Ovarian cancer treatment & prevention: promising new approaches

Genetic analysis is an emerging field of cancer research. For ovarian cancer, such research can lead to better prevention and more effective treatments.
Our Chief Medical Officer provides the latest details.

 

Women with known family history of breast or ovarian cancer may have an inherited susceptibility for ovarian cancer. These women are usually carriers of BRCA1 or BRCA2 mutations.

In a very recent study, researchers analyzed tumors of ovarian cancer patients without family history, as well as DNA from their normal tissues. In 20% of these cases, they identified several inherited genetic variants that increase the risk of developing ovarian cancer. [1]

Some of these variants occurred in genes already known to be associated with genetic predisposition to ovarian cancer, such as BRCA1 and BRCA2. However, other genetic variants occurred in genes without a known relationship to this type of cancer. This is a very important piece of information and requires further studies to identify possible acquired gene mutations.

Improving ovarian cancer treatment by genetic analysis

Genetic analysis of tumors may prove a very useful tool in treating cancer, by predicting which combination chemotherapy is more effective for each patient. This is because, even for a specific cancer type, tumors are not the same in all patients. Therefore, identifying the exact tumor characteristics may allow for more targeted treatments.

Many studies on this topic are ongoing, and researchers have already published some initial reports [2].

Preventing ovarian cancer: the impact of BRCA1 & BRCA2

In the field of prevention, new information appeared recently in the literature, which is important for women at high risk of ovarian cancer due to genetic mutations [3]. 

In particular, women with BRCA1 mutation may develop ovarian cancer at an earlier age, and therefore prophylactic oophorectomy (surgical removal of ovaries) should be considered by the age of 35.

On the other hand, women with BRCA2 mutation may delay their decision for oophorectomy until they reach their 40^th year of age.

Overall, based on this study, women with BRCA1 and BRCA2 mutations following prophylactic oophorectomy had a 77% lower risk of death by age 70.

Conclusion

Genetic analysis is a powerful tool for ovarian cancer prevention in high-risk women, who carry mutations of the BRCA1 or BRCA2 gene, or other mutations which are still being investigated by the research community.

In addition to prevention, ovarian cancer genomics is also very important for treatment of patients who have already developed the disease. Scientists are actively researching for further enhancements which can make treatments more efficient, and this is a source of great hope for patients.

References

1. Krishna L. Kanchi, Kimberly J. Johnson, Charles Lu, Michael D. McLellan, Mark D. M. Leiserson, Michael C. Wendl, Qunyuan Zhang, Daniel C. Koboldt, Mingchao Xie, Cyriac Kandoth, Joshua F. McMichael, Matthew A. Wyczalkowski, David E. Larson, Heather K. Schmidt, Christopher A. Miller, Robert S. Fulton, Paul T. Spellman, Elaine R. Mardis, Todd E. Druley, Timothy A. Graubert, Paul J. Goodfellow, Benjamin J. Raphael, Richard K. Wilson, Li Ding. Integrated analysis of germline and somatic variants in ovarian cancer. Nature Communications, 2014; 5 DOI: 10.1038/ncomms4156. http://www.nature.com/ncomms/2014/140122/ncomms4156/full/ncomms4156.html
2. Kim Y, Guntupalli SR, Lee SJ, Behbakht K, Theodorescu D, et al. (2014) Retrospective Analysis of Survival Improvement by Molecular Biomarker-Based Personalized Chemotherapy for Recurrent Ovarian Cancer. PLoS ONE 9(2): e86532. doi:10.1371/journal.pone.0086532. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0086532
3. Amy P.M. Finch, Jan Lubinski, Pål Møller, Christian F. Singer, Beth Karlan, Leigha Senter, Barry Rosen, Lovise Maehle, Parviz Ghadirian, Cezary Cybulski, Tomasz Huzarski, Andrea Eisen, William D. Foulkes, Charmaine Kim-Sing, Peter Ainsworth, Nadine Tung, Henry T. Lynch, Susan Neuhausen, Kelly A. Metcalfe, Islay Thompson, Joan Murphy, Ping Sun, and Steven A. Narod. Impact of Oophorectomy on Cancer Incidence and Mortality in Women With a BRCA1 or BRCA2 Mutation. Journal of Clinical Oncology, JCO.2013.53.2820, 24 February 2014: http://jco.ascopubs.org/content/early/2014/02/24/JCO.2013.53.2820.abstract