By Cory Bently, Ph.D.

The Clearity Foundation presented evidence for the use of biomarkers in ovarian cancer treatment decisions at the 2011 American Association for Cancer Research (AACR) Annual Meeting. Using a tumor's biomarkers, or molecular and genetic characteristics, is commonplace for several cancer types. For example, in breast cancer, over-expression of the Her2 protein is predictive of response to the drug Herceptin. And in colon cancer, a mutation in the kras gene is predictive of lack of response to the drug Cetuximab.  

Biomarkers help physicians personalize the cancer treatment to fit the molecular profile of the patient. Ovarian cancer has so far not benefited from this personalized approach, but work at the Clearity foundation aims to change that. Clearity's poster presentation at AACR used a meta-analysis, essentially combining the results of hundreds of clinical studies, to identify biomarkers that correlate with response to chemotherapeutic drugs commonly used in ovarian cancer. View a copy of Clearity's poster presentation from the AACR Meeting  here. 

The researchers at Clearity, led by Dr. Deb Zajchowski, combed through the medical literature of the National Library of Medicine database to find clinical research studies that demonstrated statistically significant correlations of a biomarker with response or lack of response to chemotherapeutics. The team identified 24 biomarkers in which multiple clinical research studies found the same drug-biomarker correlation. They showed that by using a subset of the biomarkers, nearly three quarters of patients in the study group could be assigned to a chemotherapy. A patient's biomarkers lined up with the correlations found in the literature to suggest that she would most likely respond to a specific therapy.

In the absence of a personalized approach, physicians must rely their own experience and that of their surrounding colleagues. This type of evidence, termed anecdotal, is limited by the number of patients seen by a given physician and her colleagues. Work from IntrinsiQ, an oncology data and analysis company, lead by CEO Jeff Forringer, shows that only a small fraction of breast cancer patients are given the optimal therapy. Evidence from IntrinsiQ's extensive database of patient treatments and outcomes shows that only 8% of breast cancer patients that do not express the Her2 biomarker are receiving the optimal treatment (http://www.cancernetwork.com/practice/content/article/10165/1771390). Most ovarian cancer patients' treatments are also based on the personal experience of their physicians.

The work from the Clearity Foundation shows that substantial evidence exists in the scientific literature to support a biomarker approach to ovarian cancer treatment. Dr Zajchowski plans to continue building the knowledge base to personalize ovarian cancer treatment further, "This is the first step. We have completed a thorough review of biomarkers for chemotherapy drugs frequently used in ovarian cancer treatment."  Dr. Zajchowski explained that many of these markers are already in Clearity's tumor profiling panel.  For the newly identified markers, Clearity plans to develop assays so the new markers can be integrated into the panel as soon as possible. Clearity also plans to improve personalization further by identifying and utilizing biomarkers for other drug classes and those drugs making their way through clinical trials. 

Annette Bennington McElhiney is a wife, a mother, and a grandmother.  She is a painter and a writer, a former English teacher, and a certified RN.  She is an ovarian cancer patient and survivor.  Somewhere amongst these many identities, Annette has discovered a new, feisty and fiery part of herself she has named Althea, from the Greek word for self-healer.  She paints her Althea identity to express her emotions throughout the challenging process of cancer treatments using acrylic, feathers, string, and other textured materials.  Annette's "Althea" self is helping her to embrace life after ovarian cancer treatments, which she details in her autobiographical brochure, "Althea Re-balances her Life."  Annette explains, "So Althea and I hope that in sharing with you our teetering-journey through the ovarian-cancer-circus of our lives, you will recognize that we all go through so many of the same experiences. We are all survivors from the day of our diagnosis until the end of our lives. But the quality of that survivorship is up to us - to the Althea, the self healer in each of us. So I say to myself and to all of you what Althea would say: 'You go girl!'"  We couldn't have said it better ourselves, Annette!  Annette's personal story can be found here.