Ovarian Cancer and Immune Therapy

Currently, as many as 3100 new patients with ovarian cancer were diagnosed in Canada only in the year 2020. As high as 1950 cases died from this disease in the last year. This information was posted on the Canadian Cancer Society website and updated as of August 2021

For more details, check out their website here    https://www.cancer.ca/en/cancer-information/cancer-type/ovarian/statistics/?region=pe 

 

The mainstream medical oncology treatment for ovarian cancer is surgery and chemotherapy (Cisplatin and Taxol), however, the effectiveness of these interventions may not be the same for every stage of ovarian cancer, so, in advanced stages (Stages III and IV) a considerable portion of patients will eventually relapse and have disease recurrence or metastases.

For that reason, medical oncologists researched over the last 25 years other means to fight this type of aggressive cancer. One of these means was Immunotherapy.

Before discussing today’s topic (Ovarian Cancer and Immune Therapy), let us talk about the basics of the biology of ovarian cancer and our immune system.

Ovarian cancer cells are considered foreign to our body so, the immune system will definitely recognize them and start fighting against them by many means such as CD8  Immune cells, Macrophages, and NK (Natural Killer cells). However, the fight is not as easy as we imagine as the Ovarian Cancer cells will do their best  to fight against them, so they do the following:

-        Recruit cells from our immune system to work with them !! so in this case they have some assets from our own immune system examples of these cells are Myeloid-derived Suppressor Cells (MDSCs), Regulatory T cells, Cancer-Associated Fibroblasts, and Adipocytes

-        Making themselves invisible to the immune system by hiding from it and this is achieved by activation of what is called Immune Checkpoint Receptors

So, without going into more scientific terminology and medical jargon, the backbone of the immunotherapy for Ovarian Cancer rests mainly on many ways which are

-        Inhibition of the Checkpoint Receptors by using the Checkpoint Blockers  such as Pembrolizumab (Keytruda)

-        Activation of the anti-cancer immune cells such as Dendritic cells using cancer vaccine which can be either cellular vaccine, a protein vaccine or genetic vaccine)  

-        Adoptive cell immunity; which means bioengineering our immune cells (especially T Lymphocytes) to be active against Ovarian Cancer cells then they will be infused into the patients to start the fight with more memory against Ovarian Cancer cells.

 

So, now it seems that Immune Therapy harbors many tools to help the fight against ovarian cancer, however, we need to know whether these immune therapies are safe or no, also are there any issues with the long-term use of these immune therapies? And last but not least what are the benefits of using these Immune therapies in terms of Ovarian Cancer Disease Control, Survival, and whether they are better used alone or with chemotherapy combinations.

The main downside of using immune therapies in Ovarian Cancer is the development of allergic reactions or sensitivities, also some studies showed that the long-term use of these immune therapies may result in the Ovarian Cancer cells showing resistance to them and eventually they become ineffective. Furthermore, these Immunotherapies are very expensive and may not be available for most Oncology Centers.  

Although Immunotherapy for Ovarian Cancer is a promising treatment and can definitely improve the outcome of Ovarian Cancer,  the absolute benefit in terms of overall survival, disease-free survival, and disease control is still limited even when combined with surgery and the standard chemotherapy.

 

For more information about Immune therapy for Ovarian Cancer read this article that was published recently in October 2020  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7572849/ 

 

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