Wine and cancer

Association between wine consumption and cancer: a systematic review and meta-analysis

https://tinyurl.com/2jaz8hu6

    High alcohol consumption has been shown to be associated with an increased risk for many cancers including breast and ovarian cancer. However, it has been suggested that low to moderate wine consumption (less than 2 glasses of wine daily for women) may be protective.

    This review; a meta-analysis of all the available data looked at 454 reports which conformed with the criteria for inclusion. The relative risk of developing breast or ovarian cancer for moderate drinkers was the same as the normal population (RR 1.03).

    Moderate drinking is protective against gastric cancer. The authors suggest this may be due to antibacterial activity of alcohol against H. Pylori. Low to moderate consumption of alcohol does not increase ovarian cancer risk.

Who is platinum resistant?

Proteogenomic analysis of chemo-refractory high-grade serous ovarian cancer

https://tinyurl.com/2p9bdrwk

One of the many problems with ovarian cancer is that many women (about 15%) do not respond to standard therapy. These women are termed as platinum resistant, have a recurrence before six months after initial treatment, with very poor outcomes.

This study looks at identifying those women so that alternative personalised treatment might be considered. It is a retrospective review of pretreatment biopsy obtained from 242 women with high grade ovarian cancer. Of them, 97 were platinum resistant.

Using proteogenomic analysis, which combines information from whole of genome sequencing and spectroscopic data about protein and RNA transcription, different subgroups were identified. In particular a protein signature common to all the platinum resistant cancers may assist in early diagnosis.

As of now there is no alternative effective treatment. However, the authors suggest that early identification may mean that the adverse side effects of platinum chemo can be avoided, with more palliative care being appropriate for these women.

Borderline tumours and cancer

Risks of non-ovarian cancers in women with borderline ovarian tumour: a national cohort study in Sweden

https://tinyurl.com/uchdbbnk

One of the great advantages of medical research from Scandinavia is the quality of the epidemiology data. This paper is an example of the large numbers of the sample group which can be obtained from the Swedish Cancer Registry.

Almost 5000 women were diagnosed to have a borderline ovarian tumour during the period 1995-2018. Follow up of those women showed an increased risk of non-ovarian cancer when compared to the general population.

The types of cancer included bowel, uterine, renal, lung, thyroid and pancreas. There was no association shown with breast cancer or leukaemia. The authors speculate that the presence of a borderline tumour may be a marker for increased cancer risk possibly due to a shared cause or predisposition.

FDA & PARGi

IDEAYA Receives Fast Track Designation for Potential First-in-Class PARG Inhibitor, IDE161, for Treatment of Pretreated, Platinum-Resistant Advanced or Metastatic Ovarian Cancer Patients having tumours with BRCA1/2 Mutations

https://tinyurl.com/bdhy2uuj

Defective DNA repair is important as a cause for ovarian cancer and the prevention of cancer elimination once established. Personalised treatment using PARP inhibitors acts by blocking alternative repair pathways through a process called synthetic lethality. 

Unfortunately resistance to PARPi is inevitable. Often this occurs because another repair process becomes active. One such process is Poly (ADP-ribose) Glycohydralase (PARG). A new Drug IDE161 has been developed to inhibit this repair process in a similar manner to PARPi.

The FDA has given Fast Track approval for this drug as a preliminary to full access. Usually this implies the FDA has confidence that the new treatment for those women with ovarian cancer, who have become resistant, will have a good outcome. With time it may be that the role of PARGi expands to become an alternative to PARPi as maintenance therapy.