Three cancers are often referred to as ovarian cancer…
primary peritoneal cancer, fallopian tube cancer, and ovarian epithelial cancer. They share a common ancestor and undergo analogous care. Because of their close anatomical proximity, the ovaries and fallopian tubes can sometimes be confused as the source of cancer, according to S. John Weroha, MdotD. Ph. D, a Mayo Clinic oncologist and head of the Gynecologic Cancer Disease Group at the Mayo Clinic Comprehensive Cancer Center. When we diagnose patients with primary peritoneal cancer, I explain that although the ovaries are not affected, the cancer appears to be ovarian cancer under a microscope and in the pattern of spread throughout the body.
The tissue lining the abdominal cavity and its organs is called the peritoneum, and this is where primary peritoneal cancer originates. The tissue lining the tubes that carry eggs from the ovaries to the uterus is where fallopian tube cancer develops. Ovarian epithelial carcinomas, also referred to as epithelial ovarian cancers, account for 85-90% of ovarian cancer cases. These cancers originate in the tissue that lines the outside of the ovaries. Dr. According to Weroha, more patients are surviving ovarian cancer of all kinds thanks to new treatments, and clinical trials are being conducted by researchers to examine these therapies and screening techniques. He would like you to know that there is hope if you have been diagnosed with ovarian cancer. This is the reason why.
Advanced targeted treatments are enhancing lifespans. 2. Surgical and chemotherapeutic interventions are no longer the sole methods for managing ovarian cancer; targeted therapies have emerged as alternatives. These innovative treatments employ drugs to pinpoint and eliminate cancerous cells. Among these are monoclonal antibodies and poly (ADP-ribose) polymerase, or PARP, inhibitors.
Monoclonal antibodies
Lab-engineered molecules known as monoclonal antibodies are designed to recognize and bind to particular proteins linked to cancerous cells. A monoclonal antibody called bevacizumab is used in conjunction with chemotherapy to treat ovarian cancer recurrence by inhibiting the development of new blood vessels, which is necessary for tumor growth.
To get better results, researchers are mixing bevacizumab with novel medications. One such is mirvetuximab soravtansine, a monoclonal antibody that the Food and Drug Administration (FDA) recently approved for use in patients experiencing a recurrence of ovarian cancer. This medication targets a protein known as folate receptor alpha and is used when a patient’s cancer has been previously treated with at least one systemic therapy.
Folate receptors are abundant in ovarian cancers. Dr. Weroha says that the majority of normal cells don’t. Chemotherapy is applied to an antibody to create this medication. Imagine it like a guided missile that flies through the body, attaching itself to cells that have folate receptors. Mirvetuximab soravtansine is far more effective than any other treatment at shrinking tumors in patients whose ovarian cancer has returned and whose tumors contain a high number of folate receptors. The response rate is roughly twice as high as with any other form of treatment.
PARP inhibitors
PARP inhibitors are medications that prevent DNA repair, potentially leading to the death of cancer cells. When someone has ovarian cancer and their tumors have mutations in the BRCA1 or BRCA2 gene, one PARP inhibitor that is used to stop the disease from coming back is olaparib. Olaparib has been found to dramatically increase a patient’s chances of survival without recurrence in those with this diagnosis. According to Dr. Weroha, this is a front-line treatment, which means it is a part of the initial course of care that patients receive after receiving a new diagnosis.
One day, ovarian cancer may be combated with a vaccine. Theodore Block, M.D. Ph. D. , a medical oncologist at the Mayo Clinic, and Keith Knutson, Ph. D. , a researcher at the Mayo Clinic, is creating a vaccine to stop the recurrence of ovarian cancer tumors in patients with advanced disease whose tumors have returned despite chemotherapy and surgery. After being drawn from the blood, white blood cells are processed to create dendritic cells, which are immune cells that strengthen the body’s defenses. In order to stimulate the immune system to identify and combat the cancer, these cells are given back to the patient in the form of a vaccine.
Pembrolizumab, an immunotherapy medication, will be administered in addition to the vaccine to detect and eradicate any tumors that do not react to the dendritic cells. According to Dr. Weroha, pembrolizumab belongs to a class of medications known as immune checkpoint inhibitors. The purpose of this medication is to unblock the immune system and enable it to carry out its innate function of eliminating unwanted substances. It is hoped that the vaccine and immunotherapy medication will significantly reduce the incidence of ovarian cancer. The research is fascinating.
A screening test may be on the horizon.
Ovarian cancer does not currently have a screening test, however Jamie Bakkum-Gamez, MdotD. , a gynecologic oncologist at the Mayo Clinic, wants to alter that. She and her research team found that vaginal fluid collected with a tampon could be used to identify endometrial cancer using methylated DNA markers. This same science may eventually apply to ovarian cancer.
A mechanism that cells use to regulate gene expression is methylation, which turns on a gene in a cell so that it can produce RNA and proteins. A gene is said to be a tumor suppressor when a specific region of its DNA is methylated, which turns the gene off or silences it. Tumor suppressor gene silencing can indicate cancer and is frequently an early stage in the development of cancer.
A panel of methylated DNA markers was created by Dr. Bakkum-Gamez and her associates in order to differentiate vaginal fluid from noncancerous tissue and endometrial cancer. Her goal is to create a low-cost, tampon-based, at-home screening test for high-risk HPV, ovarian, cervical, and endometrial cancers based on her research. According to Dr. Weroha, this is exciting because people living in rural areas can use this kind of screening test. If it is successful, it may make it easier for medical professionals to detect ovarian and other gynecologic cancers in residents of all the communities we serve at an earlier stage, when they are more treatable.
Clinical trials and a gynecologic oncologist can assist you in receiving the best care available. Dr. Weroha advises scheduling a consultation with a gynecologic oncologist if you have been diagnosed with ovarian cancer. A gynecologic oncologist will be knowledgeable about the most recent guidelines for managing side effects and treatment recommendations. He says, That’s important. But once the strategy is established, any medical oncologist could carry it out.
Additionally, Dr. Weroha advises recently diagnosed patients to enquire with their care teams about their eligibility for clinical trials, mirvetuximab, or PARP inhibitors. Newer medications like mirvetuximab and PARP inhibitors may have an impact on how well your entire course of treatment goes. Always inquire about clinical trials, he says, since there is no treatment so effective that we can give up on finding a better cure when ovarian cancer returns. If your cancer returned, there’s a very real chance we would have something better than what we have now.
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