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The future of ovarian cancer research: Q&A with scientist Joanne Kotsopoulos

September 25, 2017

By Lindsay Jolivet

Ovarian cancer is the deadliest women’s cancer. About 2,800 women will be diagnosed in Canada this year. Nearly two-thirds will most likely die from the disease.

Joanne Kotsopoulos, PhD
Joanne Kotsopoulos

Scientists at Women’s College Research Institute (WCRI) are investigating approaches to prevent, detect and treat ovarian cancer. Joanne Kotsopoulos, PhD, a scientist at WCRI’s hereditary cancer research team, is leading studies on the forefront of ovarian cancer research. Connect interviewed Kotsopoulos during Ovarian Cancer Awareness Month about the most challenging and promising areas of ovarian cancer research.

What is the biggest question in ovarian cancer research right now?

There are no effective screening strategies for ovarian cancer. Women are usually diagnosed when the disease has already progressed to a late stage, when the tumor has already spread, and so treatment is not as effective as it could be if the cancer was diagnosed at an earlier stage. Our research team’s big focus is on identifying women who are at a high risk of developing ovarian cancer and making sure they are aware of their options for reducing their risk or preventing cancer entirely. For example, women who carry a harmful mutation in their BRCA1 or BRCA2 gene have up to a 40 per cent risk of developing ovarian cancer in their lifetime. The general population’s risk of ovarian cancer is about 1.3 per cent, which is substantially lower. Our research investigates approaches to lower or eliminate risk, as well as methods to screen high-risk women for ovarian cancer, so that women who are diagnosed have a better chance of surviving.

What are the options for women to reduce their risk of ovarian cancer?

We have shown that oral contraceptives can reduce the risk of ovarian cancer in high-risk women, and pregnancy and tubal ligation, or having your tubes tied, are also associated with a lower risk. Surgery to remove both the ovaries and fallopian tubes virtually eliminates the risk of ovarian cancer, but it is drastic, so this is recommended for women who carry a BRCA1 or BRCA2 gene. One study that our team is conducting now offers genetic testing for BRCA1 and BRCA2 mutations to anyone in Canada. It’s called The Screen Project. We think we could prevent about 15 per cent of ovarian cancers in Ontario by identifying those at a high risk and offering them preventive measures.

How are you trying to improve screening for ovarian cancer?

Our team recently was funded by the Canadian Institutes of Health Research to study the role of circulating tumor DNA in helping identify cancers at an earlier stage. We’re hoping that by looking at levels of DNA in the blood that is believed to come from a tumor or small precancerous lesion, we could potentially identify women with ovarian cancer before the cancer is detectable in the clinic. This is also referred to as a “liquid biopsy.” In the future, if we could offer high-risk women the option of effective screening with liquid biopsy, they may be able to delay surgery and the negative effects that can sometimes come with having your ovaries removed surgically.

What surprises have you had in the area of research?

I have been surprised at how challenging it has been to develop effective screening for ovarian cancer. MRI imaging is very effective for early detection of breast cancer, but recent screening trials for ovarian cancer have not been successful. I am hopeful that we will be able to help more women affected by this disease in the years to come with the promising approaches we’re exploring.

 

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