What's New and Yet to Come?

Promising New Drugs and Therapeutic Approaches for Treatment of Ovarian Cancer—Targeting the Hallmarks of Cancer 

https://tinyurl.com/bdzu8nr5 

As we begin a new year, it's an opportune time to examine both current advances in ovarian cancer treatment and potential breakthroughs on the horizon. 

Recent progress in ovarian cancer treatment has been marked by the advent of personalised medicine, which targets specific genetic and molecular variations in individual patients. This approach has led to improved survival rates through the introduction of novel therapeutics, particularly PARP and angiogenesis inhibitors. 

Innovative drug delivery mechanisms are revolutionizing treatment, most notably through antibody-drug conjugates (ADCs). The latest example is MIRV (mirvetuximab soravtansine), which has shown promise in treating recurrent ovarian cancer. 

This article examines ongoing phase III clinical trials and evaluates their potential impact on patient care. Immunotherapy, while previously showing limited efficacy, is experiencing a renaissance through combination approaches. The DUO trial, which combines PARP inhibition with checkpoint inhibition, suggests a promising new direction in treatment. 

This year's basic research emphasizes tumour-specific characteristics rather than broader patient parameters, aiming to identify novel targets for personalised therapy. These developments offer renewed hope for improving outcomes in ovarian cancer treatment.

BRCA, even more worrisome

New tool puts reproductive risk for BRCA carriers into perspective

https://tinyurl.com/24hrpkzp

Ever since the 1960s, the familial risk of breast and ovarian cancer has been recognised as the hereditary breast and ovarian cancer syndrome (HBOC). The genetic mutations responsible were shown to be located on chromosomes 17 and 13 and labelled BRCA1 and 2.

These mutations are dominant, meaning only one copy of the gene needs to be affected. More recently the effect of both genes bearing the mutation causing childhood disease and early onset cancers is becoming clearer. Many women carrying one of the BRCA mutations are unaware of this additional risk.

What this means is that if both a child’s mother and father carry a BRCA mutation, that child has a 75% risk of both genes being affected and a 100% risk of being a carrier.

The major risk to the child with dual BRCA mutation is a bone marrow disorder, Fanconi’s Anaemia. This is an incurable condition with a limited lifespan of about 30 years and much associated cancer.

Obviously, the risk of this happening is much greater in populations where there is a high BRCA mutation, such as Ashkenazi Jews and the Shetlanders. Advice about possible dual inheritance should form part of genetic counselling.

Your gut biome affects ovarian cancer immune response

Integrative multi-omics analysis uncovers tumour-immune-gut axis influencing immunotherapy outcomes in ovarian cancer

https://tinyurl.com/3h5wuk33

About 50% of all ovarian cancer has an increased T cell infiltration suggesting a strong immune response. This is associated with good survival.

Targeted immune therapy which inhibits checkpoint activity unfortunately thus far has not been shown to be effective against ovarian cancer. This study looked at the impact of the faecal microbiome on immune checkpoint blockade (ICB).

Using data from another study, which tested the effect of ICB for recurrent ovarian cancer, a subgroup of patients showed a significant benefit (30%). These patients had a different microbiome when compared to those patients who did not have much benefit.

This information suggests that manipulation of the gut biome could be an aid to survival for patients with recurrent ovarian cancer.