A study looking at diffusion weighted MRI scans to check if treatment is working for ovarian cancer (DISCOVAR)

Cancer type:

Ovarian cancer
Secondary cancers

Status:

Results

Phase:

Other

This study looked at whether diffusion weighted MRI is a reliable way to see if treatment for ovarian cancer is working. 

It was for women who were having treatment for:

  • ovarian cancer 
  • peritoneal cancer 
  • fallopian tube cancer 

These cancers are treated in a similar way. When we use the term ovarian cancer in this summary, we are referring to all 3.

Cancer Research UK supported this study. 

It was open for people to join between 2012 and 2016. The team reported the results in 2018.

More about this trial

Doctors often use CT scans Open a glossary item and MRI scans to find out how well treatment is working. These scans are useful. But they cannot always clearly show the difference between healthy tissue and cancerous tissue.

This study looked at a type of MRI scan called a diffusion weighted MRI (DW-MRI scan). It had not been previously used to check if treatment was working in women with ovarian cancer in a clinical trial. DW-MRI measures the movement of water molecules within tissue. These are less free to move in cancerous compared to healthy tissue. 

The main aims of this study were to find out if it is possible to use a DW-MRI scan to:

  • work out if treatment is working
  • see early on if treatment is working
  • predict whose treatment works best 

Summary of results

The team found that the results of the DW-MRI scans were reliable and informative. The scans could find very small, early changes that happen when treatment is working. This study was looking at people with advanced ovarian cancer.

About this study
This study included women whose cancer had spread elsewhere in the body. This is advanced cancer. There were 2 groups (cohorts) in this study:

  • 47 people were studied before any treatment for their cancer. They went on to have chemotherapy followed by surgery. This group was called cohort 1.
  • 78 people with cancer that had come back after treatment were also studied. They went on to have more chemotherapy. This group was called cohort 2. 

 Everyone had 3 MRI scans. They had a routine MRI scan with the addition of DW-MRI scan at each time point. 

In cohort 1 everyone had: 

  • 2 MRI scans before starting chemotherapy
  • another MRI before surgery

The 2 scans before treatment were to make sure that it was possible to repeat the scan and get the same results. 

In cohort 2 everyone had an MRI:

  • before starting chemotherapy
  • after 1 cycle of chemotherapy Open a glossary item
  • after 3 cycles of chemotherapy 

The team used a particular measurement from the DW-MRI scan to assess if treatment was working. 

Results
The team ran the study at a number of different hospitals. To begin with they made sure that it was possible to get the same results across the different sites. They checked this carefully and found that it was possible.

Then they checked if the DW-MRI scans could show that treatment was working. First, they looked to see whose treatment was working in the usual way. They did this by:

  • checking the results of the CA125 blood tests
  • measuring the size of the cancer on the routine MRI scan

They compared these results with the DW-MRI scans results. 

Cohort 1 
After 3 or 4 cycles of chemotherapy they checked if treatment was working. 

They found it was in:

  • 33 out of 35 people based on monitoring their CA 125 blood test
  • 31 out of 36 people based on the routine MRI scan 

Cohort 2 
After 3 or 4 cycles of chemotherapy they checked if treatment was working.

They found it was in:

  • 47 out of 65 people when monitored using the CA 125 blood test
  • 44 out of 66 people based on the routine MRI scan

DW-MRI scans
The team looked at the results of the DW-MRI scans after 3 or 4 cycles of treatment. They compared the study scan to:

  • the baseline study scan done before treatment started
  • the routine MRI scan and CA 125 blood test results

In people whose treatment was working the increase in the measurement on DW-MRI scan was bigger. It was much bigger than in people whose treatment was not working. 

The team also looked at the scans after 1 cycle of treatment in people having treatment for cancer that had come back. This was cohort 2. They wanted to see if it was possible to predict whose cancer might start to grow again. 

They found that a few people had early increases in the DW-MRI measurement. The team say that these people had a longer period of time before the cancer started to grow again.

Conclusion
The team concluded that it was possible to use a DW-MRI scan to see if treatment was working in people with ovarian cancer that had spread. They found that the measurements from the DW-MRI scans were reliable and could find early changes that show the treatment is working. 

The team say they need to do more research in a larger trial for ovarian cancer. This is to confirm the usefulness of the measurement they used from the DW-MRI scan in ovarian cancer.  

Measurements from DW-MRI were useful to check how treatment worked in larger trials in breast cancer. 

Where this information comes from    
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Nandita Desouza

Supported by

Cancer Research UK (BIDD award)
Institute of Cancer Research
NIHR Clinical Research Network: Cancer

Freephone 0808 800 4040

Last review date

CRUK internal database number:

9155

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Charlie took part in a trial to try new treatments

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“I think it’s really important that people keep signing up to these type of trials to push research forward.”

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