Since a couple years there is a very good after-treatment with PARP inhibitors for a number of patients with ovarian cancer to prevent relapse after surgery and chemotherapy. In collaboration with the VIB, doctor-researchers at UZ Leuven and KU Leuven have developed a test to assess which patients would benefit from PAPR inhibitors. This can avoid unnecessary expensive treatmentd and adverse effects. The test is based on the genetic profile of the patient's tumour cells. As of May 2023 UZ Leuven is the first Belgian hospital to offer the accredited test.
Every year about 800 Belgian women are diagnosed with ovarian cancer. Usually they are diagnosed in a late stage. The ideal treatment consists of chemotherapy and surgery. Despite this treatment 8 in 10 women with advanced ovarian cancer will relapse within 2 to 3 years. Since a couple of years a number of new, more targeted therapies have been approved, in addition to the standard treatment, including PARP inhibitors. These are drugs that can postpone or even prevent the return of the disease after treatment.
This medication is only effective for about half of the patient population. That is why Leuven researchers have developed an HRD test: a genetic test that can give an indication which patients will benefit from the treatment, based on tumour tissue samples taken during surgery. HRD stands for ‘homologous recombination deficiency’; this is one of the mechanism that the human body uses to deal with DNA errors. When many mistakes are not, or incorrectly, repaired, this can be picked up by the Leuven HRD test, which shows whether the cancer cells are susceptible to PARP medication.
Thanks to the test we can avoid unnecessary expensive treatments and adverse effects.
Deployment outside research context
Until now, there was a collaboration with a commercial USA company that provides the test. This came with a significant price tag. Because samples always have to be transported to the USA for analysis, this means additional logistical problems and waiting times. UZ Leuven is now the first European hospital to deploy its own unique and cheaper version of the test outside the research context. For this it received the BELAC accreditation based on internationally recognised criteria. As the only Belgian accreditation body, BELAC is responsible for the assessing tests in Belgian labs.
This accreditation gives the in-house developed HRD test an internationally recognised stamp of quality, which is a first for the hospital sector in Europe. And this is not just good news for the patient. Because both test and analysis of the results can all be done locally, this means a significant cost saving. Patients don't need to unnecessarily undergo treatment with PARP medication if the test shows that it won't be beneficial. They will also be able to start other, more beneficial treatments quicker.
Prof. dr. Toon Van Gorp, doctor-specialist gynaecological oncology at UZ Leuven: “Thanks to the test we can avoid unnecessary expensive treatments and adverse effects. This is excellent news for patients with ovarian cancer, and the result of an elaborate collaboration between doctors in the hospital and researchers at VIB and KU Leuven.”
Prof. Diether Lambrechts (cancer researcher at VIB-KU Leuven) and prof. Hilde Brems (molecular geneticist at KU/UZ Leuven): “Developing the test is a nice example of how translational research ensures transmission and a quick translation of knowledge and innovative technology to diagnoses and treatments that benefit the patient.”
Negative tests
As with every therapy, treatment with PARP inhibitors can also mean adverse effects, such as anaemia, nausea and fatigue. If doctors know in advance that the patient does not qualify for this medication, they don't have to expose the patient to those disadvantages and can immediately offer an alternative therapy. Patients that test negatively, will therefore not be left in the cold, there are other treatment methods. Not qualifying for an after-treatment with PARP inhibitors is not automatically bad news.
Patient questions
A research breakthrough does not mean it will be immediately available to all patients. It can raise a lot of questions, both for patients and doctors. Anyone who has questions about this research, can send an email to gynoncologie@uzleuven.be.
Science Figured Out
Dr. Liselore Loverix explains in a 'Wetenschap Uitgedokterd' video (Science Figured Out) how ovarian cancer is no longer treated with the 'one size fits all' principle.