What`s new in ovarian cancer research?
Risk factors and causes
The genes involved in familial ovarian cancer ae being studied. Research is looking at how these genes normally work and how changes can lead to cancer. In the future, this research could lead to new drugs to prevent and treat certain types of ovarian cancer.
Learning how genetic and hormonal factors (such as use of “the pill”) are involved may also lead to better ways to prevent ovarian cancer.
New knowledge about how much BRCA1 and BRCA2 gene changes increase ovarian cancer risk is helping women make decisions about prevention. For instance, there are ways to help estimate how many years of life an average woman with a BRCA gene change might gain by having both ovaries and fallopian tubes removed to prevent ovarian cancer from starting. Doctors can predict the average outcome of a group of many women, but they still can’t predict the outcome for any one woman.
Recent studies suggest that many primary peritoneal cancers and some ovarian cancers really start in the fallopian tubes. Cells from these very early fallopian tube cancers can become detached and then stick to the surface of the peritoneum or the ovaries. For reasons that are still not understood, these cancer cells may grow more quickly in their new locations.
If this theory is correct, some experts have suggested that some women with a strong family history and/or BRCA gene mutations might think about having just their fallopian tubes removed. They then can have their ovaries removed when they are older. This approach lets women keep their ovaries working longer and perhaps avoid problems from lack of estrogen, such as bone loss, cardiovascular disease, and menopause symptoms. But because this approach might not help breast cancer risk as much. This is an active area of research.
Other studies are testing new drugs to reduce ovarian cancer risk. Researchers are always looking for clues such as lifestyle, diet, and medicines that may alter the risk of ovarian cancer.
Finding ovarian cancer early
Better methods for finding ovarian cancer early could have a great impact on the cure rate. A national “bank” for blood and tissue samples from women with ovarian cancer is being set up. This will allow researchers to look for patterns of blood proteins in women with ovarian cancer. This might help them find new ways to test (screen) for ovarian cancer.
Two large studies of screening tests have been done − one in the United States and the other in the United Kingdom. Both studies looked at using the CA-125 blood test along with ovarian ultrasound to find ovarian cancer. In these studies, more cancers were found in the women who were screened. Some of these were found at an early stage. But the outcomes of the women who were screened were not better than the women who weren’t screened. The screened women did not live longer and were not less likely to die from ovarian cancer.
From time to time, lab companies have marketed unproven tests to look for early ovarian cancer. Because these tests had not yet been shown to help find early cancer, the US Food and Drug Administration (FDA) told the companies to stop selling them. So far, this happened with 2 different tests: OvaSure and OvaCheck. Both were taken off the market at the request of the FDA.
A test called OVA1 is meant to be used in women who have an ovarian tumor. It measures the levels of certain proteins in the blood. The levels of these proteins, when looked at together, are used to assign women with tumors into 2 groups: low risk and high risk. The women labeled low risk are not likely to have cancer. The women who are called high risk are more likely to have a cancer and so should have surgery done by an expert (a gynecologic oncologist). This test is NOT a screening test - it is only meant for use in women who have an ovarian tumor.
Research into treatment includes testing methods now in use as well as finding new treatments.
New chemotherapy (chemo) drugs and drug combinations which may help treat cancers that resist current treatments are always being studied. Studies are also looking at using targeted therapy drugs to fight ovarian cancer.
Another approach is to give intraperitoneal chemotherapy (IP) chemo during surgery using heated drugs. While it can be effective, it is very toxic. It still needs to be studied and compared with standard IP chemo to see if it really works better.
Targeted therapy is a newer type of cancer treatment that uses drugs or other substances to find and attack cancer cells while doing little damage to normal cells. Each type of targeted drug works differently, but they all attack the cancer cells’ inner workings. Bevacizumab (Avastin) is the targeted drug that has been studied best in ovarian cancer, but other drugs are also being looked at, as well.
Pazopanib (Votrient®) is a targeted therapy drug that, like bevacizumab, helps stop new blood vessels from forming. It has shown some promise in studies.
Enzymes have been found that act to control cell survival and cell death. Drugs that work against these enzymes help fight cancers caused by mutations in BRCA1 and BRCA2. These drugs may make cancers in women without BRCA mutations respond better to radiation treatment and some kinds of chemo. Clinical trials are in going on to find out whether these drugs will improve outcomes for ovarian cancers in women without BRCA mutations.
Other treatments are being studied. One approach is to make tumor vaccines that program the immune system to better spot cancer cells. Also, monoclonal antibodies that find and attack ovarian cancer cells are being developed. Monoclonal antibodies are like the antibodies our bodies make to fight infection. But these are made in the lab and are aimed at the cancer cells. Farletuzumab is a monoclonal antibody that is aimed at a protein on the surface of ovarian cancer cells. It has shown promise in treating ovarian cancer in early studies. Another monoclonal antibody being studied in ovarian cancer is called catumaxomab. When it is given into the belly (abdominal cavity), it can help treat fluid buildup (ascites) that can happen when cancer is present.
Last Medical Review: 04/22/2013
Last Revised: 02/06/2014