Ovarian Cancer

Ovarian Cancer

Advances in treatment and an improved understanding of ovarian cancer have led to longer lives and better quality of life for women with the disease.

The breakthrough discovery that specific gene mutations – in the BRCA 1 and 2 genes – increase a woman's risk for ovarian and breast cancer has led to important risk-reducing strategies. Additionally, recent studies have shown that ovarian cancer is not one disease, but a spectrum of related diseases with unique genetic characteristics, creating the potential for developing more effective, personalized treatment regimens. 
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2018

Maintenance Olaparib Extends Progression Free Survival in Patients With Advanced BRCA-Mutated Ovarian Cancer

Maintenance Olaparib Extends Progression Free Survival in Patients With Advanced BRCA-Mutated Ovarian Cancer

Poly (ADP-ribose) polymerase, or PARP inhibitors, represent a major treatment advance in ovarian cancer. These enzymes promote cancer cell death by interfering with DNA replication in cancers that have faulty DNA damage-repair genes, such as BRCA1/2. In this phase-III trial, women with newly diagnosed advanced-stage BRCA-mutated ovarian cancer received maintenance therapy with the PARP inhibitor olaparib following surgery and chemotherapy. Women treated with olaparib had a 70% lower risk of disease progression or death compared to no maintenance treatment. Not only did these results lead to FDA approval of olaparib for this indication, they represent a big step forward in treating patients with this type of cancer.

 

More Information: 

N Engl J Med 2018;379:2495-2505

2010

Bevacizumab significantly delays progression of advanced ovarian cancer

Bevacizumab significantly delays progression of advanced ovarian cancer

Badge indicating that research was paid for using federal funds

A large study finds that adding the targeted drug bevacizumab (Avastin) to initial chemotherapy treatment, and then using it as longer term "maintenance" therapy, significantly slows the spread of the disease in women with cancer in their ovaries and surrounding tissue. Bevacizumab is designed to interfere with the growth of blood vessels needed to fuel a tumor's growth – a process called angiogenesis. The drug continues to be studied to determine its optimal use and whether it actually extends the lives of women with ovarian cancer.

More Information: 

Journal of Clinical Oncology; 28(18)
Journal of Clinical Oncology 2008; 26(1); 76-82
Pre-surgery chemotherapy proven an effective option for women with advanced ovarian cancer

Pre-surgery chemotherapy proven an effective option for women with advanced ovarian cancer

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Major European trial reports that giving chemotherapy prior to surgery (called neo-adjuvant chemotherapy) or after surgery (called adjuvant chemotherapy) is equally effective in women with advanced ovarian cancer. These results resolve long-standing debate and provide an important treatment alternative, particularly for women with larger tumors. In this group, giving chemotherapy first can shrink the tumors so that less extensive surgery is needed later on in the course of therapy.

More Information: 

Cancer.Net; Treatment Options
N Engl J Med 2010; 363: 943-53
Regular CA125 testing to monitor for ovarian cancer recurrence is questioned

Regular CA125 testing to monitor for ovarian cancer recurrence is questioned

A major study suggests that women who have completed ovarian cancer treatment may not need frequent CA125 blood tests to monitor for early signs of disease recurrence. (CA125 is a protein found at elevated levels in the blood of women with ovarian cancer and other conditions to track response to treatment). The study finds that overall survival is similar between patients who restart cancer treatment based on recurrence detected by regular CA125 testing and those who restart treatment when physical symptoms of recurrence arise. Debate continues over the implications of these findings and whether CA125 testing is justified in these patients.

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Lancet 2010; 376(9747): 1155-63

2009

Preventive surgery confirmed to reduce breast and ovarian cancer risk in women with BRCA gene mutations

Preventive surgery confirmed to reduce breast and ovarian cancer risk in women with BRCA gene mutations

Badge indicating that research was paid for using federal funds

A major review of previously published studies confirms that surgical removal of the ovaries and fallopian tubes in healthy premenopausal women with BRCA gene mutations reduces the risk of breast cancer by 51 percent and the risk of ovarian and fallopian tube cancers by 79 percent. Among postmenopausal women with BRCA gene mutations, this surgery is found to significantly reduce the incidence of ovarian cancer but not breast cancer.

Without the surgery, women with inherited mutations in the two BRCA genes have up to an 84 percent lifetime risk of breast cancer and up to a 46 percent risk of ovarian and fallopian tube cancers. With these data, women with these mutations have a proven option for reducing their cancer risk, although it comes with many side effects (including early-onset menopause) and prevents women of child-bearing age from having children.

More Information: 

Cancer.Net; Ovarian, Fallopian Tube, and Peritoneal Cancer
Journal of the National Cancer Institute 2009; 101: 80–87

2008

Researchers identify at least two ovarian cancer subtypes

Researchers identify at least two ovarian cancer subtypes

Badge indicating that research was paid for using federal funds

Researchers begin showing that ovarian cancer is not one disease, but many. In particular, researchers identify two types of ovarian cancer tumors, called low malignant potential and low grade ovarian tumors and poorly differentiated tumors, which are especially unique. The former tends to be slow-growing, whereas the latter is far more aggressive. These findings pave the way for research on personalized regimens for each subtype, with the goal of sparing patients with less-aggressive tumors from potentially unnecessary treatment and providing them with more effective therapies.

More Information: 

Frontiers in Bioscience : A Journal and Virtual Library; 14: 2089–2102
Curr Oncol Rep. 2008;10(6): 519-23

2006

Direct chemotherapy approach increases survival

Direct chemotherapy approach increases survival

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Researchers report that adding intraperitoneal chemotherapy – delivering chemotherapy directly into the abdomen through a catheter – to intravenous chemotherapy following surgery extends survival by over a year for women with advanced ovarian cancer, compared to surgery and intravenous chemotherapy alone. This report confirms two earlier studies and based on the combined findings, the National Cancer Institute encourages physicians to discuss the newer approach with certain patients with advanced disease. This combination regimen causes more side effects than intravenous chemotherapy alone, including some that are life-threatening, so researchers continue to study lower-dose and alternative drug approaches that provide may provide similar benefits with fewer side effects.

More Information: 

Cancer.Net; Treatment Options
N Engl J Med 2006; 354: 34-43
NCI Announcement; Treatment for Advanced Ovarian Cancer
Researchers find some ovarian cancers begin in the fallopian tubes

Researchers find some ovarian cancers begin in the fallopian tubes

Badge indicating that research was paid for using federal funds

After assessing tissue samples from women with BRCA gene mutations who had their ovaries and fallopian tubes surgically removed to reduce their cancer risk, researchers discover signs that some ovarian cancers may actually begin in the fallopian tubes and spread to the ovaries. (Women with BRCA gene mutations have a significantly higher risk of developing ovarian and breast cancers, and some choose to undergo preventive surgery.) These fallopian tube cancers, called tubal intraepithelial carcinomas, have different characteristics than cancers arising in the ovaries, suggesting that traditional ovarian cancer therapy may not be the best option. This poses an additional challenge for cancer screening, since cancers that arise in the fallopian tubes are even harder to detect than ovarian cancers, which can sometimes be detected with a pelvic ultrasound.

More Information: 

Cancer.Net; Ovarian, Fallopian Tube, and Peritoneal Cancer
Advances in Anatomic Pathology 2006; 13(1): 1-7

2005

Researchers work to decode the ovarian cancer genome

2003

New chemotherapy regimen – docetaxel and paclitaxel – provides important treatment option

New chemotherapy regimen – docetaxel and paclitaxel – provides important treatment option

A large study finds that combination chemotherapy with docetaxel (Taxotere) and carboplatin (Paraplatin, Paraplat) is as effective as the standard paclitaxel (Taxol) and carboplatin regimen for newly diagnosed, advanced ovarian cancer. The docetaxel combination has different side effects than the paclitaxel combination, offering patients a potential treatment alternative. However, docetaxel is not FDA approved for ovarian cancer and has not been widely used for this purpose in the United States.

More Information: 

Journal of Clinical Oncology 2003; 21(10): 136-44

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