Ovarian cancer treatment to be made available to more women

THE number of women with ovarian cancer who are now eligible for a powerful targeted treatment will dramatically increase, following a landmark discovery by Melbourne researchers.

THE number of women with ovarian cancer now eligible for a powerful targeted treatment will dramatically increase, after a landmark discovery by Melbourne researchers of why some women respond to the medication.

Just like testing for the cancer-causing BRCA gene mutations has revolutionised the diagnosis and treatment of women at risk of breast and ovarian cancer — as it did for Angelina Jolie — the team has uncovered that they need to be just as precise at knowing how much of the gene is “silenced”, in determining who can benefit from certain treatments.

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Lead researcher Professor Clare Scott, of the Walter and Eliza Hall Institute of Medical Research, said while it was known potent anti-cancer drugs called PARP inhibitors could only work when the BRCA1 gene was silenced, they could not predict in which patients the drug would work.

The PARP inhibitor kills cells by stopping them being able to repair themselves.

Professor Clare Scott says the discovery makes it possible identify which patients can benefit from certain treatments.

Using models developed from cancerous tissue from Victorian women, acting as snapshots in time to track how cancers were responding to treatment, they found that if it was fully silenced the drug could be effective. But if it was only partially inactive, the drug would not control the cancer.

“That has not been understood before. No one even knew to look for that,” Prof Scott said.

“We can now identify these patients with fully silenced cancers, and give them PARP inhibitors. That’s really exciting because those women were just going to be ignored.”

The research has been published in the prestigious journal Nature Communications, and also involves the Olivia Newton John Cancer Research Institute and La Trobe University.

Prof Scott said the work built upon the evidence that PARP inhibitors should also be given after first diagnosis, not just upon relapse, given that initial chemotherapy could silence the gene and make the inhibitor ineffective.

“Herceptin is the wonder drug for breast cancer; PARP inhibitors are the wonder drug for ovarian cancer,” she said.

“We’ve just doubled the response rate for PARP inhibitors by talking about the silencing of BRCA1. No one in the world understood how silencing worked until now.”

The number of women eligible for treatment is set to dramatically increase following the discovery.

Melbourne grandmother Susan Fox was diagnosed with advanced ovarian cancer 20 years ago.

After the cancer returned three times she was put on a trial of PARP inhibitor with the hope it would buy her a couple more years of life.

Eight years on, the 67-year-old has been labelled a “super responder”, one of the rare cases who have been in extended remission while on the daily tablet.

“It was very late stage when I was diagnosed.. Most people don’t recover from that,” she said.

“I take my capsule every day with no side effects. The fact that other women will get the chance at life like I have had, is a fabulous thing.”

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