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Ovarian cancer is usually diagnosed at advanced stages with poor survival and limited treatment options. When diagnosed in stage I, up to 90% of patients can be cured with cytoreductive surgery and chemotherapy. Presently, only 25% of ovarian cancers are detected in stage I due, in part, to the absence of specific symptoms and to lack of an effective screening strategy or early detection test. It has been thought that increasing the fraction of women with ovarian cancer detected at an early stage could improve survival and decrease disease mortality. Digital droplet PCR (ddPCR) will be used to detect specific DNA methylation changes that are present in ovarian cancer cells but not in the blood of women without cancer (Dr Kristina Warton and Prof Caroline Ford, UNSW). ddPCR is used for extremely low-target quantitation. However, ddPCR instruments are not usually available in diagnostic laboratories. Therefore, for this early detection test to be used as a diagnostic test, more readily available techniques such as quantitative PCR or next-generation sequencing will be developed.

Aims of Project

The aims of this project are to:

1. Develop a sensitive molecular test to detect ovarian cancer from blood samples
2. Validate the test using quantitative PCR and targeted bisulfite next-generation sequencing Blood will be collected from ovarian cancer patients and controls through the Sequential Blood Collection of the Hunter Cancer Biobank.

Ethics approval for sample collection has been obtained (HNEHREC Reference No: 2019/ETH00835). Cell-free DNA (cfDNA) will be extracted using established methods. Specific regions of dDNA methylation in cfDNA will be analysed by ddPCR, qPCR, and targeted bisulfite next-generation sequencing. The development of a sensitive and specific method to detect specific methylation changes in blood from women with ovarian cancer has to potential to be translated into a much-needed early detection test for ovarian cancer. This aligns with the NSW Regional Cancer Research Network objective of making appreciable improvements in health outcomes of patients, especially those in regional and rural NSW.

This project also increases the consumer involvement in translational health research, as the consumers have provided advice that an early detection test is urgently needed to improve ovarian cancer survival rate. The NSW Regional Cancer Research Network is funded by the Cancer Institute NSW through the Cancer Research Translation and Capacity (CRTC) Building program and established through NSW Regional Health Partners to build capacity in translational cancer research across the geographical area covered by the Central Coast, Hunter New England, Mid-North Coast and Northern NSW Local Health Districts. Over the next 4 years we will support and develop cancer research across these regions.

The Successful Applicant

The successful applicant will be required to:

• become a formal member of the NSW Regional Cancer Research Network
• publish regular updates on the project via the NSW Regional Cancer Research Network’s virtual collaboration platform
• provide a presentation of their project at NSW Regional Cancer Research Network and/or NSW Regional Health Partners’ events, when requested, to share their work or experience for the benefit of other members 
• provide a copy of the student’s annual PhD progress report to the NSW Regional Cancer Research Network
• notify the NSW Regional Cancer Research Network of any upcoming presentations they will make about their project prior to the presentation, to enable the NSW Regional Cancer Research Network the opportunity to promote and attend the event, if appropriate
• acknowledge the funding support by the Cancer Institute NSW, the NSW Regional Cancer Research Network and NSW Regional Health Partners and use the relevant logo(s) on all presentations