Researchers from The University of Manchester and The Christie NHS Foundation Trust, both part of Manchester Cancer Research Centre, confirmed that a test helping physicians to predict which ovarian cancer patients will respond to particular types of treatment is a step closer. The researchers believe that such as test can be available that such as test can be available in just a few years.[1]
Such a test could mean that physicians would be able to distinguish which patients will benefit from blood vessel-targeting drugs, such as bevacizumab (Avastin?; Genentech/Roche), in addition to conventional therapy. At the same time, the test would make it possible to spare women time and side effects associated with having the drug if they are not going to benefit from the treatment. The test would also help to reduce the cost to the National Health Service/NHS.
…We’re keen to identify predictive biomarkers so we can better target these drugs to patients who are most likely to benefit…
Survival rates
Ovarian cancer has seen little increase in survival rates over the last few decades and scientists are seeking new treatment strategies to improve the standard approach of surgery and chemotherapy. A number of randomized clinical trials, including ICON7, have reported improved progression-free survival or PFS when bevacizumab, a vascular endothelial growth factor (VEGF)-specific angiogenesis inhibitor, was added to conventional cytotoxic therapy.[2]
These recent advance show benefit when physicians target the development of new blood vessels within the tumor, preventing the cancer from receiving the nutrients it needs to grow. Bevacizumab used in combination with standard chemotherapy eases symptoms in patients with platinum-resistant recurrent ovarian cancer and has shown significant but modest improvements in patient survival. Based on these results, doctors are seeking ways to predict which patients are most likely to gain an advantage from this type of blood vessel-targeting drug.[2]
The research team looked at blood samples from patients enrolled in an international trial of bevacizumab. These patients received either standard chemotherapy treatment alone or chemotherapy plus bevacizumab.
Commenting on the study, Professor Gordon Jayson, Professor of Medical Oncology at The University of Manchester and Honorary Consultant at The Christie who led the study, noted: “We are keen to identify predictive biomarkers, measures that can indicate how well a patient will respond to treatment, so we can better target these drugs to patients most likely to benefit.”
“We investigated levels of a range of proteins in patients’ pre-treatment blood samples to see if any were associated with improved survival,” Jayson continued.
Ang1 and Tie2
The findings, published online first in the June 19, 2014 edition of journal Clinical Cancer Research, show that two particular proteins, Ang1 and Tie2, could be used in combination to predict patient response. The findings have also been published in the September 1, 2014 print edition of the journal. Patients with high levels of Ang1 and low levels of Tie2 were most likely to benefit from bevacizumab. Both these proteins are involved in controlling the formation of new blood vessels. Conversely, they found that patients with high levels of both proteins did not benefit from the additional drug.
Study co-author Professor Caroline Dive, from the Cancer Research UK Manchester Institute based at The University of Manchester, added: “We will now look to further explore the potential of using a blood test to personalise treatment for ovarian cancer patients. Moving towards a more individualised treatment plan specific for each patient and their particular tumour is key to improving outcomes for patients while sparing those unlikely to benefit from potential side effects of therapy.”
For more information:
[1] Backen A, Renehan AG, Clamp AR, Berzuini C, Zhou C, Oza A, Bannoo S, Scherer SJ, Banks RE, Dive C, Jayson GC. The combination of circulating ang1 and tie2 levels predicts progression-free survival advantage in bevacizumab-treated patients with ovarian cancer. Clin Cancer Res. 2014 Sep 1;20(17):4549-58. doi: 10.1158/1078-0432.CCR-13-3248. Epub 2014 Jun 19.[Article][PubMed]
[2] Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, et al. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011 Dec 29;365(26):2484-96. doi: 10.1056/NEJMoa1103799.[Article][PubMed]
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