September 07, 2010
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Coming Soon? Targeted Therapies for Ovarian CancerAnother study compared a group of cancer patients given a placebo with a group given the anticoagulant heparin. The cancers in the study included breast, colorectal, ovarian and pancreatic.(19) Thirty-four percent (34%) of the heparin group and 31% of the placebo group received chemotherapy alone, 8% of each group received radiation therapy alone; the remainder received radiation and chemotherapy. Estimated overall survival at one, two and three years was not significantly different between the groups. But the estimated overall survival among those with less-advanced cancer when they enrolled in the study was significantly longer in the heparin group, both at two years and at three years. A second study confirmed these findings.(20) Although the exact mechanism by which heparin helps fight cancer development and metastasis is not yet known, further research is being done on the drug as a potential targeted therapy. Targeted Gene Therapy
There is widespread optimism about gene therapy as an important treatment for cancer. Experts think that ovarian cancer is caused by a build-up of genetic defects or "mistakes" within cells. These genetic defects may be inherited or they may be caused by exposures to environmental factors such as poisons or pollution. The hope is that someday it may be possible to correct this kind of damage by transplanting normal genes into genetically damaged cells. Another idea is to alter tumor cells so that they attack themselves, become targeted by the immune system or become more vulnerable to chemotherapy.(21) The strategies for gene-targeted therapy are somewhat similar to those developed for immunotherapy except, instead of antibodies doing the carrying and targeting, in gene therapy viruses would perform that function. Targeted gene therapy would be based on using a type of virus to selectively deliver a toxin that would attack only cancer cells.(22)(23)(24)(25)(26)(27)
What Is Taking So Long?
Despite some spectacular laboratory results, progress has been slow towards developing viable ovarian cancer-targeted gene therapy.(28)(29)(30) One big technical roadblock is the difficulty of gathering enough information to perform the therapy with precision. The answer to this problem may well lie in improved noninvasive imaging. Imaging technology is advancing rapidly and noninvasive imaging techniques are likely to become increasingly important in the development of more effective targeted gene therapies. As more and better "transport agents" are developed, many researchers believe that gene therapy will offer much improved treatments for women with ovarian cancer.
Conclusion
The effectiveness of most treatments now available for ovarian cancer — surgery, chemotherapy, radiotherapy — is limited by the fact that the disease is rarely detected in its early stages. A number of new treatments, however, are now under development. Hundreds of clinical trials have examined the safety, effectiveness and side effects of gene therapy and other, so-called "targeted" therapies. Although some early findings look promising, the practical applications of gene therapy are still being worked out. As we learn more about the genetics and biochemistry of ovarian cancer, the closer we are coming to developing genetic and other targeted therapies that will save women's lives.
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