Researchers Find Connection Between Nutrition and Ovarian Cancer Treatment Resistance

Scientists have long been studying ovarian cancer and potential therapies. This includes understanding how the tumor is able to survive despite our best efforts. It's not really known why some tumors are more aggressive and robust, and researchers are working hard to decipher the complicated relationships between drug resistance, inflammation, and cancer. 

According to past research, immunologic status and nutrition can be associated with survival and prognosis of cancer. To assess the immune and nutritional status of the person several laboratory tests can be used.  For example the C reactive protein will be high when the body is going through some autoimmune process or is fighting off infection or cancer. A commonly used marker is albumin since this test is simple and when someone has poor nutrition its level falls.

There has been intense interest in the varying levels of albumin and C reactive protein as a prognostic marker for cancer. From the patient’s blood they can be easily collected and the test is inexpensive and rapid. Thus without putting the patients in much danger we can gain a lot of information. To evaluate patients the scientists use nutritional and inflammatory markers through the prognostic nutritional index and modified Glasgow prognostic score.  Several scales and scoring systems have been developed to assess these markers.

One such marker that incorporates the ratio of different WBC and the ratio of C reactive protein o albumin level is the prognostic nutritional index. Another scale that incorporates the factors related to albumin and C reactive protein is the modified Glasgow prognostic score. With the prognosis and survival of many different cancers this scale has been correlated and it is simple and efficient too. Scientists wondered whether for the prognosis of ovarian cancer, prognostic nutritional index can be helpful. A research analysis was performed on this.

Data was collected from 237 women. These women with ovarian cancer between 2007 and 2015 underwent standard surgery and platinum based therapies. For clinical assessment these women were clinically followed up every few months for serum levels of CA-125. After the information was collected prognostic nutritional score and Glasgow prognostic score was calculated. Despite platinum based chemotherapy, within 6 months of completing the standard treatment if they exhibited disease progression then such patients were identified with chemoresistant tumors.

Any other correlations that existed, resistance to platinum based therapy and survival rate was also analyzed. It was found that 53 percent out of 237 patients were platinum sensitive and platinum resistant tumors were 44.7 percent. The optimal cut off of prognostic nutritional index was 47.2 points and based on this cut off patients were divided into two groups. Patients had poor nutrition, residual tumor mass, advanced tumor stage, high levels of CA-125 biomarker was high and were platinum resistance if their score was below 47.2 points.

It was observed that nutritional index and survival was associated with each other. Shorter disease-free survival was in those with lower scores. However only in patients that had platinum sensitive tumors this trend was observed. An independent risk factor that can help predict the overall survival and progression free survival turns out to be the prognostic nutritional index.

To monitor disease progression our current best biomarker test that is much powerful in predicting the platinum resistance and mortality is prognostic nutritional index. Here the only exception is those in stage 3 of the disease.  This study has showed that the outcome of the disease can be predicted by nutritional assessment. Compared to CA-125, the prognostic nutritional index has fared well. To assess ovarian cancer this is the biomarker currently used.