FDA Approves Elahere to Treat Platinum-Resistant Ovarian Cancer https://tinyurl.com/4sv787ff         One of the many difficulties in managing ovarian cancer is the treatment of platinum resistant cancer i.e. recurrence of cancer within 6 months after initial therapy.        The FDA has recently approved the use of Elahere an antibody-drug conjugate that targets the cancer by attaching to a commonly found cell surface protein (Folate Receptor Alpha; FR 𝛂),  thereby enabling cytotoxic access.        FR 𝛂  is found in 45% of all platinum resistant ovarian cancers. The approval followed the improved survival shown in the SORAYA trial with better response and duration of effect. The principal side effects include ocular toxicity, nausea and marrow suppression. This new treatment, the first approved by the FDA since 2014 helps in the management of a challenging condition.

Therapeutic effect of haploidentical peripheral blood stem cell treatment on relapsed/refractory ovarian cancer https://tinyurl.com/3s2xsckt            Marrow stem cell transplant has been used in the treatment of leukemia for many years. Previously this has required a donation from a compatible donor. This has been problematic due to the few suitable donors. New technology has enabled the use of donations from family members, (parents or some siblings) who share 50% of the genetic signature of the recipient, (known as haploidentical).          These readily available stem cells are being put to other purposes, notably in the treatment of renal cancer. This small study looks at the benefit or otherwise of stem cell treatment of recurrent or resistant ovarian cancer.          13 patients received this treatment, it is known that recurrence and resist...

Genetic Technologies to Launch Ground-breaking Comprehensive Risk Test for Breast & Ovarian Cancer https://tinyurl.com/y2f44mch            As discussed during the recent education session, the excess capacity for genetic testing post Covid is a resource that will be used.           This article refers to a proposed new saliva test for BRCA positive mutations. A commercial company; (Genetic Technologies) has developed it, the testing aimed at the US market, will be done in Fitzroy, Melbourne.          The expected positive rate is 0.5%, the company suggest a negative result will provide comfort. However, with the normal incidence of breast and ovarian cancer being much greater, this may be cold comfort. Apparently FDA approval is not required for Consumer Initiated Testing. Currently the legality in Australia is in doubt. 

Implementing HRD Testing in Routine Clinical Practice on Patients with Primary High-Grade Advanced Ovarian Cancer https://tinyurl.com/r8mj6cnt          Personalised treatment of ovarian cancer is the preferred and seemingly most effective course of management. With the development of PARP inhibitors this becomes available for those women who have a genetic mutation (HRD), which limits DNA, repair.          It is now possible to screen ovarian cancer patients for the presence of HRD either directly or indirectly via the BRCA status. This small review of 163 women showed 44% to be HRD, with only 12% being BRCA positive.          There are however difficulties in direct HRD testing with 27 patients having insufficient tumor load for HRD testing and the median delay for results was 37 days. HRD testing will not replace germ line BRCA screen but does increase...

Lifetime ovulatory years and risk of epithelial ovarian cancer: a multinational pooled analysis https://tinyurl.com/hk687y9f          For many years the incidence of epithelial ovarian cancer (EOC) has been decreasing, it is thought that a major contributing factor has been the suppression of ovulation with the use of hormonal contraception. Breast-feeding, which similarly suppresses ovulation, is also protective.          This meta-analysis looks at a large number of cases and controls and measures the number of lifetime ovulatory years and compares the risk of developing EOC.          Results from the survey show that risk of developing all types of ovarian cancer, other than mucinous tumours, increased with the number of ovulatory years. Further analysis of the data indicated that other unknown factors, apart from the number of ovulatory cycles, are i...

Diagnostic and prognostic potential of the microbiome in ovarian cancer treatment response https://tinyurl.com/2p95fw7a          There are many causes of ovarian cancer, some environmental. Changes to the microbiome have been thought to be a contributing factor.           This small study looks at the microbiome of the vagina, cervix, uterus, tubes and ovaries together with samples from the peritoneum. Data was collected from 30 women known to have ovarian cancer and 34 other women having surgery for benign conditions.          The usual microbiome is mostly composed of lactobacillus. For those women with ovarian cancer the microbiome was much more diverse with less predominance of lactobacillus. It is unknown whether this is a cause or effect. However, the authors suggest that changes in the microbiome could be a predictor for ovarian cancer and al...

Identification of TP53 mutations in circulating tumour DNA in high grade serous ovarian carcinoma using next generation sequencing technologies https://tinyurl.com/ykn95w8y            Ovarian cancer frequently recurs and early treatment of recurrence improves survival. Currently the progress of ovarian cancer is monitored by serial measurement of serum CA125, a cancer antigen.           There are problems with this approach; CA125 has a long half-life so there may be a lag in detecting change. Also, the CA125 measurement does not relate to tumour size, which is an important indicator of survival impact.          For other cancers such as prostate and colon, circulating tumour DNA (ctDNA) is used to determine residual or recurrent tumour size; ctDNA is present as a result of cancer cell disruption.        ...