New Treatments and Research on Ovarian Cancer, Obesity

Cancer Cell

Ovarian cancer is a deadly disease, but new first-class drugs are in the pipeline and new research that looks at the link between obesity and the spread of the cancer may be able to help stop it from spreading so fast.

While ovarian cancer only accounts for about 3% of cancers among women, its still a very serious disease.  It causes more deaths than any other cancer of the female reproductive system because its so hard to detect until it has progressed significantly. Currently more than 75 percent of women diagnosed with ovarian cancer have metastasis at the time of diagnosis, resulting in a low five-year survival rate of less than 30 percent.

New Cancer Treatments in the Pharmaceutical pipeline

Its not just immunotherapy treatments that are making the news, ovarian cancer treatment also has a strong pipeline of 462 diverse and innovative products in active development, says GBI Research. Their new report, Frontier Pharma: Ovarian Cancer – Identifying and Commercializing First-in-Class Innovation – states that as the ovarian cancer therapeutics market becomes more diverse, it will become less reliant on indiscriminate and highly cytotoxic chemotherapy regimens.

The range of new products in active development signals significant potential for alternatives to chemotherapy, which does not target specific proteins in aberrant pathways in ovarian cancer.

Analyst for GBI Research Joshua Libberton says, “Despite limited therapeutic options for ovarian cancer patients at the moment, almost 52% of ovarian cancer products in active development in the pipeline are considered to be first-in-class, as they have a molecular target not associated with any marketed products. According to GBI Research, the high proportion of first-in-class innovation implies that the industry is pursuing novel approaches to treatment and reducing the focus on established therapies. Although innovation to date has been slow, greater disease understanding and awareness has created an environment in which it will thrive.

New Research, Obesity related to growth of the ovarian cancer

A large number of studies have shown that an increased body mass index (BMI) is associated with a greater risk for ovarian cancer with worse overall survival. More than 35 percent of women in the United States are obese, putting them at increased risk for the cancer. However, the influence of obesity on ovarian cancer metastasis had not been evaluated until recently. Researchers from the University of Notre Dame and its affiliated Harper Cancer Research Institute (HCRI) have just unveiled important new insights into the relationship between ovarian cancer and obesity on their quest to discover if tumor cells better able to successfully metastasize when the “host” is obese versus lean.

“Ovarian cancers metastasize through a distinct mechanism that results in large numbers of lesions anchored throughout the abdominal cavity, making surgery challenging,” Stack said. Stack and Harper researcher Yueying Liu led a team of researchers that used an integrative approach combining three-dimensional cell culture models, tissue explants and mouse models to evaluate tumor cell adhesion to the cells that line the abdominal cavity, called “mesothelial cells.”

“In 3-D tissue culture models, we found that lipid-loading the mesothelial cells, or growing them in the presence of components that make up fat, increased the ability of tumor cells to bind to them,” Stack said. “As tumor cell-mesothelial cell binding is a key step in ovarian cancer metastasis, this prompted us to study this further in mouse models. We used a ‘diet-induced obesity’ (DIO) protocol in which mice were fed a high fat diet, which was 40 percent fat, relative to mice fed control chow. When mice were significantly different in weight, they were injected with fluorescent ovarian cancer cells, and we monitored metastatic seeding in the abdominal cavity by in vivo imaging.”

Individual organs were removed from the mice and imaged to quantify tumor burden in each organ. Researchers also used another mouse model of obesity, termed the ob/ob mouse, which harbored a mutation that caused it to become highly obese.”In all of these models, we found that obesity enhances ovarian cancer metastatic success,” Stack said.

The researchers hope that further research in this direction may provide new targets for dietary and therapeutic interventions to slow or inhibit metastatic dissemination and thereby impact the long-term survival of women with ovarian cancer. However, Stack pointed out that they are just at the beginning of understanding this complex disease.

“Our ongoing efforts are aimed at understanding the mechanism by which obesity impacts metastatic success. For example, we have found that tumors growing in obese host mice turn on lipid synthesis and lipid transport, suggesting that they are better able to acquire and utilize nutrients from fat. The blood supply to the tumors is also impacted, as is the presence of specific immune cells. There is still a lot of work needed to figure out where we can intervene in this process.”

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