The simple test to transform lives of women with ovarian cancer
Beth Slayter was given a 50 per cent chance of surviving five years after being diagnosed with this cancer. This is how a simple blood test may now save other lives.
A simple new blood test developed by Victorian researchers can pinpoint which women with ovarian cancer will likely respond to a targeted drug, potentially saving lives.
The drug called PARP inhibitor is considered the most exciting new drug approved for use in ovarian cancer this century.
It is available for those whose cancer has a defect in DNA repair, called HRD positive.
But it doesn’t work for every woman, and the current test is not good enough.
Now researchers hope it can be guided by a blood test they developed which promises to transform outcomes for women.
Annually around 1700 Australian women are diagnosed with ovarian cancer, which is a malignant tumour in one or both ovaries.
The researchers published the results of a major Australian clinical trial in Nature Communications, a collaboration of 15 hospitals, four research groups and 114 women with ovarian cancer.
Called SOLACE2, the trial was co-led by RMIT University, WEHI and the University of Sydney’s NHMRC Clinical Trials Centre (CTC) and co-ordinated by the Australia New Zealand Gynaecological Oncology Group (ANZGOG).
“PARP inhibitor is the most exciting new drug approved for ovarian cancer,” study co-lead and WEHI Laboratory Head Clare Scott said. “But only about half the women benefit and we’re not really sure with the current test who should be in the half who receive it.”
She said an important finding in this study was how immune cells in the cancer affected the drug’s response, particularly in combination with immunotherapy.
PARP inhibitor therapy works by stopping cancer cells from repairing their own damaged DNA and that drives an immune response.
“However, the majority of ovarian cancers are able to hoodwink the immune system,” Professor Scott said. “They set up multiple ways to evade it, which is what this test looks at, so it is built on individual mechanisms of evasion of the immune system by the ovarian cancer cells.
“Then these multiple layers that this test reflects get built one on top of each other like a stack of cards which loads up the cancer cell to win. What we have to do is collapse that stack of cards, including with more effective types of immunotherapy, so that instead the immune system can win.”
RMIT lead researcher and co-senior author Professor Magdalena Plebanski developed the blood immune biomarker test. She said there had been no easy way to more effectively target PARP inhibitor therapy.
Professor Plebanski, like Professor Scott, has spent more than 15 years working on developing therapy for ovarian cancer.
Together they have helped improve ovarian cancer outcomes for women worldwide.
Professor Scott said PARP inhibitors work best in BRCA2 mutated ovarian cancers.
“Women can be cured, and that’s what we want to do for everyone,” she said. “We expect this promising new test will enable more effective identification of women who should be eligible for PARP inhibitors, allowing us to provide this leading treatment to the women most likely to benefit.”
Beth Slatyer, 68, was successfully treated with PARP inhibitors following surgery and chemotherapy five years ago and said it was serendipitous that for her everything came together when it did.
She said a blood test would be fantastic for women because it would be more up-to-date than testing a tumour itself.
“PARP inhibitors are strong drugs and you do not want to be on a drug if it is not going to work for you,” Ms Slatyer said. “It can also mean you’re effectively going up the wrong path.”
She is now in remission.
“When I was diagnosed I had a 50 per cent chance of living five years, and now I’m still well so I am feeling incredibly lucky.”
She said hats off to the researchers.
“They work collaboratively. It is painstaking work and they are all so dedicated to saving women’s lives.”
Professor Chee Khoon Lee, clinical lead at CTC, said while more work was needed, the study showed the blood test had the potential to transform outcomes for many women diagnosed with ovarian cancer.
Professor Scott, who is also a medical oncologist at the Peter MacCallum Cancer Centre, Royal Women’s Hospital and Royal Melbourne Hospital and Chair of ANZGOG, said it was about giving women choice.
“It will make sure that women get the right treatment rather than wasting their precious time with the wrong treatment,” she said.
“Long term I believe it will be a life saver because this research will give us information that allows us to develop better immunotherapies.”
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Originally published as The simple test to transform lives of women with ovarian cancer
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