Investigating Causes for poor outcomes of ovarian cancer patients in Manitoba
Our team is working toward improving the life expectancy for Manitoba women diagnosed with ovarian cancer. Recently published research suggests that Manitoba women have a poorer chance for survival than other Canadian women. We will develop a database with the intention of obtaining an accurate understanding of the survival statistics and to identify any factors that contribute to potentially decreased survival. We will develop the database and ask two initial questions: 1) compare outcome with the type of physician treating the patients, and 2) compare outcome with the type of treatment patients receive (e.g. surgery, chemotherapy, surgery + chemotherapy). By answering these initial questions, we can develop tools to help direct patients to specialist treatment more rapidly, and to identify best treatment options for the population of Manitoba women affected by this disease. This research will uncover whether the burden of ovarian cancer in Manitoba women is higher than the rest of Canada. We will create educational resources to promote the best care to improve overall survival.
Department Investigator(s): Dr. Alon Altman (PI); Dr. Robert Lotocki (Co-I)
Dr. Erin Dean (Co-I); Dr. Shaundra Popowich (Co-I);
Dr. Mark Nachtigal (Co-I)
Funding Agency: CancerCare Manitoba Foundation Operating Grant
Year 1 - $35,241
Year 2 - $22,783
Paclitaxel/Carboplatin versus Doxorubicin/Cisplatin as Postoperative Adjuvant Chemotherapy for Advanced Endometrial Adenocarcinoma
Endometrial cancer is the fourth most common cancer in women. There is no consensus among caregivers regarding optimal therapy in patients diagnosed with stage III or IV disease. For many institutions, postoperative adjuvant chemotherapy is the mainstay of therapy in these patients but no standard chemotherapy protocol has been established. Doxorubicin/cisplatin has been considered a standard regimen for treating advanced endometrial cancer. However, paclitaxel has emerged as a chemotherapeutic agent with the greatest single agent response rate and, when compared to doxorubicin, a lower toxicity rate. At the Tom Baker Cancer Centre, a doxorubicin/cisplatin regimen was used in the past as adjuvant chemotherapy for the treatment of advanced endometrial adenocarinoma. This chemotherapy regimen has since been substituted for a paclitaxel/carboplatin regimen to reduce the incidence of adverse events. Our goal is to determine if this change in chemotherapy regimen has had an effect on progression free survival and overall survival in women diagnosed with stage IIIc and IV endometrial endometrioid adenocarcinoma and if there was indeed a reduction in the adverse events experienced by patients. A retrospective cohort study will be undertaken of all women with stage IIIc or IV endometrial endometrioid adenocarcinoma treated with at least one cycle of paclitaxel/carboplatin chemotherapy at the Tom Baker Cancer Centre in Calgary, Alberta. For comparison, an equal number of charts will be selected and reviewed from a similar cohort of patients treated with at least one cycle of the doxorubicin/cisplatin chemotherapy. Our primary outcome is the progression free survival and 3 year survival rate. The adverse events experienced by the patients in the following categories: hematologic toxicity, neurotoxicity, gastrointestinal toxicity, cardiac toxicity, dermatologic toxicity, nephrotoxicity and ototoxicity will also be compared.
Department Investigator(s): Dr. Alon Altman (Co-I)
Funding Agency: --
Nutritional status and the effects on ovarian cancer patients
Department Investigator(s): Dr. Alon Altman (Co-I)
Funding Agency: --
Time to surgery and the risk of cancer progression in patients with gynecologic cancers of the lower genital tract
Cancers of the cervix, vulva, and vagina are an important cause of morbidity and mortality among women. Limited research has been done to examine the risk of progression of early invasive cancer to more advanced disease. It is unclear whether there is a risk of progression of cancers of the lower genital tract during time to surgery. It is important that this be evaluated, so that we can gain evidence to support a definition of appropriate surgical wait times. The aim of this study is to examine whether there is a risk of cancer progression with increased time to surgical treatment in patients with early-stage cervical, vulvar, and vaginal cancers. This is to be achieved through a population-based retrospective cohort study including all women presenting with stage I squamous cell carcinoma of the cervix, vulva, and vagina undergoing primary surgical treatment in Calgary, Alberta between the years of 2000-2010. Data is to be obtained through a review of health records. Pertinent dates, information relating to cancer stage, and several patient characteristics will be collected. Cancer stage and disease characteristics will be compared at two time points: time of initial presentation to Gynecologic Oncology and time of surgery. Times of initial contact with a Primary Care Physician, General Gynecologist, or a Colposcopist will also be used as points for comparison. Statistical analysis will involve a comparison of the proportion of patients with cancer progression in relation to time to surgical treatment.
Department Investigator(s): Dr. Alon Altman (Co-I)
Funding Agency: --
Combined Methotrexate and Actinomycin D for Gestational Trophoblastic Neoplasms
A retrospective chart review for the treatment of gestational trophoblastic neoplasm at CancerCare Manitoba from 1977-2010 will be undertaken. Low-risk disease (as determined by their FIGO risk score 0-6) has been treated with alternating Methotrexate and Actinomycin-D. The literature has shown that both agents have low rates of toxicity and good efficacy. Multiple regimens have been described, rarely with both agents used in combination. High-risk disease (as determined by their FIGO risk score >7) is conventionally treated with multi-agent chemotherapy, and again there is no consensus regarding optimal regimen. This study examines the use of both Methotrexate and Actinomycin-D in an alternating regimen for low-risk GTN in order to determine response rates and toxicity. Data collection will also include the high risk GTN group for determination of toxicity and response rates within that group using various treatment
Department Investigator(s): Dr. Alon Altman (Co-I); Dr. Robert Lotocki (Co-I);
Dr. Erin Dean (Co-I); Dr. Shaundra Popowich (Co-I)
Funding Agency: --
Mathematical modeling of ovarian cancer survival based on hematological values
Department Investigator(s): Dr. Alon Altman (Co-I)
Funding Agency: --
CHREC - Canadian High Risk Endometrial Cancer Consortium: Unlocking the differentiating high risk subtypes of endometrial cancer
Department Investigator(s): Dr. Alon Altman (Co-I)
Funding Agency: Society of Gynecologic Oncology Research Study
Randomized Clinical Trial Comparing Mini-Arc with Trans-Vaginal Obturator Tape (TVT-O) for Surgical Management of Stress Urinary Incontinence
Department: Investigator(s): Dr. Ken Maslow (PI)
Funding Agency: --
Medications use patterns, treatment satisfaction, and inadequate control of osteoporosis study (MUSIC-OS): an international study of postmenopausal women treated for osteoporosis in clinical practice
Department Investigator(s): Dr. Richard Boroditsky (PI)
Funding Agency: Merck Sharp & Dohme Corp.
Molecular epidemiology of human papillomavirus in cervical cancer in Manitoba
Department Investigator(s): Dr. Robert Lotocki (Co-I)
Funding Agency: Manitoba Health
NanoVanlent vs. Quadravalent Vaccine
Department Investigator(s): Dr. Robert Lotocki (Co-I)
Funding Agency: Merck
Clinical Presentation and Management of Cervical Cancer in Manitoba: A 10 year experience
Department Investigator(s): Dr. Robert Lotocki (PI)
Funding Agency: --
NCIC CTG OV. 18/MRC ICON 6 - A Randomized Placebo-Controlled Trial of Concurrent Cediranib (AZD2171)(with Platinum Based Chemotherapy) and concurrent and maintenance Cediranib in women with platinum-sensitive relapsed ovarian cancer
Department Investigator(s): Dr. Robert Lotocki (PI)
Funding Agency: --
Phase 2B Randomized International Double-Blinded/Controlled with Gardasil, Dose-Ranging, Tolerability, Immunogenicity, (Cont.) and efficacy study of a multivalent HPVL/VLP vaccine administered to 16 - 26 year old women
Department Investigator(s): Dr. Robert Lotocki (PI)
Funding Agency: MERCK
New Plan for patient attending Early Pregnancy Assessment Clinic: Is ultrasound really necessary at a B HCG <500m/u/mL
Women who are seen in the emergency department of Health Sciences Centre with bleeding in pregnancy under 14 weeks gestational age and who re suitable for outpatient management are currently referred to the Early Pregnancy Assessment Clinic (EPAC). This program started in January 2006. Patients are initially seen by a nurse, then have an ultrasound performed by an obstetrician and/or a bhCG to determine the need for further management. We would like to review our patients to see if there is a bhCG and a clinical scenario-eg absence of severe pain where a patient can have a repeat bhCG only. This will decrease the waiting time required for the patient appointment.
Department Investigator(s): Dr. Helen Pymar (Co-I)
Funding Agency: --
A study of quality of life, anxiety and depression in women with abnormal uterine bleeding
Department Investigator(s): Dr. Richard Boroditsky (PI)
Funding Agency: --
Database and permission to be contacted for Future Research (formerly "Mature Women's Program Research Database and Permission to be Contacted for future Research")
Department Investigator(s): Dr. Richard Boroditsky (PI)
Funding Agency: --
IDM-001-01 Thermablate EAS Endometrial Ablation for Heavy Menstrual Bleeding
Department Investigator(s): Dr. Richard Boroditsky (PI)
Funding Agency: --
20101218 Prospective Observational Study to Evaluate Persistence with Prolia (Denosumab) in Postmenopausal Women with Osteoporosis in Routine Clinical Practice
Department Investigator(s): Dr. Richard Boroditsky (PI)
Funding Agency: --
CZOL446HAC 10 IVORY: Intra-Venous zOledRonic acid once yearly: A real-world study cohort of post menopausal women with osteoporosis in Routine Clinical Practice
Department Investigator(s): Dr. Richard Boroditsky (PI)
Funding Agency: --