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Ovarian Cancer

Research Program
VISION: Eliminate ovarian cancer
MISSION: To support patient-centered research to
prevent, detect, treat, and cure ovarian cancer

Ovarian cancer is a devastating disease. It is responsible


for more deaths than any other cancer of the female
reproductive system. In 2015, just over 21,000 new cases
of ovarian cancer were diagnosed, and over 14,000 women
died of the disease – one of the highest ratios of mortality
to incidence of any cancer.
The Department of Defense (DoD) Ovarian Cancer Research
Program (OCRP) has transformed the landscape of ovarian
cancer research to the benefit of patients everywhere. Our
overarching goals are:
• Understanding the precursor lesion/stem cell,
microenvironment, and pathogenesis/progression of all
types of ovarian cancer, including rare subtypes
• Developing or improving the performance and reliability
of screening, diagnostic approaches, and treatment
• Developing and validating models to study the initiation
and progression of ovarian cancer
• Addressing issues in primary prevention and
survivorship
• Investigating tumor response to therapy, including tumor
survival, dormancy, cell death, clonal evolution, and
tumor heterogeneity
• Enhancing the pool of ovarian cancer scientists
The success of the OCRP can be attributed to the
synergistic efforts of many talented and dedicated
individuals. A hallmark of the OCRP is the partnership of
ovarian cancer survivors and advocates with scientists
and clinicians, all of whom work together to set program
priorities, conduct peer review of research proposals, and
identify high-impact, innovative research that will lead to
the elimination of ovarian cancer. More than 500 ovarian
cancer survivors and advocates, scientists, and clinicians
have participated in the OCRP. The disease survivors and
advocates bring their unique perspective and the human
dimension of the disease into the OCRP’s policy, investment
strategy, and research focus to encourage funding
recommendations that reflect the concerns of ovarian
cancer advocates and their families, as well as the clinicians
who treat them.

U.S. Army Medical Research and Materiel Command


GAP 1 GAP 2
Understand Create new tools
how all types of for studying
ovarian cancer ovarian cancer
begin, grow, and
metastasize

GAP 1 & GAP 2 of human ovarian cancer and will


New Models to Study the Effect of likely prove useful for preclinical
BRCA1 on Ovarian Cancer testing of therapies. Two additional
Developed a new mouse model that mouse models for endometriosis and
deleted the BRCA1 gene from ovarian endometriod ovarian adenocarcinoma
cells. This gene was found to result in were developed and provide invaluable
cystic tumors forming in the ovaries insight into the pathogenesis of ovarian
and uterine horns. Another novel cancer, testing of molecular therapies,
transgenic mouse strain provided a and development of methods of early
unique experimental model to study the detection and cancer prevention.
sensitivity of ovarian tumors to various Rong Wu, University of Michigan;
therapies that may interfere with Tyler Jacks, Massachusetts Institute
the immune system. Together these of Technology
models may help reveal the etiology of GAP 2
hereditary ovarian cancers, as well as New Animal Model of Spontaneous
help evaluate therapies that target the Epithelial Ovarian Cancer
BRCA1 pathway.
Validated and supported the functional
Louis Dubeau University of Southern
use of hens as a model of spontaneous
The DoD OCRP was established California; Sandra Orsulic, Cedars-
ovarian cancer. This strain of hen
Sinai Medical Center
in 1997 to define and address develops epithelial ovarian cancer,
GAP 1 & GAP 2 similar to human disease. This work
the critical research gaps The Effect of Two Oncogenes helped identify molecular targets for
facing the ovarian cancer on the Development of Ovarian therapeutic intervention and supported
community. The OCRP is the Leiomyosarcoma the use of the hen as a low-cost model
Generated a new mouse model that for large-scale pre-clinical studies of
leading funder of new ovarian targeted therapeutics.
inactivated both BRCA1 and p53,
cancer research projects and two oncogenes that have individually Dale B. Hale, Southern Illinois
the second-leading funder been implicated in the development of University
epithelial ovarian cancer. Surprisingly, GAP 2 & GAP 3
overall of ovarian cancer this work demonstrated that Using Animal Proteins to Predict
research in the United States. inactivating both genes at once actually Ovarian Cancer Risk in Humans
With $256 million (M) in reduces the chance of developing
Developed a large bio-repository of
epithelial ovarian carcinomas, a new
Congressional appropriations insight into the genetic contribution
reproductive tract cancers from hens
of varying ages, strains, reproductive
between fiscal year 1997 to ovarian cancer development. This
history, and chemopreventive drug
(FY97) and FY15, the OCRP research also produced a novel tumor
exposure. This led to standardized
cell line for ovarian leiomyosarcoma.
has funded 346 research Denise Connolly, Fox Chase Cancer
histological criteria to describe
ovarian tumors in the hen model.
awards, resulting in over 1,370 Center
Genetic research determined p53
peer-reviewed publications, GAP 1 & GAP 2 and HER2 are similar between
over 100 patent applications, New Endometriosis Ovarian Cancer human and chicken ovarian
Animal Models cancer. Additional research using
and high-impact advances archived hen serum demonstrated
Developed a new mouse model of
in the prevention, screening, ovarian cancer that more closely that the protein AOA can act as
a predictive marker for ovarian
diagnosis, and treatment of resembles the morphological features,
biological behavior, and gene cancer development. This can aid
ovarian cancer. expression profiles of human cancers. in developing a screening test for
This model should help advance early detection of ovarian cancer, as
understanding of the pathogenesis many proteins that are associated
with human ovarian cancer, including
GAP 3 GAP 4 GAP 5
Increase Devise and Investigate tumor
prevention and advance new response and/
improve quality of and improved or resistance to
life for survivors techniques to treatment
diagnose and treat
ovarian cancer

AOA, are also found in hens with changes that lead to ovarian high-grade and migration. Repurposing of these
ovarian cancer. serous cancer, a disease whose 5-year FDA-approved drugs provides an
Gustavo Rodriguez, NorthShore survival rate is only 27%. This research advantage over new chemical entities
Research Institute; Judith Luborsky, developed and validated an algorithm that require safety testing prior to
Rush University Medical Center to help pathologists diagnose STIC clinical application, thereby offering
(serous tubal intraepithelial carcinoma) the potential for rapid translation to
GAP 3
lesions, which are precursors to the clinic. This study has completed a
Ovarian Cancer Risk-Reducing ovarian cancer. The algorithm is pilot clinical trial and is now in Phase I
Surgery: A Decision-Making available online at: http://www. testing.
Resource ovariancancerprevention.org/. Laurie Hudson, University of New
Supported research contributing to the Robert Kurman, Johns Hopkins Mexico Health Sciences Center
preparation of a book, Ovarian Cancer University
Risk-Reducing Surgery: A Decision- GAP 4 & GAP 5
Making Resource. This resource assists GAP 4 Virus-Based Toxin Delivery for
women who carry the BRCA1/2 gene RAD51D Genetic Testing Kit Ovarian Cancer Tumors
or have a family history of ovarian Loss-of-function mutation in the Investigated the use of a virus
cancer in determining whether or not to RAD51D gene predisposes women engineered to deliver toxic therapy
undergo prophylactic oophorectomy as without BRCA1/2 mutations to to ovarian tumors. This virus can
a preventive measure. This resource is ovarian cancer, but not breast cancer. specifically attach to ovarian cancer
available at no cost online (http://www. This information helped guide genetic cells and deliver a toxic gene that will
igcs.org/files/TreatmentResources/ testing kits for women in families with kill the cells. The goal is to develop
OCRRS_2008.pdf). For a paper copy, ovarian cancer, both with or without this technology into an alternative
email surgerybook@fccc.edu with breast cancer. This work is cited as treatment method for patients.
your name, address, and reason for part of the foundational logic leading David T. Curiel, Washington
requesting the book. to a commercially available genetic University, St. Louis
Mary Daly, Fox Chase Cancer Center testing kit from Ambry Genetics.
GAP 4 & GAP 5
Tomas Walsh, University of
GAP 3 & GAP 4 Using MSC1 Immunotherapy to
Washington
Genetic Testing Guidelines for Create an Anti-Tumor Response
Ovarian Cancer GAP 4 Identified an anti-tumor MSC1 therapy
Identified that 44% of women with OVA1™ Diagnostic Index Test as a novel cancer immunotherapy. This
non-mucinous ovarian cancer and Discovered, identified, and validated therapy safely and effectively retrains
mutations in BRCA1/2 did not have five serum biomarkers for use in the immune system to switch from a
a family history of the disease. As a detecting ovarian cancer. OVA1™, pro-tumor state to an anti-tumor state,
result, genetic testing guidelines in an in vitro diagnostic multivariate slowing the progression of ovarian
Australian Familial Cancer Clinics and index test, is approved by the Food cancer.
other countries were changed to include and Drug Administration (FDA) and Aline Betancourt, Tulane University
all women diagnosed under the age of is the only approved blood test to
GAP 4 & GAP 5
70. Implementing these changes should help determine whether an ovarian
save lives by identifying those at risk mass is malignant or benign prior to Targeting Tumor Vasculature to
more effectively than current strategies, surgery, facilitating surgical planning Eliminate Ovarian Cancer Cells
as well as by improving current and and identifying patients for referral to Supported research leading to a
experimental treatment regimes. a gynecologic oncologist. patent for an immunotherapy drug,
Gillian Mitchell and David Bowtell, Zhen Zhang, Johns Hopkins which is now in Phase I clinical trials.
Peter MacCullum Cancer Centre University This immunotherapy drug uses
antibodies to eliminate TEM1, a
GAP 3 & GAP 4 GAP 4 critical factor for tumor vasculature.
A Computational Approach to Using NSAIDs to Treat Ovarian Results from this clinical trial are
Diagnosing Precursor Lesions to Cancer forthcoming.
Ovarian Cancer Repurposed the use of non-steroidal George Coukos, University of
Supported a multi-institutional, multi- anti-inflammatory drugs (NSAIDs) to Pennsylvania
approach award to investigate early inhibit ovarian cancer cell adhesion
Recruit and retain outstanding scientists
for a lifetime career as ovarian cancer
researchers

The Ovarian Cancer Research Academy


Founded in FY09, the Ovarian Cancer Academy (OCA) is a unique and innovative virtual community that
provides outstanding early-career investigators (ECIs) with intensive mentoring, national networking,
a peer group, and a collaborative research environment. The goal is to develop successful, productive
scientists and foster in them a lifelong commitment to ovarian cancer research. To date, the 19 current
and former Academy ECIs in laboratories across the United States have produced 362 publications and
198 presentations, and have obtained nearly $23M in external ovarian cancer research grants.

John Liao
Mary Disis, mentor
University of Washington

Martina Bazarro
Amy Skubitz, mentor
University of Minnesota

Erinn Rankin
Jonathan Berek, mentor
Stanford University
Jeremy Chien
Andrew Godwin, mentor
University of Kansas

Anda Vlad
Robert Edwards, mentor
Magee-Womens Hospital

Wa Xian
Christopher Crum and
Nita Maihle, PhD Guilio Draetta, mentors
University of Texas Health
Georgia Regents University Science Center
OCA Dean, FY15–FY20
Douglas Levine, MD
Memorial Sloan Kettering Cancer Center
OCA Assistant Dean, FY15–FY20
Karen McLean
Panagiotis Konstantinopoulos
Ronald Buckanovich, mentor
Alan D’Andrea, mentor
University of Michigan
Dana-Farber Cancer Institute

Elizabeth Poole
Geeta Mehta Shelly Tworoger, mentor
Ronald Buckanovich, mentor Brigham and Women’s Hospital
University of Michigan David Pepin
Patricia Donahoe and
Kathryn Terry
Michael Birrer, mentors
Daniel Cramer, mentor
Massachusetts General Hospital
Brigham and Women’s Hospital

Dmitriy Zamarin
Carol Aghajanian, mentor
Anirban Mitra Memorial Sloan Kettering
Kenneth Nephew, mentor Cancer Center
Indiana University
Yang Yang-Hartwich
Gil Mor, mentor
Yale University
Juan Cubillos-Ruiz
Jose Conejo-Garcia, mentor Rugang Zhang
Cornell University Dario Altieri, mentor
Wistar Institute

Charles Landon Neil Johnson


Ronald Alvarez, mentor Jeff Boyd, mentor
University of Virginia Fox Chase Cancer Center
Providing Hope: Increasing Long-Term
Survivorship of Ovarian Cancer Patients
Patients diagnosed with ovarian cancer today face a difficult reality: with an overall
5-year survival rate of just 45%,¹ ovarian cancer is the deadliest gynecologic
cancer. Yet amid the uncertainty and apprehension of diagnosis, there is hope.
To improve the prognosis for those with ovarian cancer, the OCRP offered the
Outcomes Consortium Development Award in FY12 to lay the groundwork for
a new, multi-institutional research effort to identify and understand specific
predictors of disease outcomes in ovarian cancer patients. A subset of patients
diagnosed with ovarian cancer become long-term survivors (over 10 years survival
from their date of diagnosis); the consortium was aimed at building teams of
Malcolm Pike, Ph.D., Memorial talented researchers who would work to discover what differentiates these
Sloan-Kettering Cancer Center patients from the others. In FY15, the OCRP offered the Outcomes Consortium
Photo by permission of Dr. Malcom Pike.
Award as the second stage of this effort with the goal of advancing the consortia
from the development phase to the research phase. Two teams, one led by
Dr. Malcom Pike and the other by Dr. Michael Birrer, were chosen to receive the
FY15 Outcomes Consortium Award to support their efforts to identify predictors
of long-term survival and to enable physicians to tailor therapies to individual
patients to increase their survival and quality of life.
The Multidisciplinary Ovarian Cancer Outcomes Group (MOCOG), led by Dr. Pike at
Memorial Sloan Kettering Cancer Center, is working with patients with advanced-
stage, high-grade serous cancer, which accounts for over 80% of ovarian cancer
deaths. They will investigate the role of the patients’ immune response; their
genetics, especially those related to DNA repair; and epidemiological and lifestyle
Michael Birrer, M.D., Ph.D.,
Massachusetts General Hospital
factors that contribute to long-term survival. The MOCOG is a collaboration of 10
Photo by permission of Massachusetts international sites that will leverage samples, data, and techniques to search out
General Hospital. novel immune therapy approaches to ovarian cancer treatment and identify the
patients who would benefit from these targeted immune therapies.
The Ovarian Cancer Consortium for Long-Term Survival, led by Dr. Birrer at Massachusetts General Hospital, focuses
on finding predictive biomarkers that will aid in the design of individualized care for ovarian cancer patients. With
the majority of ovarian cancer patients succumbing to this progressively chemo-resistant disease, this international
consortium, comprised of nine sites, will work to determine the characteristics of long-term survivorship by
investigating both patients and their tumors. They will gather genomic, proteomic, and biologic data, as well as
environmental and quality of life data, to identify novel therapeutic targets and biomarkers for the early detection of
ovarian cancer and to develop and identify tailored therapies for those patients.
The highly focused studies and combined efforts of the world’s leading investigators in these consortia will have a
major impact on understanding the predictors of outcomes in ovarian cancer that will ultimately and significantly
accelerate progress toward long-term survivorship. Their efforts are integral to the OCRP’s mission to support
patient-centered research to prevent, detect, treat, and cure ovarian cancer. Research supported by the OCRP
continues to provide hope that one day all women diagnosed with ovarian cancer will become long-term survivors.

¹ American Cancer Society, 02/04/2016


DEFENSE HEALTH PROGRAM

Pathway of Discovery to a Cure Impact of the


Patents Created by OCRP Investigators DoD OCRP
Use of modified Herpes Simplex Virus – 2 (HSV) as a Compounds for targeting cancer stem cells The OCRP has produced many high-
cancer therapy This patent is for chemical compounds that can be used impact advances in the prevention,
HSV-2 with a fusogenic activity (FusOn-H2) as a cancer as therapeutic agents against cancer stem cells. The PI detection, diagnosis, and treatment of
therapy. The Principal Investigator (PI) has two National received an NIH Probe Development Award with funding to ovarian cancer, including:
Institutes of Health (NIH) grants totaling $3.5M to perform start June 2017. Ronald Buckanovich (61,730,832 patent
clinical trials on solid tumors. Xiaoliu Zhang (Patent No. pending) Prevention, Detection,
8,986,672) Cell lines for the continuous production of and Diagnosis
Enzyme-mediated tumor imaging and therapy alphavirus vectors • RAD51D Genetic Testing Kit
Prodrugs that can be used to detect solid tumors and then Sindbis viral vectors can be used to deliver cancer gene
deliver drugs directly within the tumor. The technology has therapy. This technology has been purchased by CYNVEC • mAGIC App to Encourage Genetic
been licensed to Sabik Medical, Inc. Amin Kassis (Patent and their first drug candidate, CYN-101, is designed to treat Counseling
No. 9,320,815) ovarian cancer. Daniel Meruelo (Patent No. 7,378,272) • OVA1™ Diagnostic Index Test
Vaccines against tumor vascular markers Use of Elafin to detect ovarian cancer • Genetic Testing Guidelines for
MORAb-004 has been part of three completed Phase 1 Detecting ovarian cancer using the Elafin polypeptide Ovarian Cancer
and two completed Phase 2 clinical trials. MORAb-004 as a biomarker. The Elafin polypeptide has been shown
is licensed by Morphotech, Inc., and is now called to correlate with poor outcomes in high-grade serous • A Computational Approach to
Ontuxizumab. George Coukos (Patent No. 9,290,556) ovarian cancer. Michael Seiden, Ronny Drapkin (Patent No. Diagnosing Precursor Lesions to
Ovarian Cancer
Detection of cancer by elevated levels of BCL-2 8,486,648)
Detection and monitoring of ovarian cancer by testing • Ovarian Cancer Risk-Reducing
elevated Bcl-2 levels in the urine. This technology was Surgery: A Decision-Making Resource
purchased by Ovation Diagnostics and is preparing for Treatment
clinical trials. Patricia Kruk (Patent No. 8,034,549)
• Using NSAIDs to Treat Ovarian Cancer
Clinical Development • Using Statins to Treat Ovarian Cancer
Salpingectomy to reduce ovarian cancer mortality Accelerated FDA approval for rucaparib and companion • Targeting Tumor Vasculature to
First federally funded study exploring the Fallopian tube diagnostic CDxBRCA
Eliminate Ovarian Cancer Cells
as a possible source of ovarian carcinoma, which led to Data from the PI’s Synergistic Translational Leverage
a paradigm shift in the understanding of ovarian cancer. Award was used to support accelerated FDA approval of • Using MSC1 Immunotherapy to
OC073389, Elizabeth Swisher rucaparib for women with ovarian cancer. OC120506, Create an Anti-Tumor Response
Recommendations on genetic testing and clinical Elizabeth Swisher • Using Viruses to Deliver Toxins to
stratification. Understanding non-BRCA hereditary risk in African- Treat Ovarian Cancer Tumors
2,000 patient study identifying the genetic underpinnings American women
New Research Tools
of ovarian cancer that led to the recommendation for The hereditary risk of BRCA1 and BRCA2 mutations in
genetic testing of women and the stratification of women African-American (AA) women isn’t fully known. This work • New Model to Study the Effect of
in clinical trials, based on their genetic profile. OC120312, will be used for improving access to care and genetic BRCA1 on Ovarian Cancer
Elizabeth Swisher testing of AA women. OC140243, Elizabeth Swisher • The Effect of Two Oncogenes
on the Development of Ovarian
Clinical Trials Leiomyosarcoma
Statins and improved survival JO-1 improves drug penetrance
Statins are shown to inhibit HMGCoA reductase and are The protein JO-1 can open the tight junctions that hold • Using Animal Proteins to Predict
being tested to determine whether the administration of cancer cells together, allowing chemotherapies to advance Ovarian Cancer Risk in Humans
statins in women can show anti-tumor effects. OC130622, further into the tumor. OC110283, Andre Lieber • The Ovarian Cancer Research
Kala Visvanathan mAGIC App to encourage genetic counselling Academy: Recruit and Retain
AIM & response prediction The overall study objective is to develop and assess the Outstanding Scientists
AIM (AZA Immune gene set) is a set of biomarkers used to feasibility and effectiveness of a theory-based intervention
predict and monitor epigenetic therapy in advanced ovarian aimed to encourage ovarian cancer survivors to receive
cancer. OC130454, Stephen Baylin genetic counseling. OC130444, Melissa Geller
Research on the Horizon
Combining PARP Inhibitors with Making Chemotherapy More Effective Chemotherapy-Induced Cognitive Screening Liquid-Based Pap Tests:
GLS1 Inhibitors to Treat Resistant and Less Toxic Impairment: A Novel Prospective Study A Paradigm Shift for Ovarian Cancer
Ovarian Cancer In a previous OCRP award, this “Chemobrain” is a side effect of Detection
The PARP inhibitor, olaparib, is FDA- investigator discovered the protein JO-1 chemotherapy experienced by some Early diagnosis is a key factor in ovarian
approved to treat platinum-resistant can open the tight junctions between ovarian cancer patients. It affects cancer survival. Most patients (60%) are
ovarian cancer in women with BRCA cancer cells, allowing chemotherapies memory, attention, information diagnosed in the deadly late stages.
mutations. The majority of ovarian to advance further into the tumor. processing, and thought organization. • Developing non-invasive screening
cancer patients do not have these • New award supports a Phase I trial to • This clinical trial is currently that can be readily incorporated into
mutations; for them, olaparib is combine JO with the chemotherapy enrolling ovarian cancer patients to a routine Pap test.
rarely effective. drug, Doxil, in platinum-resistant understand chemobrain. • Uses mass spectrometry to identify
• Clinical trial will test combining ovarian cancer patients. • The goal is to assist physicians in peptides and proteins associated
olaparib with another kind of drug, • Could make Doxil more effective by timely diagnosis and delivery of with early-stage ovarian cancer.
called an GLS1 inhibitor, in women increasing tumor cell exposure and treatment to alleviate symptoms. • Impact: Simultaneous screening
without BRCA mutation. less toxic by requiring fewer sessions • Impact: Brings an important for early-stage ovarian and cervical
• Scientists believe GLS1 inhibitors and/or lower dosage. survivorship and quality of life issue cancers would be a game-changer
will create conditions similar to BRCA • Impact: New approach meets the to the forefront of ovarian cancer for women’s health.
mutation, making the PARP inhibitors urgent need to address recurrence research. Amy Skubitz, University of Minnesota,
effective. and overcome resistance to present Rachel Miller, University of Kentucky Twin Cities
• Impact: New treatment strategy therapies.
could extend effective PARP inhibitor Andre Lieber, University of Washington A New Anti-Diabetes Drug as a Novel
therapy to a much larger population
Therapy for Epithelial Ovarian Cancer
of ovarian cancer patients.
Enhancing Immunotherapy with Sitagliptin, a drug that is commonly
Michael Birrer, Massachusetts Epigenomic Priming prescribed to treat Type II diabetes,
General Hospital
Ovarian cancer tumors evade detection targets a protein that has been shown
by the body’s natural immune system. A to be important in epithelial ovarian
New Imaging Biomarker to Predict better understanding how this happens cancer.
Benefit of PARP Inhibitors could unlock an entire new class of • A protein called DPP4 is involved in
PARP inhibitors can sometimes be much-needed therapies. throwing the cellular “off switch” that
an effective treatment for ovarian • Tests the hypothesis that tumors use shuts down the anti-tumor immune
cancer patients who do not have BRCA DNA methylation to hide from the response.
mutations, but it is very difficult to immune system. • Sitagliptin targets DPP4, and
identify which ones will benefit. • Combines drugs that block DNA researchers are testing its use in
• Investigates a new molecular imaging methylation with immunotherapy combination with chemotherapy to
biomarker to non-invasively measure agents, potentially making the treat ovarian cancer.
PARP levels inside ovarian cancer cancer cells more recognizable. • Impact: By repurposing an existing
cells. • Impact: Could unlock an entire new drug, this approach could rapidly
• Could be used to identify women class of much-needed therapies for advance a new treatment for women
whose tumors are likely to respond women with poor prognosis who are with epithelial ovarian cancer.
to PARPi therapy, so that women take experiencing relapse. Magdalena Plebanski, Monash
the drugs that are most likely to help. Daniela Matei, Northwestern University University, Australia
• Could allow providers to switch
women to alternative therapy months
sooner.
• Impact: Could form the basis for
image-guided chemotherapy.
Fiona Simpkins, University of
Pennsylvania

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