Ovarian cancer is the sixth leading cause of death from cancer among women.

At first, chemotherapy works for 80% of women with this cancer. But within a couple of years, it comes back for most, and this time is resistant to treatment. Experts are still far from fully understanding why this happens, and how they can stop ovarian cancer from returning.

Dr Rachel Pounds, Academic Clinical Lecturer at the University of Birmingham, is aiming to change this.

What is high-grade serous ovarian cancer?

This form of the disease is a sub-type of epithelial ovarian cancer, which develops in the epithelial tissue that lines the ovaries and fallopian tubes.

This is the most common type of ovarian cancer.

More than 6 in every 10 cases of epithelial ovarian cancer are high-grade serous.

Visit our information page to learn more about what is ovarian cancer.

Understanding how and why treatment resistance occurs

Dr Pounds and her team studied tissue samples from women with high-grade serous ovarian cancer. This included fresh and frozen samples as well as cancer cells grown in the laboratory.

Using cutting-edge technology, researchers were able to compare cells before chemotherapy with those after chemotherapy in all three sample types.

This allowed them to explore what really happens when cancer becomes resistant to treatment and if certain changes to the cells could predispose women to developing treatment resistant cancer later.

The team analysed thousands of cancer cells and discovered that tumour recurrence and treatment resistance can be predicted at an early stage of initial treatment, including even before treatment has started.

Dr Pounds says:

“Ovarian cancer is a complex disease and we are still learning about the mechanisms by which it grows, spreads, recurs and becomes resistant to treatment. But it’s imperative that we learn about this to help the thousands of women diagnosed with this awful disease every year in the UK.

“My research, generously funded by Wellbeing of Women, adds to the body of evidence we need to begin developing treatments that tackle the issue of treatment resistance so that we can continue to give women hope.

“My team and I discovered that different types of cancer cells co-exist together within one tumour, all of which have different functions. Interestingly, some of these cells show signs of resistance to chemotherapy drugs even before they have been exposed to them. This suggests that some cells will never respond to chemotherapy and means it is more likely that the cancer will return.

“If a woman does receive chemotherapy, there is evidence that in any ovarian cancer tissue that remains, the cells change and some of them show clear signs of treatment resistance. Again, this suggests the disease will recur at some point and when it does, chemotherapy will no longer work."

What’s next?

Dr Pounds continues to investigate this issue and is analysing further samples and using other laboratory techniques to confirm her findings.

She intends to match her research findings to clinical outcomes to see if her results can potentially help reduce the number of tumours that recur, and delay the cancer from progressing or even increase overall survival.

Wellbeing of Women is funding several research projects to help improve treatment and care for women with gynaecological cancer.

Other studies focusing on ovarian cancer include:

• Professor Gordon Jayson’s work into predicting treatment response to bevacizumab (Avastin) in ovarian cancer
• Dr David Jeevan investigating a potential new test for a rare type of ovarian cancer
• Dr Samar Elorbany’s research to explore if our cells can be ‘re-educated’ to fight ovarian cancer
• The PARP-inhibitor Study (PAIRS) to investigate if resistance to PARP inhibitors can be overcome in advanced ovarian cancers. This is funded in partnership with Artios Pharma Limited.

Our health information on gynaecological cancers

As a women’s health charity, part of what we do is improve awareness and understanding of women's reproductive and gynaecological health.