Launched in 2023, researchers on the University of Saskatchewan campus are developing a precision diagnostics platform that will soon be rolled out across Canada. The impacts and benefits for ovarian cancer patients could be profound.

It is one of the most challenging diseases that affect hundreds of thousands of women each year. It is ovarian cancer, and today, the world is recognizing those affected by the disease and those working hard to fight it.

Held every May 8th, World Ovarian Cancer Day was initiated by a coalition of organizations highlighting research and issues related to the disease. The day also aims to foster greater awareness about ovarian cancer, which is the 7th most common cancer and 8th most common cause of death from cancer among women in the world.

While several diagnostic and treatment advances have been made in recent years, the number of people affected by ovarian cancer is projected to accelerate globally in the coming years. According to GlobalCan, by the middle of this century, the number of women diagnosed with ovarian cancer is expected to grow by 55% to more than half a million new cases annually. By 2025, a projected 320,000 women are expected to die each year from the disease.

Ovarian cancer is particularly challenging disease, mainly because, for many women, diagnosis often comes after the disease has metastasized in patients. While treatment and responses vary among individual patients, the overall 5-year relative survival rate, according to the American Cancer Society, is approximately 50%.

However, there may be brighter days ahead. A team of researchers that includes Drs. Mary Kinloch and John DeCoteau from the College of Medicine at the University of Saskatchewan are currently making advances leveraging the power of genomics to identify key risk stratification markers for ovarian cancer patients. Providing accurate and timely prognostic information could not only result in better patient outcomes but also result in patients avoiding invasive and often taxing therapies, depending on their type of cancer.

The Ovarian Cancer Genomics Project is a collaboration between the Saskatchewan Cancer Agency, the Saskatchewan Health Authority, the University of Saskatchewan and Genome Prairie.

“We know approximately 3,100 Canadian women are diagnosed with ovarian cancer every year,” said Kinloch, who is the project’s receptor lead. “Our ultimate goal is universal testing so that every patient has the most complete picture of their diagnosis to make the best choices for their therapy.”

A significant challenge in diagnosing ovarian cancer patients is determining their disease subtype. About half of all ovarian patients have homologous combination deficiency or HRD. Those among the HRD subtype generally have more therapeutic options.  The other (roughly) half of patients are homologous combination proficient (HRP), with a more difficult prognosis.

According to DeCoteau, the project co-lead, a major aim for researchers will be developing a refined genomics-based strategy that more accurately diagnoses cancer subtypes in patients.

“Our test is designed to more accurately separate patients between the two HRD and HRP subtypes, one subtype of those identified as being HRD (homologous combination deficiency) and one subtype being HRP (homologous combination proficient). For those diagnosed with HRD, a class of drugs called PARP inhibitors is known to be quite effective. Much research is being done right now to develop even better PARP inhibitor drugs.

“In the HRP category, the therapies are comparatively more limited. However, it’s very important to diagnose this accurately because there’s a lot of work happening right now among HRP patients trying to find more targeted therapies.”

“I see the future of genomics in ovarian cancer, certainly in the short term, providing more precise guidance for oncologists,” said Kinloch. “The hope is that with precision diagnostics, patients can avoid entering into therapies that offer no benefit.”

“In the medium to long term, we think there’s lots of opportunity to try and find more biomarkers, especially among those in the HRP group, who don’t have a lot of options. This could mean more therapy options.”

The project officially launched in the summer of 2023 has already developed a diagnostics platform that could be deployed to the rest of Canada.

“Since the project began, we have recruited 75 patients into our study to locally validate the gold standard for Ovarian Cancer diagnostics,” said Kinloch. At this point, we’ve selected a diagnostics platform for oncologists. Moving forward, we will spend the next year determining how the platform can be deployed around Saskatchewan and beyond.”

“The goal of our project is to implement the most effective way of diagnosing HRD or HRP patients and, from there, transferring that information efficiently to pathologists and oncologists.”

The project will soon be conducting clinical trials in other medical centers across Canada, including the Sunnybrook Health Sciences Centre in Toronto and facilities in Halifax, Nova Scotia, and Edmonton, Alberta.

So, what is the future of diagnostics and therapies for ovarian cancer?

While advances have been made in recent years, the general prognosis for many women remains challenging. “From where we are and where we were ten years ago, if you’re identified as HRD subtype, your prognosis is much better. If you’re HRP, your prognosis is about the same,” said DeCoteau.

Still, Kinloch and DeCoteau are upbeat when asked if they could deliver a message to women battling ovarian cancer about the near and long-term advances in combating the disease.

“My message would be that in the future, patients will be treated based on their genomics,” said DeCoteau. “With recent advances in HRD therapies, I think there’s compelling evidence genomics information is ultimately going to lead to improvements in the management of patients with HRP forms of ovarian cancer.”

“Also, even though we have a category of half the women who have HRP, which is very difficult to manage, it’s very clear we’re going to make advances among those groups of patients by continuing to mine genomic information.”

“I think my message would be of empowerment,” said Kinloch. “Patients will have a greater understanding of their tumour profile to make decisions that fit best with their healthcare journey.

“In other words, in the future, ovarian cancer patients will have greater control of their own healthcare decisions.”

The Ovarian Cancer Genomics Project is a Genome Prairie-Administered project that receives funding support from Genome Canada and other partners, including the Saskatchewan Health Authority, the Saskatchewan Cancer Agency, the University of Saskatchewan, Ovarian Cancer Canada and The Terry Fox Foundation. The project is scheduled to be completed by 2026.

Top Photo: The Ovarian Cancer Genomics Project team, April 2024, at the University of Saskatchewan. Photo credit: David Livingstone, Department of Pathology and Laboratory Medicine, University of Saskatchewan.

Thank you to Genome Prairie for submitting the article and photos.

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