Researchers Work to Create Screening Tool for Early or Pre-cancerous OC

Researchers from Clemson University and doctors from South Carolina’s Prisma Health-Upstate are collaborating to develop a screening tool that can identify ovarian cancer in its earlier stages, or even before it arises.

Ovarian cancer is one of the deadliest for women. The best way to increase survival is to screen for it before patients develop symptoms and the cancer advances.

Current research indicates that the cervical mucus, a fluid secreted by the cervix, undergoes changes during the pre-cancerous stage. Thus, researchers hope to identify these changes and develop a tool that will be easy to use, similar to undergoing a pap smear.

“Of all the advanced-stage ovarian cancer patients, which make up about 75 percent of the cases, only 10-15 percent will survive,” Larry Puls, director of gynecologic oncology at Prisma Health Cancer Institute, said in a press release. “But if you can find it when it’s confined to just the ovary alone, 90 percent of patients beat their cancer. If we could shift women out of stage 3 and into stage 1, we can make a huge impact on this disease. We can even make a bigger impact if we could find a pre-cancerous change.”

At this point, there is no simple, reliable technique to screen for the presence of ovarian cancer, particularly in women who don’t show any symptoms. Furthermore, none of the tests used to find evidence of ovarian cancer works when the disease is in the pre-cancerous stage.

“People have looked at pelvic exams, blood tests and transvaginal ultrasonography as screening tools and none of it has worked as we would like,” Puls said. “To this day, there is no adequate screening protocol for ovarian cancer and that’s part of the reason why it’s such a lethal disease. We can’t find it early enough.”

Therefore, Puls, Terri Bruce, research assistant professor of bioengineering at Clemson, and Ken Marcus, professor of chemistry at Clemson, have been working together for over a year to create a screening tool.

They have combined their research expertise on cervical mucus, exosomes, and chromatography, and have found a way to determine pre-cancerous changes in the cervical mucus in a diagnostic setting.

Researchers think that most ovarian cancer cases are fallopian tube cancer. If true, this means that pre-cancerous changes could be identified using the cervical mucus, as it has a direct connection to the fallopian tube.

To identify changes in the composition of the mucus, researchers are looking at exosomes — small lipid droplets emitted by cells throughout the body. These are found in any fluid of the body, including mucus.

“Exosomes were once simply dismissed as a way of eliminating ‘trash’ from cells, but researchers now realize that they may be the key to the development of liquid biopsies,” Bruce said.

Exosomes contain important information about cell types, including any cancerous changes that may be occurring. Unfortunately, current methods of capturing exosomes are long, cumbersome, and inaccurate. Therefore, they cannot be used to make a simple diagnostic test.

Thus, researchers came up with a way to separate the exosomes from the cervical mucus using a method developed by Marcus that uses capillary-channeled polyester fibers and hydrophobic interaction chromatography. The process takes 8-10 minutes.

“We’ve been getting patient samples so we can really start looking at possible ways of isolating very specific exosomes to identify common marker proteins as well as mRNA messages to help identify early-stage ovarian cancer,” Bruce said. “The hope is to be able to come up with an early diagnostic test so that we can catch this deadly cancer much earlier and give women a fighting chance.”

The researchers are testing their screening tool through trials, which will continue for several months.