The need for an early detection test for ovarian cancer

Ovarian cancer is the sixth most common cancer in Australian women, with approximately 1300 women diagnosed with the disease every year.

Ovarian cancer generally has few specific symptoms in their its early stages, and hence most women are diagnosed at an advanced stage when the cancer has spread out of the ovaries and into the abdominal cavity and sometimes beyond. For this reason, most women diagnosed with ovarian cancer will die of their disease, currently around 800 women in Australia every year.

Unlike the “Pap” smear test, which tests for cervical cancer before symptoms appear, or breast mammograms that can visualise small breast cancers, there is no screening test for early ovarian cancer. As early stage ovarian cancers are essentially curable by surgery and chemotherapy, the development of an accurate and reliable early detection test would dramatically improve the chance of survival for women diagnosed with this disease.

The major aim of our research is to use the genetic information encoded within ovarian cancers to identify markers that could form the basis of a blood test to detect early signs of ovarian cancer.

Our Research

The Ovarian Cancer Project is a collaboration between the Cancer Research Program at the Garvan Institute of Medical Research, and the Gynaecological Cancer Centre at the Royal Hospital for Women, both in Sydney.

The Gynaecological Cancer Centre at the Royal Hospital for Women is the largest referral and treatment centre for women with ovarian cancer in New South Wales, and is headed by Professor Neville Hacker, one of the world’s leading ovarian cancer surgical specialists.

The Garvan Institute is home to one of the largest cancer research programs in Australia and has an internationally established reputation for cancer research excellence, particularly in the translation of basic research into clinical applications. The Garvan Institute is very well equipped with state-of-the-art facilities, and attracts a high level of both national and international research funding, enabling world-class research to be carried out.

The major aim of the Project is to develop a blood-based screening test that can detect early signs of ovarian cancer, which would dramatically improve the survival for women diagnosed with this disease. Our work focuses on the most common type of ovarian cancer, called high grade serous ovarian cancers, which have a particularly poor survival.

The Project has established a large ovarian cancer tissue bank and clinical database with information on over 800 patients treated at the Royal Hospital for Women. Using this powerful resource and tools emanating from the elucidation of the human genome, we are using the genetic information encoded within high grade serous ovarian cancers to identify markers that could form the basis of a blood test to detect early signs of ovarian cancer.

Specifically, we are identifying changes in a particular chemical modification to cancer cell DNA called “methylation”. Alterations in DNA methylation are a common and critical occurrence in cancer, and occur very early in cancer development. Using highly sensitive assays developed at the Garvan Institute, we have some promising early results that show that DNA methylation changes can be detected in the blood of women with early stage ovarian cancer, suggesting this approach could form the basis of a diagnostic test for early disease. Our current research is focused on identifying which genes are affected by DNA methylation changes in high grade serous ovarian cancer, and using this information to design a blood-based detection test that can identify women with early ovarian cancer.

We are optimistic that this collaboration between a leading clinical treatment centre and a world-class medical research institute will ultimately result in an improved outlook for patients with ovarian cancer.

The Research Team

The Project staff includes scientists, surgeons, pathologists, nurses and statisticians from both institutions. This multidisclipinary team and the collaborative nature of the Project ensures that our research remains clinically-focused and allows the translation of our research into real clinical benefits for patients.

Major Research Staff:

	Professor Robert Sutherland, PhD, FAA Director, Cancer Research Program, Garvan Institute of Medical Research
	Professor Rob Sutherland, one of the world’s most recognised experts in hormonally based cancer research, heads the Cancer Research Program at the Garvan Institute. Together with Professor Hacker at the RHW, Professor Sutherland has been responsible for the initiation and development of the research program in ovarian cancer at the Garvan Institute.

	Dr Philippa O’Brien, PhD Head, Ovarian Cancer Project, Garvan Institute of Medical Research
	Dr Pip O’Brien has directed and overseen the research in the Ovarian Cancer Project for over 6 years. She has more than 10 years of experience in basic research in gynaecological cancers, focusing on cervical and ovarian cancer.

Current Research Staff (2008 - 2009)

Dr Kristina Warton, Post-Doctoral Scientist
Dr Celine Montavon, Visiting Research Fellow, University Berne Hospital, Switzerland

Ms Kate Patterson, PhD student
Ms Maria Gonzalez, PhD student
Mr Brian Gloss, PhD student
Ms Gabrielle Matta, MB BS (Hons) student

Ms Janani Savasuthan, Clinical Data Coordinator
Ms Jacqueline Geraghty, MB BS student and Data Entry Clerk

Associated Clinical Staff

Professor Neville Hacker, Gynaecological Cancer Centre, Royal Hospital for Women
Dr James Scurry, Nextpath, Newcastle
Dr Rajmohan Murali, Royal Prince Alfred Hospital

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