Doctors have made a significant breakthrough in the treatment of ovarian cancer by discovering a way to reverse the resistance to drugs that denies thousands of women patients each year a chance of survival.
The disease is the fourth most common cancer in women in the UK - after breast, bowel and lung - but is also one of the hardest to treat. There are around 6,900 new cases each year, but 70 per cent of patients cannot be cured because they develop resistance to the chemotherapy which targets the malignant cells.
Professor Hani Gabra and his team at the Hammersmith Hospital in west London have discovered four major gene pathways that could reverse the resistance. This opens up the prospect of developing a drug to block these pathways and allow the chemotherapy to carry on working. The drugs in question, cisplatin and carboplatin - also known as platinum chemotherapy - are given as injections after surgery.
The hope is that a treatment can be developed which would allow the majority of women, in whom the disease has spread, to carry on living with it as a 'chronic' condition, which cannot be cured but can be treated.
Gabra, a professor of medical oncology and head of the West London Gynaecological Cancer Centre, said: 'The discovery could mean we change the outlook for patients suffering from ovarian cancer and potentially other cancers too. This really is a significant advance.'
Ovarian cancer, known as the 'silent killer', has no obvious symptoms in the early stages and is difficult to detect. There is no effective screening procedure that can indicate pre-cancerous cells as there is in cervical and bowel cancers.
Symptoms of the disease, which causes 4,500 deaths annually in the UK, include indigestion, bloatedness, nausea, unusual vaginal bleeding and pelvic or stomach discomfort, which can all be easily dismissed as a touch of the flu, irritable bowel syndrome or normal period pains. Three out of every four women are only diagnosed with ovarian cancer once it has spread significantly, when survival rates fall dramatically.
Women who have never been pregnant or who take fertility drugs for a prolonged period without falling pregnant and those who have had breast cancer are at increased risk of ovarian cancer, and it is known to run in families. Breastfeeding and taking the oral contraceptive pill lowers the risk.
The breakthrough was made at a new clinical and research unit, organised jointly at Hammersmith Hospital and the Royal Marsden. Plans for the venture already include a range of studies spanning both basic science and clinical trials, with some projects pulling in collaborators from Australia and the US.
The team hopes to begin clinical trials targeting the reversal of resistance to the drugs given to sufferers within the next few months. If it proves successful, it could result in significant improvements in treatment and outcomes for thousands of women.
Age is also a factor in ovarian cancer, with women under 60 almost twice as likely to survive, according to research produced by Stanford University in California earlier this year. Their study showed that the survival rate is in contrast to breast cancer, where younger sufferers tend to have more aggressive tumours. The Stanford study found that 59 per cent of women diagnosed with ovarian cancer between the ages of 30 and 60 survived for at least five years, compared with 35 per cent of those who were older.
Genetic changes in ovarian cancer have also come under the spotlight. Hammersmith researchers identified a particular gene, known as OPCML, about two years ago and demonstrated its role in cell adhesion. OPCML seems to be switched off in about 90 per cent of ovarian cancers, allowing cells to replicate more quickly and form tumours.
