Find out about the latest UK research looking at ovarian cancer.
Research into prevention and early detection
There are various trials looking at ways to prevent and detect ovarian cancer earlier.
We outline some of these trials below.
Screening for ovarian cancer
At the moment, there is no screening test reliable enough to use for ovarian cancer. A trial called UKCTOCS has been looking at ovarian cancer screening in the general population between the ages of 50 to 74. They were looking at the CA125 blood test and transvaginal ultrasound scan.
The UK Familial Ovarian Cancer Screening Study (UK FOCSS) is looking at screening women who are at a high risk of developing ovarian cancer because they have a family history of cancer of the ovary or breast, or they have family members with a known genetic fault (such as BRCA 1 or BRCA 2).
The research team found that yearly screening may not be enough to detect early stage ovarian cancer in women who are at high risk of developing the disease.
From these screening studies, researchers now have a large number of blood samples that they can study to try and find biomarkers, other than CA125, for ovarian cancer.
BRCA 1 and 2 and other genes
We can now test for 3 gene faults involved in ovarian cancer. If you have breast cancer and ovarian cancer in your family, it may be that people in your family are carrying a fault in one of the cancer genes BRCA1 or BRCA2. If you have one of these gene faults, you have an increased risk of breast and ovarian cancer.
Another gene fault that increases risk of ovarian cancer is HNPCC (hereditary non polyposis colorectal cancer), also called Lynch syndrome.
Scientists have discovered that faults in the RAD51D gene can also increase the risk of developing ovarian cancer. Testing for this gene fault in the future may be helpful for women with a family history of the disease. The researchers hope this discovery may also lead to the development of new treatments.
It is important to remember that most cancers happen because of damage to cells that occurs during our lives, not because we have inherited any specific gene fault. But the Familial Ovarian Cancer Registry trial found that in families where at least 2 relatives have (or have had) ovarian cancer, there were faults in the BRCA1 or BRCA2 genes.
Fluid and ovarian tissue samples
Researchers are looking at tissue and body fluid samples which they hope will help them diagnose, monitor and treat ovarian cancer more easily. Read about one of these trials.
Research into borderline ovarian tumours
Borderline ovarian tumours are not considered to be true cancers. They are made up of abnormal cells that may become cancer. They develop in the ovary but do not usually grow into surrounding tissue and rarely spread.
Doctors and researchers want to find out more about how these tumours develop. They will gather information from samples of tumour tissue. They will also look at what treatment women have and will collect data from follow up visits.
They hope this information will help them to be able to shape treatments to better suit individual women in the future.
Research into treatment
Past trials have found which chemotherapy drugs work well for ovarian cancer. But current trials are testing the best time to have chemotherapy, the best combinations and doses of drugs, and different ways of giving chemotherapy.
Biological therapies are drugs that change the way cells work. They can boost the body's immune system to fight off or kill cancer cells, or they can block signals that tell cells to grow.
There are many different types of biological therapy, including:
Growth factor blockers
Growth factor blocker drugs work by blocking proteins that make cells grow and multiply. Nintedanib (BIBF 11200) and trametinib are examples.
Blood supply blockers
Blood supply blocker drugs stop tumours from developing their own blood vessels. Without its own blood supply, a cancer cannot continue to grow. Angiogenesis means growth of new blood vessels, so you may hear these drugs called anti angiogenic drugs.
Three blood supply blocker drugs being tested in ovarian cancer trials are:
- bevacizumab (Avastin)
- cediranib (Recentin)
- pazopanib and fosbretabulin (also known as CA4P or combretastatin).
Monoclonal antibodies recognise abnormal proteins on cancer cells. They can:
- change how the cancer cell works
- take chemotherapy or radiotherapy into the cell to kill it
- make it easier for the immune system to recognise and kill cancer cells
Monoclonal antibodies being researched in ovarian cancer include nivolumab and ipilimumab.
PARP-1 inhibitors are drugs that block proteins that help cells repair their DNA. Rucaparib and olaparib are examples.
Vaccines help the immune system recognise and attack cancer cells. Research is looking at how they can stop cancers coming back. There is a trial looking at a vaccine called TroVax for ovarian cancer.
Research is trying to find out whether hormone treatment may help women with hormone receptor positive gynaecological cancer. The drug anastrozole is being studied in the PARAGON trial.
Helping with bowel problems after radiotherapy
Side effects of radiotherapy for ovarian cancer include frequent bowel movements, diarrhoea, pain, bleeding from the bowel and the forming of scar tissue in the bowel (radiation fibrosis). Trials are looking at ways to help with these side effects.
The PPALM trial is looking at the use of a palm oil supplement and a drug called pentoxifylline to relieve symptoms caused by pelvic radiotherapy. Doctors think these may work well together to reduce radiation fibrosis. The trial team want to find out if this combination of treatment helps, and to learn more about the side effects.