David Bowtell lab

Exceptional responders and long-term survivors of ovarian cancer

Typically, cancer studies have focused on the determinants of poor survival, that is, intrinsic and acquired resistance to therapies, with less attention paid to those patients who exceed expectations. As part of a U.S. DoD-funded international collaboration “MOCOG” (the Multidisciplinary Ovarian Cancer Outcomes Group), our team is taking an unconventional approach: to study patients who achieved long-term survival (survived more than 10 years from diagnosis), despite having clinical features typically associated with a poor prognosis. Using contemporary multi-omic technologies, we are investigating whether differences in the tumour genome and/or the immune response could contribute to long-term survival. Our aim is to learn how these remarkable patients managed to “beat-the-odds” and apply this knowledge to identify strategies to prevent the emergence of resistant disease and improve survival outcomes of all patients with ovarian cancer.

Project lead: Dr Dale Garsed

Clinical trials platform 

Stemming directly from findings in the lab, we now have a number of investigator-led clinical trials such as IGNITE (ACTRN12619001185156) and BEACON (NCT03363867). Samples including blood, ascites, tumour biopsies and microbiome will be utilised in the lab to better understand biomarkers of response and resistance. Results of these studies have significant potential for rapid translation back to the clinic in shaping the design of future clinical trials. 

Project lead: Dr George Au-Yeung

The Australian Ovarian Cancer Study (AOCS)

The Australian Ovarian Cancer Study (AOCS) is a collaborative research program between clinicians, scientists, patients, and advocacy groups aimed at improving the prevention, diagnosis, and treatment of ovarian cancer.  

AOCS works collaboratively with several national and international groups to establish and support very successful research initiatives –  

• AOCS was one of 25 groups invited to participate in the Multidisciplinary Ovarian Cancer Outcomes Group (MOCOG). It is the clinical data hub and the largest contributor to this international consortium (AOCS Project Lead – Sian Fereday) 

• AOCS was approached by AstraZeneca to initiate recruitment across the eastern states of Australia with the aim to identify a cohort of women exposed to new treatment patterns (PARPi) and look closely at the uptake of BRCA testing (AOCS Project Leads – Sian Fereday, Nadia Traficante) 

• The INFORM study utilised the AOCS clinical data to look at treatment patterns of newly diagnosed advanced stage ovarian cancer in Australia compared to South Korea and Taiwan (AOCS Project Lead – Sian Fereday) 

• A collaboration with Ovarian Cancer Australia (OCA) and major hospitals and research sites across the country led to Australian Federal Government funding for TRACEBACK. This program is utilising genetic testing to identify families that may have a hereditary risk of cancer development because of inherited mutations in BRCA1, BRCA2 and other cancer risk genes. (Project Lead – Kath Alsop) 

• Federal Government funding led to the establishment of TRACKFORWARD, a collaborative study with the Christie Lab investigating ovarian cancer patients with BRCA1/2 mutations to determine how frequently and when during a patient’s disease journey reversion mutations arise, identify which treatments patients with reversions respond to, and to improve our understanding of why not all patients will develop reversions (AOCS Project Leads – Sian Fereday and Nadia Traficante) 

• AOCS provides valuable infrastructure support to the ovarian cancer arm of CASCADE, a program enrolling patients with advanced metastatic disease who consent to undergo rapid autopsy following death (AOCS Project Lead – Kath Alsop) 

• AOCS is also actively involved in several clinical trials and is a TR-ANZGOG Network Laboratory, supporting the translational arm of ANZGOG funded clinical trials (AOCS Project Lead – Nadia Traficante) 

Project leads: Sian Fereday, Nadia Traficante, Kath Alsop 

Find out more about the Australian Ovarian Cancer Study.