Chemo given into the abdomen could boost ovarian cancer survival

British Journal of Cancer

Chemotherapy given straight into the abdomen of certain ovarian cancer patients could allow them to live an extra three years on average, according to new research* published in the British Journal of Cancer.

But this extended survival was only found among patients whose tumours had low levels of the protein made by the BRCA1 gene1.

Researchers with the Gynecologic Oncology Group and the University of Pittsburgh compared the overall survival of 400 women who received chemotherapy drugs in different ways. Half the women had their drugs administered directly into the abdomen (intraperitoneal injection) while the other half had the traditional route of treatment, into the vein (intravenous injection).

The researchers then measured the levels of the BRCA1 protein in these women’s tumours.

Results from the study showed that women with low BRCA1 levels in their cancer cells who had intraperitoneal treatment had a 36 month survival improvement on average over those who received their chemotherapy intravenously. For patients with normal BRCA1 levels there was no significant difference in survival between the two treatment options.

Dr Thomas Krivak, gynaecological oncologist at Magee Womens Hospital of the University of Pittsburgh and lead author of the study, said: “This research should allow us to target a particular group of ovarian cancer patients and give them an improved outlook by making a very simple change to their treatment.

“When chemotherapy is given directly into the abdomen it reaches the cancerous cells in a higher concentration than when it’s administered into a vein. This means that it can work more effectively. This type of administration of chemotherapy seems to have the greatest improvement in outcomes for women who have low levels of the BRCA1 protein.”

Martin Ledwick, head information nurse at Cancer Research UK, said: “Further work needs to be done to verify these results but the initial findings are extremely encouraging. This study could mark another step on the path to personalised medicine, where treatments are tailored to a patient’s individual needs and genetic makeup to give the best possible benefit.”

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References

* Lesnock, JL et al, BRCA1 Expression and Improved Survival in Ovarian Cancer Patients Treated with Intraperitoneal Cisplatin and Paclitaxel: A Gynecologic Oncology Group Study British Journal of Cancer DOI: 10.1038/bjc.2013.70

Notes to Editor

1. The BRCA1 protein helps repair damaged DNA and without it cells are at risk of accumulating mistakes and developing into a cancer. Women with faults in their BRCA1 gene, which carries the instructions for making the protein, are at much higher risk of developing breast and ovarian cancers than the general population.