Ovarian Cancer

卵巢癌是一种影响女性初级生殖器官的毁灭性疾病. At birth the ovaries are rendered as body tissue, until very sophisticatedly, 一旦雌性进入青春期，身体成熟, so do her ovaries.^1,2

尽管在治疗方面取得了进步，但卵巢癌是最常见的女性癌症之一³ 也是全球女性癌症死亡的第八大常见原因.⁴ The goals of front-line therapy have always been to delay progression of the disease for as long as possible and maintain the patient’s quality of life with the intent of achieving complete remission - yet currently ~70% of patients relapse within three years of initial treatment.^5,6,7,8

These statistics show there is still much to be done for women with ovarian cancer and that there needs to be a clear and accessible understanding of the latest scientific advancements and novel therapies. 在澳门在线赌城娱乐，澳门第一赌城在线娱乐将注意力集中在这一领域. Our aim is to help improve the outcomes of these patients and our ambition is to one day eliminate cancer as a cause of death.

要了解卵巢癌，澳门第一赌城在线娱乐必须首先了解卵巢的进化作用. One function only starts at puberty; the ovaries secrete reproductive hormones, 最常见的是雌激素和黄体酮, 驱动生殖周期，发展女性生理特征. When a female goes through menopause, usually in her 40s or 50s, 卵巢不再产生那么多的雌激素，不再每个月释放一个卵子^1,9,10 – the menstrual cycle stops.

The amount of hormone secreted therefore changes not only throughout the menstrual cycle but also across a lifespan. There is also disparity in ovarian cancer across the ages; although younger women can develop ovarian cancer, it usually affects women who have reached menopause⁵ 近80%的患者是50岁及以上的女性.⁵

快速诊断卵巢癌与提高生存率之间存在着令人放心的联系.^11,12,13,14 Cancer progresses through four stages of development, 从早期(1-2期)到晚期(3-4期)，一旦成为“晚期”, 它可能已经从卵巢扩散到身体的其他部位，并且更难以控制.^8-11

目前三分之二的妇女被诊断患有晚期疾病, when the cancer has already spread beyond ovaries, making it harder to treat, and greatly reducing survival. 尽管快速诊断和生存率之间存在明显的相关性, most ovarian cancers are diagnosed at a late stage^15,16,17 – but why?

Part of the complexity comes from recognising early symptoms so that the cancer can be diagnosed at an early stage. Symptoms are non-specific, meaning they can often go unnoticed or may be misdiagnosed for another illness until the cancer is advanced.^17,20  重要的是要记住四种最常见的症状, listed here, may also not indicate the presence of cancer.

Another reason is that unlike other cancers, 目前尚无可靠有效的卵巢癌筛查方法,^2,18 further delaying the ability to diagnose it. It is known that certain lifestyle¹⁹ 医学因素确实表明，患卵巢癌的风险增加了，这与年龄无关, such as a lack of parity, endometriosis or a family history of ovarian, breast, or colorectal cancer.^3,15,20  除了身体特征和生活方式因素, 女性的基因构成也会影响她患卵巢癌的风险。

Every cell in the body suffers from DNA damage and undergoes a repair process in order to function normally.²¹ The Homologous Recombination Repair (HRR)途径只是产生蛋白质的遗传途径之一, such as BRCA1/2, among others, 通过双链断裂进行修复过程. PARPs (poly(ADP-Ribose) Polymerases) are an example of a family of enzymes vital to another genetic pathway, to repair single-stranded DNA breaks.^21,22 This DNA damage response (DDR) shines a light on the connection between gene mutation and ovarian cancer.

HRD stands for Homologous Recombination Deficiency, a lack of functional components in one or more of the DNA repair pathways and a common trait of cancer cells, which have a high genetic mutation rate. One example is BRCA. 男性和女性都有BRCA1和BRCA2蛋白, when functioning normally, act as tumour suppressors.²³ Their role within the HRR pathway is to repair cell damage and prevent them from growing and dividing too quickly – mutated BRCA genes result in abnormal cells which grow uncontrollably²⁴ and are just one of many HRDs.

你可以找到更多关于DDR、HRD和其他相关分子的信息 here.

Genetic testing allows both clinicians and patients to make an informed decision when it comes to the treatment they receive. Conducting testing prior to or at the point of diagnosis can be important in improving patient care and enabling access to certain targeted therapies.²⁵ By understanding the heritability of a woman’s cancer (if the mutation she possesses can be inherited) a patient’s family can also understand their risk of developing the disease – understanding the full picture has important implications for cancer risk assessment and prevention among relatives.²⁶

了解基因突变和癌症发展之间的联系是一回事, 另一个目标是利用科学和针对遗传脆弱性，以优化治疗. Targeted therapy for advanced ovarian cancer hinges on understanding the repair pathways and exploiting HRD by targeting PARPs. By inhibiting PARPs, the cells cannot repair single-stranded DNA breaks through its normal way and must rely on other pathways (such as HRR) to do so. Because cancer cells have HRD there are already fewer functional pathways; for BRCA mutations, there are fewer HRR pathways. 这意味着细胞损伤超出了修复的范围，导致细胞死亡. Thus, the growth of abnormal cells is prevented.²¹

Our understanding of how to exploit HRD is evolving. We will continue our research in this pathway to further our understanding of how treatment options and combinations can potentially help achieve the best possible outcome.

Treatment falls into active and maintenance therapy. Active treatment includes surgery, 化疗、放疗和维持治疗通常在一轮积极治疗后进行. When a woman with ovarian cancer is in remission, 她可能没有接受任何治疗或以其他方式接受维持治疗来控制癌症.^27,28 Age may influence such treatment options.²⁹

As leading pioneers, AstraZeneca has a portfolio of approved and potential treatment for advanced ovarian cancer including in newly diagnosed patients. Through our research, we have made progress in increasing the time that women can live without disease progression and improving quality of life. Our approach is based on using ground-breaking science to further our understanding of targeted therapy within ovarian cancer, focusing on patients with HRD and transferring our learnings to the wider patient population and paving the way to achieve the best possible outcomes for progression-free and overall survival.

尽管在了解疾病和新疗法方面取得了进展, 要揭露卵巢癌的威胁，帮助挽救更多的生命，还有很长的路要走. Improvements in earlier diagnosis and accelerated access to the best available diagnostic testing and medicines are achievable goals which could help save countless lives.

As a founding member of the Ovarian Cancer Commitment (OCC), together with our partners European Society of Gynaecological Oncology (ESGO) and the European network of Gynaecological Cancer Advocacy Groups (ENGAGe) we have a bold ambition to improve the experience and survival of people living with ovarian cancer.

Our aim is to facilitate earlier interventions -包括强调获得快速诊断的重要性, genetic and biomarker testing and specialised care – and empower healthcare teams 因为他们为患有这种疾病的人提供持续的管理和支持.

The OCC provides a platform for partners to pledge their commitment and implement tangible actions. 随着计划的发展，澳门第一赌城在线娱乐的目标是增加伙伴组织的成员, 反映和解决全球在卵巢癌患者护理方面仍然存在的差距.

References

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