What’s New in Treating Ovarian Cancer?
An estimated 300,000 women will be diagnosed with ovarian cancer each year, which ranks fifth in cancer deaths among women. Treatments for ovarian cancer have certainly improved over the past 40 years. Until recently, ovarian cancer patients had limited treatment options with bleak outcomes and 70% disease recurrence. Because there is no early detection test for ovarian cancer, patients are often diagnosed when the disease has already progressed. But, results are improving with surgical advancements, genetic testing, and new drug treatments recently introduced. Better outcomes give hope for ovarian cancer patients to see a brighter future.
Targeted Drug Therapy
Targeted therapy is an exciting type of cancer treatment because it identifies and attacks cancer cells while doing little damage to normal cells. The treatments attack the programming that makes cancer cells different from normal, healthy cells. They have the ability to change the way a cancer cell grows, repairs itself, and interacts with other cells. Tumors need new blood vessels to grow and spread so cancer cells can nourish themselves. Bevacizumab (Avastin) is an angiogenesis inhibitor, which can slow or stop cancer growth by attaching to a protein that signals new blood vessels to form. When combined with chemotherapy, Bevacizumab shows good results in shrinking or stopping the growth of tumors. Bevacizumab is an infusion given every 2 to 3 weeks.
Genetics can play a significant role in the probability a patient may receive a cancer diagnosis. Those same genetics play a role in giving patients better treatment options and outcomes. BRCA1 and BRCA2 genes are sometimes called tumor suppressor genes because when these genes have certain changes or mutations, cancer can develop. A BRCA mutation occurs when the DNA of the gene becomes damaged in some way. When a BRCA gene is mutated, it may no longer be effective at repairing broken DNA and helping to prevent cancer. Chances of developing ovarian cancer can increase as much as 44% for those who inherit a harmful BRCA1 or BRCA2 variant.
Targeting Genetic Mutations
Olaparib (Lynparza), rucaparib (Rubraca), and niraparib (Zejula) are drugs known as PARP inhibitors. PARP enzymes normally help repair damaged DNA inside cells. The BRCA genes are also normally involved in DNA repair, and mutations in those genes can block that from happening. PARP inhibitors work by preventing the PARP pathway, making it very hard for tumor cells with an abnormal BRCA gene to repair damaged DNA, which often leads to the death of these cells. Olaparib (Lynparza) is used to treat advanced ovarian cancer when chemotherapy has already been tried. This drug can be used for patients with or without mutations in one of the BRCA genes. For women with the BRCA mutation, Olaparib can be used as a maintenance treatment for ovarian cancer that has advanced but gotten smaller in response to the first treatment with chemotherapy containing cisplatin or carboplatin. Olaparib can also be used in combination with Bevacizumab as a maintenance treatment in women whose cancers have shrunk with chemotherapy containing carboplatin or cisplatin. Both Rucaparib (Rubraca) and Niraparib (Zejula) can be used for women with or without a BRCA mutation as maintenance for advanced ovarian cancer that has come back after treatment but has shrunk due to chemotherapy containing cisplatin or carboplatin. All three of these drugs are taken daily by mouth, as pills or capsules.
A very small number of ovarian cancers have changes in one of the NTRK genes, which leads to abnormal cell growth and cancer. Larotrectinib (Vitrakvi) and Entrectinib (Rozlytrek) are targeted drugs that stop the proteins made by the abnormal NTRK genes. These drugs can be used by patients with advanced ovarian cancer having tumors with an NTRK gene change that continue to grow, despite other treatments. Larotrectinib and Entrectinib are taken as pills, once or twice a day.
Finding a better way for early detection of ovarian cancer will have a great impact on the cure rate. Researchers are trying new ways to screen women for ovarian cancer. Methods like looking at the pattern of certain proteins in the blood could find ovarian cancer early. Until earlier detection is possible, knowing the signs and symptoms of ovarian cancer is important. Talk to your doctor if you have a family history of cancer and discuss your risk factors.
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