Ovarian, Fallopian Tube, and Peritoneal Cancer - Latest Research

Approved by the Cancer.Net Editorial Board, 08/2016

ON THIS PAGE: You will read about the scientific research being done to learn more about this type of cancer and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about ovarian, fallopian tube, and peritoneal cancer. They are looking for ways to prevent them, as well as looking for the best ways to treat them and provide care to people diagnosed with these diseases.

The following areas of research may include new options for patients through clinical trials. As mentioned in the Clinical Trials section, most ovarian cancer trials now include patients with fallopian tube and peritoneal cancers.

Always talk with your doctor about the diagnostic and treatment options best for you.

  • Screening. Screening is used to look for cancer before a person has any signs or symptoms. There are no effective screening methods for these diseases suitable for the general symptom-free population. A screening method that uses serial CA-125 blood tests and pelvic ultrasonography for detecting early-stage ovarian cancer has been completed, and it is not clear whether this approach will produce an improved survival rate. As explained in Diagnosis, CA-125 is a substance called a tumor marker that is found in higher levels in women with ovarian, fallopian tube, and peritoneal cancer, and in many benign conditions.

    In 2012, the U.S Preventative Services Task Force released a statement saying that for the general population of women with no symptoms, screening for ovarian cancer is not helpful and may lead to harm.

    Although some have recommended that women at high risk for ovarian cancer because of their family history or presence of BRCA1 or BRCA2 or other high-risk gene mutation(s) (see Risk Factors) should be screened with CA-125 blood tests and transvaginal ultrasound, this approach has not been shown to improve survival or detect cancers at an earlier and more curable stage.  Therefore, if a high-risk gene mutation exists, the recommendation is to remove both fallopian tubes and ovaries preventively (prophylactically) after the completion of child-bearing, in most women by age 40.

  • Targeted therapy. Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. Some targeted therapy drugs are directed at specific genes that might be found with abnormalities in certain types of epithelial ovarian cancer. For this purpose, serous ovarian cancers are divided into two groups: high-grade serous cancer (HGSC) and low-grade seous cancer (LGSC). Standard chemotherapy has been most effective in HGSC. Typically, these tumors have mutations in TP53 and BRCA genes and are diagnosed at later stages. Other tumor mutations are rarely seen.

    The BRCA mutation, even if found only in the tumor and not in the blood, may increase the effectiveness of certain classes of drugs, such as PARP inhibitors (see below).

    Other types of ovarian cancer are much less common, and include LGSC, endometrioid, clear cell, and mucinous cancers. These tumors have a variety of mutations including KRAS, BRAF, PI3KCA and PTEN, which may mean there is an available targeted treatment. Clinical trials in these groups are ongoing.    

  • Anti-angiogenesis inhibitors. Drugs called anti-angiogenesis inhibitors block the action of a protein called vascular endothelial growth factor (VEGF). These drugs have been shown to increase the cancer’s response to treatment and delay the time it takes for the cancer to return. VEGF promotes angiogenesis, which is the formation of new blood vessels. Because a tumor needs nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor. Bevacizumab (Avastin), an antibody that binds VEGF and prevents it from being active, has been shown to be effective in ovarian cancer.  FDA approval was given in the United States for its use in combination with selected chemotherapy for patients with platinum resistant recurrence (see Treatment Options).

  • PARP inhibitors. Researchers are evaluating another class of drugs, called PARP inhibitors, for ovarian cancer. These drugs act on DNA repair in cancer cells, making it difficult for them to replicate. The BRCA genes (BRCA1 and BRCA2) are normally involved in DNA repair, and a mutation in these genes interferes with this pathway function. PARP inhibitors make it particularly difficult for cells that otherwise have a BRCA mutation to grow and divide.  

    The FDA approved the PARP inhibitor olaparib (Lynparza) for recurrent disease in patients who have the inherited BRCA mutation and who have received 3 or more lines of chemotherapy. In the supporting study of 137 patients with a BRCA mutation, 34% of patients experienced shrinkage in tumor for an average of 7.9 months. A very small number of patients developed secondary, hematologic (blood) cancers after use of these drugs. Studies are underway with other PARP inhibitors that do not all require the inherited BRCA mutation. Researchers are testing these to see if these inhibitors can keep the cancer from coming back after chemotherapy. You should discuss the potential benefits and risks of PARP therapy with your doctor.

    Many other new targeted treatments are now in clinical trials. Increasingly, doctors are learning about each patient’s individual tumor's biology through direct molecular testing. This information may be useful in matching patients with a clinical trial for a specific targeted therapy. Learn more about the basics of targeted therapy.

  • Immunotherapy. Immunotherapy is usually designed to boost the body’s natural defenses to fight a cancer. It uses materials made either by the body or in a laboratory to bolster, target, or restore immune system function.

    Researchers are examining whether drugs called checkpoint inhibitors may boost the immune system's ability to destroy cancer cells. Examples of these drugs target PD-1, PD-L1, and CTLA4 and they have been shown to cause shrinkage in other cancer types such as melanoma and some lung cancers, as well as having some activity in patients with ovarian cancer.

    Cancer vaccines are another type of immunotherapy researchers are testing for use against ovarian cancer. Some approaches called “adoptive cell therapy” use killer T cells found as part of the immune system in an individual patient. Researchers grow them in the laboratory and train them to attack certain targets, such as MUC 16 (CA125), that are found on ovarian cancer cells. Doctors then give the T cells back intravenously to the patient. This approach has been tried in patients with blood cancers with some early success. Clinical trials are opening for ovarian cancer.  Learn more about the basics of immunotherapy.

  • Hormone therapy.  For treatment of recurrent or later-stage ovarian cancer, tamoxifen (Nolvadex, Soltamax), aromatase inhibitors, and enzalutamide (Xtandi), a blocker of the androgen receptor, are being used.

  • Gene therapy. A new area of research is discovering how damaged genes in ovarian cancer cells can be corrected or replaced. Researchers are studying the use of specially designed viruses that carry normal genes into the core of cancer cells and then replace the defective genes with the functional ones.

  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of standard cancer treatments, to improve a patient’s comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding ovarian cancer, fallopian tube cancer, and peritoneal cancer, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment.  It offers guidance in how to cope with the physical, emotional, and social changes that cancer and its treatment can bring. You may use the menu to choose a different section to continue reading in this guide.