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The presence of a particular type of immune cell can predict how long patients with ovarian cancer will remain cancer-free after chemotherapy
and helps determine their overall chances of survival, according to research led by the
laboratory of George Coukos, MD, PhD of the University of Pennsylvania. This research
marks the first time researchers have found that a spontaneous immune response against
cancer influences the course of the disease. Dr. Coukos and colleagues hope to develop
individualized treatments based on this information to improve the outcome for ovarian
cancer patients.
Ovarian cancer is the sixth most common cancer among women and the fifth leading cause
of cancer deaths in women. The American Cancer Society estimates that 25,400 new cases of
ovarian cancer will be diagnosed in 2003, and approximately 14,300 women will die from
ovarian cancer this year. There are several different types of ovarian cancer. The most
common form, epithelial carcinoma, develops on the surface of the ovary (the epithelium).
A second type of ovarian cancer, a germ cell tumor, is less common than epithelial
carcinoma and occurs when cancer develops in the egg-producing cells of the ovaries.
In a paper recently published in the New England Journal of Medicine, Dr. Coukos
and his colleagues showed that the presence of certain immune cells called
tumor-infiltrating T-cells can predict an improvement in the outcome of patients with
advanced ovarian cancer. In their study, researchers identified the presence of these
tumor-infiltrating T-cells in 102 of 186 women with ovarian cancer tumors. Among the
advanced ovarian cancer patients with these T-cells, 38% were alive five years after their
cancer diagnosis while only 4.5% of the women without these T-cells were still alive.
Among the patients who received aggressive chemotherapy, those who had tumor-infiltrating
T-cells were more likely to survive than patients without the T-cells.
Since the level of T-cells within ovarian cancer tumors can predict improved outcomes,
researchers can now focus on determining why some patients’ immune systems mount a
response to tumors while others do not. This could also lead to the possibility of
inducing anti-tumor responses in patients who do not naturally launch an attack on tumors,
thus improving patients’ chances of surviving ovarian cancer.
Finding effective treatments for advanced ovarian cancer is critical since only around
53% of women who are diagnosed with the disease survive longer than five years. The
chances of surviving ovarian cancer are much higher when the disease is detected in its
early stages.
The following are descriptions of two ovarian cancer clinical trials currently
available to eligible women at the University of Pennsylvania:
- The first trial is available to women with epithelial ovarian cancer whose cancer has
spread to the peritoneal cavity after surgery and chemotherapy. This trial is
investigating whether an immune therapy called intraperitoneal IL-12 (rhIL-12) can slow
the growth of cancer in these patients. Eligible patients must have undergone surgery and
chemotherapy and be candidates for a "second look" surgery. The trial will
involve removing samples of tissue and placing a catheter (a small tube) into the abdomen,
through which antibiotics and rhIL-12 will be administered.
- The second trial is available to women with epithelial ovarian cancer who have not
responded to chemotherapy or whose cancer has returned after treatment. Patients will
receive stem cell transplants from sibling
donors, followed by a vaccination with white blood cells. Other trials involving tumor
vaccination without stem cell transplants are also planned.
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