We look forward to providing more news during 2019. As a reminder of what mattered most to you in 2018, here are the 10 most-read articles of last year.
In this study, a research team at Southern Methodist University identified three compounds that prevent cancer cells from pumping out harmful substances that can counter chemotherapy. The compounds inhibited the pumping machinery and, when delivered in combination with chemotherapeutic agents, reversed chemo resistance even in some of the most aggressive forms of ovarian cancer. The approach is a long way from the market, but researchers are hopeful it will bring alternatives to future ovarian cancer patients
Targeting cancer stem cells has also shown some promise in ovarian cancer patients. These cells can proliferate and differentiate to create new tumors, but are mostly resistant to common treatment, being the major cause of relapses and cancer spread. In an ongoing Phase 1 trial (NCT02903771) still recruiting participants, researchers have shown that Kazia Therapeutics’ Cantrixil — which targets cancer stem cells — stabilized disease in 60% of women whose ovarian cancer had failed at least two prior therapies. The treatment also reduced tumor burden in 20% of patients when given in combination with chemotherapy.
Another approach for ovarian cancer treatment might be to increase the levels of functional p53 in cancer cells. p53 is a tumor suppressor protein that inhibits cell proliferation and survival when cells are not working properly, but is mutated in most cancers. Innovation Pharmaceuticals developed a novel p53 modulator, called Kevetrin, that counteracts these mutations and helps abnormal p53 regain its function. The approach showed efficacy in a Phase 2 trial (NCT03042702) for late-stage ovarian cancer patients who failed prior platinum-based chemotherapy; researchers are now working to develop an oral formulation of the treatment.
We reported on a study that aimed to use an online service to improve genetic testing in women at risk of ovarian cancer. The study, called MAGENTA, is recruiting women living in the U.S. who have a family or personal history of breast or ovarian cancer, and have never received genetic testing or counseling. If eligible, participants will receive a saliva test kit at their homes, eliminating the need to travel to a healthcare provider. Women will be tested for 19 genes associated with inherited cancer risk, after which they will be selected for genetic counseling over the phone.
With few therapeutics available for advanced ovarian cancer, a Phase 1b clinical trial is testing a combination treatment of two immunotherapies — Forty Seven‘s Hu5F9-G4 and Merck KGaA‘s Bavencio (avelumab) — in patients who failed platinum-based chemotherapy. The trial (NCT03558139) is recruiting up to 32 participants who have never received an immune checkpoint inhibitor such as Bavencio across five clinical sites in the U.S.
A combination of PARP inhibitors and immune checkpoint inhibitors also seems to benefit heavily treated ovarian cancer patients, as shown in the TOPACIO Phase 1/2 trial (NCT02657889). Ovarian cancer patients who first responded but became resistant to platinum-based chemotherapy experienced a 25% response rate after receiving Zejula (niraparib) and Keytruda (pembrolizumab), and an additional 43% achieved stable disease. For those who failed to respond to platinum-based chemotherapy, response rates were also high, at 24%. These responses were superior to that seen in historical controls treated with either drug alone.
No. 4 — “A Second Surgery Can Improve Survival for Women with Recurring Ovarian Cancer, Study Shows”
A study suggests that women whose ovarian cancer returned after initial surgery and chemotherapy may benefit from a second round of surgery and chemotherapy. This retrospective study included 75 women who received a second surgery and 322 who were offered chemotherapy only after recurrence. Those receiving the surgery followed by chemotherapy lived one year longer without their disease progressing, and survived four years longer than those given chemotherapy alone. Researchers are now conducting two clinical trials to confirm the findings and develop recommended guidelines for patients with recurrent ovarian cancer.
Treatments that prevent cancer cells from repairing their DNA errors have shown promise in multiple cancer types. Cancer cells accumulate mutations at a faster pace than healthy cells, and at some point the mutations become toxic and lead to cell death. Eli Lilly‘s prexasertib prevents cells from pausing cell division for repairing DNA errors, and reduced tumor burden in one-third of women with ovarian cancer in a Phase 2 trial (NCT02203513). The women had failed prior platinum-based chemotherapy and had the most aggressive form of ovarian cancer, yet the treatment kept their tumors from progressing for 7.5 months. Researchers will include ovarian cancer patients with BRCA mutations — who are more susceptible to DNA errors — in the second part of the trial.
No. 2 — “Study Aims to Identify Women with Ovarian Cancer Who May Benefit from Maintenance Treatment”
Lynparza (olaparib) is another treatment that makes cancer cells accumulate DNA errors, and may be given as a maintenance therapy to ovarian cancer patients with BRCA mutations who responded to second-line platinum-based chemotherapy. Researchers are now testing a combination of Lynparza and Avastin (bevacizumab) as an alternative maintenance regimen, and Myriad Genetics and AstraZeneca will be using a genetic test — myChoice HRD Plus — to identify patients more likely to benefit from the combination. The test assesses the mutational status of BRCA1 and BRCA2 and tumor genomic instability — the frequency at which mutations are found within the genome.
The most interesting topic for our readers in 2018 was the use of cell therapy in advanced ovarian cancer. Researchers at Aivita Biomedical are conducting a Phase 2 trial (NCT02033616) with 99 women to test a kind of immunotherapy — called AVOVA-1 — where a patient’s own dendritic cells are used. Once in contact with tumor stem cells from the patient, dendritic cells will teach the immune system to seek out and destroy the tumor. Aivita is also developing a test to determine the effectiveness of the treatment.
At Ovarian Cancer News Today, we hope that these news, along our reporting throughout 2019, help educate, inform, and improve the lives of everyone dealing with ovarian cancer.
We wish all our readers a happy and inspiring 2019.