COXEN model picks the best drug for ovarian cancer

February 18, 2014

There are three common drugs for advanced ovarian cancer: paclitaxel, cyclophosphamide, and topotecan. Like a shell game, if you pick the right drug a patient is likely to respond. And, unfortunately, picking the wrong drug can lead to treatment failure. As reported in this month's issue of the journal PLoS ONE, a University of Colorado Cancer Center and University of Virginia study used a sophisticated model of ovarian cancer genetics to match the right tumor with the right drug. Patients who were matched in this way lived an average 21 months longer than patients who were not matched.

Because it has been so difficult to predict which ovarian cancers will respond to each of these three drugs, doctors have largely been forced to guess which will work best – and so in this study of four groups of 783 patients each, some were accidentally given what would turn out to be the best possible whereas others were given one of the two other, less good drugs. The model, called COXEN (CO-eXpression gENe analysis), sorts through the massive genetic data of thousands of samples to discover differences between tumors that responded and tumors that did not.

"The model allowed us to ask what would have been the right drug in each case, how could we have known from the tumor's genetics, and what difference it made," says Jennifer R. Diamond, MD, CU Cancer Center investigator and medical oncologist at the University of Colorado Hospital.

When COXEN looked back through this registry of advanced ovarian cancer, it first sorted tumors into those that had responded and those that had not responded to each drug ("what would have been the right drug in each case"). It then pinpointed genetic signatures of tumors that responded to each drug ("how could we have known from the tumor genetics"). And the study finally showed that patients who had been serendipitously given the drug that the COXEN model would have picked for them lived 21 months longer than the average patient with advanced ovarian cancer.

"We have traditionally considered site-specific cancer to be homogenous – one ovarian cancer is like the next ovarian cancer. But we are increasingly learning that isn't the case at all. The COXEN model allows us to identify the heterogeneity within the disease. It lets us see why some respond and others don't," Diamond says.

Diamond is also quick to point out that while the current study shows that COXEN could have been used to predict the most useful drug in many of these cases of advanced ovarian cancer, the actual use of the will be possible only after validation with a prospective clinical trial. In fact, a similar strategy led to similar results in , and a prospective clinical trial of COXEN in bladder cancer is underway at the CU Cancer Center and elsewhere.

"This study supports the idea that we could test ovarian cancer tumors and say they're more likely to respond to one or the other drugs," Diamond says.

Explore further: Drug delivery system successfully treats deadly ovarian cancer in mice

Related Stories

Drug delivery system successfully treats deadly ovarian cancer in mice

December 6, 2013
(Medical Xpress)—Scientists at Rutgers University have developed a targeted drug delivery system that they believe could make ovarian cancer more treatable and increase survival rates for the most deadly gynecological cancer ...

Biomarkers predict time to ovarian cancer recurrence

August 15, 2013
Ovarian cancer often remains undetected until it is at an advanced stage. Despite positive responses to initial treatment, many patients are at risk of tumor recurrence. A multitude of genetic markers have been implicated ...

Drug can delay ovarian cancer relapses: study

June 1, 2013
A drug already approved for treating kidney cancer was successful at delaying the return of advanced ovarian cancer by an average of nearly six months, a clinical study released Saturday found.

Ovarian cancer cells hijack surrounding tissues to enhance tumor growth

September 4, 2012
Tumor growth is dependent on interactions between cancer cells and adjacent normal tissue, or stroma. Stromal cells can stimulate the growth of tumor cells; however it is unclear if tumor cells can influence the stroma.

New ovarian cancer treatment succeeds in the lab

October 17, 2013
In a study to be published today in Scientific Reports, researchers from the Florida International University Herbert Wertheim College of Medicine and the FIU College of Engineering and Computing describe what could be a ...

New drug extends life in women with advanced ovarian cancer

November 5, 2013
Women with ovarian cancer that has returned after previous treatment had their life extended by almost three months after treatment with a drug called Cediranib, according to trial results presented today at the National ...

Recommended for you

Lung cancer triggers pulmonary hypertension

November 17, 2017
Shortness of breath and respiratory distress often increase the suffering of advanced-stage lung cancer patients. These symptoms can be triggered by pulmonary hypertension, as scientists at the Max Planck Institute for Heart ...

Researchers discover an Achilles heel in a lethal leukemia

November 16, 2017
Researchers have discovered how a linkage between two proteins in acute myeloid leukemia enables cancer cells to resist chemotherapy and showed that disrupting the linkage could render the cells vulnerable to treatment. St. ...

Computer program finds new uses for old drugs

November 16, 2017
Researchers at the Case Comprehensive Cancer Center at Case Western Reserve University School of Medicine have developed a computer program to find new indications for old drugs. The computer program, called DrugPredict, ...

Pharmacoscopy improves therapy for relapsed blood cancer in a first clinical trial

November 16, 2017
Researchers at CeMM and the Medical University of Vienna presented a preliminary report in The Lancet Hematology on the clinical impact of an integrated ex vivo approach called pharmacoscopy. The procedures measure single-cell ...

Wider sampling of tumor tissues may guide drug choice, improve outcomes

November 15, 2017
A new study focused on describing genetic variations within a primary tumor, differences between the primary and a metastatic branch of that tumor, and additional diversity found in tumor DNA in the blood stream could help ...

A new strategy for prevention of liver cancer development

November 14, 2017
Primary liver cancer is now the second leading cause of cancer-related death worldwide, and its incidences and mortality are increasing rapidly in the United Stated. In late stages of the malignancy, there are no effective ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.