Recent Advancements in Ovarian Cancer Research

In 2012, the World Trade Center Health Program recognized malignant neoplasm of the ovary (ovarian cancer) as a 9/11-caused cancer. While this was a landmark finding, much work remains to be done since ovarian cancer remains one of the most challenging cancers to treat, primarily when it is not detected early. Traditionally, the treatment of ovarian cancer involves a combination of surgery and platinum-based chemotherapy, which often affects healthy cells along with cancerous ones, and leads to adverse side effects among patients with ovarian cancer. Furthermore, outcomes for ovarian cancer cases not detected early have been poor, and most patients treated with chemotherapy go on to develop chemo-resistant ovarian cancer. Recent advancements in research and treatment, including more precise chemotherapies and targeted therapies, are providing new hope for patients, including those with an increased risk of ovarian cancer due to toxic exposure like those present in the aftermath of the September 11, 2001 attacks. 

The most common type of ovarian cancer is high-grade serous ovarian adenocarcinoma, accounting for approximately 75% of epithelial ovarian cancers. Clear cell carcinoma is the second most common type of ovarian cancer and is seen in approximately 1 out of 10 women diagnosed with epithelial ovarian cancers. Other less common forms of epithelial ovarian cancer include endometrioid adenocarcinoma, mucinous adenocarcinoma, and low-grade serous carcinoma. Other rare types of ovarian cancer include stromal tumors, germ cell tumors, and small cell cancer of the ovary.

PARP Inhibitors

One of the most significant advancements in ovarian cancer treatment has been the development and use of a type of targeted therapy called PARP (Poly ADP-Ribose Polymerase) inhibitors. These drugs are designed to exploit deficient mechanisms in cancer cells' DNA repair pathways, making it harder for cancer cells to fix themselves. PARP inhibitors have shown substantial effectiveness in extending both progression-free survival and overall survival significantly, especially in patients with recurrent, platinum-sensitive ovarian cancer and those with BRCA gene mutations. 

In recent years, the FDA has approved four new uses of these drugs for the treatment and maintenance of ovarian cancer. Rucaparib (Rubraca) is used for maintenance treatment of recurrent ovarian cancer. Maintenance therapies can slow the progression of ovarian cancer or keep it from coming back after initial treatment has destroyed it. Olaparib (Lynparza) is for women with advanced epithelial ovarian cancer that has a BRCA mutation. Bevacizumab (an antibody that works by blocking a certain protein and restricting blood supply to the tumor) can be combined with olaparib for maintenance treatment in those with advanced ovarian cancers that have specific genetic traits. Niraparib (Zejula) is used for maintenance treatment to keep advanced epithelial ovarian cancers from recurring after chemotherapy.

Anti-Angiogenics

Angiogenesis refers to the formation of new blood vessels. Anti-angiogenic therapy targets the blood vessels that supply tumors with the necessary nutrients to grow, thereby starving the cancer cells. Bevacizumab, a widely recognized anti-angiogenic drug, has been used in combination with chemotherapy to treat recurrent ovarian cancer and has recently been approved for use as a first-line therapy. This approach has demonstrated a significant improvement in delaying disease progression by inhibiting vascular endothelial growth factors, thereby stifling the tumor's ability to establish a robust blood supply.

Targeted Therapies

The exploration of targeted therapies continues to expand, with researchers identifying new molecular targets each year. Antibody-drug conjugates (ADCs) represent a breakthrough in targeted therapies for ovarian cancer, delivering cytotoxic drugs with targeted precision to cancer cells, while minimizing damage to normal tissues. These therapies attack cancer cells selectively, increasing their efficacy and reducing the side effects typically associated with conventional chemotherapy.

Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

HIPEC, an innovative treatment approach for advanced ovarian cancer, is a two-step treatment that involves the surgical removal of as much visible tumor as possible followed by the direct administration of heated chemotherapy into the abdomen. This technique allows for high concentrations of chemotherapy to come into direct contact with cancer cells in the abdomen, enhancing drug absorption and effectiveness while limiting systemic exposure and side effects. HIPEC has shown promising results in extending survival among women with advanced ovarian cancer.

NCI-Supported Research Programs

The National Cancer Institute (NCI) supports a wide range of research programs aimed at improving ovarian cancer outcomes. NCI-funded researchers are finding ways to treat ovarian cancer more effectively. These programs focus on everything from basic research to uncover the disease's molecular and genetic foundations to clinical trials testing new and innovative treatments. The NCI's efforts are crucial in advancing our understanding and treatment of ovarian cancer. Current NCI-supported research programs include the following:

• The Women’s Malignancies Branch in NCI’s Center for Cancer Research: Conducts basic and clinical research in breast and gynecologic cancers, including early-phase clinical trials at the NIH Clinical Center in Bethesda, Maryland. 
• The Ovarian Specialized Programs of Research Excellence (SPOREs): Promotes collaborative translational cancer research and works to improve prevention and treatment approaches, along with molecular diagnostics, in the clinical setting to help people with ovarian cancer.
• The Ovarian Cancer Cohort Consortium, part of the NCI Cohort Consortium: An international consortium of more than 20 cohort studies that follow people with ovarian cancer to improve understanding of ovarian cancer risk, early detection, tumor differences, and prognosis. 
• NCI’s clinical trials programs, the National Clinical Trials Network, Experimental Therapeutics Clinical Trials Network, and NCI Community Oncology Research Program: These programs all conduct or sponsor clinical studies of ovarian cancer.

Early Detection Methods

Early detection remains a critical challenge in the treatment of ovarian cancer. Recent research efforts have been directed toward improving screening techniques that can detect ovarian cancer at its earliest stages. Biomarker discoveries, along with advances in imaging technology, are at the forefront of these developments. While preventing ovarian cancer is not yet a reality, early detection significantly improves treatment outcomes, as the disease is much more manageable in its initial stages. This is why it is essential for women present in the aftermath of the 9/11 attacks to conduct regular screenings for 9/11-related ovarian cancer. 

What This Means for Your 9/11 Ovarian Cancer

For those exposed to toxic substances in the aftermath of the 9/11 attacks, these ongoing advancements are particularly relevant. The World Trade Center Health Program (WTCHP) recognizes certain types of ovarian cancer as 9/11-related conditions, making it essential for affected individuals to stay informed about the latest treatment and screening options. Understanding and accessing these new therapies can be crucial for improving outcomes and quality of life. If you or a loved one has been diagnosed with 9/11-related ovarian cancer, contact the 9/11 attorneys at Hansen & Rosasco, LLP today to find out more about the benefits and compensation available to you.