Is Epigenetic Therapy The Key to Treating Ovarian Cancer?

According to a review in the academic journal Clinical Epigenetics, epigenetic therapy could be a potential future treatment option for ovarian cancer. Epigenetics refers to genetic changes, sometimes heritable, that take place over a long period of time and can have impacts on several generations. Genetic changes are known in many diseases, but less study has been dedicated to the influence of epigenetics on these diseases.

About Ovarian Cancer

Ovarian cancer can appear on or within the ovary. Ovarian cancer rarely causes distinctive symptoms in its early stages, so many patients are often diagnosed with advanced disease. The risk of getting ovarian cancer is connected to how long a woman has ovulated during her life; women who ovulate for longer periods are at greater risk. Late menopause or early puberty are risk factors, as are not having children, fertility medication, certain genetic variants and mutations (such as BRCA mutations), and exposure to talc, herbicides, and pesticides. Some symptoms of ovarian cancer include fatigue, bloating, a feeling of fullness, loss of appetite, indigestion, abdominal swelling, and pelvic pain. Treatment can include chemo, radiation, surgery, hormone therapy, and immunotherapy. There are many different kinds of ovarian cancer. Five year survival rate is 45 percent in the US. To learn more about ovarian cancer, click here.

Overall Outcomes Stagnant

The fact remains that, while some new therapies have been introduced, the overall five year survival rate for ovarian cancer has not really improved over the last twenty years or so. Since many cases of ovarian cancer are discovered at an advanced stage, there is a good chance that that disease will recur after most conventional treatments, such as surgery or chemotherapy. 

Part of the reason that is has been difficult for survival rates to improve in ovarian cancer is related to the fact that there are many different types of ovarian cancer. All of them have distinctive characteristics and they do not respond to treatment in the same way. While targeted therapies such as PARP inhibitors can be effective for some types of ovarian cancer, they are not helpful at all in others.

Finding Epigenetic Targets

However, recent research has revealed that mutations impacting epigenetic regulators are present in ovarian cancer. Many of these mutations are critical for treatment resistance and tumor growth. These regulators could be potential therapeutic targets. Some examples include the RASSF1A gene, which normally regulates the cell cycle and cell growth; mutations allow for uncontrolled cell growth and tumor proliferation. HDAC enzymes represent another epigenetic modulator that could be targeted for ovarian cancer.

Prior single agent trials with epigenetic therapy have not been productive in treating ovarian cancer in the past. It may that greater utility will be found when they are used in combination with other approaches like chemotherapy and immunotherapy. Some clinical trials testing such combinations are showing more promising results.

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