Broome Oncology

Ovarian Cancer: Doctors at Sloan Kettering Explore Immunotherapy

CancerConnect News:  All gynecologic cancers are challenging to treat. They can be hard to find and are usually diagnosed when they are advanced. Although these cancers can be held at bay with surgery or chemotherapy, they often return and become difficult to control. Researchers at Memorial Sloan Kettering are exploring whether harnessing the power of the immune system could better combat these stubborn diseases.

There are logical reasons to think that gynecologic cancers may respond to immunotherapy. Some of these cancers carry genetic mutations that are known to respond to these drugs. Others bear clinical markers showing that the immune system is already primed to respond. Ovarian cancers, for example, are typically infiltrated by immune cells that were drawn to the tumor, even if they ultimately were not effective. This means the immune cells were drawn to these cancer cells, even if they ultimately were not effective.

Ovarian Cancer: Multiple Treatment Strategies

Boosting Checkpoint Inhibitors

One type of immunotherapy showing great promise is a class of drugs called immune checkpoint inhibitors.

Immune checkpoint inhibitor drugs are currently the most widely used and publicized precision immunotherapy treatment. A patient’s cancer cells can express molecules that activate PD-1 or CTLA-4 inhibitory “receptors” on their “T-cells” or other cells in the immune system.  When these receptors are activated on the T-cells, they are prevented from attacking the cancer cells and evade the immune response.  Checkpoint inhibitor drugs that block PD-1, PD-L1, or CTLA-4 work to “release the brakes” allowing the cancer cells to be detected and attacked by T-cells.

Researchers at Memorial Sloan Kettering are exploring a combination approach to treat ovarian cancer that combines the checkpoint blockade drug Tecentriq® (atezolizumab) with chemotherapy and another drug, Avastin®  (bevacizumab), which interferes with blood vessel growth. The therapy is being tested in women with advanced ovarian cancer that has continued to grow despite treatment with platinum-based chemotherapy.

There are other strategies for enhancing the immune system’s ability to recognize cancer cells as foreign. Another investigative treatment combines checkpoint inhibitor drugs with cancer vaccines. The idea behind cancer vaccines is that they make it easier for the immune system to detect the tumor by telling it what the foreign substance looks like. Therapeutic cancer vaccines train your body to protect itself against its own damaged or abnormal cells — including cancer cells.

Doctors are also exploring CAR-T cell therapy in ovarian cancer. CAR-T uses a patient’s own T cells which are engineered to attack the cancer. The CAR T cells are modified to target a protein called MUC16ecto on the surface of ovarian, fallopian tube, or primary peritoneal tumors that have come back after prior therapy.

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