Ovarian cancer is an insidious disease. It develops asymptomatically, and when symptoms appear, the cancer is advanced, which often means a death sentence. Worse still, there are still no methods that can detect ovarian cancer early. However, a sensational study was presented at the congress of the European Society of Clinical Oncology in Munich. A way has been found, thanks to which women with cancer will live much longer.
Ovarian cancer is the eighth most common malignant neoplasm in women and has a high mortality rate. Every year, 295 thousand. women, of which 185 thousand. dies. (every year more than 3 Polish women learn about ovarian cancer). The high mortality rate of this type of cancer is mainly due to the fact that – due to the lack of characteristic symptoms – it is detected late. According to research, only 20 percent. patients with stage III ovarian cancer survive for five years, while among patients with stage IV ovarian cancer, this percentage is 5%.
The sensational study presented at the congress in Munich may change that. A therapy has been developed thanks to which the lives of women suffering from ovarian cancer can be significantly extended. The condition is to use a drug from the group of the so-called PARP inhibitors – called olaparib (it was treated, among others, Kora Jackowska). PARP inhibitors block proteins responsible for one of the DNA damage repair pathways. When DNA repair fails, cancer cells die.
“Several new drugs have been approved in the last seven years to prolong the life of patients after ovarian cancer has come back,” said Dr. Susana Banerjee of the Royal Marsden NHS Foundation Trust in London. The first was a drug called bevacizumab, which inhibits the formation of new blood vessels to nourish the tumor. PARP inhibitors – olaparib, niraparib, and rucaparib. PARP inhibitors were initially intended for women with ovarian cancer who have mutations in the BRCA1 and BRCA2 genes. They are the most effective in this group. Mutations in BRCA genes increase the risk of developing breast and ovarian cancer (because of them Agelina Jolie removed her breasts and ovaries). According to the data presented by Dr. Banerjee, among women with the most common type of ovarian cancer, one in six has a mutation in these genes. In the following years, PARP inhibitors (niraparib and olaparib) were also registered for women with ovarian cancer, regardless of the mutation in BRCA genes.
Dr Banerjee noted that PARP inhibitors are currently only used in women with ovarian cancer who have come back. When PARP inhibitors are used in patients after relapse (with BRCA mutations), the risk of death or disease progression decreases by 70-75%. For example, olaparib, approved by the European Medicines Agency (EMA) in 2014, increased the progression-free life span from an average of five to 19 months. She was treated with this drug, inter alia, Kora Jackowska.
In this study, olaparib was given to women who had recently been diagnosed with stage III and IV ovarian cancer. They all had mutations in the BRCA1 / 2 genes and all had surgery and chemotherapy. As part of the treatment of the so-called 260 maintenance women received olaparib (300 mg twice daily) and 131 placebo. “Treatment was continued until the cancer returned, and in patients who had no signs of disease after two years, the drug was discontinued,” explained Dr. Kathleen Moore Stepehnson’s Cancer Center University of Oklahoma (USA), who presented the study. On the other hand, patients whose tumor only shrank could continue the therapy for more than two years. The women’s health was followed on average for 41 months.
It turned out that 60,4 percent. of patients taking olaparib were still alive after three years, compared to 26,9% in the group taking placebo instead of olaparib. Moreover, it was noted that most of these 60 percent. women have not experienced disease progression and that they will live longer.
– This is a big step forward in the treatment of ovarian cancer patients. This therapy can significantly delay the first relapse of the disease, and it is possible that in some patients it will prevent it at all – commented Prof. Jonathan Ledermann from University College and the Cancer Institute in London.
In this study, the PARP inhibitor drug was discontinued for the first time in ovarian cancer patients after two years of treatment (it is now used until the disease comes back). – Despite this, the therapeutic effect lasts much longer. And here the question arises whether olaparib is so effective in destroying cancer cells in the body, or is there any other mechanism at work here – emphasized prof. Ledermann. Experts point out that it is too early to answer this question. ‘But we hope our results mean that a large percentage of women with ovarian cancer will be cured by this method,’ said Dr Kathleen Moore.