In January, Women & Infants Hospital awarded a $25,000 grant from the Constance A. Howes Women’s Health Innovation Research Fund to Jennifer Ribeiro for her study investigating how epithelial ovarian cancer tumors escape immune system elimination.
In December, Ribeiro, a researcher in the hospital’s women’s oncology program, presented her project, entitled “Identification of relevant immune regulators in epithelial ovarian cancer,” to a panel of scientific advisers and donors for the Constance A. Howes Fund.
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Providence Business News asked her about her research.
PBN: The title of your project hints at an immune response to epithelial ovarian cancer. What do you hope to learn from the research?
RIBEIRO: Our main goal with this project is to start to better define an immune signature specifically for epithelial ovarian cancer. While immunotherapies have been quite successful for other cancers, like melanoma, they have had less success in ovarian cancer. Through this research, we hope to begin to understand reasons for why this is, and identify potential promising immunotargets that are most relevant for ovarian cancer.
To do this, we have stratified our patient samples by progression-free survival – in other words, by how long after their treatment ended that their disease did not progress. We hope to identify immune-related factors and cell types that are associated with increasing the time until their disease progressed. Eventually, by identifying these factors and learning how they work to regulate immune response to ovarian cancer, we can hopefully modulate the immune microenvironment to be more favorable for the patient.
PBN: What is epithelial ovarian cancer?
RIBEIRO: There are several kinds of ovarian cancer that a woman can get, and of these, the most common type, is epithelial ovarian cancer. High-grade serous ovarian cancers represent the most common subtype of EOC, and are classified based on their appearance under the microscope. Interestingly, many ovarian cancers are actually derived from the fallopian tubes as opposed to the ovary itself. Regardless of the origin of the tumor, HGSC arise from tissue of the same developmental origin and share similar molecular characteristics, and so are treated in the same way.
PBN: Can you tell us about how common this type of cancer is and how tough it is to fight?
RIBEIRO: Ovarian cancer is considered an uncommon cancer, but is very deadly. Only 22,240 women were diagnosed with ovarian cancer in the U.S. last year, compared to approximately 266,120 new breast cancer diagnoses. However, the five-year survival for ovarian cancer is only 47.5 percent, meaning that only 47.5 percent of women will still be alive five years after being diagnosed.
Unfortunately, overall survival for ovarian cancer patients has not improved much for the past several decades. One of the unique aspects of this disease is that it is disseminated easily throughout the pelvis, which makes treatment more difficult.
Furthermore, because the signs and symptoms of ovarian cancer can often be overlooked, many patients are diagnosed after the cancer has already spread. The current frontline treatment for ovarian cancer is surgery and chemotherapy, which many women initially respond to quite well. However, once the disease recurs, it becomes resistant to therapy and difficult to treat. Because of these challenges, new approaches and novel therapies are needed to combat this deadly disease.
PBN: How long have you been studying this disease?
RIBEIRO: I began studying ovarian cancer as a graduate student in 2009. I continued my studies on ovarian cancer as a post-doctoral research fellow at Women & Infants Hospital in 2014, and am currently leading the research in the lab as an assistant professor/associate research scientist.
PBN: What are the possible next steps once you’re done with this study?
RIBEIRO: This study will serve as a pilot study looking at expression of immune receptors and immune cell types in 10 patients. Once we identify the most promising targets, we will be looking at these targets specifically in a larger cohort of patients so we can better elucidate correlations between these factors and patient outcomes.
There are many future directions we plan to take based off results from this study. For example, we plan to use single-cell RNA-sequencing to characterize immune cell populations in the solid tumor versus ascites – free-floating cells in the pelvic cavity that are responsible for the spread of the tumor.
As we gain a better understanding of relevant immune targets in EOC, we also hope to use in vitro models of ovarian cancer where we can test the efficacy of inhibiting or activating these targets.
Rob Borkowski is a PBN contributing writer.
