Ovarian cancer patients given new hope thanks to double drug treatment

Ovarian cancer patients given fresh hope thanks to double drug treatment that keeps disease at bay for at least two years

• Research showed that combining two drugs that target specific cancer cells dramatically boosts their ability to block tumour growth
• Trial used type of drug called MEK inhibitor, which stops a tumour releasing the enzymes it needs to grow but which becomes ineffective over time
• This was overcome by adding the drug defactinib, which blocks release of a protein inside cancer cells that fuels tumour’s drug resistance
• Twin treatment for advanced ovarian cancer could soon become the ‘routine standard of care’ 

A double attack on advanced ovarian tumours offers fresh hope to patients who fail to respond to standard treatment.

Research showed that combining two drugs that target specific cancer cells dramatically boosts their ability to block tumour growth – keeping the disease at bay for at least two years.

The trial used a type of drug called an MEK inhibitor, which stops a tumour releasing the enzymes it needs to grow but which becomes ineffective over time. 

This was overcome by adding the drug defactinib, which blocks the release of a protein inside cancer cells that fuels a tumour’s drug resistance. 

Experts now say that this twin treatment for advanced ovarian cancer could soon become the ‘routine standard of care’.

A double attack on advanced ovarian tumours offers fresh hope to patients who fail to respond to standard treatment. Research showed that combining two drugs that target specific cancer cells dramatically boosts their ability to block tumour growth – keeping the disease at bay for at least two years. One patient to benefit is 64-year-old Ruth Joy, a retired teaching assistant from West Sussex who was diagnosed with advanced, slow-growing ovarian cancer in 2006 (above, with her husband, Keith)

‘Until now, it’s been really hard to treat these patients because other treatments don’t work,’ says Dr Susana Banerjee, consultant oncologist at The Royal Marsden NHS Foundation Trust and a researcher in gynaecological cancers at the Institute of Cancer Research.

‘We suspected that targeting these specific signals would result in shrinkage, but seeing the effect in real life, offering my patients another chance, has been fantastic.’

More than 7,000 women in the UK are diagnosed with ovarian cancer every year. 

The prognosis is good when it’s spotted early, with 95 per cent of patients living for at least five years. But once the disease has spread, that drops to 15 per cent.

The standard treatment is major surgery to remove the tumour, along with organs and tissues that the disease may have spread to. 

Usually this involves extraction of the reproductive organs, including the womb, ovaries and fallopian tubes. Chemotherapy then aims to kill any remaining cancer cells, together with hormone therapies to halt growth of undetected tumours.

More than 7,000 women in the UK are diagnosed with ovarian cancer every year. The prognosis is good when it’s spotted early, with 95 per cent of patients living for at least five years. But once the disease has spread, that drops to 15 per cent. (File image)

In most cases, this offers a cure. But roughly one in ten women have a type of tumour that becomes resistant to the drugs, and the disease quickly spreads elsewhere in the body. 

These patients have what’s known as low-grade serous ovarian cancer – tumours that grow slowly on the surface of tissues.

‘These tumours are able to bypass the chemotherapy’s mechanism of attack,’ explains Dr Banerjee.

If diagnosed early, doctors can offer targeted therapies that cut off the blood supply to cancer cells.

But due to the slow-growing nature of the serous tumour, symptoms take a while to appear, meaning that most patients are diagnosed at a late stage.

If the cancer has spread, the option is subsequent courses of chemotherapy and hormone therapies, which rarely work. 

However, half of the patients on the combination drug trial saw their tumours shrink, compared with 13 per cent who were treated with standard chemotherapy.

Participants carried on taking the drugs for as long as they worked, and, more than two years later, tumours continue to shrink in half of cases. 

The trial was small, involving 25 patients, so another study with a larger group of patients is already under way.

And the same drug combination is currently the subject of trials for use in lung cancer.

One patient to benefit is 64-year-old Ruth Joy, a retired teaching assistant from West Sussex who was diagnosed with advanced, slow-growing ovarian cancer in 2006.

She was successfully treated, but in 2016 the cancer returned.

The grandmother-of-nine was then offered a hormone therapy, which kept the cancer at bay for 18 months.

But the disease eventually returned and had spread to her surrounding organs. 

Two clinical trials, offering experimental drugs, kept tumours stable for a while, but in May 2020 Ruth found herself out of options with further chemotherapy unlikely to work – until specialists at The Royal Marsden enrolled her on the trial testing the combination of MEK inhibitors and defactinib.

Now, more than a year on, Ruth remains on the treatment and her tumours continue to shrink.

‘I’m so lucky to have been thrown another lifeline,’ she says.

‘The treatment has given me hope and, while there are some side effects, like fatigue, none has been able to stop me living my life.

‘My eldest grandchild is 18 in 2024 – he was born the year I was originally diagnosed – and I’m determined to be around for it.’

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