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1.
Gynecol Oncol Rep ; 50: 101296, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37920829

RESUMO

As Immune checkpoint inhibitors are being expanded for use in gynecologic malignancies, rare immune-related adverse events are more frequently being reported. Here we describe a 63-year-old with Stage IIIB mismatch repair deficient uterine adenocarcinoma who underwent six cycles of carboplatin and paclitaxel with partial response but persistent disease. She was then started on single agent pembrolizumab. After six cycles of pembrolizumab, she developed bilateral vision changes and was diagnosed with posterior scleritis. Pembrolizumab was held and she was treated with oral prednisone, with rapid resolution of symptoms. One month after completion of prednisone, vision changes were again reported and she was restarted on a longer oral prednisone course. She then underwent definitive surgical management consisting of a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy, with final pathology of benign endometrial hyperplasia. She has completed her steroid course without any symptoms. Given her complete pathologic response, she was subsequently placed into surveillance and is currently without evidence of disease. Prompt recognition and treatment of this rare immune-related adverse event led to the prevention of potential permanent, debilitating outcomes.

2.
Semin Oncol Nurs ; 35(2): 166-174, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30878194

RESUMO

OBJECTIVE: To provide an overview of the etiology, prevention, diagnosis, treatment, and long-term survivorship concerns surrounding cervical cancer. DATA SOURCES: A review of articles dated 2006-2018 from PubMed. CONCLUSION: The landscape for cervical cancer is changing dramatically because of vaccine-driven prevention. Despite these advances, there are both newly diagnosed individuals as well as survivors of cervical cancer who require continued evidence-based care. IMPLICATION FOR NURSING PRACTICE: Nurses are integral in diverse settings to promote prevention through timely vaccination, as well as to educate patients about the signs, symptoms, and management of cervical cancer when it occurs.


Assuntos
Neoplasias do Colo do Útero/fisiopatologia , Neoplasias do Colo do Útero/terapia , Fatores Etários , Gerenciamento Clínico , Feminino , Humanos , Fatores de Risco
3.
Gynecol Oncol ; 151(2): 374-380, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30213435

RESUMO

The success of targeted and immune therapies in other malignancies has led to an exponential increase in the number of active and pending clinical trials using these therapeutic approaches in patients with gynecologic cancers. These novel investigational agents are associated with unique and potentially life-threatening toxicities and many require special multidisciplinary logistical considerations. The objective of this review is to describe a practical approach for the safe implementation of targeted and immune therapies in academic gynecologic oncology practices based on our experience at M.D. Anderson Cancer Center.


Assuntos
Neoplasias dos Genitais Femininos/imunologia , Neoplasias dos Genitais Femininos/terapia , Imunoterapia/métodos , Antineoplásicos Imunológicos/uso terapêutico , Feminino , Humanos , Imunoterapia/efeitos adversos , Imunoterapia/normas , Imunoterapia Adotiva/métodos , Terapia de Alvo Molecular
4.
Front Oncol ; 6: 102, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27200291

RESUMO

Fertility preservation in the young cancer survivor is recognized as a key survivorship issue by the American Society of Clinical Oncology and the American Society of Reproductive Medicine. Thus, health-care providers should inform women about the effects of cancer therapy on fertility and should discuss the different fertility preservation options available. It is also recommended to refer women expeditiously to a fertility specialist in order to improve counseling. Women's age, diagnosis, presence of male partner, time available, and preferences regarding use of donor sperm influence the selection of the appropriate fertility preservation option. Embryo and oocyte cryopreservation are the standard techniques used while ovarian tissue cryopreservation is new, yet promising. Despite the importance of fertility preservation for cancer survivors' quality of life, there are still communication and financial barriers faced by women who wish to pursue fertility preservation.

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