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Research in ovarian and fallopian tube cancers
Ovarian and fallopian tube cancers include peritoneal cancer, which is a very rare cancer. Cancers that start in the ovaries, fallopian tubes and peritoneum are closely related, and they are treated the same way.
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 and fallopian tube cancers. They are also looking for ways to improve the quality of life of women with ovarian or fallopian tube cancer.
The following is a selection of research showing promise for ovarian and fallopian tube 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).
Preventing ovarian and fallopian tube cancers
Some substances or behaviours may prevent ovarian and fallopian tube cancers or lower your risk of developing them. The following is noteworthy research into ways to prevent ovarian and fallopian tube cancers or lower your risk.
Prophylactic salpingectomy is surgery to remove the fallopian tubes before cancer develops. Researchers now believe that most high-grade serous carcinomas (a type of epithelial tumour) start in the fallopian tubes rather than in the ovaries (Obstetrics and Gynecology, PMID 28885426). The advantage of removing just the fallopian tubes to lower the risk for cancer is that the ovaries remain in place, which means women do not experience the problems of treatment-induced menopause. Studies are looking at prophylactic salpingectomy to lower the cancer risk for women who have BRCA gene mutations and have a high risk for developing ovarian and fallopian tube cancers (The Oncologist, PMID 28314837; International Journal of Gynecological Cancer, PMID 29252925). Other research is looking at whether the incidence of ovarian cancer is lower in women who are not at high risk of the disease but have had a salpingectomy to treat a non-cancerous gynecological condition or to prevent pregnancy (South Asian Journal of Cancer, PMID 29600234). More research is needed to find out the role that prophylactic salpingectomy has in reducing the risk of ovarian and fallopian tube cancers in women with normal risk or high risk for the disease.
Find out more about research in cancer prevention.
Finding ovarian and fallopian tube cancers early
Screening tests help find ovarian and fallopian tube cancers before any signs or symptoms develop. This is important because most women with ovarian or fallopian tube cancer are diagnosed with advanced disease, as there are few early symptoms. The following is noteworthy research into screening for ovarian and fallopian tube cancers.
Transvaginal ultrasound, CA-125 testingor a combination of both may help find ovarian and fallopian tube cancers early. A recent review looked at screening trials for these cancers. The study noted that screening tests caused women to have surgery that they did not need because the tests falsely indicated ovarian or fallopian tube cancer. Results found that regardless of the type of test, there was no difference in the number of women who died from ovarian and fallopian tube cancers when compared to women who did not have screening tests (JAMA, PMID 29450530). More research is needed to determine which tests can find ovarian cancer and fallopian tube cancers more effectively.
Find out more about research in screening and finding cancer early.
Diagnosis and prognosis
A key area of research looks at better ways to diagnose and stage ovarian and fallopian tube cancers. Researchers are also trying to find ways to help doctors predict a prognosis (how likely it is that the cancer can be successfully treated or that it will come back after treatment). The following is noteworthy research into diagnosis and prognosis.
Biomarkers 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 biomarker may mean that a person has a certain type of cancer. Tumour marker tests can also help doctors predict the prognosis or response to treatment in people with ovarian and fallopian tube cancer. Researchers are looking at the following biomarkers to see if they can help doctors diagnose, predict recurrence or resistance to treatment, and find out which treatments will benefit a woman with ovarian or fallopian tube cancer:
- HE4 (Expert Review of Anticancer Therapy, PMID 28756722)
- transthyretin (TTR) (Journal of Gynecology Obstetrics and Human Reproduction, PMID 29609043)
- CA 72.4 and anti-TP53 autoantibodies (Expert Review of Molecular Diagnostics, PMID 28468520)
Find out more about research in diagnosis and prognosis.
Researchers are looking for new ways to improve treatment for ovarian and fallopian tube cancers. 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. The following is noteworthy research into treatment for ovarian and fallopian tube cancers.
Targeted therapy uses drugs to target specific molecules (for example, genes or proteins) in cancer cells to stop them from growing and spreading. Researchers are studying targeted therapy drugs as maintenance therapy after chemotherapy to see if they will reduce recurrence and improve survival in women with ovarian or fallopian tube cancer. They are also looking at certain targeted therapy drugs as additions to standard chemotherapy treatments, or as a treatment by themselves, to see if using these drugs are better or more effective treatments.
- ribociclib (Oncotarget, PMID 29644000)
- mirvetuximab soravtansine (Future Oncology, PMID 29424243)
- cediranib (Recentin) (Expert Opinion on Pharmacotherapy, PMID 28933580)
PARP inhibitors are drugs that slow or stop a protein called poly(ADP-ribose) polymerase, which helps a cell repair DNA damage. PARP inhibitors are effective against high-grade serous ovarian and fallopian tube cancers that are sensitive to platinum drugs, which are used to treat these cancers (Therapeutic Advances in Medical Oncology, PMID 28491146; Recent Patents on Anticancer Drug Discovery, PMID 29512470). Researchers are looking at different PARP inhibitors to treat ovarian and fallopian tube cancers, including rucaparib (Cancer Treatment Reviews, PMID 29605737; The Lancet, PMID 28916367).
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. Bevacizumab (Avastin) is an anti-angiogenesis drug currently being used to treat ovarian and fallopian tube cancers. Researchers are studying other drugs of this type to see if they are also effective for these cancers, including trebananib (Gynecologic Oncology, PMID 27546885; European Journal of Cancer, PMID 27914241) and nintedanib (Expert Opinion on Investigational Drugs, PMID 28721753).
Hyperthermic intraperitoneal chemotherapy (HIPEC)
Intraperitoneal chemotherapy uses chemotherapy drugs injected into the abdominal cavity. When the drugs are warmed before being put into the abdominal cavity, it is called hyperthermic intraperitoneal chemotherapy (HIPEC). While researchers have been studying both forms of chemotherapy for a number of years, more research is needed to find out if either can be used as a standard treatment for ovarian or fallopian tube cancer (Annals of Oncology, PMID 29232474; International Journal of Hyperthermia, PMID 28092994). A recent study reported that women who received HIPEC after surgery had longer periods of time before the cancer came back when compared to women who only had surgery. There was no difference in side effects between the 2 groups (New England Journal of Medicine, PMID 29342393).
Learn more about cancer research
Researchers continue to try to find out more about ovarian and fallopian tube cancers. Clinical trials are research studies that test new ways to prevent, detect, treat or manage cancer that starts in the ovaries, fallopian tubes or peritoneum. 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 and fallopian tube cancers were first shown to be effective through clinical trials.
The membrane that lines the walls of the abdomen and pelvis (parietal peritoneum), and covers and supports most of the abdominal organs (visceral peritoneum).
BRCA1 and BRCA2 genes are tumour suppressor genes. Changes to genes are called mutations. Mutations of the BRCA genes are inherited from one or both parents, and these mutations increase the risk of cancer.
Women with BRCA mutations have a higher risk of breast and ovarian cancers. Men with BRCA mutations also have a higher risk of breast cancer, and may have a higher risk of prostate cancer. The risk of other cancers – such as stomach or pancreatic cancer – may also be higher with BRCA mutations.
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.
I’m extremely grateful to the Canadian Cancer Society for funding my research with an Innovation Grant.
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