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Research in ovarian cancer
We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat ovarian cancer. They are also looking for ways to improve the quality of life of women with ovarian cancer.
The following is a selection of research showing promise for ovarian cancer. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract). We have also included links to abstracts of the research presented at meetings of the American Society of Clinical Oncology (ASCO), which are held throughout the year.
Reducing the risk of ovarian cancer
Prophylactic salpingectomy is surgery to remove the fallopian tubes before cancer develops. New research suggests that most high-grade serous carcinomas (a type of epithelial tumour) start in the fallopian tubes rather than in the ovaries (American Journal of Surgical Pathology, PMID 25517954). Researchers hope that this different understanding of how ovarian cancer starts will lead to new ways of testing for, reducing the risk of and treating ovarian cancer (American Journal of Obstetrics and Gynecology, PMID 25818671). Studies are trying to find out if women who have a high risk for ovarian cancer should have surgery to remove their fallopian tubes rather than surgery to remove their ovaries.
Find out more about research in reducing the risk of cancer.
Diagnosis and prognosis
A key area of research looks at better ways to diagnose and stage ovarian cancer. Researchers are also trying to find ways to help doctors predict a prognosis (the probability that the cancer can be successfully treated or that it will come back after treatment). The following is noteworthy research into diagnosis and prognosis.
ADAMTS gene mutations
Gene mutations are changes to a normal gene. Researchers think that testing for ADAMTS gene mutationsmay help doctors identify ovarian cancer that will respond better or longer to chemotherapy. The presence of these mutations may also help doctors predict who will have a better long-term prognosis (JAMA Oncology, PMID 26181259).
Tumour markers are substances, such as proteins, genes or pieces of genetic material like DNA and RNA, that are found naturally in the body. They can be measured in body fluids like blood and urine or tissue that has been removed from the body. A gene mutation or a change in the normal amount of a tumour marker can mean that a person has a certain type of cancer. Tumour marker tests can help doctors predict the prognosis or response to treatment in women with ovarian cancer.
Looking for tumour markers in vaginal washing fluids may help doctors find cancerous ovarian tumours. A study found cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) in vaginal washing fluids. It also found that levels of these tumour markers, especially CA125, were higher in vaginal washing fluids from women with cancerous ovarian tumours and lower in fluids from women with non-cancerous conditions. More research is needed to find out the role that vaginal washing fluids may play in looking for tumour markers, but researchers think that they could use these fluids to help diagnose ovarian cancer (European Journal of Gynecological Oncology, PMID 26513883).
Human epididymis protein 4 (HE4) is normally found in ovary cells. Research shows that ovarian cancer cells make more HE4 than healthy ovary cells. One study found that a higher than normal level of HE4 is a better marker of ovarian cancer than the presence of CA125 (European Journal of Gynecological Oncology, PMID 26390703). Another study found that high levels of HE4 in the urine identified women with ovarian cancer. High levels of HE4 in the urine also helped doctors identify tumours of borderline malignancy that had a higher risk of becoming cancerous (Gynecologic Oncology, PMID 25866324). Studies also show that high HE4 levels may help doctors identify ovarian cancer that is more likely to spread quickly (Oncotarget, PMID 26575020). High levels of HE4 may help doctors identify ovarian cancer that will not respond to chemotherapy with platinum drugs. Platinum drugs are platinum-based chemotherapy drugs, such as cisplatin or carboplatin (Paraplatin, Paraplatin AQ). High levels of HE4 may also help doctors predict which cancers are more likely to come back after treatment (Gynecologic Oncology, PMID 25866324).
Lysophosphatidic acid (LPA) levels can help doctors diagnose cancerous ovarian tumours. Studies show that testing for a high level of LPA is a better way to find ovarian cancer before it spreads than testing for the presence of CA125. They also found that LPA levels increase as ovarian cancer spreads (Journal of Cancer Research and Therapeutics, PMID 26148603; Journal of Obstetrical and Gynecological Research, PMID 26472266; Lipids in Health and Disease, PMID 26174150).
Hair loss (alopecia) is a common side effect of chemotherapy for ovarian cancer. Researchers recently reviewed the results of several studies that looked at how much hair loss women had and when it started during their chemotherapy for ovarian cancer. They found that survival was longer when a woman lost almost all of her hair by the 3rd treatment than if it took more chemotherapy treatments for a woman to lose most of her hair (European Journal of Cancer, PMID 25771433). More research is needed to find out whether or not faster hair loss means that cancer is more sensitive to chemotherapy and may have a better prognosis.
Find out more about research in diagnosis and prognosis.
Researchers are looking for new ways to improve treatment for ovarian cancer. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer.
Targeted therapy drugs may be used in maintenance therapy for ovarian cancer. The results of a study that reviewed a large number of clinical trials show that maintenance therapy with targeted therapy drugs improved survival rates for women with ovarian cancer (PLoS One, PMID 26402447). Find out more about targeted therapy.
Anti-angiogenesis drugs slow or stop the growth of new blood vessels. Cutting off the blood supply will starve a tumour of oxygen and nutrients, which it needs to grow. Researchers are currently studying several anti-angiogenesis drugs to treat ovarian cancer, including aflibercept (Zaltrap), cediranib (Recentin), fosbretabulin (Zybrestat), imatinib (Gleevec), nintedanib (Ofev), sorafenib (Nexavar) and sunitinib (Sutent). Some results show that these drugs help increase the time before cancer comes back after treatment (Frontiers in Oncology, PMID 26500886). These drugs can cause many side effects, so researchers are looking for ways to identify ovarian cancer that will respond best to each anti-angiogenesis drug (Expert Opinion in Emerging Drugs, PMID 26001052).
Tyrosine kinase inhibitors block a specific enzyme (called tyrosine kinase) that helps send signals within cells. When this enzyme is blocked, the cells stop growing and dividing. Researchers are currently doing clinical trials to study tyrosine kinase inhibitors as a treatment for ovarian cancer (Expert Opinion in Investigative Drugs, PMID 26560712). One of these trials looked at using pazopanib (Votrient) as maintenance therapy. The results show that pazopanib increased the length of time that women with advanced ovarian cancer lived with the disease without it getting any worse (called progression-free survival). More research is needed to find out the role pazopanib may have as a treatment for ovarian cancer (Expert Review in Anticancer Therapy, PMID 26296187).
Cediranib (Recentin) is a drug that blocks vascular endothelial growth factor (VEGF), which is a protein that tells cells to make new blood vessels. Canadian researchers took part in a trial that looked at using cediranib to treat ovarian cancer that came back after chemotherapy with platinum drugs. The results showed that women who received cediranib had a longer time of progression-free survival if the ovarian cancer had responded to platinum drugs than if the cancer hadn’t responded to these drugs (Gynecologic Oncology, PMID 25895616).
Nintedanib (Ofev) is also a drug that blocks VEGF. A study looked at giving nintedanib to women with newly diagnosed advanced ovarian cancer. All the participants received standard first-line chemotherapy of carboplatin and paclitaxel (Taxol). Some women received nintedanib with this chemotherapy. The findings show that nintedanib combined with carboplatin and paclitaxel increased progression-free survival. But women who received nintedanib had more gastrointestinal side effects than the women who did not receive this drug (Lancet Oncology, PMID 26590673).
Olaparib (Lynparza) is a targeted therapy drug that stops the action of the enzyme poly (ADP-ribose) polymerase (a PARP inhibitor). This type of drug kills cancer cells by preventing them from repairing damage and possibly making them more sensitive to anticancer treatments. It is used to treat advanced ovarian cancer with a BRCA1 or BRCA2 mutation. A study looked at olaparib in women with recurrent ovarian cancer whose original cancer responded to platinum-based drugs. All the participants were given chemotherapy with carboplatin and paclitaxel. Some women received olaparib with this chemotherapy and were also given olaparib as maintenance therapy. The findings showed olaparib with carboplatin and paclitaxel followed by maintenance therapy with olaparib improved progression-free survival better than carboplatin and paclitaxel alone. Women with ovarian cancer that had a BRCA mutation benefited most from olaparib (New England Journal of Medicine, PMID 22452356; Lancet Oncology, PMID 25481791).
Niraparib is a targeted therapy drug (a PARP inhibitor). A study looked at this drug as a treatment for platinum-sensitive, recurrent ovarian cancer. The results of the study show the median length of time of progression-free survival for women who received niraparib was longer than for those who received a placebo, whether or not there was a BRCA mutation (New England Journal of Medicine, PMID 27717299).
Veliparib (ABT-888) is a targeted therapy drug (a PARP inhibitor). Researchers studied veliparib as a treatment for persistent or recurrent fallopian tube cancer, epithelial ovarian carcinoma or primary peritoneal carcinoma in women with a BRCA gene mutation. They looked at how well veliparib worked in treating these cancers and the side effects of the drug in women who had up to 3 previous chemotherapy regimens and had not taken a PARP inhibitor in the past. Results show that further study is needed for veliparib to be given alone as a treatment for these cancers (Gynecologic Oncology, PMID 25818403).
Ixabepilone (Ixempra) given weekly with or without bevacizumab (Avastin) may be a treatment option for women with recurrent or persistent fallopian tube cancer, epithelial ovarian carcinoma and primary peritoneal carcinoma. A study looked at ixabepilone with or without bevacizumab in women with one of these cancers that was resistant to a platinum and taxane chemotherapy regimen. Results show that this combination of drugs appears to have an effect on these cancers and the side effects could be managed. Further study is needed in these groups of women (Gynecologic Oncology, PMID 25792179).
Paclical is a special form of the drug paclitaxel (Taxol), which is often used to treat ovarian cancer. A clinical trial found that paclical and carboplatin had the same effectiveness as the standard chemotherapy of paclitaxel and carboplatin and didn’t cause any more side effects. The advantage of paclical is that it doesn’t cause the same allergic reactions as paclitaxel and it can be given over a shorter period of time (ASCO, Abstract 5517).
Hyperthermic intraperitoneal chemotherapy uses heated chemotherapy drugs injected into the abdominal cavity. Researchers looked at several studies that used hyperthermic intraperitoneal chemotherapy after surgery to remove as much cancer as possible. They found that giving hyperthermic intraperitoneal chemotherapy after surgery improved overall survival. It was effective for both newly diagnosed ovarian cancer and ovarian cancer that came back after treatment (European Journal of Surgical Oncology, PMID 26453145).
Living with cancer can be challenging in many different ways. Supportive care can help people cope with cancer, its treatment and possible side effects. The following is noteworthy research into supportive care for ovarian cancer.
Fertility-sparing surgery leaves at least one ovary, one fallopian tube, the uterus and the cervix in place so that the woman may still be able to have children. It may be a treatment option for low-grade epithelial ovarian carcinomas that have not grown outside of the ovary. This type of surgery may be offered to women younger than 40 years of age who wish to have children. Studies are looking at how many women can become pregnant after this treatment, if the type of chemotherapy given after surgery affects fertility and if there is a higher risk that ovarian cancer will come back after this treatment (Gynecologic Oncology, PMID 25969349; Journal of Surgical Oncology, PMID 26193338).
Hormone replacement therapy (HRT) taken for a short period of time can help treat the symptoms of treatment-induced menopause and improve the quality of life for ovarian cancer survivors. Researchers reviewed several studies that looked at HRT in ovarian cancer survivors and found that HRT did not increase the risk of cancer coming back or lower overall survival rates (Gynecologic Oncology, PMID 26232517). Women who are thinking about taking HRT should talk to their doctor because it can increase the risk of blood clots and stroke. It may also increase the risk of breast cancer.
Learn more about cancer research
Researchers continue to try to find out more about ovarian cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage ovarian cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for ovarian cancer were first shown to be effective through clinical trials.
Treatment given after the first-line therapy (the first or standard treatment) to keep a disease (such as cancer) under control or to prevent it from coming back (recurring). It may be given for a long period of time.
Maintenance therapy may include drugs, vaccines, antibodies or hormones.
Research at the Canadian Centre for Applied Research in Cancer Control led to a new standard in leukemia testing.
What’s the lifetime risk of getting cancer?
The latest Canadian Cancer Statistics report shows about half of Canadians are expected to be diagnosed with cancer in their lifetime.