Ovarian Cancer Canada’s research initiatives employ a bench-to-bedside approach to drive transformative change in outcomes for those diagnosed with this disease. Two funded clinical trials, though different in their approach and focus, share a dedication to exploring innovative treatment pathways and a made-in-Canada pedigree.

B.C. Cancer Medical Oncologist Dr. Anna Tinker is leading a nationwide study dedicated to improving understanding of the biomarkers that predict how specific patients with low-grade serous ovarian cancer (LGSC) will respond to two commonly used treatments. This trial, titled Molecular Evaluation of MEK\ER Response in LGSCs: A Clinical-Translational Study is significant in several regards. First, these cancers are often diagnosed in younger individuals – and though they are usually slow to grow, they also tend to spread early, and are often incurable. In addition, given the relative rarity of LGSC, deep research into this form of the disease is a significant milestone.

This work provides the opportunity to understand what treatments work best in this population of women, who currently have very few options.

Alicia Tone, PhD, OvCAN Project Manager & Scientific Advisor, Ovarian Cancer Canada.

“This is a very important trial because it is focused on individuals diagnosed with one of the less common types of ovarian cancer, and many of these individuals do not respond to standard of care treatments and are not included in clinical trials,” says Alicia Tone, PhD, OvCAN Project Manager & Scientific Advisor, Ovarian Cancer Canada. “This work provides the opportunity to understand what treatments work best in this population of women, who currently have very few options.”

Unique to Ovarian Cancer Canada’s research initiative, patient reviewers are engaged and weigh in on discussions and share their first-hand experience to support the decision-making process when awarding research funding. “This study holds great significance for all low-grade serous patients as this disease is rare, typically refractory, incurable, with an 80% mortality rate,” said one patient reviewer. “Low-grade serous patients are at an extreme disadvantage as very few research opportunities exist and therefore fewer treatment options are available. There is an urgent need for an improved understanding of low-grade serous cancer and a subsequent discovery of new and effective treatments.”

This is particularly true in the case of this study, which seeks to deepen understanding of the efficacy of drugs that target estrogen receptors, as well as those that inhibit the MAPK (mitogen-activated protein kinase) pathway. The MAPK pathway is an important signaling pathway in the growth and spread of LGSCs. Anti-estrogen treatments are commonly used to treat both breast cancer and LGSCs, but little is known about their effectiveness as a treatment for ovarian cancer. The MAPK pathway inhibitor (called a “MEK inhibitor”) used in this trial, meanwhile, has been proven effective in 25 to 40% of patients, but has many side effects. In both cases, a test that identifies biomarkers that predict whether someone with LGSC will benefit from a specific treatment represents a great scientific advance.

Discovering these biomarkers, through a series of complex molecular tests, is the goal of Dr. Tinker’s research – and the results will greatly impact the design of future clinical trials, as well as treatment pathways. “It’s a very rich translational study,” Tone says. “More so than any of the other studies that have been done into these treatments, it will give us answers as well as identify new questions for future studies.”

The geographical breadth of this trial is also noteworthy. Dr. Tinker and her co-lead, B.C. Cancer Gynecologic Oncologist Dr. Mark Carey, are engaging up to 40 people with recurrent LGSC in Vancouver, Halifax, Montreal, Toronto, Edmonton, and Calgary. This reinforces Ovarian Cancer Canada’s tireless efforts to unite and grow the community of ovarian cancer scientists and researchers across the country, as well as bring together those who have been diagnosed, and their families and supporters from coast to coast to coast. The importance and urgency of this work cannot be understated. “For all low-grade serous patients and especially for those who have inoperable disease and/or have become resistant to their current treatment, this could be life changing,” says the patient reviewer.

The study has positive ramifications beyond the two treatments upon which it is focused. “It could also uncover additional molecular changes in LGSCs that scientists could then go on to test as a potential treatment target,” Tone says. “This is really the next step in improving precision medicine for people with this type of ovarian cancer.”