line with Cochrane Handbook 5.0.1, and Meta-analysis was performed by using RevMan 5.0.24 software. Results Three RCTs involving 214 patients were included. Meta-analysis showed that compared with the paclitaxel plus carboplatin group, the paclitaxel liposomes plus carboplatin group didn’t show significant differences in the total effective rate (P=0.62), while it was obviously superior in reducing the adverse events, such as muscle and joint pain (Plt;0.000 01), peripheral neurotoxicity (P=0.04), nausea or vomiting (P=0.000 2), facial blushing (P=0.03) and rashes (P=0.003). But there were no significant differences between the two groups in trichomadesis, dyspnea, diarrhea, bellyache and blood system abnormalities. Conclusion As current clinical evidences shows, the paclitaxel liposomes and carboplatin in treating ovarian cancer is as effective as the paclitaxel and carboplatin, and it can reduce some of the adverse reactions. Therefore, the paclitaxel liposomes and carboplatin is available for ovarian cancer as a new, safe and effective treatment. Due to small scale and low quality of the included studies, this conclusion has to be further proved with more high-quality, large-scale, and double-blind RCTs.
