Professor Hani Gabra's Presentation - Professor of Medical Oncology - Imperial College - 25 September 2012

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I attended a lecture by Professor Hani Gabra at the Ovarian Cancer Action Research Centre in East Acton. I took notes for Gill (Midwife Gill) who wasn't able to attend but thought it would be helpful to put a résumé of the notes I took as I felt his message was full of hope.

Professor Gabra's research team is the largest in Europe. They work in eight centres across the UK including Glasgow, Edinburgh, Newcastle, Manchester, Cambridge, London, and Hammersmith. Their aim is to gain a better understanding of the molecular basis of Ovarian Cancer - why and how it happens, and then to improve options to provide more effective and targeted treatment.

He told us that in 3 - 4 years' time new treatments will become available. Trials with Avastin had turned out well for 2nd and 3rd line treatment. Dose-dense Taxol works in a similar way to Avastin and reduces the side-effects of joint pain and neuropathy associated with this chemotherapy.

He advised us to look up the Watson and Crick research papers.

Professor Gabri told us that ovarian cancer doesn't start in the ovaries but most starts in the Fallopian Tube. He posed the problem as to why women become platinum resistant. He believes that platinum resistant cancer cells are always there when we're first treated. When the cancer comes back the cells don't come from the primary cancer. Cancer resistant cells were present before the initial diagnosis and they are completely different from the primary cancer. He believes that platinum-based treatments are the most effective we have and if the medical experts could avoid women becoming platinum resistant they could be kept alive. I questioned whether this applied to Refractory Disease, which is where women are platinum resistant from the outset, and he said this is a completely different problem and one his research does not investigate.

The gene P53 (shown in the image above) is linked to all Ovarian Cancer mutation and its mutated form of protein is present in all high grade Ovarian Cancer. A company in Norway has produced a drug to tackle P53 and they wish to extend trials to the UK and other countries in order to get a wide sample group. It will be trialled on a sample of 15 women by Professor Gabra's team and the intention is to combine the drug with carbo-platin and gemcitibine. After the initial trial it will be extended to 2,000 patients. Anti-P53 therapy is a daily infusion. The research is so new at this stage that it has not yet been published. However, five patients with Leukaemia have been successfully treated with the drug.

Professor Gabri went on to explain other areas of research. Work continues on immunotherapy. This is research to improve the functioning of the immune system. In cancer some proteins are turned on and if a treatment could be discovered to tackle the malfunctioning protein the disease could be wiped out. This is leading-edge research which is the domaine of astrophysicists and it would take a year to 18 months to set up a trial.

There are laboratory trials with a protein called OPCML which is a cancer suppressor. In laboratory conditions artificially-created OPCML inserted into active cancer cells stopped the progression of tumours. This is currently being tested on mice which has been effective. There is hope that the trials will be extended to humans in the next few years. OPCML is absent in nearly 90% of Ovarian Cancer cells.

You can find out more about Professor Hani Gabra's research on the website Ovarian Cancer Action and you can also sign up to be a 'Voice'. It's an advocacy programme where you may be called upon to give a talk about Ovarian Cancer in your local area, or collect a cheque on behalf of Ovarian Cancer Research. I received the invitation to the lecture via this charity. When I do some volunteering for them I always make sure to take my BEAT cards and to mention the wonderful work that Ovacome do for us.

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Thankyou for attenting the lecture and for giving us such a clear informative summary. It is great to know that there is such hope for the future and makes you realize the importance of trying to keep going. You never know what help there is around. Sometimes it is accessing that information and having the courage to follow it through. Not always easy when faced with the 'experts', when you are feeling vulnerable. So many slip through the net.

Well done in your new role, you are doing a fantastic job and complementing the others in a similar role. I admire and am greatful to you all.

Love Suex

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Hi Annie,

A very interesting blog Annie thank you,I shall need to read it more in depth when my head is clearer or maybe read it through a few times for it to sink in...well done for your informative notes I don't know how you do it....love x G x

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I will certainly link up with this research, Annie - thanks for your report.

I am particularly heartened to see that mainstream research is finally taking the immune system and it's support seriously. It does seem to me to make so much sense (and I certainly put my own immune system at the centre of all I do to avoid recurrence), but it is often treated as slightly cranky and even threatening that simple immune support might be one of the keys to cure.

I have an Aussie friend staying at the moment who has had treatment for an aggressive breast cancer. It is surprising to me that, even in the excellent, (private in her case) health service in Aus, where cancer survival is so much better than in ours, no advice is given on immune support, or mental health, nor on diet and how these affect the immune system. I suspect this is because the health professionals would have to recognise their own poor practices in terms of lifestyle, work balance and diet!

Best wishes,

Isadora.

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Dear Isadora, I think you're absolutely right. Diet and exercise is essential for everyone - and I was astonished there was so little advice in my oncology unit. They rather poo-pooed the idea that you can do anything at all other than just wait until it comes back when they will zap it again.

Funnily enough someone said to me recently that I'm not a typical candidate for Ovarian Cancer. I'm short of stature (apparently this is relevant!), have had several pregnancies to reduce ovulation, I'm reasonably slim, eat well and wisely, I take regular exercise and I don't belong to one of the cultural groups with high instances of ovarian cancer. I was unlucky to get this cancer in that I only had one fallopian tube and one ovary. Putting all this together you could have a sympathy for the way oncologists think. I'd like to think it adds up to help me survive longer.

Professor Gabra explained the funding of his research is from the charity Ovarian Action, match-funded by private organisations and this increases the likelihood of Government funding. He explained the funding mix enables the research to be developed into clinical trials more promptly as the Government are aware of progress. This is good news.

The process is as follows: mechanistic research starting with the patients in his practice at the Hammersmith Hospital who donate their tumours for his research, translational development, pre-clinical, then clinical trials, leading to new treatments which are offered to the patients. This is our hope - that research, trials and new treatments will be fast-tracked. We need to keep ourselves as well as we can so we're ready when the times comes.

Apparently Ovarian Cancer Research sent a delegation to Downing Street a couple of years back. Professor Gabra says the government are currently interested in increasing screening - but having said that he said CA125 is useless as a diagnostic test.

What a shame there isn't more funding and focus within the GP practice to set up Lifestyle Counselling Services to avoid getting disease in the first place. My dad always talked about 'Dis-ease' saying that sickness and health were largely in the mind. He lived to the great age of 92.

xx Here's to our health and happiness. Annie

[Gina555]

Many thanks for sharing this

Gx

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"If a treatment could be found to tackle the malfunctioning protein the disease could be wiped out!" That is a sentence to make our hearts skip a beat and I hope they will find such a treatment- soon . It sounds like they have a number of hopeful avenues to explore. Thank you Annie for passing this on to us. It will be interesting to see how it all develops.

I have to say that weekly carbo/taxol didn't stop me getting neuropathy tho....

Monique x

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Yes, it was also heartening to listen to Gerard Evan's lecture. You can find this at:

scienceblog.cancerresearchu...

Gerard Evans said that his children, who are aged 21 and 22, will never have to worry about dying of cancer. That's an amazing thing to think about. Professor Gabra's discussion about advances in immunotherapy - and controlling proteins - is leading edge and experimental so that's probably some way off yet. xx

[MidwifeGill]

Thank you Annie for the very well written critic of the study session... Things are coming..... As OC becomes more public and awareness with it the research will follow... We just have to stay as informed and as healthy as possible to catch the rewards x always of course happy to help along the way x thanks again. dr Hana was at the members day and brought Us up to date with recent research, but think you had more... X

Ps am getting stronger.... Vowel obstruction cleared got to gradually reduce all the medication and increase chemo.... Have been funded for Alvastin

[Whippit]

Dear Gill, The best news I've had on this blog is hearing you're getting stronger and the bowel obstruction is clearing so you can increase the chemotherapy.

I'm delighted you've had funding for Avastin. Professor Gabra mentioned it was found to be very successful in some women for 2nd and 3rd line treatments. It sounds as though you're an ideal candidate. It's good, however, to hear his message that dose dense Taxol is also effective as I think many of us were disturbed to hear good things about Avastin but that it wasn't available to everyone. I'm reassured to have it all explained and I understand now when it can be used most effectively.

Did you listed to Professor Gerard Evans' paper? URL given above. That was also uplifting. Adding up Professor Gabra's belief that we can continue to live with cancer within 4 years and Professor Evans' belief that in 20 years' time cancer can be wiped out completely makes me feel as though we're making a contribution in our little way to that. This brings us all together with a real focus.

When you're feeling better, and up and about, perhaps a coffee somewhere to share ROCC ideas? I'm rather keen on the idea of using this blog to agree something that we can all do in our various parts of the UK and elsewhere to raise awareness of Ovarian Cancer and perhaps raise some funds. xxxx Annie

[iamstillme]

Hi Annie this is really great of you to provide us with this information and it is very inspiring.

Thank you so much and will look at the research

Love

Ally