Researchers around the world are looking at better ways to diagnose and treat ovarian cancer.
Go to Cancer Research UK’s clinical trials database if you are looking for a trial for ovarian cancer in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.
Research into early diagnosis and detection
There are various trials looking at ways to diagnose and detect ovarian cancer earlier.
At the moment, there is no screening test reliable enough to use for ovarian cancer. A trial called UKCTOCS looked at ovarian cancer screening in the general population between the ages of 50 to 74. The researchers looked at the CA125 blood test and transvaginal ultrasound scan.
The UK Familial Ovarian Cancer Screening Study (UK FOCSS) looked at screening women who were at a high risk of developing ovarian cancer. These women had a family history of cancer of the ovary or breast, or they had 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.
A team of researchers funded by Cancer Research UK and NIHR, have been investigating the CA125 blood test for ovarian cancer. They wanted to find out more about how well it works when people go to their GPs with symptoms. They have found that it works better than they thought for ovarian cancer and could potentially pick up other forms of cancer. They found that around 1 in 10 people (10%) with a raised CA125 have ovarian cancer.
Researchers are looking for substances in the blood (biomarkers), other than CA125, for ovarian cancer. They hope these might help diagnose ovarian cancer earlier.
Doctors can now test for 3 gene faults involved in ovarian cancer.
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.
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.
How genetic testing affects you
Before you have genetic testing, you talk through your options with a genetic counsellor. Researchers want to find out how genetic counselling affects your emotional quality of life. They also want to find out more about the decisions women with gene changes make about screening or treatment to prevent ovarian cancer.
Tests to diagnose
Doctors are looking at a type of MRI called a multi parametric (mp) MRI scan. They want to know if it is better than a CT scan before surgery in showing who needs an operation and how big the operation should be. They want to see if an mp MRI scan should either replace or be used as well as a CT scan.
In another study, researchers are collecting information about current tests. They hope this could help to identify better tests in the future which might help to improve diagnosis.
Research into treatment
Before new treatments can be introduced they need to be tested thoroughly. This is so we can be sure that they work and that they are safe.
Past trials have found which chemotherapy drugs work well for ovarian cancer. Current trials are looking more closely at factors that affect how well chemotherapy works for ovarian cancer, and why some cancers are more sensitive to chemotherapy than others. Doctors are also looking at new chemotherapy drugs.
Targeted cancer drugs
Targeted cancer drugs 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 targeted cancer drugs, 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).
PARP inhibitors are drugs that block proteins that help cells repair their DNA. Rucaparib, olaparib, niraparib and talazoparib are examples.
Vaccines help the immune system recognise and attack cancer cells. Research is looking at how they can stop cancers coming back. A trial looked at a vaccine called TroVax for ovarian cancer.
Research into living with ovarian cancer
Ovarian cancer can sometimes cause a blockage in the bowel (bowel obstruction). Researchers are looking at a diet called elemental for women with a bowel obstruction caused by their cancer. An elemental diet is a drink containing energy, broken down proteins, vitamins and minerals.
Most women with ovarian cancer have surgery. Doctors sometimes control the pain after surgery by blocking the nerves that go to the skin of the abdomen. This is called a TAP nerve block. Researchers want to find out if TAP nerve block improves pain control after surgery to remove ovarian cancer.