Ovarian cancer national alliance

WASHINGTON -- The synthetic retinoid fenretinide (4-HPR), an analogue of vitamin A, may hold promise as a chemoprevention agent for ovarian cancer patients, Mary Daly, M.D., said at the annual meeting of the Ovarian Cancer National Alliance.

"This drug has many, many positive effects that have been touted. Some may have been over-touted. It is known to be an important agent in cell differentiation and inhibiting growth factors," said Dr. Daly of Fox Chase Cancer Center, Philadelphia.

She referred to a small study done by researchers at the Cancer Family Clinic of the Istituto Nazionale per lo Studio e la Cura dei Tumori in Milan (Gynecol Oncol. 2002;86:24-7). Investigators conducted a 5-year randomized clinical trial on the effect of fenretinide on the prevention of second breast cancer.

"They found no effect on breast cancer but they found a marked effect on decreasing rates of ovarian cancer," she said.

Dr. Daly and her colleagues hypothesize that the histologic differences seen in women at increased risk of ovarian cancer due to a genetic predisposition, compared with women without this heightened risk, may actually represent precursor lesions to cancer development. She and her associates have planned a study to examine the possibility that fenretinide may have a modifying effect on these lesions.

The researchers are enrolling women who plan to have a prophylactic oophorectomy.

The women are being randomized to one of two groups: One group will take fenretinide for 6-8 weeks and then have the surgery; the second group will have surgery immediately, without taking the drug.

"We're looking at the tissues to see an effect of the 4-HPR on the ovarian cells. We're looking for apoptosis. We're looking for occult new cancers. We're looking for a variety of changes in the cells," she said.

The study is being sponsored by the Gynecologic Oncology Group.

BY DEEANNA FRANKLIN

Senior Writer