Monday, January 27, 2020

Niraparib in Patients With Newly Diagnosed Ovarian Cancer

This article appeared in the New England Journal of Medicine (NEJM). The conclusion showed that women with newly diagnosed OC who were not platinum resistant had a longer progression free survival - regardless of their BRCA status - than those on placebo.

Here's the abstract to the study:

Abstract

BACKGROUND

Niraparib, an inhibitor of poly(adenosine diphosphate [ADP]–ribose) polymerase (PARP), has been associated with significantly increased progression-free survival among patients with recurrent ovarian cancer after platinum-based chemotherapy, regardless of the presence or absence of BRCA mutations. The efficacy of niraparib in patients with newly diagnosed advanced ovarian cancer after a response to first-line platinum-based chemotherapy is unknown.

METHODS

In this randomized, double-blind, phase 3 trial, we randomly assigned patients with newly diagnosed advanced ovarian cancer in a 2:1 ratio to receive niraparib or placebo once daily after a response to platinum-based chemotherapy. The primary end point was progression-free survival in patients who had tumors with homologous-recombination deficiency and in those in the overall population, as determined on hierarchical testing. A prespecified interim analysis for overall survival was conducted at the time of the primary analysis of progression-free survival.

RESULTS

Of the 733 patients who underwent randomization, 373 (50.9%) had tumors with homologous-recombination deficiency. Among the patients in this category, the median progression-free survival was significantly longer in the niraparib group than in the placebo group (21.9 months vs. 10.4 months; hazard ratio for disease progression or death, 0.43; 95% confidence interval [CI], 0.31 to 0.59; P<0.001). In the overall population, the corresponding progression-free survival was 13.8 months and 8.2 months (hazard ratio, 0.62; 95% CI, 0.50 to 0.76; P<0.001). At the 24-month interim analysis, the rate of overall survival was 84% in the niraparib group and 77% in the placebo group (hazard ratio, 0.70; 95% CI, 0.44 to 1.11). The most common adverse events of grade 3 or higher were anemia (in 31.0% of the patients), thrombocytopenia (in 28.7%), and neutropenia (in 12.8%). No treatment-related deaths occurred.

CONCLUSIONS

Among patients with newly diagnosed advanced ovarian cancer who had a response to platinum-based chemotherapy, those who received niraparib had significantly longer progression-free survival than those who received placebo, regardless of the presence or absence of homologous-recombination deficiency. (Funded by GlaxoSmithKline; PRIMA/ENGOT-OV26/GOG-3012 ClinicalTrials.gov number, NCT02655016. opens in new tab.)

Monday, January 20, 2020

Where Does Ovarian Cancer Originate?

It used to be thought that the ovaries were the origin of high grade serous ovarian cancer - certainly the name of the cancer suggests its origins. However research at multiple health centers points to another source: the fallopian tubes.

The consortium of centers included Johns Hopkins University, Toronto University Health Network, Yale University and Memorial Sloan-Kettering Cancer Center. Using molecular profiling, researchers were able to show that the cellular origin of the cancer was most closely aligned to the fallopian tube region rather than the ovaries. This is significant because in high-risk women, currently the ovaries and the fallopian tubes are generally removed. The ability to preserve the ovaries could reduce the risk of heart disease, osteoporosis and other diseases associated with ovarian resection.

To read more about this study, follow this link.  



Monday, January 13, 2020

SCIENTISTS DEVELOP PROMISING DRUG FOR TREATING OVARIAN AND PANCREATIC CANCERS

As we know, ovarian and pancreatic cancer are very difficult to treat because by the time they are diagnosed, they are often late stage.

Houston Methodist and MD Anderson have filed a joint patent for a new monoclonal antibody. (Monoclonal antibodies are cloned from a single parent cell and can mimic a variety of immune functions in cancer treatment.)

MFAP5, a protein secreted in high levels in both these cancers, is a marker of poorer survival rates. Researchers have developed a monoclonal antibody that blocks MFAP5 found in the areas surrounding the tumor cells that feed and support the tumor. Blocking MFAP5 effectively starves the tumor since MFAP5 is associated with sustaining the tumor with nutrients. Without this, these cells are more sensitive to chemo. Phase 1 clinical trials will hopefully start in 2020.

You can read more about this by following this link