Olaparib

AstraZeneca (AZ) has received marketing authorisation from the Medicines and Healthcare products Regulatory Agency (MHRA) for its Imfinzi (durvalumab) regimen in a subset of adults with resectable non-small cell lung cancer (NSCLC). The anti-PDL1 antibody is now approved in Great Britain for use alongside platinum-based chemotherapy as a neoadjuvant treatment before surgery and then as an adjuvant monotherapy after surgery. Patients eligible for the regimen will have resectable NSCLC and no known epidermal growth factor receptor mutations, ALK rearrangements or aberrations. The MHRA’s decision, which means that Imfinzi is now approved in Great Britain to treat both resectable and unresectable NSCLC, was supported by positive results from the late-stage AEGEAN trial. Patients treated with the Imfinzi regimen achieved a 32% reduction in the risk of recurrence, progression or death compared to neoadjuvant chemotherapy alone. The combination also demonstrated a pathologic complete response rate of 17.2% versus 4.3% for patients receiving neoadjuvant chemotherapy only. Lung cancer accounts for 21% of all cancer deaths in the UK and NSCLC accounts for up to 85% of all lung cancer diagnoses. David Harland, head of oncology medical affairs, AZ UK, said the latest approval “marks a major advancement and opens a new chapter in the treatment of resectable NSCLC”. Hardland added that the company is now “committed to working with the National Institute for Health and Care Excellence and NHS England to ensure rapid access for patients”. Sharing a similar sentiment, Dr John Conibear, clinical director of thoracic oncology at Barts Cancer Centre, said: “This decision by the MHRA recognises an important clinical improvement in outcomes for patients with resectable NSCLC, where new options are urgently needed for long-term survival.” The approval comes just over one week after Imfinzi and AZ’s PARP inhibitor Lynparza (olaparib) were recommended by the European Medicines Agency’s human medicines committee to treat certain endometrial cancer patients. The Committee for Medicinal Products for Human Use recommended Imfinzi plus chemotherapy as a first-line treatment, followed by Lynparza and Imfinzi, for use in patients with mismatch repair proficient primary advanced or recurrent endometrial cancer. Imfinzi plus chemotherapy, followed by Imfinzi alone, was also recommended to treat those with mismatch repair deficient disease

The initiative seeks to understand the crucial role of the omentum, a lesser-known yet vital organ in cancer treatment and overall health. From diagnosis to determination Meg's journey with ovarian cancer began in 2014, marked by vague symptoms like nausea and abdominal distension. “I looked like I was four months pregnant by night,” she recalls. Despite these signs, the absence of an early detection test for ovarian cancer delayed her diagnosis until her gynecologist identified a suspicious complex cyst. A subsequent CA 125 test confirmed elevated levels, leading to a surgical intervention by a gynecological oncologist, who discovered and removed the cancer. Meg added: “In 2014, I faced a stage two cancer diagnosis, and for eight years thereafter, I had no evidence of disease. It was a period of cautious optimism and recovery. However, in 2023, I experienced a recurrence, which led to another round of surgeries and chemotherapy. As I approach nearly a year since completing chemotherapy, I'm grateful that all my personal health indicators and statistics are currently positive. “Ovarian cancer is notoriously under-diagnosed because of its vague symptoms. The acronym B.E.A.T. helps: Bloating, Eating difficulties, Abdominal and back pain, and Toilet issues.” The omentum and digestive woes Post-surgery, Meg faced unexpected digestive issues, which she traced back to the removal of her omentum. The omentum, an apron-like fat organ, plays significant roles in the immune and lymphatic systems and fat storage. Its removal often results in severe digestive issues, especially when commercial foods high in salt are consumed. googletag.cmd.push(function () { googletag.display('text-ad1'); }); Meg’s personal experience with digestive distress, such as a six-inch abdominal distension after consuming a small amount of chili at a restaurant, highlighted the urgent need for more research on living without an omentum. “Quality of life was a real issue,” she emphasizes. Birth of the Omentum Project The Omentum Project ​was born out of Meg’s determination to address these challenges. The study focuses on salt’s impact on women with and without an omentum. “We’re seeking 200 women with an omentum and 200 without, who are randomly assigned to low-sodium or high-sodium groups,” Meg details. The study involves a one-time home experiment where participants consume a standardized amount of popcorn and water, with the high-sodium group adding a bouillon cube to their water. This citizen science initiative faced recruitment challenges due to strict eligibility criteria, such as excluding those with high blood pressure, heart disease, or obesity. Yet, the project aims to gather significant data to understand better the omentum’s role and its impact on digestive health. The omentum’s untapped potential The omentum’s potential extends beyond ovarian cancer. Meg highlights innovative uses in brain cancer treatment, lymphedema management, and Alzheimer’s research. At Lenox Hill Hospital, researchers are using the omentum to cross the blood-brain barrier with chemo in recurrent brain cancer cases. MD Anderson studies show success in resolving lymphedema by transplanting the omentum into affected areas, while the University of California at Davis explores its application in improving blood flow in Alzheimer’s patients. “Despite its critical functions, the omentum is largely overlooked in medical education and research,” Meg points out. Dr. de Nicola’s article ​ on the omentum as a powerful regenerative source underscores its importance and the need for heightened awareness. Empowering survivors with knowledge Meg stresses that the project does not advocate against removing the omentum for cancer treatment. Instead, it seeks to empower survivors with knowledge to manage life without this organ. “Just like we educate those without an appendix about their microbiome, we want to provide information for those without an omentum,” Meg says. “We aim to improve their quality of life by understanding how they might need to adjust their diet and lifestyle.” The Omentum Project represents a crucial step in recognizing and addressing the challenges faced by ovarian cancer survivors. By shedding light on this understudied organ, Meg hopes to pave the way for more research and support, ultimately improving the lives of many women worldwide. The unpredictable nature of cancer ​ She told OSP the journey has underscored the unpredictable nature of cancer and the importance of ongoing vigilance and treatment advancements. “One significant advancement in my journey has been the approval of new drugs like Olaparib for ovarian cancer, which has been pivotal for cases like mine where there's been recurrence. Knowing that such targeted therapies are available provides a sense of reassurance and hope, demonstrating the strides made in personalized medicine.” Meg says that living without an omentum, as a result of my surgeries, has brought its own set of challenges. The omentum, often overlooked, plays a crucial role in health, particularly in dietary considerations post-surgery. Learning about the impact of salt intake has been eye-opening. Many undergoing chemotherapy find comfort in foods that are often high in salt, like canned soups, not realizing the potential harm. Raising awareness about these nuances, Meg says, is crucial for empowering individuals to make informed choices during recovery. She said: “My involvement with the Omentum Project has been immensely fulfilling. Initially, finding information specific to living without an omentum was challenging. This gap inspired me to collaborate with dedicated volunteers and medical professionals to fill that void. Our efforts have already made a tangible difference, particularly in educating others about dietary adjustments post-omentectomy.” Looking ahead, Meg says her advocacy work aims to expand awareness and support for those navigating similar journeys. The support she received from the community—volunteers who dedicate their time, medical professionals who share their expertise, and fellow survivors who offer empathy—has been invaluable. “Together, we strive to improve outcomes and quality of life for individuals facing similar challenges, ensuring that no one feels alone in their battle against cancer,” she says. As Meg reflects on her experience, she says she’s reminded of the resilience of the human spirit and the power of community in overcoming adversity. “By sharing my story and contributing to initiatives like the Omentum Project, I hope to inspire others and contribute to a future where cancer treatments continue to advance, offering renewed hope and healing.”