Ovarian Cancer: Epithelial, Germ Cell, Stromal Tumors
Comprehensive information about ovarian cancer, its types, symptoms, diagnosis, and the latest treatment options including PARP inhibitors and immunotherapy.
Understanding Ovarian Cancer
Ovarian cancer is a type of cancer that begins in the ovaries, the female reproductive organs that produce eggs.
Ovarian cancer is the seventh most common cancer in women worldwide and the eighth most common cause of cancer death. It often goes undetected until it has spread within the pelvis and abdomen, making it more difficult to treat.
There are three main types of ovarian cancer: epithelial tumors (which start from the cells on the outside of the ovary), germ cell tumors (which start from the egg-producing cells), and stromal tumors (which start from structural tissue cells that hold the ovary together and produce hormones).
Recent advances in genetic testing, targeted therapies, and surgical techniques have significantly improved outcomes for ovarian cancer patients. PARP inhibitors and immunotherapy are showing promise in treating advanced and recurrent ovarian cancer.
According to the American Cancer Society, about 1 in 78 women will develop ovarian cancer during their lifetime. The risk is higher in women with a family history of ovarian, breast, or colorectal cancer.
Types of Ovarian Cancer
Understanding the different forms of ovarian cancer is crucial for accurate diagnosis and treatment.
Epithelial Ovarian Cancer
Epithelial ovarian cancer is the most common type, accounting for about 85-90% of all ovarian cancers.
- Most common type (85-90%)
- Arises from surface epithelium
- Typically affects older women
- Subtypes: serous, mucinous, endometrioid
Germ Cell Tumors
Germ cell tumors develop from the egg-producing cells and typically occur in younger women and teenagers.
- Affects younger women
- Highly treatable
- Often diagnosed at early stage
- Subtypes: teratoma, dysgerminoma
Stromal Tumors
Stromal tumors develop from connective tissue cells that hold the ovary together and produce hormones.
- Rare type (5-8%)
- Often produces hormones
- Usually diagnosed at early stage
- Good prognosis
Advanced Treatment Options
Modern approaches to ovarian cancer treatment have significantly improved patient outcomes.
Ovarian Cancer Surgery
Surgery is the primary treatment for ovarian cancer, aiming to remove as much of the tumor as possible (debulking) and determine the cancer stage.
Modern surgical techniques for ovarian cancer include cytoreductive surgery (debulking) to remove all visible tumors, which is associated with improved survival. For early-stage disease, fertility-sparing surgery may be an option for women who wish to preserve their ability to have children.
In China, advanced minimally invasive techniques like robotic-assisted surgery are increasingly used for ovarian cancer treatment, offering shorter recovery times and reduced complications while maintaining oncological outcomes.
Chemotherapy for Ovarian Cancer
Chemotherapy uses drugs to kill cancer cells and is typically administered after surgery for ovarian cancer.
The standard chemotherapy regimen for ovarian cancer typically includes a combination of platinum-based drugs (carboplatin or cisplatin) and taxanes (paclitaxel). For advanced disease, intraperitoneal (IP) chemotherapy may be recommended, which delivers chemotherapy directly into the abdominal cavity.
Chinese oncology centers are increasingly using hyperthermic intraperitoneal chemotherapy (HIPEC) during surgery for selected patients with advanced ovarian cancer, which has shown promising results in clinical trials.
Targeted Therapy
Targeted therapies attack specific molecules involved in cancer cell growth, offering more precise treatment with fewer side effects.
PARP inhibitors (olaparib, niraparib, rucaparib) have revolutionized ovarian cancer treatment, particularly for patients with BRCA mutations or homologous recombination deficiency (HRD). These drugs prevent cancer cells from repairing DNA damage, leading to cell death.
Bevacizumab (Avastin), an anti-angiogenesis drug, is another targeted therapy used in combination with chemotherapy for advanced ovarian cancer. It works by blocking the formation of new blood vessels that tumors need to grow.
Immunotherapy
Immunotherapy harnesses the body's immune system to fight cancer, with several approaches showing promise for ovarian cancer.
Immunotherapy approaches for ovarian cancer include checkpoint inhibitors (pembrolizumab, nivolumab), cancer vaccines, and adoptive cell therapy. While single-agent immunotherapy has shown limited efficacy, combinations with chemotherapy, PARP inhibitors, or other targeted therapies are showing more promise.
Chinese researchers are actively developing novel immunotherapies for ovarian cancer, including CAR-T cell therapies and bispecific antibodies. Clinical trials in China are exploring these innovative approaches, particularly for patients with recurrent or treatment-resistant disease.
Clinical Trials in China
Access to cutting-edge ovarian cancer treatments through clinical trials available in China.
Novel PARP Inhibitor Combination
Phase III clinical trial evaluating a novel PARP inhibitor in combination with anti-angiogenesis therapy for platinum-sensitive recurrent ovarian cancer.
RecruitingImmunotherapy for Recurrent Ovarian Cancer
Phase II trial investigating a novel PD-1 inhibitor combined with chemotherapy for recurrent platinum-resistant ovarian cancer.
RecruitingCAR-T Cell Therapy for Ovarian Cancer
Phase I/II study evaluating the safety and efficacy of mesothelin-targeted CAR-T cell therapy for advanced ovarian cancer.
RecruitingScientific References
Evidence-based information from reputable medical sources and recent research.
- American Cancer Society. (2023). Ovarian Cancer Statistics. Atlanta: ACS.
- National Comprehensive Cancer Network. (2023). NCCN Clinical Practice Guidelines in Oncology: Ovarian Cancer.
- Ledermann, J. A., et al. (2022). Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 33(10), 992-1004.
- Moore, K., et al. (2018). Maintenance Olaparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. New England Journal of Medicine, 379(26), 2495-2505.
- Chinese Society of Clinical Oncology. (2023). CSCO Guidelines for Diagnosis and Treatment of Ovarian Cancer.
- Lheureux, S., et al. (2019). Epithelial ovarian cancer: Evolution of management in the era of precision medicine. CA: A Cancer Journal for Clinicians, 69(4), 280-304.
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