HOW CAN PERSONALIZED CARE LEAD TO BETTER QUALITY OF LIFE FOR PATIENTS WITH ENDOMETRIAL AND OVARIAN CANCER?
For decades, cancer treatment has often followed a one-size-fits-all approach. Patients have typically been treated based on where their cancer originated, with many receiving the same combinations of surgery, chemotherapy, and radiation. But as our understanding of cancer evolves, so does the way we approach treatment.
For Drs. Amy Jamieson and Jessica McAlpine in Vancouver, British Columbia, the future of cancer care is about looking beyond where a cancer is located and understanding what makes each person’s tumour unique. The COMPARE Trial in co-existent and ovarian cancers (CEOCs), takes a precision lens that tailors treatment to the individual patient and the specific characteristics of their cancer. It uses molecular and features of the tumours to identify patients who are expected to have excellent outcomes after surgery and where there may be no benefit from receiving additional treatments like radiation or chemotherapy.
This matters because, although cancer treatments can be lifesaving, they typically also come with significant side effects, such as loss of feeling in the fingers and toes, fatigue, joint pain, and bowel or bladder changes.
“We have a very coarse lens on most cancer treatments,” explains Dr. McAlpine. “We’re recognizing that some people are getting too much treatment, some people not enough, or more nuanced treatment is needed.”
Study leads Dr. Jessica McAlpine (left) and Dr. Amy Jamieson (right)
What is the goal of this research?
The goal of Drs. Jamieson and McAlpine’s research is to better understand CEOCs, a rare diagnosis in which cancers occur in both the endometrium and ovary without spreading to other parts of the body. CEOCs are associated with excellent outcomes, including a very low risk of disease recurrence. Current treatment approaches to CEOC can vary depending on where a patient receives care. Some patients may simply be monitored for recurrence or disease progression after surgery, while others may receive months of chemotherapy and radiation.
“That’s not equitable,” McAlpine explains. “For some people, standard treatment is absolutely necessary and lifesaving. But if we can identify who is at very low risk of recurrence, wouldn’t it be fantastic to spare them all the short and long-term side effects that come with treatment?”
Cancer care is not only about survival, but also about what life looks like after treatment.
How can this approach create a better quality of life for patients?
Through this research, the team hopes to develop a more personalized approach to care. For patients living with CEOCs, this could mean more patients being safely directed to treatment options with fewer side effects, optimizing quality of life. By closely monitoring patient outcomes throughout the trial, they aim to generate evidence to address an important knowledge gap.
“It’s like using a scalpel or a set of tweezers instead of a hammer,” explains Dr. McAlpine. “But also recognizing that, while some cancers might need a hammer, this one doesn’t.”
Who does this benefit?
If successful, the impact could extend far beyond those enrolled in the COMPARE Trial. Evidence generated through this research could inform international guidelines.
“The ideal outcome would be recognition internationally that it’s safe to give these [specific] patients less treatment,” says Dr. McAlpine. “A huge proportion of patients who are getting short and long-term toxicities from treatment would then not have that.”
Why do patient voices matter in research?
A key part of this work is the involvement of patient partners with lived and living experience, who help shape research from the beginning. Dr. McAlpine highlights the contributions of patient partners, Karen Bemister and Steph Baker, who have collaborated with the research team on everything from informing the research questions to refining the trial design and co-creating study materials.
“Engaging patient partners from the beginning not only motivates researchers and clinicians, but also just makes a better trial all around,” says Dr. McAlpine. “When it’s about quality of life or decision making, the patient voice becomes even more important.”
How does Ovarian Cancer Canada support this research?
Hand-selected by a patient committee, our investment in this work is a step towards a future in which care is informed by and created with patients at the forefront.
Cancer treatment looked very different just decades ago, and through continued investment in Canadian-made research and prioritizing the patient voice, we are already seeing changes.