Recruitment status: Open

Ovarian cancer is a challenging disease to treat and despite surgery and chemotherapy at time of diagnosis the cancer will return in most women. Recent advances in medical research have identified that certain genes—the machinery responsible for keeping human cells healthy and working correctly—such as BRCA1/2 can help ovarian cancer grow when they are damaged. As a result, drugs such as Olaparib, take advantage of this to make cancer cells highly vulnerable to treatment. Known as Poly (ADP-ribose) polymerase (PARP) inhibitors, these drugs have been shown to be effective at keeping cancer at bay after women have finished chemotherapy when they are newly diagnosed as well as when it returns compared with no treatment at all. However, despite this effective delay, cancer will return in many women and at this point, treatment becomes somewhat challenging. There are a number of scientific studies looking at other ways to block cancer cell growth in patients who have developed resistance to PARP inhibitors. These targets include blood vessel growth, such as vascular endothelial growth factor (VEGF), cell dividing pathways (Wee-1 like protein kinase; WEE1) and other structures that support the cancer such as cells and tissues that can affect growth. As a result, various classes of drugs including immune therapies, VEGF inhibitors and other targeted treatments affecting cell growth are showing promise both alone and in combination with other drugs.

A research team led by Dr. Lheureux is taking a close look at how using detailed cancer information at the molecular level can help direct treatment when cancer has returned; an approach that is unique and specific to each patient and her disease. Launched across Canada’s leading cancer centres, the REVOLVE clinical trial will enroll women whose cancer has returned after treatment with PARP inhibitors. The research team will closely examine genes and proteins—the building blocks of cells—that have been changed and may be promoting a more aggressive cancer that is evading treatment. As a result, each woman will have her cancer tissue examined and reviewed by a team of Canada’s leading cancer experts to determine the most appropriate treatment needed next. Upon successful completion of the study, findings hold the potential to change the way women with ovarian cancer are treated, as well as lay the groundwork for new areas of drug development.