Source: Centenary Institute of Cancer Medicine and Cell Biology - December 2002
The research challenge
Ovarian cancer is the fourth most common cause of cancer deaths in Australian women. The cancer is often silent until it is quite advanced, so that treatment is not as effective as in other cancers such as breast and cervical cancer, which are usually detected earlier. The overall five-year survival is less than 30 percent. There is a 60 to 70 percent chance of disease recurrence within two years of standard treatment with surgery plus chemotherapy.
The path to discovery
The Centenary Institute of Cancer Medicine and Cell Biology is testing a new type of therapy for ovarian cancer. The therapy involves stimulating the patient's immune system to fight the cancer. The therapy is administered in addition to the first-line treatment currently available, namely excision of the tumour followed by six courses of chemotherapy at monthly intervals. The therapy is being offered to women enrolled in a pilot study through the Sydney Cancer Centre at Royal Prince Alfred Hospital.
Significance and value
There are more than 1200 new cases of ovarian cancer in Australia each year. Because relapse following chemotherapy is so common, a totally new approach to therapy is needed. Immunotherapy is important because it offers the prospect of harnessing the power of the immune system to find and destroy residual cancer cells before they grow and cause a relapse. It is particularly important for cancers that have proven resistant to chemotherapy.
This is the first trial to make use of the paradoxical ability of the immune system to respond more strongly when the number of immune cells is abnormally low. The Centenary Institute of Cancer Medicine and Cell Biology discovered the importance of this pathway as part of our studies into inflammatory bowel disease models in mice. We were able to apply it to ovarian cancer because of our multi-disciplinary collaboration with the Sydney Cancer Centre.
So far we have treated nine patients and enrolled a further 10. No side effects of the treatment have been experienced. We are aiming to treat a total of 20 to 30 women in this first trial. Success will be judged by the length of the disease-free interval, measured from the time of surgery. Follow-up will therefore require several years. We will also be measuring immune responses to the patients' ovarian cancers using immune cells harvested from blood samples.
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