Moffitt Focuses On Ovarian Cancer During Gynecologic Cancer Awareness Month

Main Category: Ovarian Cancer
Also Included In: Cancer / Oncology;  Women's Health / Gynecology
Article Date: 06 Sep 2007 - 1:00 PST

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Doctors and researchers at Moffitt Cancer Center are harnessing the power of genomic technology to personalize cancer care for women with gynecologic malignancies by matching the right patient with the right drug.

"Although there are many drugs available to treat ovarian cancer, only a small proportion of patients benefit from each drug," said Dr. Johnathan Lancaster, Ph.D., chief of the division of Gynecologic Oncology and medical director for Lifetime Cancer Screening & Prevention Center (LCS). "Unfortunately, at present we do not have the ability to predict which patients fall into that small proportion so we have to treat all patients with all drugs. We are developing tools that will enable us to predict which patients will respond to which drug so treatments can be personalized."

Lancaster and others are examining genetic signatures in ovarian cancers to understand why some tumors respond to treatment and some do not.

"The more samples we have to study, then the better chance we have to develop gene profiles that will enable us to look at a patient's tumor and determine whether they will respond to a certain treatment because of recognizable patterns," said Lancaster.

Gynecologic cancers include ovarian, uterine, cervical, vulvar, vaginal and tubal. While endometrial cancer, the most common type of uterine cancer, is the most common gynecologic cancer (about 6 percent of all cancers in women), ovarian cancer remains the deadliest. The American Cancer Society (ACS) estimates 22,430 cases of ovarian cancer in the United States this year and an estimated 15,280 deaths, making it the fourth leading cause of cancer-related death among women in the United States.

Ovarian cancer kills more women because it is usually not detected until it is too late. Developing a blood and urine test to detect earlier-stage, more curable ovarian cancer in women is the goal of Dr. Rebecca Sutphen, director of Clinical Genetics at Moffitt and director of the Family Cancer Genetics Network (FCGN).

Sutphen is currently the principal investigator of the only NCI-funded, population-based, 5-year study using state-of-the-art proteomic technology. This $3.9 million research effort involves collecting blood samples before surgery from 1,000 women with suspected ovarian cancer.

"Only one in four of these women will actually have ovarian cancer," said Sutphen. "This is one of the reasons it is so important to develop an accurate test so women do not have to undergo unnecessary surgery."

The samples will then be analyzed to find proteins that differ from those found in healthy women. If certain proteins show up in cancerous samples, a blood test could be developed to test for those proteins that make women susceptible to ovarian cancer.

Sutphen is also researching the link between ovarian and breast cancer.

"There are certain genes that can put you at risk for ovarian cancer," said Sutphen. "People want to know why they get ovarian cancer, and we have found that two genes, BRCA-1 and BRCA-2, put you at high risk, about 30 times the risk as most women."

When a woman finds out she has invasive ovarian cancer, there is a 15 percent chance she will have one of these mutant genes. "There is a 50/50 chance you can pass these genes to all of your children, both males and females," said Sutphen. "Our program does genetic testing for these genes that give these women a very high risk for breast cancer as well."

Open Clinical Trials

Moffitt has three open clinical trials for ovarian cancer. "Two trials are for ovarian cancer that uses one of the most exciting new drugs in cancer, Avastin. It works by choking the tumors off by attacking their blood supply," said Dr. Robert Wenham, the principal investigator and a physician in Moffitt's Gynecologic Oncology program.

1. The Taxotere and Avastin combination treatment of recurrent ovarian cancer is for women whose cancer has come back within a year after they have been treated with platinum chemotherapy. These two drugs in combination have the potential to work together to kill the cancer. Patients may have two prior treatments, one for the initial diagnosis and one for a recurrence.

Eligibility for trial:

-- 18 years of age
-- No more than two previous chemotherapy regimens for this cancer
-- Measurable disease
-- No brain metastases
-- At least four weeks since surgery, open biopsy or chemotherapy
-- At least three weeks since radiation therapy
-- Never been treated with either drugs in study

2. Oxaliplatin, Taxotere and Avastin are used for newly diagnosed ovarian cancer.

Eligibility for trial:

-- Diagnosis of ovarian, primary peritoneal or fallopian tube cancer
-- Stage Ib-IV with either optimal or suboptimal residual disease
-- Must sign consent prior to 50 days after initial surgery
-- May have measurable or non-measurable disease
-- First time being treated for this cancer

"Another trial uses new 'targeted' drugs to improve the response to platinum chemotherapy for women with recurrent cancer, combining Carboplatin and Taxol with Sorafenib, which is the first drug to ever improve survival in liver cancer," said Wenham. Since chemotherapy drugs stop tumor cells from dividing so they stop growing or die, adding Sorafenib may kill more tumor cells.

Eligibility for trial:

-- 18 years of age
-- Platinum Sensitive (treatment free interval > 6 months)
-- No more than two prior chemotherapy regimens
-- Measurable disease on an X-ray
-- No brain metastases
-- Never been treated with Sorafenib

About Moffitt Cancer Center

Located in Tampa, Florida, Moffitt Cancer Center is the only Florida-based cancer center with the NCI designation as a Comprehensive Cancer Center for its excellence in research and contributions to clinical trials, prevention and cancer control. Moffitt currently has 15 affiliates in Florida, one in Georgia and two in Puerto Rico. Additionally, Moffitt is a member of the National Comprehensive Cancer Network, a prestigious alliance of the country's leading cancer centers, and is listed in U.S. News & World Report as one of "America's Best Hospitals" for cancer and ear, nose and throat. Moffitt's sole mission is to contribute to the prevention and cure of cancer.

http://www.moffitt.org