Madrid, May 5, 2021.- With around 3,645 cases a year in Spain, according to the latest data from the Spanish Society of Medical Oncology (SEOM), ovarian cancer is a rare disease when compared with the incidence of other types of tumors, like breast tumors with 26,000 cases per year. Despite such low incidence, ovarian cancer can be a very aggressive type of tumor if detected in the advanced stages. The latest pharmacological advances place antiangiogenics and PARP inhibitors as the most appropriate therapeutic alternative for treatment, especially the latter, which, for patients with a BRCA mutation, achieve an average disease-free survival rate, according to the latest studies on this type of drug, of up to 56 months compared to the 13 months that had been achieved so far1.
“We are looking at a type of treatment that works very well in patients with ovarian cancer with a BRCA mutation, which usually occurs in 20-30% of patients. Many women with advanced ovarian cancer relapse into the disease at 18 months but, if we provide them with this drug, they could reach up to 56 months”, says Dr. Raul Marquez, head of the Gynecological Tumors Section of the Medical Oncology Service at MD Anderson Cancer Center Madrid.
PARP inhibitors are a series of drugs that intervene in the repair of genetic damage, and it has been shown that, in the first line of treatment; that is, right after surgery or chemotherapy, they achieve high remission rates, especially in patients with a BRCA mutation and / or HRD (homologous recombination deficit). On the other hand, “we have seen that another type of treatment, for which there was great hope, immunotherapy, has not been very effective in first-line treatment of ovarian cancer2, and has not had a very relevant role in treating the disease”, says the doctor.
Nonspecific symptoms that make early diagnosis difficult
Although efforts have been made to achieve early diagnosis of the disease by means of screening like that done for breast and cervical cancer, the reality is that 70% of women are diagnosed in advanced stages, which significantly affects the prognosis and evolution of the disease.
This may also be due to the fact that ovarian cancer is a type of tumor with nonspecific symptoms, which makes its early diagnosis difficult. These symptoms can be very varied and are often related to other ailments like abdominal discomfort or pain (gas, indigestion, pressure, bloating, cramps), nausea, diarrhea, constipation, loss of appetite, abnormal vaginal bleeding, back pain, weight gain or loss or pain during sexual intercourse, among others. "This range of symptoms makes it difficult for the patient to associate them to an ovarian problem, and this means patients seek consultations at very advanced stages", says Dr. Marquez. "That is why we recommend that, if any of these symptoms last for several weeks or occur more than 12 times a month, the patient consult her doctor and, of course, go for regular gynecological check-ups".
Regarding the risk factors involved in the development of ovarian cancer, age may be a determining factor. It is not usual for a patient to be diagnosed with ovarian cancer at an early age, it is more common in the age group of between 45 and 75. Likewise, there are other associated risk factors like pelvic disease or hormone replacement therapy that may be associated with ovarian cancer. "Faced with a patient under the age of forty, where the grandmother or mother has suffered from breast or ovarian cancer, we would have to expect the possibility of finding familial BRCA mutations," confirms Dr. Marquez.