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Intercepting Ovarian Cancer

INTERCEPTING OVARIAN CANCER

High-grade serous ovarian carcinoma (HGSOC) is a highly aggressive gynecologic cancer and the fifth most common cause of cancer-related death for women in the United States. Unfortunately, most women are diagnosed with late-stage disease, and the prognosis in these cases is poor.

High-grade serous ovarian carcinoma (HGSOC) is a highly aggressive gynecologic cancer and the fifth most common cause of cancer-related death for women in the United States. Unfortunately, most women are diagnosed with late-stage disease, and the prognosis in these cases is poor.

PROJECT HIGHLIGHTS

  • Recent research has shown that most, if not all, high-grade serous ovarian cancer originates as precursor lesions of the fallopian tubes. This presents an opportunity to reduce ovarian cancer incidence by exploring the impact of fallopian tube removal as a primary prevention strategy (known as opportunistic or prophylactic salpingectomy).
  • The team will develop strategies to expand awareness of and access to safe and effective ways for women to undergo opportunistic salpingectomy, particularly in women who are done having children and already undergoing elective abdominal surgeries.
  • The team will create new cross-specialty collaboration between gynecologic and general surgeons, advocate for universal health insurance coverage for opportunistic salpingectomy and create a national registry of women who elect this preventative intervention.
  • The culmination of the project will be a public health campaign to empower women to know about and to have opportunity to decrease their risk of ovarian cancer.
  • At the same time, the Intercepting Ovarian Cancer team will work together to create an ovarian “pre-cancer atlas” by conducting exhaustive molecular analyses on many rare, precancerous fallopian tube lesions obtained from all 4 participating cancer centers.
  • The team will identify new biomarkers that can be used to advance ovarian cancer screening and new, cutting-edge technologies for detecting and analyzing pre-cancers, including “OvaSeek”, a system that will rapidly image excised fallopian tubes and the “iCollector” to nondestructively harvest living cells from fallopian tube lesions.

MEET THE TEAM

AllDana-Farber Cancer InstituteThe Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsMemorial Sloan Kettering Cancer CenterThe University of Texas MD Anderson Cancer CenterMIT’s Koch Institute for Integrative Cancer Research

MEET THE TEAM

View Team
AllDana-Farber Cancer InstituteThe Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsMemorial Sloan Kettering Cancer CenterThe University of Texas MD Anderson Cancer CenterMIT’s Koch Institute for Integrative Cancer Research

PROJECT SUMMARY

As with many cancers, detection of ovarian cancer at earlier stages may improve outcomes for patients. Unexpectedly, research has shown that most ovarian cancers do not originate from the ovaries, but rather from the fallopian tubes – the structures that connect the ovaries to the uterus. This provides an enormous opportunity for prevention. Since the fallopian tubes have non-essential function after child-bearing, women who wish to drastically reduce their chance of developing ovarian cancer later in life can choose to have their fallopian tubes removed at the time of other planned abdominal surgeries.

The Intercepting Ovarian Cancer team will harness the broad expertise and access to rare fallopian tube samples only available in sufficient numbers by pooling access across the Break Through Cancer institutions and their collaborators. The team will apply an array of advanced single cell and spatial characterization technologies to deeply profile the disease at its earliest stages with the goal of improving early detection and disease interception. The team will also advance clinical approaches designed to prevent the deadliest forms of ovarian cancer altogether.

Today, there is a striking lack of pre-cancerous tissue samples that would allow a comprehensive analysis of the origins of high-grade serous ovarian carcinoma. This limitation will be mitigated by the open sharing of clinical samples between Break Through Cancer institutions. New, non-invasive imaging methods, also being developed by engineers, clinicians and molecular biologists working together across the Break Through Cancer team, will dramatically improve and streamline the detection and harvesting of early lesions in the fallopian tubes, including capturing living lesion cells for downstream culture and studies. With these new resources, the team will gain a window into the early evolution of ovarian cancer.

Biological, computational and engineering expertise will allow this team to create an early draft of an ovarian “Pre-cancer Atlas” – a comprehensive, multidimensional view of the development and evolution of ovarian cancer. Information derived from this atlas will inform new ways to detect the earliest stages of the most aggressive ovarian cancers.

The discovery that ovarian cancer originates in the fallopian tubes has profound clinical implications, in that salpingectomy (removal of the fallopian tubes) could be a powerful strategy for prevention. After reproductive age, which is when most ovarian cancers occur, the fallopian tubes can be removed with no known health risks. This is in contrast to the ovaries, which are required for normal female hormone production through menopause. A major goal of the Break Through Cancer clinical teams will be to educate both patients and their surgeons about the very low-risk opportunity of fallopian tube removal, so-called “opportunistic salpingectomy” (OS), which could be made available to the hundreds of thousands of women undergoing elective abdominal surgeries in the US each year. Break Through Cancer clinicians will design a pilot study to test the feasibility of OS at the time of non-gynecologic abdomino-pelvic surgery and create a set of national guidelines for OS that will serve as a blueprint for establishing it as standard practice in the medical community. The groundwork laid with this effort will be particularly important as the goals described above come to fruition, increasing the number of patients who stand to benefit from primary ovarian cancer prevention and from treatment when the disease is in its earliest stages. The genius of the Intercepting Ovarian Cancer project is its unprecedented pairing of an immediate deliverable of a life-saving intervention with scientific discovery to ultimately decrease the incidence and mortality from ovarian cancer.

MAKE A DIFFERENCE

Break Through Cancer was created in February 2021 with an extraordinary matching gift of $250,000,000. Every gift to the Foundation supports groundbreaking cancer research and helps us to meet our matching commitment.

For questions about giving please email Lisa Schwarz, Chief Philanthropy Officer at LMS@BreakThroughCancer.org

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