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Certain integrins that control the growth of tumors may be missing in cancerous cervical tumors. Integrins are cell receptors that control cell reproduction and differentiation. Researchers analyzed 18 tissue samples from cervical tumors and four normal samples and found that the integrins alpha-3, -4, and -5 were missing in the cells lining the cervical tumors. The greater the lack of integrin alpha-5, the greater the number of cancerous cells. Future cancer treatments may be based on manipulating the activity of integrins, perhaps with fibronectin, a natural cell adhesive.

In spite of the use of cisplatin, other powerful anti-cancer drugs, and the development of chemotherapy using multiple drugs, the survival rate of women with ovarian cancer in later stages (from IIC to IV) is still under 25 percent. Recurrent ovarian cancer is often resistant to drugs and radiation, even if the tumor is small, and no therapy is known to be curative in the majority of these cases. Hexamethylmelamine is an anti-cancer drug that has been used since 1964. Over 30 percent of patients with new ovarian cancer, and up to 20 percent of those previously treated, respond to this agent. However, its use in ovarian cancer is not standardized, as it has not been rigorously evaluated. Eight years of experience in treating 49 patients with recurrent or persistent ovarian cancer is described. The average patient age was 59 years old, and 40 had stage III to IV disease at diagnosis. Forty-six of the 49 patients had previously received cisplatin-based chemotherapy. Of 24 women with non-measurable tumors, seven were alive at 10 to 35 months after start of hexamethylmelamine, five without sign of disease. Of 25 the women with measurable tumors, three had complete and two had partial responses to treatment, a response rate of 20 percent. Patients who did not respond to cisplatin-based chemotherapy did not respond to hexamethylmelamine. Side effects were mild and included numbness or tingling on arms or legs, nausea, weakness, muscle aches, and herpes zoster infections. The results indicate that hexamethylmelamine is generally well tolerated and is active against ovarian cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

In patients with locally advanced cervical cancer, cancer cells have spread from the primary cancer in the cervix to lymph nodes in the pelvic area, particularly the para-aortic lymph nodes in the back near the aorta. Such patients have a high risk of cancer recurrence after surgery, and radiotherapy is the mainstay of treatment for these patients. As a part of research evaluating the treatment of cervical cancer, data were collected from 626 patients with primary carcinoma of the cervix; all had surgical evaluation of the para-aortic lymph nodes and received radiation therapy. These data were analyzed to determine which factors bear most strongly on the risk of recurrence and upon the likelihood of long-term survival from this cancer. The data analysis revealed that the para-aortic lymph nodes were an especially strong prognostic factor. In most forms of cancer, the spread of cancer cells to neighboring lymph nodes indicates a worse prognosis. In the case of cervical cancer, the spread of cancer cells to the pelvic lymph nodes doubles the risk of suffering recurrence and dying within a given time. However, if cancer cells are found in the para-aortic lymph nodes, the relative risk of recurrence is 11 times greater and the relative risk of dying is over six times as great. It is important to always obtain pathological information on the para-aortic lymph nodes in cases of cervical cancer, as this is the single most meaningful prognostic factor. As would be expected, larger cancers and more advanced cancers are also significantly associated with an increased risk of recurrence and death. When conducting clinical trials of treatment programs for cervical cancer, the failure to pathologically examine the para-aortic lymph nodes would result in considering together patients with drastically different prognoses; this would very likely make interpretation of the effects of treatment difficult or impossible. In the present series of patients, two-thirds of the patients who have been followed for at least five years have died. (Consumer Summary produced by Reliance Medical Information, Inc.)