New treatment for ovarian cancer gives patients freedom during chemotherapy

New treatment for ovarian cancer gives patients freedom during chemotherapy

Laurie McAndrews was approaching retirement in December 2014 when she felt something unusual in her midsection.

“The symptoms were so quiet, it’s what I’d describe as a persistent twinge in my lower stomach.”

After deciding to have it investigated by her doctor, the northern Illinois resident was referred to the UW’s Carbone Cancer Center, where she was diagnosed with Stage 3C ovarian cancer. Surgery was performed within a week, and she began an 18-week course of traditional chemotherapy.
Good news came at the end of treatment,

“At the end of the 18-week treatment I was considered, ‘no evidence of disease.’ So I was ecstatic’ I was like ‘this is it,'” McAndrews said.

However, as is often the case with cancer patients, the fear of recurrence came to fruition. In Laurie’s case, it came 18 months later. An elevated CA-125 blood test led to a CT scan, which revealed the cancer had returned.

“I fully expected to hear again ‘no evidence of disease,’ I figured ‘Oh, I’ve beat it’ Well … it wasn’t all gone but it’s very small and manageable.”

The cancer’s reduced size made her eligible for a maintenance therapy.

In the same month, cancer researchers received FDA approval on the first of three breakthrough cancer-treating drugs. They are called PARP (Poly ADP-Ribose Polymerase) inhibitors. In simpler terms, they are drugs that attack cancer cells without damaging healthy cells. While there are still side effects, the concept is to make life more comfortable during chemotherapy for cancer patients.

Laurie’s doctor at the University of Wisconsin-Madison’s Carbone Cancer Center, Dr. Lisa Barroilhet says, PARP inhibitors are making a difference.

“What’s happened in ovarian cancer in the last three years, is a huge insurgence of new medications that can be used both up front and in the recurrent setting,” Barroilhet says. “So when we use targeted therapy, we’re successfully targeting the bad actors in the patient’s body and allowing the rest of the body to go on business as usual. It’s a revoltuion.”

So far, there are three PARP inhibitors that have received FDA approval: Olaparib (marketed as Lynparza) was approved in December 2014, Rucaparib (marketed as Rubraca) was approved in December 2016, and Niraparib (marketed as Zejula) was approved in March 2017. The first two are for BRCA mutated ovarian cancer, and Niraparib was approved earlier this year for the treatment of non-BRCA mutated cancers of the ovaries, fallopian tubes and primary peritoneal cancer. More PARP inhibitors are currently in various phases of more clinical trials.

Further, what has made the maintenance therapy with PARP inhibitors so tolerable for patients like Laurie, is the fact that they are administered orally. Living more than 90 minutes from the UW’s Carbone Cancer Center, it has given her freedom and time to live her life, since she doesn’t have to make the daily trek from her home to Madison for exhausting and lengthy intravenous chemotherapy treatments. While Laurie hasn’t seen any side effects to date and is feeling well, Dr. Barroilhet says it’s still a challenge for patients.

“It’s still chemotherapy, these drugs certainly still have side effects,” says Barroilhet, “but the idea that you can take that medication at home, and have the freedom in your day in your life to fit in your chemotherapy treatment that quickly, is totally different from anything we’ve been able to offer patients in the past. “

For Laurie, that’s allowing her to live her life to the fullest.

“I’ve got eight grandchildren, so now I have time to go to their events, take them around, before it was like ‘No, I have no energy’. Now I can get me out there and I’m feeling really good.”

Barroilhet, forever a cautious cancer researcher and clinical caregiver, feels like it’s a big step forward.

“We have so much work to do. I don’t want to make it sound like we’ve won this war, but I do feel and this is the first time I’ve felt this way in several years, that we’ve just won a major battle.”

The UW Carbone Cancer Center will again this year celebrate survivors of female reproductive cancers, as well as honor those who have lost their lives to this silent killer, at their annual Sparkle of Hope Benefit . The fundraiser will be held Oct. 20 at Monona Terrace.