A More Precise Way to Understand Tubo-Ovarian Cancer

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A More Precise Way to Understand Tubo-Ovarian Cancer

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In this episode of Bench to Bedside and Beyond, Diane Mapes talks with Fred Hutch Cancer Center and UW Medicine clinical researcher and gynecologic oncologist Dr. Elizabeth Swisher about research that may refine how scientists understand and treat tubo-ovarian cancer — and potentially help guide targeted treatment for some people with triple-negative breast cancer. Swisher explains why many cancers long called ovarian cancer begin in the fallopian tubes, why "tubo-ovarian cancer" is a more accurate term and how researchers are studying tumors' current biological vulnerabilities to better match patients with treatment options. The conversation also explores HRDefine, an investigational assay designed to identify the current causes of homologous recombination deficiency, or HRD, a tumor weakness that can make some cancers responsive to PARP inhibitors. Key takeaways Many cancers commonly called ovarian cancer begin in the fallopian tubes. Using the term tubo-ovarian cancer more accurately reflects where these cancers often originate and may inform future prevention and early-detection research. Homologous recombination deficiency, or HRD, is a weakness in how some tumor cells repair damaged DNA. That weakness can make certain tumors more responsive to PARP inhibitors. Swisher and colleagues developed HRDefine, an investigational assay designed to identify the current cause of HRD. It can examine BRCA1/2 and other gene changes, as well as methylation changes that can affect gene activity. Unlike older measures of HRD, which may continue to show a past vulnerability after a tumor has become resistant to treatment, HRDefine is designed to assess the tumor's current biology. The assay may help identify which patients are most likely to benefit from PARP inhibitors in tubo-ovarian cancer and, potentially, triple-negative breast cancer. It is still being validated in hundreds of samples before any broader clinical or commercial use. This work reflects a broader goal of precision oncology: matching treatment decisions to a tumor's biological features, not solely to the organ where the cancer began or to inherited genetic risk.

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