A new genetic test may guide ovarian cancer treatment
Researchers have developed an optimized genetic test for ovarian cancer to help precisely target an effective but expensive drug. The drug has significantly improved the prognosis of ovarian cancer patients.
A genetic test developed in research conducted at the University of Helsinki and Helsinki University Hospital identifies ovarian cancer patients who benefit from PARP inhibitors as a treatment option.
Because the treatment has potentially serious side effects, it is important to be able to target the patients who will benefit the most.
The genetic test helps to identify patients who do not benefit from the drug, thereby avoiding unnecessary treatment and drug-related side effects. At the same time, up to millions of euros in public funds can be saved.”
Anniina Färkkilä, specialist, HUS Helsinki University Hospital
The test, optimized for the Finnish population, has been clinically approved by HUSLAB and is used to test all ovarian cancer patients in Finland. In 2022, the National Pension Service (Kela) included PARP inhibitors in the list of drugs to be reimbursed based on a genetic test.
“This therapy can now be given to up to half of ovarian cancer patients”, Färkkilä is happy.
Ovarian cancer has a worse prognosis than other gynecological cancers, as diagnosis is often delayed due to minor and unclear symptoms.
In recent years, new PARP inhibitors have achieved excellent results in the maintenance treatment of ovarian cancer after surgery and in cytostatic treatment in newly diagnosed ovarian cancer.
“PARP inhibitor treatment increases disease-free years and prolongs survival. Some patients with advanced ovarian cancer can even be considered cured in the future thanks to PARP inhibitors,” says Färkkilä.
Targeted treatments using artificial intelligence
The test, developed by researchers with the help of machine learning, reliably identifies patients whose tumors have certain gene errors typical of ovarian cancer.
“The majority of ovarian cancers are deficient in a specific DNA repair pathway. Cancer cells with this deficiency are unable to accurately repair DNA double-strand breaks, causing the accumulation of DNA damage,” says PhD researcher Fernando Perez Villatoro. from the University of Helsinki.
The lesions result from a deficiency in the homologous recombination DNA repair (HRD) pathway. It is these tumor types that are sensitive to PARP inhibitors.
“Clinical studies have shown that patients with HRD tumors have a strong response to PARP inhibitors, while other patients have a poor response,” notes Perez Villatoro.
The results of the study showed that each type of cancer is associated with different characteristics of the genetic lesions associated with HRD. In fact, the development of a test optimized for ovarian cancer was important to advance the accuracy of treatments for this type of cancer.
“The gene test and algorithms are now freely available and can be used in clinical care and research to guide ovarian cancer treatment,” concludes Perez Villatoro.
Source:
Journal reference:
Perez-Villatoro, F., et al. (2022) Optimized detection of homologous recombination deficiency improves prediction of clinical outcomes in cancer. npj Precision Oncology. doi.org/10.1038/s41698-022-00339-8.