Targeted way to treat ovarian cancer discovered
Researchers at Women & Infants Hospital of Rhode Island have developed a biologic drug that would prevent the production of a protein known to allow ovarian cancer cells to grow aggressively while being resistant to chemotherapy. This would improve treatment and survival rates for some women.
The work coming out of the molecular therapeutic laboratory directed by Richard G. Moore, MD, entitled “HE4 (WFDC2) gene overexpression promotes ovarian tumor growth” was recently published in the international science journal Scientific Reports, a Nature publishing group.
“We have known that the protein HE4 is present in women who have ovarian cancer,” says Moore, who created the Risk of Ovarian Malignancy Algorithm (ROMA) to determine if a pelvic mass is cancerous based on the levels of HE4 and another protein. “What no one knew was why the protein is there or what activates it.”
The WFCD2 gene produces a “messenger RNA” that encodes for the HE4 protein, not only imparting an aggressiveness to the tumor, enabling it to grow quickly, but also conveying a resistance to chemotherapy drugs used to treat the tumor.
“It plays a part in allowing the cancer to grow without restriction,” Moore says. “We have determined that HE4 plays a part in allowing ovarian cells to become cancer cells, giving them the ability to grow and resist chemo.”
Once they identified the function of the protein, Moore’s research team was able to design a biologic drug that can prevent the messenger RNA gene from creating HE4. The novel biologic has been tested in cell and animal models, and the results are that the cancer does not grow as aggressively and responds to chemotherapy.
Can I reduce my risk of ovarian cancer?
There is limited information on what you can do to reduce your likelihood of developing this disease.
However, we do know that:
Using the oral contraceptive pill for five years reduces the risk of ovarian cancer by 50 per cent.
Tubal ligation (having your Fallopian tubes tied) and hysterectomy reduces the risk of ovarian cancer by between 30 and 40 per cent.
“We would give this biologic - which has minimal side effects - to any patient we identify through a blood test as producing HE4,” he says, adding that oncologists have recognized that women with high levels of HE4 do not respond to treatment and their survival rates are lower. “This would be an individualized treatment that could increase survival rates of some women with ovarian cancer.”
Moore and his team will continue testing the biologic drug, preparing for clinical trials in humans.
“This is a tremendous discovery and could mean the difference between life or death for some women with ovarian cancer,” says Maureen G. Phipps, MD, MPH, chief of obstetrics and gynecology at Women & Infants. “Dr. Moore’s research is ground-breaking in the area of ovarian cancer, and it’s all happening in his laboratory in the Knowledge District of Providence.”
What are ovaries?
The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus. The uterus is the hollow, pear-shaped organ where a baby grows. Each ovary is about the size and shape of an almond. The ovaries produce eggs and female hormones. Hormones are chemicals that control the way certain cells or organs function.
Every month, during a woman’s menstrual cycle, an egg grows inside an ovary. It grows in a tiny sac called a follicle. When an egg matures, the sac breaks open to release the egg. The egg travels through the fallopian tube to the uterus for fertilization. Then the sac dissolves. The empty sac becomes corpus luteum. Corpus luteum makes hormones that help prepare for the next egg.
The ovaries are the main source of the female hormones estrogen and progesterone. These hormones affect:
The way breasts and body hair grow
Body shape
The menstrual cycle
Pregnancy
About Women & Infants Hospital
Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation’s leading specialty hospitals for women and newborns. The primary teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women’s medicine, Women & Infants is the eighth largest stand-alone obstetrical service in the country with nearly 8,400 deliveries per year. In 2009, Women & Infants opened the country’s largest, single-family room neonatal intensive care unit.
New England’s premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, women’s mental health, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation’s only mother-baby perinatal psychiatric partial hospital, as well as the nation’s only fellowship program in obstetric medicine.
Ovarian cancer is the ninth most common cancer in women in NSW.
In 2003, 363 women were diagnosed with ovarian cancer. Most cases (86%) occur in women over the age of 45.
What causes ovarian cancer?
We don’t know what causes most ovarian cancers, but we do know that some factors increase the risk. These factors include:
Age: Ovarian cancer is most common in women aged over 45.
Family history: Around 5-10% of cases of ovarian cancer are caused by inheriting a damaged gene. If you have a close relative who has had cancer of the breast or ovary, you may be at increased risk of ovarian cancer. However, most women who develop ovarian cancer do not have a family history of the disease.
Not having children: Ovarian cancer is more common in women who have not had children.
However, many women who have these risk factors do not develop ovarian cancer.
Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute’s Gynecologic Oncology Group and the National Institutes of Health’s Pelvic Floor Disorders Network.
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Care New England Health System