Targeted therapy for ovarian cancer has been an elusive goal for researchers for many years because ovarian cancer is a heterogeneous disease, exhibiting a plethora of genetic alterations.
In a small percentage of patients, the cancer is found to be hereditary. In these patients, mutations in the BRCA gene lead to an increased risk of ovarian, fallopian tube and primary peritoneal cancer as well as non-gynecologic cancer, most notably breast cancer.
The mutation or defect in the BRCA gene allows cancer cells to repair damage caused by chemotherapy. A novel type of targeted therapy called PARP inhibitors blocks an enzyme that is needed to repair DNA damage. PARP or poly (ADP ribose) polymerase is an enzyme that is needed to repair DNA. Patients with BRCA associated cancers are particularly suited for treatment with these new drugs.
This novel treatment may have a broader application in nonhereditary ovarian cancer. It turns out that as many as 50 percent of nonhereditary ovarian cancers have acquired changes in the BRCA gene that make their cancer susceptible to PARP inhibition.
In a study presented as an abstract at American Society of Clinical Oncology (ASCO) this year, patients with recurrent ovarian cancer treated with PARP inhibitors combined with standard chemotherapy had improved progression free survival or slowed recurrence of their cancer without increasing serious toxicity.
Baylor All Saints Medical Center at Fort Worth is one of the sites for a clinical trial evaluation of PARP inhibitor in women with recurrent ovarian, fallopian tube and primary peritoneal cancer. Many questions remain such as which patients benefit most from this type of treatment and whether the drugs work best alone or in combination with standard chemotherapy. We have now identified a specific target in cancer cells and exploited it to improve treatment. This is the start of personalized care for patients with ovarian cancer.
Learn more about the clinical trials at this website.
This blog post was contributed by Dr. Noelle Cloven, a gynecological oncologist on the medical staff at Baylor All Saints Medical Center at Fort Worth.