Drug trial offers hope of improved ovarian cancer treatments

A clinical trial of women with low grade serous ovarian cancer also found the treatment can halve the speed of relapse.

Experts say the randomised trial of a drug called trametinib, previously used to treat melanoma, paves the way for better outcomes. Trametinib is a type of drug called a MEK inhibitor. This class of drug works by blocking an abnormal signal in the cancer cell that causes it to multiply in an uncontrolled fashion. Until now low grade serous ovarian cancer has been particularly difficult to treat. Standard treatment for ovarian cancer currently involves surgery and chemotherapy. Most patients show no evidence of disease after treatment, but around 70 per cent will relapse within three years.

Ovarian cancer is typically incurable once it returns. Patients go on to receive several types of treatment but, over time, the interval between relapses becomes progressively shorter. Low grade serous ovarian cancer is different from other types of ovarian cancer in that it affects women at a younger age and is often resistant to standard chemotherapy.

The trial involved 260 patients and was led by the University of Texas’ MD Anderson Cancer Centre and the University of Edinburgh’s Nicola Murray Centre for Ovarian Cancer Research – part of the CRUK Edinburgh Centre. Patients were randomly assigned either trametinib daily or their doctor’s choice of any five currently available therapies, known as standard of care.

The average follow-up was around two and a half years. Patients who received trametinib showed a chance of progression-free survival that was more than double that of those who received standard of care treatment. The percentage of patients whose tumour shrank was more than four times higher in trametinib patients compared to those treated with the standard of care.

The project was supported by the National Cancer Institute and Cancer Research UK. It was presented at the European Society for Medical Oncology (ESMO) Congress 2019 in Barcelona. The trametinib was supplied by Novartis.

UK lead for the study Professor Charlie Gourley, Clinical Director of the CRUK Edinburgh Centre and Director of the Nicola Murray Centre for Ovarian Cancer Research at the University of Edinburgh, said: “Low grade serous ovarian cancer is different from other ovarian cancers because it affects younger women and is often resistant to chemotherapy. This is the first positive, randomised trial in this disease and represents a major breakthrough for patients with this type of ovarian cancer.”

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