Experts Meeting on Gynecologic Oncology May 19-21, 2016 San Antonio,Texas, USA

Theme: Integrating the Milestones in Gynecologic Oncology Globally

Summary

Gynecology oncology is the field of medicine that focuses on cancers of the female generative system, including vaginal cancer, ovarian cancer, cervical cancer,uterine cancer. As experts they have wide training in the diagnosis and treatment of these cancers.

In 2012, there were about 4.7 million cases of women cancer worldwide in which 54% casesarose in less developed countries. Gynecologic Cancers, with cancer of the vulva, vagina, endometrium, ovary, placenta and adnexa, accounted for 9% of all female major tumours worldwide and 45% of all genital cancers.

Although the occurrence and mortality from endometrial and ovarian cancer are major, other cancers are very uncommon. Primary cancers of the vulva, vagina, placenta and adnexa total 0.6% of all woman cancers.

Gynecologic Cancer Statistics

In the world 82,000 women are identified with Gynecologic cancer each year. In 2013, an expected 91,730 were diagnosed.

An estimated 88,000 new cases of Gynecologic cancer were expected to be diagnosed in 2014 in the U.S.A, and over 29,000 American females will lose their battle with this deadly disease. In addition to imposing a significant load on patients and their relations, Gynecologic cancer places a major burden on the health care organization. Despite advances in cancer care in the United States, cancer-related diseases and death for advanced and recurrent Gynecologic malignancies remain at intolerable stages.  Endometrial cancer has seen a slight rise in both new cancer incidents and annual death rates over the past 30 years.

Every woman is at risk for emerging a Gynecologic Cancer. It is expected that there will be about 98,000 new cases diagnosed and around 30,000 deaths from Gynecologic Cancers in the United States during 2015.

Cancer of the Ovary

Accounting for 3% of all cancers in women and figuring more than 165,000 new cases estimated in2013, ovarian cancer is the sixth most common female cancer and the sixth prominent cause of death in women globally. In Canada, ovarian cancer accounts for 4% of all female cancers or 31%ofall genital cancers in women, it is estimated that in 2014 there were 2,500 new cases and 1,500 deaths

There is large variation in incidence rates of ovarian cancer worldwide, from 3/100,000 in central Africa to 13/100,000 in northern Europe. Developing nations have incidence rates that are nearly half those of the most resource-rich countries. Canada and the United States are the countries with the highest rates of ovarian cancer globally, with rates of 12 and 11 per 100,000 respectively. Within countries, mortality rates are generally negative indicators of the region's incidence, and unlike the situation for other Gynecologic Cancers, mortality from ovarian cancer does not seem to be related to the country's level of development.

Cancer of the Vulva

Although tumours in the vulva occur two to three times as frequently as those in the vagina, they are still a rare finding. The cancer registry reporting the most elevated incidence rate of vulvar cancer is that of Prince Edward Island in Canada (2.6/100,000 women). Rates above 2/100,000 are found elsewhere, in Peru and Brazil (2.5/100,000 and 2.3/100,000 respectively). All provinces in Canada have rates above 1/100,000 women; these are among the highest reported internationally.

Cancer of the Endometrium

Most neoplasias of the corpus of the uterus develop in the endometrium which is the seventh most common malignancy affecting women worldwide, with almost 190,000 cases annually It is the most common uterine malignancy in Canada, accounting for 43% of all female genital cancers.

There is great difference in the incidence rates of endometrium internationally. The highest threat areas are Central and North America and Polynesia, whereas rates that are 10 times lower occur in western Africa. Canada and the United States Incidence rates are among the 20 highest worldwide (14.9 and 15.5 per 100,000 respectively). High-risk countries with better resources tend to have relatively low mortality rates.

Cancer of the Vagina

Neoplasms of the vagina are extremely uncommon. The reported annual age-standardized incidence rate is less than 1/100,000 women in all countries with the exception of Argentina (1.5/100,000) and Colombia (1.2/100,000). Nova Scotia is the Canadian province with the highest ASIR for vaginal cancers at 0.8/100,000 which is ranked fourth highest in the world. For the other reporting provinces, rates vary between 0.3/100,000 and 0.7/100,000. Since neoplasia found in the vagina may represent infiltration of primary cancers occurring in a different place in the body, it is possible that such rates are inflated.

Incidence Rate in USA:

Scope and Importance of Gynecologic Oncology Research

Ovarian cancer presents a very varied prognosis depending on age: whilst 70% of the group between 15 and 44 years survives this form of cancer, this is the case for only 19% of those over 74 years-old.

Cervical cancer is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in females’ worldwide, accounting for 9% (529,800) of the total new cancer cases and 8% (275,100) of the total cancer deaths among females. More than 85% of these cases and deaths occur in developing countries.

Tumor biology early detection, and treatment of ovarian cancer in older women as compared to younger women suffering with this malignancy. Effort was devoted to the type of problems met in conducting the analyses and, where data were inadequate, recommending research guidelines or approaches.

The center are at the forefront of research in the early discovery of ovarian cancer and uterine cancer , which is involved in developing blood tests to precisely determine the absence or presence of early stage ovarian cancer before it reveals, as well as on going translational research programs for all Gynecologic Cancers.  Physicians are also involved in leading-edge programs in the prevention of cervical cancer through regular screenings and the identification of precancerous cervical lesions associated with papilloma virus infections.

Organized screening procedures can support to detect Gynecologic Cancer, including cervical cancer, uterine cancer, and ovarian cancer, early.

A pap smear can identify cervical and uterine cancers. It is suggested to begin analysis every three years early at age 21.

A pelvic exam images the rectum, vagina, cervix, fallopian tubes, uterus, ovaries, and Pelvic tests should be done annually, beginning at 21 and can help detect irregularities of the female reproductive system.

An endometrial tissue sample checks for abnormal cells or signs of uterine cancer which can be done for women with a high risk for endometrial cancer due to an inborn susceptibility or when there are symptoms that need to be evaluated.

Why it’s in San Antonio, USA.

Gynecologic Cancer confers a large burden among women in the United States. Several evidence-based interventions are available to reduce the incidence, morbidity, and mortality from these cancers. The National Comprehensive Cancer Control Program (NCCCP) is uniquely positioned to implement these interventions in the US population. Every woman is at risk for developing a Gynecologic Cancer. It is estimated that there will be about 91,000 new cases diagnosed and approximately 28,000 deaths from Gynecologic Cancers in the United States during 2014.Post-menopausal women aged 45–70 years have the highest risk of developing uterine cancer. It is more common in Caucasian women than in other populations. Women living in North America or Europe develop uterine cancer more often than those living in other parts of the world. Women in higher income groups also tend to be affected more often than women in lower income groups.

Members Associated with Gynecologic Oncology Research

Gynecologic Oncology research associated members in San Antonio are about 418,in USA 5684 members and worldwide about 10214 research members.

Hospitals Associated with Gynecologic Oncology Research

Major Gynecologic Oncology associated hospitals in San Antonio are around 2% when compared to worldwide.

 Hospitals in San Antonio and USA are:

• San Antonio Cancer Care

• Methodist Hospital

• Southwest General Hospital

• Cancer Care Centers of South Texas

• Methodist Women's Center

• Metropolitan Methodist Hospital

• South Texas Oncology Group

• Advocate Good Samaritan Hospital

• Anderson Hospital

• Aspirus Wausau Hospital

• Aultman Hospital

• Aurora St. Luke's Medical Center

• Banner Good Samaritan Medical Center

• Barnes-Jewish Hospital

• Beaumont Hospital

• Bon Secours Memorial Regional Medical Center

• Boone Hospital Center

• Boston Medical Center

• Brigham and Women's Hospital

• Bryn Mawr (Pa.) Hospital

• Carle Foundation Hospital

• Cedars-Sinai Medical Center

• Christiana Hospital

• Dartmouth-Hitchcock Medical Center

• Duke University Hospital

• Emory University Hospital

• Evanston (Ill.) Hospital

• Fairview Southdale Hospital

• Flagler Hospital

• Florida Hospital

• Glendale (Calif.) Memorial Hospital and Health Center

• Gundersen Lutheran Medical Center

• Hackensack (N.J.) University Medical Center

• Halifax Health Medical Center of Daytona Beach

• Hutzel Women's Hospital

• Hartford (Conn.) Hospital

• Holy Cross Hospital

• Hospital of the University of Pennsylvania

• Huntington Hospital

• Indiana University Health Methodist Hospital/University Hospital (Indianapolis)

• Ingalls Memorial Hospital

• Inova Fairfax Hospital

• Johns Hopkins Hospital

• Keck Hospital of the University of Southern California

• Lancaster (Pa.) General Hospital

• LDS Hospital

• Magee-Womens Hospital of UPMC

• Massachusetts General Hospital

• MedStar Georgetown University Hospital

• Memorial Hermann Memorial City Medical Center

Societies Associated with Gynecologic Oncology Research

In world there are about 9,685 societies which are specifically associated with Gynecologic Oncology, in which 1289 societies are from USA and the remaining 269 societies are from San Antonio.

American gynecological and obstetrics society

American society of clinical oncology

National cancer institute

Society of Gynecologic Oncology

Society of Gynecologic nurse Oncologists

International Gynecologic cancer society

American college of Phlebology

American congress of Obstetricians and Gynecologists

Asian Society of Gynecologic Oncology

Female Genital Tract Pathology

Foundation for Women's Cancer

GYN-ONC - Gynecologic Cancers Support Group

Gynecologic Oncology

Gynecologic Oncology Group

Northern Gynecologic Oncology Centre

Queensland Centre for Gynecologic Oncology

Industries Associated with Gynecologic Oncology Research

Industries associated with Gynecologic cancer over all world is about 85% in which 12% of industries are in USA and in San Antonio about 3%.

·        Johnson & Johnson

·        Novartis

·        Roche

·        Pfizer

·        Sanofi

·        Merck

·        Bristol-myers squibb

·        Eli Lilly

·        Celgene

·        Takeda

·        AstraZeneca

·        Merck & Co.

·        Amgen

·        Bayer

·        Otsuka

·        Pharmacyclics

·        Incyte

Universities Associated with Gynecologic Oncology Research

Gynecologic cancer associated universities in world are about 3284, in USA 612 universities.

The University of Texas at San Antonio

The University of Texas Health Science centre at San Antonio

Trinity University

St. Mary's University

Our Lady of the Lake University

Baptist University of the Americas

University of Texas Medical Branch

University of Texas Medical School at Houston

University of Texas Rio Grande Valley School of Medicine

Dell Medical School at The University of Texas at Austin

University of Alabama School of Medicine

University of Arizona College of Medicine

Charles R. Drew University of Medicine and Science

Keck School of Medicine of University of Southern California

Loma Linda University School of Medicine

Stanford University School of Medicine

UC Davis School of Medicine

University of California, Irvine School of Medicine

David Geffen School of Medicine at UCLA

UC Riverside School of Medicine

University of California, San Diego School of Medicine

University of Colorado School of Medicine

Frank H. Netter M.D. School of Medicine at Quinnipiac University

University of Connecticut School of Medicine

Yale School of Medicine

George Washington University Medical School

Georgetown University School of Medicine

Howard University College of Medicine

Florida Atlantic University Charles E. Schmidt College of Medicine

Florida State University College of Medicine

University of Florida College of Medicine

University of South Florida College of Medicine

Mercer University School of Medicine

Loyola University Chicago Stritch School of Medicine

Northwestern University Feinberg School of Medicine

Rush Medical College

Indiana University School of Medicine

University of Iowa Roy J. and Lucille A. Carver College of Medicine

University of Kansas School of Medicine

University of Kentucky College of Medicine

University of Louisville School of Medicine

Louisiana State University School of Medicine in New Orleans

Tulane University School of Medicine

Johns Hopkins University School of Medicine

Boston University School of Medicine

Harvard Medical School

Oakland University William Beaumont School of Medicine

Wayne State University School of Medicine

Mayo Clinic College of Medicine

University of Minnesota Medical School

University of Mississippi School of Medicine

University of Missouri-Columbia School of Medicine

Rutgers New Jersey Medical School

University of New Mexico School of Medicine

Icahn School of Medicine at Mount Sinai

New York Medical College

New York University School of Medicine

Market Value on Gynecologic Oncology Research

The global Gynecologic cancer market in 2010 was valued at $54bn, an increase of 5.1% over the previous year‘s sales of $51.3bn, and is forecasted to grow at a CAGR of 6.9% from 2010–16, reaching $81bn in 2016.    Collectively, the seven major markets (US, 5EU, and Japan) represented 79.1% (or $43bn) of in the global cancer market in 2010. In terms of size, the US dominated the global cancer market, with 2010 sales of $21bn and a market share of 38.5%. The global cancer market is becoming increasingly competitive, with two therapeutic classes, namely antineoplastics and cytostatic hormonal treatments, dominating this sector. Collectively, the leading 10 brands accounted for almost 58.2% (or $31.4bn) of the global cancer market in 2010. In 2010 antineoplastics was the leading drug class in the global cancer market. The global antineoplastic market was valued at $46bn in 2010 at a year-on-year (Y-o-Y) growth of 7.3%. The major drugs that contributed to the 2010 sales in the antineoplastic category were Roche‘s Avastin (bevacizumab) at $6.2bn, Herceptin (trastuzumab) at $5.2bn, and MabThera (rituximab) at $5.1bn, with Y-o-Y sales growth of 3.8%, 3.1%, and 3.3% respectively. The cytostatic hormonal market registered 2010 sales of $8bn at a Y-o-Y decline of 6.5%. AstraZeneca‘s Arimidex (anastrozole) and Novartis‘s Femara (letrozole) led this class, reaching sales of $1.5bn and $1.3bn respectively in 2010

Market Growth of Gynecologic Oncology Research in the last and upcoming ten years

TechNavio's analysts forecast the Global Gynecologic Cancers market to grow at a CAGR of 12.47% over the period 2013-2018. One of the key factors contributing to this market growth is the increase in prevalence of gynecological cancer. The Global Gynecologic cancer market has also been witnessing the emergence of personalized medicines. However, the increase in use of CAM could pose a challenge to the growth of this market. In next ten years as population ages, the number of people diagnosed with cancer is expected to be double. According to the American Cancer Society, cancer accounts for every 1 of every 4 in U.S deaths, for women it is one in three .The volume of cancer services continues to grow. Radiation therapy by 3%,infusion therapy by 7% ; Gynecologic services by 10%(annually).With earlier detection,cancer patients will be identified earlier with improvements in chemotherapy,patients will be able to tolerate more treatments, all of which will result in more treatments per patient and more lives saved.

Fund Allotment to Gynecologic Oncology Research

Fund allotted to the individual types of Gynecologic Cancer research in Dollars for Ovarian, Cervical and Uterine cancers 147$, 119$ and 59$ in which Cervical cancer is funded majorly.

Statistics of Physicians, Researchers and Academicians working on Gynecologic Oncology

San Antonio's Biosciences industry employs over 100,000 people. The largest areas of research are conducted by institutes in or around the South Texas Medical Center. These include the oncology division of one of the world's top five biotechnology firms, the world's largest Phase I clinical trials program for new anti-cancer drugs, and the new $200 million woman’s Cancer Research Institute. San Antonio also houses the world's largest genomics computing cluster and the state's public bank for stem cell-rich umbilical cord blood.

Products manufactured by the industry related Gynecologic Oncology Research

Market Value:

·        Neosar (Cyclophosphamide)- manufactured by Roxane Laboratories Inc and the market value is17.06$

·        Paraplat (Carboplatin)-manufactured byBristol-Myers Squibb Companyand the market value is128$

·        Platinol (Cisplatin)-manufactured byBristol-Myers Squibb Companyand the market value is15.3$

·        Gemzar (Gemcitabine Hydrochloride)-manufactured by Eli Lilly and Companyand the market value

          is26.1$

·        Clafen (Cyclophosphamide)-manufactured bySelleckchemand the market value is150$