Tackling drug resistance – a role for precision medicine in ovarian cancer

Ovarian cancer, the most deadly gynaecological cancer, frequently presents late, when chemotherapy is the most appropriate treatment. Response to chemotherapy, particularly to initial “first-line” treatment is important, as this has a major influence on disease progression. Although many patients respond well, approximately one third of patients respond less well, as their cancers are drug “resistant”. We currently don’t understand why some patients respond well to chemotherapy treatment, while others fail to respond – if we can find out why this happens, we will be able to develop screening tests which could help doctors to make better, more personalised drug choices for individual cancer patients, and to limit exposure to ineffective toxic drugs in patients who are unlikely to respond.

To address this issue, we have designed an ambitious clinical study, the Dundee Ovarian Cancer Study (DOCS), in which we are collecting blood samples and primary ascites-derived cell lines from drug-sensitive and drug-resistant patients as they progress through treatment. The DOCS study provides a unique opportunity to identify novel clinically relevant resistance mechanisms, and to develop quantitative biomarker assays – screening tests which we hope to use in future precision medicine approaches to make treatment more personalised.

This translational PhD project will combine state of the art laboratory analysis with detailed clinical histories from patients who responded well or who failed to respond to first-line chemotherapy.