Role of Skin Capillary Density in Epithelial ovarian cancer
Research type
Research Study
Full title
The assessment of skin capillary density before, during and after treatment for epithelial ovarian cancer and its correlation to treatment outcome.
IRAS ID
60542
Contact name
Vivek Vasudev Nama
Contact email
Sponsor organisation
Bristol University
Duration of Study in the UK
5 years, 11 months, 29 days
Research summary
Ovarian cancer is the most lethal of gynaecological malignancies, with 5 year survival rates reported as approximately 45% in the UK according to cancer research statistics in 2010-11. The most common type is epithelial ovarian cancer (EOC). Most patients present with advanced stage disease – with disease outside the pelvis, involving the abdominal organs. The management involves surgery and chemotherapy. In patients who are at high risk of surgery, chemotherapy may be given as the first treatment (neoadjuvant chemotherapy, NAC), followed by surgery and then postoperative chemotherapy. Alternatively, patients may have surgery first, followed by chemotherapy. With both treatment regimens the patient typically undergoes surgery and 6 cycles of chemotherapy. Currently standard chemotherapy treatment includes carboplatin and paclitaxel. Most centres use Bevacizumab for patients with tumour spread outside the tummy cavity and this is currently available through the cancer drug fund. It is not currently available for earlier stage ovarian cancers as NICE has ruled that it is too expensive and may not be of benefit to all types of ovarian cancer. It has been hypothesised that a cohort of patients with EOC do not have tumour vessel growth (angiogenesis)as the main route of tumour spread and may not benefit from Bevacizumab. Bevacizumab works by blocking tumour vessel growth.
Although two trials show that patients who have either chemotherapy first or surgery first do not have different survival rates, many centres believe in primary surgery as the primary surgery group fared slightly better than the delayed surgery group. The delayed surgery group had less post operative morbidity. Currently there are no reliable surrogate markers that predict post-operative morbidity.
Measurement of skin capillary density, serum angiogenic markers and tissue angiogenic markers may help to identify a reliable marker to predict patients that will benefit from either surgery or bevacizumab chemotherapy first.
REC name
East Midlands - Nottingham 2 Research Ethics Committee
REC reference
15/EM/0489
Date of REC Opinion
26 Oct 2015
REC opinion
Favourable Opinion