New Study Finds Hidden Disease in Nearly Half of Ovarian Cancer Patients in ‘Remission’

Using minimally invasive surgery and blood tests Break Through Cancer TeamLab found cancer cells, new drug targets, and biological clues for future therapies

(CAMBRIDGE, MASS.) August 01, 2025 – Survival rates for advanced ovarian cancer have remained stagnant for over four decades, largely because it so often recurs. While patients respond well to initial surgery and chemotherapy, it comes back in 4 out of 5 cases. A new Break Through Cancer study published in Clinical Cancer Research, a journal of the American Association for Cancer Research, offers insight into why that happens, and importantly, how to intervene.

Led by Break Through Cancer’s Targeting Minimal Residual Disease (MRD) in Ovarian Cancer TeamLab—a multi-institutional collaboration involving The University of Texas MD Anderson Cancer Center, Dana-Farber Cancer Institute, Memorial Sloan Kettering Cancer Center, the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and MIT’s Koch Institute for Integrative Cancer Research—the study found that nearly half of patients who showed no signs of cancer on scans still harbored hidden cancer cells.

Researchers used a minimally invasive approach called ‘second-look laparoscopy’ (SLL) to detect cancer cells after completing chemotherapy and experimental blood tests that measure cancer cell DNA. Despite appearing cancer free on scans, 42% of patients had lingering cancer cells, known as MRD that would have been missed by conventional tests.

“This work shows that what we see on a scan doesn’t always tell the whole story” said Dr. Amir Jazaeri, co-senior author and Professor of Gynecologic Oncology at MD Anderson. “With SLL, we’ve been able to uncover disease that was otherwise invisible, and more importantly, study how to target it”

The TeamLab analyzed these MRD samples in unprecedented detail, using advanced spatial transcriptomic and proteomic profiling. They identified specific druggable targets and observed key biological features, like hypoxia signaling, immune evasion, and epithelial-mesenchymal transition—all factors that may help explain why some cancer cells survive treatment and point to new drug combinations that could specifically target MRD.

The research also explored the use of circulating tumor DNA (ctDNA)—fragments of cancer DNA in the blood stream—as a blood-based tool to detect MRD. The results were encouraging: ctDNA identified high-risk patients and offered a window into how the disease may be tracked over time, without surgery. With further development, this blood-based approach could become a powerful tool to personalize care and catch recurrence.

This study is just one piece of the Targeting MRD in Ovarian Cancer TeamLab’s work to understand and intercept residual ovarian cancer. One ongoing trial, funded by Break Through Cancer is using MRD detected through SLL as a primary endpoint to evaluate a novel immunotherapy.

“Using MRD offers two key advantages over current approaches for advanced ovarian cancer,” said Dr Jazaeri. “First, it can show early whether a treatment is working, allowing for quicker, smaller trials and faster access to new therapies. Second, by studying MRD’s biology, we can uncover ovarian cancer’s weaknesses and develop more effective, potentially curative treatments.”

These findings emerge from Break Through Cancer’s broader initiative to understand and intercept MRD across multiple cancers like acute myeloid leukemia and ALK+ lung cancer. The study marks a milestone in the foundation’s effort to drive faster, cross-institutional solutions for some of the hardest-to-treat cancers.

“This is exactly the kind of collaborative, ambitious science Break Through Cancer exists to accelerate,” said Tyler Jacks, PhD, President of Break Through Cancer. “These findings don’t just answer long-standing questions; they open the door to smarter trials, understanding where recurrence comes from and blocking it from occurring.”

By combining deep biological insights with new ways to measure response, this TeamLab aims to reshape how ovarian cancer is studied, and ultimately, how it is treated more effectively.

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About Break Through Cancer

Founded in 2021, Break Through Cancer empowers outstanding researchers and physicians to both intercept and find cures for several of the deadliest cancers by stimulating radical collaboration among outstanding cancer research institutions, including its founding partners: Dana-Farber Cancer Institute, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Memorial Sloan Kettering Cancer Center, MIT’s Koch Institute for Integrative Cancer Research, and The University of Texas MD Anderson Cancer Center.

The Foundation is supported by a Board of Directors from the five partner institutions and a Scientific Advisory Board of U.S. cancer experts. The Foundation was launched with an extraordinary challenge pledge of $250 million from Mr. and Mrs. William H. Goodwin, Jr. and their family, and the estate of William Hunter Goodwin III.

For further information, please visit the Foundation’s website at www.breakthroughcancer.org.

Further information about the Targeting Clonal Hematopoiesis to Prevent AML program can be found here.