1999


From: Fred Hutchinson Cancer Research Center

Hutchinson Center to lead $11.5 million ovarian-cancer research consortium

Consortium to include University of Washington, Swedish and Virginia Mason medical centers, Pacific Northwest Research Institute and VA Puget Sound Health Care System

Media briefing: Researchers will be available to discuss these findings at 10:30 a.m. today at the Center's Metropolitan Park East campus, 1730 Minor Ave. (between Olive and Howell). A media relations representative will greet you in the main lobby at 10:15 a.m. and escort you to the briefing room. Complimentary visitor parking is available in an underground garage (entrance off Minor).

The National Institutes of Health has selected the Fred Hutchinson Cancer Research Center in Seattle to lead a five-year, $11.5 million investigation into the causes, prevention, early detection and treatment of ovarian cancer. The Pacific Ovarian Cancer Research Consortium, funded by the National Cancer Institute, will involve researchers from the University of Washington, Swedish Medical Center, the Pacific Northwest Research Institute, the VA Puget Sound Health Care System (Seattle Division) and Virginia Mason Medical Center. Cedars-Sinai Medical Center and the Gilda Radner Ovarian Cancer Screening Program in Los Angeles also will participate.

At least 3,500 women throughout Washington, Wyoming, Alaska, Montana and Idaho are expected to participate in the Consortium's various studies. Funded as a Specialized Program of Research Excellence, or SPORE, in Ovarian Cancer, the initiative will be led by principal investigator Nicole Urban, Sc.D., a member of the Hutchinson Center's Public Health Sciences Division and an associate professor of health services in the UW School of Public Health and Community Medicine.

Co-principal investigators are immunologist Mary (Nora) Disis, M.D., an associate professor of medicine/oncology at UW; and molecular-medicine researcher Steven Collins, M.D., a member of the Hutchinson Center's Human Biology and Clinical Research divisions.

Established by Congress in 1992, the organ-based SPORE Program was created to promote collaboration between basic and applied scientists to speed the testing of new approaches to the prevention, early detection, diagnosis and treatment of a variety of cancers. While previous SPORE programs have existed for breast, prostate, lung and gastrointestinal cancers, this is the first time the NCI has directed SPORE funding toward ovarian cancer.

A major strength of the Pacific Ovarian Cancer Research Consortium is its history of interdisciplinary collaboration in ovarian-cancer research. "We have a track record of working together," Urban says, referring to a working group of ovarian-cancer researchers throughout Seattle that has met every two weeks for the past two years. "Our interdisciplinary collaboration is real; it's not just on paper," says Urban, who also directs the Marsha Rivkin Center for Ovarian Cancer Research in Seattle, a "center without walls" that is jointly sponsored by Swedish Medical Center and the Hutchinson Center. (Coincidentally, today's announcement falls on the sixth anniversary of the death of Marsha Rivkin, who in 1994 died of ovarian cancer at age 49, leaving five daughters as well as her husband, Saul Rivkin, M.D., a medical oncologist at Swedish Medical Center.)

The Consortium has three major goals: the first is gene discovery, from which all else flows. The second is translational research, finding innovative ways to use newly discovered genes and gene products in cancer prevention, early detection and treatment. The third is outcomes research, which ensures that the Consortium's efforts are invested in strategies that yield the greatest reductions in ovarian-cancer incidence and mortality. The outcomes research also will focus on making substantial improvements in quality of life among women with ovarian cancer.

The Consortium will conduct five scientific studies, all of which seek to apply the insights of laboratory and epidemiological research to better prevent, detect, treat and understand the causes of ovarian cancer. Below are brief descriptions of each project:

Project 1: Discovering genes to improve treatment - Among women with advanced disease, understanding resistance to chemotherapy is a key to improving treatment. This study, using the latest DNA array, or "gene chip" technology, aims to identify the genes that influence resistance to chemotherapeutic agents such as cisplatin. Such genes would be targets for treatment strategies aimed at breaking down chemotherapy resistance. If this work leads to breakthroughs in the understanding of chemoresistance, and ways to improve treatment are identified as a result, survival might be increased by several years, and in some cases, remission might be sustained. This could lead to an important reduction in ovarian-cancer mortality. Project principal investigator: Leroy Hood, Ph.D., M.D., Gates Professor and chair of the UW Department of Molecular Biotechnology.

Project 2: Developing an ovarian-cancer vaccine - The goal of this project is to develop a nucleic-acid vaccine that would stimulate the immune system to produce antibodies that would attack ovarian-cancer cells as soon as they develop, before they have a chance to set up shop inside the woman's body. Once such a vaccine is developed, a clinical trial to test its safety would then be proposed. Project principal investigator: Ingegerd Hellstrom, M.D., Ph.D., principal scientist, Pacific Northwest Research Institute, and affiliate professor in the UW Department of Pathology.

Project 3: Identifying women at greatest risk for developing ovarian cancer - While prevention and early detection hold the greatest promise for reducing death from ovarian cancer, randomized clinical trials are needed to evaluate the effectiveness of various interventions, from vaccines to screening tools. Ovarian cancer is very rare, which makes such trials very expensive to conduct. To design such trials efficiently, there needs to be a way to identify populations that are at greatest risk for developing the disease. The goal of this project is to develop a risk model that estimates a woman's probability of developing ovarian cancer within the next several years. Such risk-prediction methods will help researchers better select potential research participants, which will help translate promising prevention and screening tools into usable techniques with proven success. Project principal investigator: Garnet Anderson, Ph.D., an associate member of the Hutchinson Center's Public Health Sciences Division, is a biostatistician who co-directs the Women's Health Initiative Coordinating Center. She also is an affiliate associate professor in the UW Department of Biostatistics.

Project 4: Refining the use of cancer-screening tools - This study will evaluate new and existing cancer biomarkers to determine how they can most effectively be used to screen for ovarian cancer. One such biomarker is CA 125, a protein found in the blood that in large amounts can signal the presence of ovarian cancer. The conventional approach for screening with CA 125 is to consider the test positive if the blood level exceeds 35 U/ml. However, this "one-size-fits-all approach" isn't appropriate for all women, some of whom normally have a consistently elevated CA 125 level. The aim of this project is to refine the use of such biomarkers to determine which markers are most useful for which women. The Consortium will also work with researchers at the NCI and in Britain to design an international screening trial for post-menopausal women. Project principal investigator: Martin McIntosh, Ph.D., research assistant professor, UW Department of Biostatistics.

Project 5: Improving quality of life for women with ovarian cancer - Can facilitated group counseling improve patients' quality of life, postpone cancer recurrence and increase survival time? This project aims to find out through a randomized controlled trial of women who undergo group counseling. Consortium researchers will work closely with local advocates (ovarian-cancer survivors) to ensure that the intervention is sensitive to the real needs of women with advanced ovarian cancer. If group counseling is found to significantly improve outcomes, it can be adopted immediately and incorporated in standard care. Already there is some evidence, from previous smaller studies, that social support can improve survival among cancer patients. For example, one study indicates that group counseling improved survival of women with advanced breast cancer from 18 months to 36 months. Project leader: M. Robyn Andersen, Ph.D., an assistant member of the Cancer Prevention Research Program within the Hutchinson Center's Public Health Sciences Division. Because ovarian cancer is relatively rare, it is particularly important that every patient diagnosed with the disease be included in the pool of potential participants for SPORE research. The project's Clinical Core will accomplish this objective by coordinating recruitment of both ovarian-cancer patients and at-risk women among Consortium patient-care facilities, and by recruiting additional facilities to participate in SPORE research. The Clinical Core will be headed by principal investigator Charles Drescher, M.D., an affiliate investigator in the Hutchinson Center's Public Health Sciences Division. In addition to mobilizing recruitment efforts, the Clinical Core also will interact with physicians and health-care providers in Washington state to translate the Consortium's research findings back to the community. "The Clinical Core is a novel feature of the Seattle SPORE program that aims to create a dynamic link between the research effort and the community," Urban says.

Ovarian cancer is the leading cause of gynecological-cancer mortality in the United States, resulting in more than 14,000 deaths each year. Overall survival after diagnosis is poor, in part because more than 75 percent of cases are diagnosed after the cancer has spread outside of the ovaries. The average woman diagnosed with the disease lives for three or four years after completing treatment. In contrast, five-year survival for localized ovarian cancer is about 90 percent, which strongly suggests that earlier detection would result in many saved lives.

Study volunteers needed: Recruitment is under way for women with a personal or family history of ovarian cancer, and any other women interested in participating in ovarian-cancer research. For more information, call (206) 215-6200.

Editor's note: For more information about the NCI's Specialized Programs of Research Excellence program, see < http://deainfo.nci.nih.gov/awards/spore.htm >.




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