'Surprising gaps' remain in ovarian cancer research, new report finds

Despite advances in cancer research, “surprising gaps” remain in the fundamental knowledge of ovarian cancer, according to a new report from an expert committee convened by the National Academies of Sciences, Engineering, and Medicine, based in Washington DC.

“While progress has been made in ovarian cancer research over the past few decades, much remains to be learned,” said the report committee chair Jerome F. Strauss III, Executive Vice President for Medical Affairs and Dean of Virginia Commonwealth University School of Medicine, in Richmond, VA. 

“The more that is understood about the basic biology of various types of ovarian cancers, such as where they originate in the body, the more rapidly we can move toward advances in prevention, screening, early detection, diagnosis, treatment, and supportive care,” he added.

In compiling the report, titled Ovarian Cancers: Evolving Paradigms in Research and Care, the committee focused on identifying the research gaps in ovarian cancer that, if addressed, could have the greatest impact on reducing morbidity or mortality.

Ovarian cancer, although relatively uncommon, is one of the deadliest cancers—the overall 5-year survival rate is 28%. Each year, more than 22,000 women in the US are diagnosed with it, and more than 14,000 die from it. So far, no reliable approaches for early detection of ovarian cancer have been found.

The report includes an overview of the latest knowledge in research. In particular, recent advances have revealed that ovarian cancer is not one disease, but rather a constellation of distinct subtypes with different sites of origin, genetic backgrounds, and disease behavior. The report also recommends approaches that will benefit the outcome of women with or at risk for ovarian cancer.

Recommendations include:

• Design and prioritize preclinical, clinical, and population-based research agendas in the context of the different ovarian cancer subtypes.
• Reach consensus on diagnostic criteria, nomenclature, and classification schemes and adopt a standardized taxonomy.
• Develop and implement innovative strategies to increase genetic counseling, testing, and sharing results among other at-risk family members.
• Identify and evaluate the underlying mechanisms of both new and established risk factors for ovarian cancers to develop and validate a dynamic risk assessment tool accounting for the various ovarian cancer subtypes.
• Focus on the development and assessment of early detection strategies that reflect the pathobiology of each ovarian cancer subtype.
• Focus on quantifying the risk-benefit balance of nonsurgical and surgical prevention strategies for specific subtypes and at-risk populations.
• Focus on improvement of current treatment strategies.
• Develop more effective pharmacologic and non-pharmacologic therapies and combinations of therapies that leverage the unique biology and clinical course of ovarian cancer.
• Investigate methods to ensure the consistent implementation of current standards of care that are linked to quality outcome metrics.
• Study the supportive care needs of patients with ovarian cancer throughout the disease trajectory.
• Coordinate efforts to develop and implement efficient, effective, and reliable methods for rapid dissemination and implementation of evidence-based information and practices to patients, families, and health providers.

Because the recommendations are interconnected, they must be considered simultaneously, not sequentially, the authors noted.

An article that summarized the report was published online March 2, 2016 in JAMA. A detailed list of the recommendations, as well as the full report, can be downloaded from the National Academy of Sciences website.