Biological therapies are some of the latest developments in treating ovarian cancer. Biological therapies are developed from, or target substances that occur naturally in the body. They have been designed or modified in the laboratory to target and destroy particular types of cancer cells. They can be used on their own or in combination with other treatments such as chemotherapy. There are many different types of biological therapies including:
Cancer growth blockers- Cancer growth inhibitors/blockers interfere with the way cancer cells use ‘chemical messengers’ to help the cell to develop and divide.
Blood supply blockers – A cancer cannot grow without its own blood supply. Anti-angiogenic drugs stop tumours (cancers) from developing their own blood vessels, so the cancer cells can’t get the oxygen and food that they need in order to grow.
Monoclonal antibodies – Monoclonal antibodies are drugs that can ‘recognise’ and find specific cells in the body. Monoclonal antibodies can be designed to find a particular type of cancer cell, attach itself to them and destroy them. They can also be designed to disrupt blood supply to a tumour or carry a radioactive molecule, which then delivers radiation directly to the cancer cells.
PARP-1 inhibitors – PARP inhibitors block an enzyme involved in repairing DNA in cells. Cells that have BRCA1 or BRCA2 gene faults are particularly sensitive to the effects of these agents.
Vaccines – These help the immune system to recognise and attack cancer cells.
Olaparib (Lynparza) is a PARP inhibitor. It is recommended by NICE – National Institute of Health and Care Excellence for: ‘maintenance treatment of relapsed, platinum-sensitive, BRCA mutation-positive ovarian cancer’. Which means it can be only be given to women if their cancer is platinum-sensitive (the cancer has come back (relapsed) more than 6 months after the last dose of platinum-based chemotherapy drugs), who have tested positive for the BRCA1 or BRCA2 gene mutations and who have had 3 or more courses of platinum-based chemotherapy.
Bevacizumab (Avastin) is a monoclonal antibody. Clinical trials showed that bevacizumab (Avastin) used to help to control advanced ovarian cancer in combination with chemotherapy did help some women live for a few months longer than with chemotherapy alone. Bevacizumab is now used with chemotherapy in women with stage IV disease (or those with inadequately resected stage III disease) or on its own as a maintenance treatment, but it hasn’t been approved by NICE as it doesn’t give enough benefit to justify the cost. In England, doctors are able to access bevacizumab (Avastin) for their patients through the Cancer Drugs Fund. Scottish Medicines Consortium (SMC) has agreed its restricted use in combination with chemotherapy (paclitaxel, topotecan, or pegylated liposomal doxorubicin) for women with platinum- resistant recurrent ovarian cancer (stage IV) who have had up to two prior chemotherapy regimens and have not had bevacizumab or other cancer growth blockers before (September 2015).
Research has shown that 20% of women with high-grade serous ovarian cancer (HGSOC) carry a BRCA gene mutation*. Many clinicians believe that all women with high grade ovarian cancer should be tested for the BRCA mutation as standard so that the best treatments can be offered. Testing for BRCA mutation is gradually being introduced in England but it is more well-established in Scotland.
We have not yet been able to speak to anyone who has had biological therapies for ovarian cancer.
*J Clin Oncol 33, 2015 (suppl; abstr e16532)