News
Better nutrition screening may improve ovarian cancer outcomes, study finds
Better detection and management of malnutrition and muscle loss could improve treatment results for women with ovarian cancer, new research has found.
The study involved a 24-item survey of 57 healthcare professionals across Australia, looking at awareness of nutrition issues, screening practices and barriers to support at diagnosis, during treatment and after treatment.
Weight loss, overweight or obesity and sarcopenia were the most frequently reported nutrition-related problems.
During treatment, 70 per cent of patients lost weight and 65 per cent developed sarcopenia – the loss of muscle mass and strength that makes it harder to cope with therapy.
After treatment, 46 per cent gained weight but 39 per cent still had muscle loss.
Researchers from several Australian institutions identified major gaps in care.
The researcher said: “The findings from this sample of HCPs suggest that nutrition care practices for patients with ovarian cancer, a vulnerable patient group, currently do not align with best practice guidelines for a coordinated multidisciplinary approach to the identification and management of cancer-related malnutrition and sarcopenia.”
Nearly 60 per cent of professionals did not screen for sarcopenia, and 18 per cent said their services did not screen for nutritional risk at all.
The respondents included nurses (39 per cent), dietitians (23 per cent) and surgeons (19 per cent), mainly from public hospitals in metropolitan areas, most with six to 10 years’ experience in ovarian cancer care.
All dietitians recognised malnutrition and sarcopenia as important issues, but awareness was lower among nurses and other professionals, leading to uneven screening and referral.
Patients on chemotherapy were at the highest nutritional risk, at 97 per cent.
Three-quarters of respondents said patients often made their own dietary changes during treatment, sometimes without professional advice.
Although 91 per cent reported dietetic services were available in their hospitals, referrals were most common at diagnosis but declined once treatment ended.
Referrals were usually triggered by unintentional weight loss, patient requests or symptom management.
Key barriers included the absence of a formal sarcopenia screening process (75 per cent), limited access to dietitians (60 per cent) and a lack of clear referral pathways for ovarian cancer (58 per cent).
The researchers called for an evidence-based clinical pathway tailored to ovarian cancer to standardise screening and ensure consistent care.
Diagnosis
Lung cancer drug shows breast cancer potential
Ovarian cancer cells quickly activate survival responses after PARP inhibitor treatment, and a lung cancer drug could help block this, research suggests.
PARP inhibitors are a common treatment for ovarian cancer, particularly in tumours with faulty DNA repair. They stop cancer cells fixing DNA damage, which leads to cell death, but many tumours later stop responding.
Researchers identified a way cancer cells may survive PARP inhibitor treatment from the outset, pointing to a potential way to block that response. A Mayo Clinic team found ovarian cancer cells rapidly switch on a pro-survival programme after exposure to PARP inhibitors. A key driver is FRA1, a transcription factor (a protein that turns genes on and off) that helps cancer cells adapt and avoid death.
The team then tested whether brigatinib, a drug approved for certain lung cancers, could block this response and boost the effect of PARP inhibitors. Brigatinib was chosen because it inhibits multiple signalling pathways involved in cancer cell survival.
In laboratory studies, combining brigatinib with a PARP inhibitor was more effective than either treatment alone. Notably, the effect was seen in cancer cells but not normal cells, suggesting a more targeted approach.
Brigatinib also appeared to act in an unexpected way. Rather than working through the usual DNA repair routes, it shut down two signalling molecules, FAK and EPHA2, that aggressive ovarian cancer cells rely on. FAK and EPHA2 are proteins that relay survival signals inside cells. Blocking both at once weakened the cells’ ability to adapt and resist treatment, making them more vulnerable to PARP inhibitors.
Tumours with higher levels of FAK and EPHA2 responded better to the drug combination. Other data link high levels of these molecules to more aggressive disease, pointing to potential benefit in harder-to-treat cases.
Arun Kanakkanthara, an oncology investigator at Mayo Clinic and a senior author of the study, said: “This work shows that drug resistance does not always emerge slowly over time; cancer cells can activate survival programmes very early after treatment begins.”
John Weroha, a medical oncologist at Mayo Clinic and a senior author of the study, said: “From a clinical perspective, resistance remains one of the biggest challenges in treating ovarian cancer. By combining mechanistic insights from Dr Kanakkanthara’s laboratory with my clinical experience, this preclinical work supports the strategy of targeting resistance early, before it has a chance to take hold. This strategy could improve patient outcomes.”
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