Ovarian cancer is very difficult to treat successfully. Usually, by the time you learn you have it, it’s already advanced. Surgery and chemotherapy can help. But many times the disease comes back. Most women diagnosed with ovarian cancer don’t survive more than 5 years.
Because of such negative outcomes for advanced ovarian cancer, many doctors urge their patients to take part in clinical trials. Researchers are constantly testing new drugs and new combinations of drugs to fight ovarian cancer. Several promising new treatments have been approved in the past few years, and more are being investigated.
The first step in ovarian cancer treatment is usually an operation to remove as much of the cancer as possible. Depending on the extent of your cancer and your overall health, you might first have chemotherapy to shrink the cancer, then have surgery. Researchers are looking at whether one strategy works better than the other.
Combining surgery with something called hyperthermic intraperitoneal chemotherapy has shown some promise. In this procedure, heated chemo drugs are pumped into the space inside your abdomen after your surgery in hopes of killing any cancer that was left behind. More studies are testing how well this works.
Chemotherapy for ovarian cancer is usually a combination of two kinds of drugs, one called a platinum compound (carboplatin or cisplatin), the other called a taxane (docetaxel or paclitaxel). It usually puts the cancer into remission, at least for a while. But it often comes back, and chemo has to be repeated. Some cancer cells are more sensitive to the platinum drugs than others. If your cancer either doesn’t respond or comes back within 6 months, it’s said to be platinum refractory or platinum resistant.
Researchers are looking for ways to overcome platinum resistance by giving you other kinds of drugs along with chemotherapy. They’re also testing new kinds of chemotherapy drugs.
A newer way to treat cancer uses drugs that target only the cancer cells, without doing damage to your healthy cells. They take advantage of weaknesses within the cancer cells to stop them from growing. Several kinds of drugs have recently been approved or are in the testing phase.
Antiangiogenics. These drugs kill cancer cells by cutting off their blood supply. Bevacizumab was approved for treating ovarian cancer in 2018. Another antiangiogenic drug being tested is cediranib.
Studies are looking at whether antiangiogenics work best in combination with other cancer-fighting drugs, whether they help keep ovarian cancer from coming back after surgery and chemotherapy, and whether certain people respond better than others.
PARP inhibitors. Poly ADP-ribose polymerases (PARPs) are enzymes that sense DNA damage within cells and signal other chemicals to start the repair process. Some kinds of ovarian cancer cells have flaws that make them more prone to DNA damage. Blocking PARPs kills these cells.
Niparabib, olaparib, and rucaparib are the three PARP inhibitors that are approved to treat ovarian cancer. Several others are being tested. Clinical trials are also looking at whether combining these drugs with chemotherapy makes that treatment work better, and how effective they are in keeping cancer from coming back after other treatments.
More experimental drugs are being tested to keep ovarian cancer cells from repairing damaged DNA that target different enzymes and proteins.
This treatment enlists your body’s natural defense system to fight your cancer. Several different kinds of drugs are being developed to either boost your immune system, or teach it to identify and attack ovarian cancer cells.
Checkpoint inhibitors. Checkpoints are proteins in your immune system that tell your body when to fight germs and when to back off. Cancer can sometimes evade this system. Checkpoint inhibitors help your immune system identify cancer cells and respond with appropriate force.
So far, studies have not found these kinds of drugs to be very helpful against ovarian cancer. Dostarlimab and pembrolizumab are approved for limited use against specific kinds of tumors. Research continues to see if they can be helpful more broadly, and whether they work better in combination with other drugs. Several similar drugs are also being tested.
Cancer vaccines. Vaccines can be used to treat, rather than prevent, some kinds of cancer, including ovarian cancer. They’re made from proteins specific to ovarian cancer, and they teach your immune system to recognize cancer cells as invaders.
This treatment approach is still experimental, and several different kinds of vaccines are being studied.
T-cell transfer. With this therapy, doctors take your own immune cells, modify and multiply them, then put them back into your bloodstream. That gives your immune system more cancer-fighting power.
This is another experimental treatment with several early clinical trials going on.
Prevention Through Surgery
People who have abnormalities in the BRCA1 or BRCA2 genes are more likely to get both breast and ovarian cancer. To lower their chances, some women who test positive for a variation in one of these genes choose to have surgery to remove their ovaries and fallopian tubes, a mastectomy (to remove breast tissue), or both.
Researchers have found that some ovarian cancers actually start in your fallopian tubes. Studies are looking at whether removing only the fallopian tubes is an effective way to prevent ovarian cancer, while letting women keep the health benefits of the hormone estrogen their ovaries make for a longer time.
How to Participate in a Clinical Trial
If you want to get cutting-edge treatment, and help scientists learn better ways to fight ovarian cancer, you can take part in a clinical trial. Your doctor is the best place to start. They may know about studies in your area that could be helpful to you, and tell you whether it’s safe to participate.
Other ways to find clinical trials include:
Clinicaltrials.gov. This is a searchable database managed by the U.S. National Library of Medicine. It lists hundreds of trials for ovarian cancer, and how to get in touch about them.
CISCRP.org. The Center for Information and Study on Clinical Research Participation also has an online tool that lets you search for clinical trials by condition and location.
Hospitals, universities, and medical schools. Check the websites of institutions in your area. They may list clinical trials they’re doing on ovarian cancer, or tell you how to contact their research departments.
Find out as much as you can about any trial that seems promising to you. Someone at the study should be able to give you detailed information about the drug or procedure being tested and what they hope to learn. That information may also be online.
Here’s what you can expect from a clinical trial:
- You’ll have an interview to see whether you qualify. Some studies need people with a certain type or stage of ovarian cancer. Others may need people who’ve never been treated, or have already tried a certain treatment.
- If you’re eligible, you’ll be asked to give what’s called informed consent. That means you understand the risks and possible benefits of the study, and any rules you need to follow to participate. Read carefully the information they give you and ask questions.
- Once you’re enrolled, you may get a physical exam or tests like blood work.
- During the study, you’ll get whatever treatment is being tested. Or you might be in what’s called a control group that gets the standard treatment, to see how the new treatment compares.
- You’ll have health checks and tests to measure how the treatment is working and whether you’re having side effects.
- There may be costs for tests or treatments related to the trial. These should either be covered by the study itself or by your health insurance. Some studies will even reimburse you for costs like travel. Check with the people at the study and with your insurance company before you commit.
- Taking part in a clinical trial is voluntary, and you’re free to quit at any time, for any reason.
If you don’t qualify for a clinical trial, you may still be able to get a chance at the newest ovarian cancer treatments. Through what’s called compassionate drug use, unapproved medications are sometimes made available to people who are very sick and have no other options. Check with your doctor.