Tackling Ovarian Cancer by Studying It Outside the Body

Personalized or precision medicine uses information about a patient’s genetics to help diagnose and treat their cancer. An understanding of the oncogenic drivers and the immune microenvironment of a patient’s tumor helps physicians select therapies that can target specific types of cancer cells, such as HER2-positive breast cancer cells. But what about a disease like ovarian cancer, which lacks predictive tumor specific biomarkers?

Erin George, MD

Moffitt Cancer Center physician-scientist Erin George, MD, in the Department of Gynecologic Oncology is developing new ways to identify targeted therapeutics for ovarian cancer using microscopic 3D models of a patient’s tumor that she is growing outside the body.  

“We collect a patient tumor sample during surgery or a biopsy, and then create hundreds of smaller tumors by mincing this sample into submillimeter size fragments, which we call microtumors. We then grow these microtumors in a Darcy plate within a liquid like solid media that allows these tumors to expand and thrive for weeks,” she explained.

Darcy plates are a new type of cell culture tool that allows liquid media to flow without a pump and brings fresh nutrients to the cells, delivers drugs and removes waste products. Moffitt bioengineer Greg Sawyer, PhD, chair of the Department of Bioengineering, created these unique tools.

Greg Sawyer, PhD

“The Darcy plate allows us to grow numerous 3D microtumors and study the evolution and response of these patient tumors to different drugs and agents,” Sawyer said. “In this ovarian cancer study, we are studying these microtumors for weeks, and we can include the patient’s immune cells helping us study the potential to use immunotherapies against this cancer.”

This is the first 3D model in ovarian cancer that includes a patient’s immune cells in the tumor microenvironment.

George and Sawyer are presenting their work at the American Association for Cancer Research annual meeting in San Diego. They will share data from five ovarian cancer patients with very different tumor biologies, and they are steadily building a larger collection of tumors to study treatment options for ovarian cancer at different stages.

Imaging shows a 3D ovarian cancer tumor model.

“So far, we have collected samples from 27 patients. Ovarian cancer gets treated in many different ways. Even at initial diagnosis, some patients get chemotherapy first; others get surgery; we’ve collected tumors from patients who have had chemo and those who have not. We’ve also been able to grow tumors for patients who have recurrent cancer,” George said.

The next step for their research is to use this 3D microtumor platform as a drug screen, where they can test different targeted therapies for patients. George and Sawyer are now integrating Darcy plates with high powered microscopes to study the dynamics of how these tumors evolve and interact with the patients’ immune cells.

According to the National Cancer Institute, 1.1% of women will be diagnosed with ovarian cancer in their lifetime.  The five-year survival rate for ovarian cancer is about 50%, which is much lower than for other cancers that affect women. Ovarian cancer remains the most deadly gynecologic malignancy largely because it’s generally diagnosed at a late stage and has a high rate of recurrence.