New pan-Canadian study seeks to increase understanding of ovarian cancer, improve diagnosis and treatment

Despite years of research, about 2,500 Canadian women are diagnosed with ovarian cancer and 1,700 Canadian women still die from the disease every year. A new pan-Canadian study led by the Terry Fox Research Institute (TFRI) hopes to change this. Using cutting-edge technology, researchers are aiming to better identify the many different subtypes of ovarian cancer. By doing so, they hope to determine what treatments will work best for each different ovarian cancer subtype, ultimately providing more targeted – and more successful – treatments for patients.

The study, called COEUR (Canadian Ovarian Experimental Unified Resource), is a consortium of 35 leading ovarian cancer experts from across Canada, 15 of whom are based in Ontario. With funding of $5 million from TFRI and the Canadian Partnership Against Cancer (CPAC), it is the largest Canadian research consortium dedicated to ovarian cancer.

“Ovarian cancer is a relatively rare disease that is also very complex. Today we know that it consists of several different subtypes; these are not yet well understood and we have significantly more work ahead to determine what treatment will work for patients and their specific tumour subtype,” says Dr. David Huntsman, a genetic pathologist with the Ovarian Cancer Research Program at BC Cancer Agency and Vancouver Coastal Health and co-leader of COEUR. “This program includes an important knowledge transfer component that will enable the results to be rapidly deployed within the Canadian pathology community and readily translated into practice.”

Currently, treatment of ovarian cancer is hampered by the fact that one in four women diagnosed are resistant to standard first-line chemotherapy. The new project is developing a new stratification system of ovarian cancer subtypes that will help guide physicians and patients towards the best therapy given the unique characteristics of each patient’s tumour. COEUR will also tap into Canada’s deep expertise in clinical oncology trials by directing patients to potential new therapies when standard treatments don’t work.

Dr. Janet Dancey, Director of Clinical Translational Research at the NCIC Clinical Trials Group and leader of the High Impact Clinical Trials program at the Ontario Institute for Cancer Research (OICR), is a COEUR investigator. She feels that the scope of the study and the innovative tools being used make COEUR unique. “COEUR addresses the “heart” of the problem for ovarian cancer patients,” she says. “It is the largest and most comprehensive national research initiative to improve outcomes of patients with this disease. We are bringing together researchers from across Canada to develop new markers and tools that will allow us to better diagnose, monitor and treat patients with ovarian cancer.”

These new markers and tools include the development of new “biomarkers” specific to ovarian cancer. Biomarkers are molecules found within the body that can show the presence of a disease and can also be used to evaluate a patient’s response to therapy. To first learn about the subtypes of ovarian cancer and test new biomarkers, the researchers will use 2,000 tissue samples collected with consent from patients at eight participating centres. The new biomarkers discovered through COEUR will allow clinicians to better predict a patient’s response to first-line chemotherapy treatments.

Getting these new tools to doctors on the frontlines is key to the COEUR project having an impact. Dr. Eva Grunfeld, Director of the Knowledge Translation Network at OICR, is leading a sub-study within the COEUR project to prepare for the implementation of research findings from the lab to the clinic and into the broader healthcare system.

“Traditionally what happens is that science progresses stepwise from the fundamental laboratory phase to the clinical phase of validation and testing. If those steps are successful, then people begin to think, ‘How are we going to roll this out into the healthcare system?’,” says Dr. Grunfeld. Her study is asking, “Are there some basic principles that we can learn now about the practical elements that need to be in place, so that when the discoveries are shown to be effective we can hit the ground running and bring them into the clinic as quickly as possible?”

The COEUR project will benefit ovarian cancer patients in the future by providing the tools of what is called “personalized medicine”. Patients will have treatments tailored to their type of ovarian cancer, allowing them to forgo treatments that would be of no benefit and avoid their side effects.

Researchers involved in the study are based all across Canada, including Calgary, Edmonton, Hamilton, Kingston, Laval, London, Montreal, Ottawa, Quebec City, Sherbrooke, Toronto, Vancouver, Victoria and Winnipeg.