Fertility-sparing surgery can be successful for borderline ovarian tumours
The ovary- and uterus-preserving procedure had same survival rate as radical surgery
Personalised molecular therapy can lead to better cancer outcomes
But it ’ s still too soon for the new treatment to enter into widespread practice
Advanced cancer patients receiving personalised therapy at an American cancer centre survived longer or experienced a longer period without the disease progressing . In a new study , cancer patients were treated with precision therapies tailored to their own molecular tumour makeup . This use of next-generation sequencing allows doctors to identify new potential targets in patients with cancer to improve outcomes .
“ Patients who underwent a molecular therapy were better matched to genomic alterations in their cancer and had improved outcomes ,” said Dr Razelle Kurzrock , who led the study , in a press release .
“ The three-year survival for patients with the highest degree of matching and who received personalised cancer therapy was approximately 55 percent , compared to 25 percent in patients who received therapy that was unmatched or had low degrees of matching ,” he said .
There are , however , challenges to using this approach widely , said Dr Shumei Kato , the first author of the study .
“ One of the hurdles is that every cancer patient appears to be carrying different molecular and genomic patterns despite having the same cancer type . This can be challenging since we are customising therapy based on the unique genomic pattern patients have , and thus it is difficult to predict the response .
“ In addition , this approach requires multidisciplinary expertise as well as access to drugs or clinical trials not always available in smaller practices ,” Dr Kato added .
W
omen who undergo fertility-sparing surgery ( FSS ) for borderline ovarian tumours are still able to have children .
According to a study in Sweden , natural fertility is preserved in most women following surgery with this technique , and only a small proportion require assisted reproductive treatment , such as in vitro fertilisation .
FSS , which preserves the uterus and at least parts of the ovaries , is the most common option for women wishing to preserve fertility . Up to 20 percent of ovarian tumours in Sweden are borderline , and a third are diagnosed in young women of fertile age .
Postoperative survival was also shown to be as high as in women who had undergone radical surgical treatment of similar tumours .
However , the relapse risk after FSS is higher than after radical cancer treatment in which the uterus and both ovaries are removed , but the researchers believe the advantage of continued fertility makes it an accepted course of action for young women .
“ The ability to become pregnant seems to be preserved with fertility-sparing surgery , a knowledge that is absolutely critical for the advice and treatment given to young women with ovarian borderline tumours ,” said the study ’ s first author Gry Johansen , of Karolinska Institutet , in a press release .
Knowledge about pregnancy and childbirth after FSS has been scant as earlier studies of FSS for borderline ovarian tumours primarily focused on oncological therapeutic outcomes .
30 NOVEMBER 2020 GlobalHealthAsiaPacific . com