Experts: New hope for ovarian cancer patients

Ovarian cancer remains a dangerous cancer, but modern diagnostics and new therapies offer a chance for long-term remission of the disease and extended survival, even in patients with a more aggressive form of the disease, said specialists in the field of gynecological oncology in a press release sent to PAP.

One of the latest breakthrough drugs is intended for women with recurrent platinum-resistant ovarian cancer. This is a particularly difficult-to-treat, more aggressive form of the disease, associated with a significantly poorer prognosis than platinum-sensitive cancers.

According to the National Cancer Registry, approximately 3,600 women in Poland are diagnosed with ovarian cancer each year, and over 2,500 die from it. Its incidence increases with age – 82% of cases occur in women over 50. It remains the cancer with the lowest five-year survival rate among gynecological cancers.

One key reason for this is late detection. In seven out of 10 patients, ovarian cancer is already in stage III or IV at the time of diagnosis. This means the disease has already spread beyond the pelvis, and distant metastases have often occurred.

Delays in diagnosing ovarian cancer are due, among other things, to the lack of routine screening tests, as with breast or cervical cancer, which increase the chances of early detection. The disease's nonspecific symptoms, often associated with gastrointestinal problems, can also be misleading. Patients often undergo lengthy treatment with medications to regulate gastrointestinal function before seeing a gynecologist.

"So far, no reliable screening test has been developed that would enable the identification of ovarian cancer at an early stage. Oncological vigilance by a specialist, as well as by the patient herself, is crucial here. Regular gynecological examinations can help detect certain abnormalities," said Prof. Anita Chudecka-Głaz, provincial consultant in gynecological oncology for the West Pomeranian Voivodeship, head of the Department of Operative Gynecology and Gynecological Oncology, SPSK-2 in Szczecin, quoted in a press release sent to PAP.

She added that recurring digestive symptoms should also raise concern.

According to the specialist, causes of ovarian cancer development include—in addition to age—infertility, lack of pregnancy, and genetic factors, such as mutations in the BRCA1 and BRCA2 genes diagnosed in family members. "Lifestyle can also play a significant role. Patients who come to us are often in poor general health. They experience circulatory disorders or embolisms. This makes it very difficult to implement effective treatment," emphasized Professor Chudecka-Głaz.

In advanced disease, treatment is systemic, with platinum-based chemotherapy being the standard of care. To maintain the therapeutic effect and maximize the time to relapse, maintenance therapy using PARP inhibitors or antiangiogenic drugs is used. At this stage, it is crucial to maintain remission for as long as possible, as each subsequent relapse typically occurs more quickly than the previous one.

It is estimated that every patient with recurrent ovarian cancer will eventually develop platinum resistance. Platinum-resistant ovarian cancer is a particularly difficult and more aggressive form of the disease, carrying a significantly poorer prognosis than platinum-sensitive cancers.

Despite years of intensive research, it has long been impossible to develop a therapy that would extend the overall survival of patients with this form of ovarian cancer. A breakthrough has only recently occurred.

"In the treatment of platinum-resistant ovarian cancer, a particularly promising approach is currently therapy using an antibody-drug conjugate – mirvetuximab soravtansine. This drug was recently included on the list of technologies with the highest level of innovation issued by the Ministry of Health and is awaiting reimbursement," commented Prof. Dagmara Klasa-Mazurkiewicz from the Department of Perinatology, Faculty of Medicine, Medical University of Gdańsk.

She explained that the mechanism of action of this conjugate is reminiscent of the mythological Trojan horse. The antibody contained in the drug recognizes and binds to the folate receptor alpha (FR-alpha), which allows cells to take up folates essential for their growth. While this receptor is present in small amounts in healthy tissues, it is present in excess on the surface of platinum-resistant ovarian cancer cells. Once the antibody binds to the FR-alpha receptor, a toxic drug is delivered to the cell, destroying it from within.

"The study results are groundbreaking. With mirvetuximab soravtansine, the number of patients whose tumors shrank or disappeared in response to therapy is more than twice as high as with current treatment. Additionally, the therapy reduces the risk of death by 33% while offering a better quality of life," explained Professor Klasa-Mazurkiewicz.

Experts pointed out that in order to more effectively treat ovarian cancer patients, it is necessary to expand access to modern genetic testing in Poland.

"Access to genetic testing in Poland has significantly improved in recent years. We're also seeing an increase in the number of tests ordered, which was at a very low level just a few years ago. However, access to the HRD test (homologous recombination deficiency test) remains a significant need, which is currently not publicly funded," said Dr. Anna Dańska-Bidzińska from the Clinic of Gynecological Oncology, Maria Skłodowska-Curie National Institute of Oncology – PIW, president of the Association of Women in Polish Oncology, Rak Misja. She added that without the results of this test, some patients cannot be prescribed PARP inhibitors available under the drug program.

As the experts concluded, improved access to modern molecular diagnostics, the introduction of breakthrough therapies for patients with platinum-resistant disease, and growing awareness among women and physicians offer real hope for improving treatment outcomes and the quality of life of ovarian cancer patients. (PAP)

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