Ovarian Cancer Action funded BriTROC researchers have made two major new ovarian cancer discoveries, published recently in Nature Communications, that will bring us closer to more women surviving ovarian cancer. Professor Iain McNeish and his team at the Ovarian Cancer Research Centre at Imperial College London have found that genetic changes are not causing cancer to recur in patients between diagnosis and relapse, and have identified 2 tumour markers that predict early relapse from chemotherapy.
What is the research about?
The team have been looking to see if genetic changes can explain why some women with high grade serous ovarian cancer (HGSOC) relapse and become resistant to treatment.
High grade serous ovarian cancer, the most common type of ovarian cancer, is difficult to detect at an early stage. It is commonly diagnosed at an advanced stage, and survival rates have not changed much over the last 20 years. Initial response to chemotherapy is usually positive in patients, however most will relapse and the effectiveness of treatment decreases with each round reducing the chance of survival each time. Patients then commonly develop chemotherapy resistance.
Why is this research important?
The complicated genetic nature in these tumours has made it difficult to develop effective treatments and current strategies looking at a patient's BRCA/HRD status only allows half of patients to access certain treatments. Other cancers such as melanoma and clear cell carcinoma show high levels of genetic mutations between diagnosis and relapse, so the research team thought this would be a good place to look.
What did they discover and what does this mean for ovarian cancer recurrence research?
The team has shown that there are few genetic changes happening between diagnosis and relapse, unlike the other cancers mentioned above. This shows that researchers need to explore other reasons as to why this type of cancer recurs and becomes resistant to treatment, which will lead to new routes towards finding new personalised treatments for women with HGSOC.
They also found two specific tumor markers which are present at the time of diagnosis, KRAS and CN signature 1, predict early relapse to chemotherapy. This may help determine which patients will benefit from receiving this type of treatment.
The team have also found clues around the immune activity in these tumours, which may link up to Professor Iain McNeish’s OCA funded project around the tumour microenvironment in ovarian cancer.
The samples used in this research were collected as part of the Ovarian Cancer Action funded BriTROC-1 trial. The trial collected ovarian cancer samples from over 500 women to investigate treatment resistance in HGSOC. As well as demonstrating that collecting these tumour samples is safe and feasible, Professor McNeish’s team previously discovered 7 tumour signatures that helped to predict how well patients responded to different treatments and whether they were likely to become resistant to chemotherapy. This is just 1 example of how the BriTROC-1 trial has helped accelerate new research discoveries that will advance ovarian cancer treatment.
What are the next steps?
The newly funded BriTROC-2 trial will collect more samples from relapsed patients across 14 research hubs around the UK to continue making steps towards more effective treatments for women.
“BriTROC was a unique project to co-fund as it was the largest prospective study of relapsed High Grade Serious Ovarian Cancer patients. These are very exciting breakthroughs in understanding this complex disease which in turn will facilitate better treatment options. We are excited to see what other exciting discoveries come from this and the newly funded BriTROC-2 trial. Together we are all working towards a shared goal – where no woman dies of ovarian cancer.”Cary Wakefield, Chief Executive of Ovarian Cancer Action
You can find out more about the OCA funded BriTROC-2 and our other research here.