The landscape of ovarian cancer treatment is changing faster than ever. In this Teal Talk episode, we speak with Dr. Michael Birrer, director of the UAMS Winthrop P. Rockefeller Cancer Institute, about some of the most promising emerging treatments for ovarian cancer.
From precision medicine and genetic testing to PARP inhibitors, antibody drug conjugates, and new clinical trial designs, survivors today have more treatment possibilities than at any other point in history. These therapies not only reflect scientific breakthroughs but also offer real, tangible hope for patients and their families.
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The evolution of ovarian cancer treatment: From chemotherapy to precision medicine
For decades, ovarian cancer treatment relied almost entirely on chemotherapy. As Dr. Birrer explains, “We used to go to meetings and argue about IV versus IP… I think a lot of ways relatively unscientific.”
At that time, drugs like cisplatin, carboplatin, Cytoxan, and Taxol were the core of treatment, but they were “completely untargeted… they just bang up the tumor… but they bang up the bone marrow.”
Chemotherapy attacks rapidly dividing cells, but it cannot distinguish tumor cells from healthy ones. This is why side effects such as neuropathy, fatigue, and hair loss are so common.
Where treatment is going now
Through genomic research, including The Cancer Genome Atlas, scientists discovered that ovarian cancers are far more genetically diverse than once believed. Different histologies, such as high grade serous, clear cell, and endometrioid, behave differently and respond differently to treatment.
This shift changed everything. As Dr. Birrer notes,
“I’ve seen more progress in maybe five to 10 years… than in the previous 30 years.”
What once appeared to be a single disease is now recognized as multiple subtypes that require tailored treatment.
Want to know more about the types and stages of ovarian cancer?
Check out this article on the types and stages of ovarian cancer.
Personalized treatment: Why molecular and genetic testing matter
One of the most important advances in modern ovarian cancer care is the routine use of molecular testing. As Dr. Birrer explains,
“It’s not sufficient now to just sort of say, well, you’re gonna get a combination of chemotherapy… all patients have to have molecular testing.”
These tests analyze the tumor itself (somatic testing) and sometimes a person’s inherited genes (germline testing).
What molecular testing can identify
Testing can reveal:
- BRCA1 or BRCA2 mutations
- Homologous recombination deficiency (HRD)
- Fanconi anemia pathway mutations
- Biomarkers such as folate receptor alpha or HER2
Identifying these markers helps doctors determine whether targeted therapies, like PARP inhibitors or antibody drug conjugates, are appropriate.
Germline testing: Why families matter
If a mutation is inherited, it has implications for parents, siblings, and children. As Dr. Birrer reminds patients,
“They then need to be assessed… because it’s very relevant to the entire family.”
Federal protections such as GINA (Genetic Information Nondiscrimination Act) help guard against discrimination based on genetic information.
Quick fact: Inherited mutations
According to the American Cancer Society, up to 25 percent of ovarian cancers are part of hereditary cancer syndromes caused by inherited gene mutations, most often BRCA1 or BRCA2.
Wondering if genetic testing is right for you or your family?
Check out our Questions to Ask Your Doctor: Genetic Testing for an Inherited Mutation to get started
Why clinical trials are essential for progress
Clinical trials are the foundation of every major breakthrough in cancer care. Yet many patients feel hesitant or unsure. Dr. Birrer addresses this fear directly:
“You’re not a Guinea pig… if the investigators are doing the right thing, then the trial is the same as standard of care, if not better.”
What a clinical trial really is
A clinical trial is a structured study designed to test whether a therapy:
- Works better than current treatments
- Has fewer side effects
- Improves quality of life
- Helps patients live longer
Clinical trials progress through several stages (Phase 1, 2, and 3), each designed to answer specific safety and effectiveness questions. Before any treatment reaches patients, it has been studied extensively in laboratories and early phase trials.
Why patients benefit
Many life-saving therapies, such as platinum chemotherapy and Taxol, were once only available through clinical trials. Dr. Birrer explains,
“The only reason we have those agents is because they were proven by clinical trial.”
Common misconception
Patients often say they don’t want to be part of an experiment. Yet the overwhelming majority of trials compare a promising therapy against the current standard of care, not an inferior alternative.
Want help searching for clinical trials?
Check out SHARE’s clinical trial matching service.
Targeted therapies: PARP inhibitors and antibody drug conjugates
Targeted therapies work by interfering with specific weaknesses in cancer cells.
PARP inhibitors: A major step forward
PARP inhibitors work by blocking a DNA repair enzyme called PARP. If a tumor already has trouble repairing DNA due to BRCA mutations or HRD, blocking PARP causes the cancer cell to accumulate lethal damage.
Dr. Birrer breaks it down:
“PARP inhibitors will stop the single stranded repair… if you don’t repair that, then the cell dies.”
Why PARP inhibitors help BRCA-positive patients most
BRCA genes are responsible for repairing double-stranded DNA breaks. Without functioning BRCA, cancer cells rely heavily on PARP to survive. Blocking PARP leaves them with no repair mechanism.
This approach can dramatically improve outcomes. As Dr. Birrer explains, trials like SOLO-1 showed “a complete home run” with curves that “are so far apart… we may be curing some ovarian cancer patients.”
Antibody Drug Conjugates (ADCs): Targeted treatment with powerful impact
ADCs are among the most promising emerging treatments for ovarian cancer. They combine:
- An antibody that recognizes a specific biomarker on tumor cells
- A linker
- A potent chemotherapy payload
As Dr. Birrer explains, the antibody binds to the tumor and then “the drug is free to do its bad thing, which is to kill the tumor cell… and the bystander effect is part of ADCs.”
Why ADCs are exciting
ADCs deliver chemotherapy directly to cancer cells, reducing exposure to healthy tissue. They may also use drugs too toxic to give freely in the bloodstream.
Some ADCs are already FDA-approved for specific ovarian cancer biomarkers, including folate receptor alpha and HER2.
Dr. Birrer explains the long-term benefit:
“We could be giving our ladies eight to 10 months per antibody… next thing you know, you’re out 30, 40, 50 months.”
Immunotherapy: Progress, challenges, and what’s next
Immunotherapy trains the body’s immune system to recognize and fight cancer cells. It has shown remarkable success in melanoma, lung cancer, and endometrial cancers with mismatch repair deficiencies.
Why immunotherapy works better in some cancers
Successful immunotherapy often requires tumors to have many mutations that help the immune system recognize them. Ovarian cancers with HRD have large DNA rearrangements, but not the types of mutations that trigger strong immune system responses.
Still, research continues. As Dr. Birrer notes, combinations of immunotherapy with other drugs, including bevacizumab or chemotherapy, may hold promise.
Conclusion
Emerging treatments for ovarian cancer are bringing new hope to a disease that has long needed more options. From personalized medicine to clinical trials to next-generation ADCs, survivors today have access to more promising pathways than ever before.
What you can do right now
- Want to know more about the types and stages of ovarian cancer? Check out this article on the types and stages of ovarian cancer.
- Wondering if genetic testing is right for you or your family? Check out our Questions to Ask Your Doctor: Genetic Testing for an Inherited Mutation to get started.
- Want help searching for clinical trials? Check out SHARE’s clinical trial matching service.
- Need emotional or peer support? Connect through NOCC’s Support Services.
- Ready to make an impact? Explore ways that you can support NOCC’s mission.
Frequently asked questions
Are emerging treatments for ovarian cancer safe?
Most emerging treatments go through years of testing before reaching large trials. Safety is monitored closely throughout every phase.
What is the difference between somatic and germline testing?
Somatic testing analyzes the tumor. Germline testing analyzes inherited DNA. Both provide important clues for treatment.
What makes PARP inhibitors effective?
They target tumors with DNA repair weaknesses, especially BRCA mutations or HRD.
How do antibody drug conjugates know where to go?
The antibody portion recognizes a biomarker on the tumor cell surface, guiding the toxic drug directly to cancer cells.
Are clinical trials only for late-stage patients?
No. Many trials enroll newly diagnosed patients, especially those with specific biomarkers.
What is progression free survival?
It measures how long a treatment keeps cancer from growing. Many targeted therapies significantly prolong PFS.
Is immunotherapy used for ovarian cancer?
It has shown limited benefit alone but may be effective in combination with other drugs.
