AbstractIntroduction: Ovarian cancer is a diverse disease with a poor survival rate and complex treatments that have potential significant morbidity. The role of angiogenesis in ovarian cancer progression is well recognised and research into angiogenic inhibitors is novel and exciting. Skin capillary density (SCD) is a dynamic marker that may provide a surrogate indicator of angiogenic activity and alter in response to treatment in cancer patients.
Methods: I conducted a longitudinal prospective cohort study to investigate skin capillary density in ovarian cancer. I recruited 50 women with high grade serous carcinoma and measured SCD and angiogenic markers at five time points during treatment. Longitudinal and survival analysis was conducted to ascertain changes in the variables during treatment and association with cancer outcomes including surgical resection, overall survival (OS) and progression free survival (PFS).
Results: Capillary rarefaction occurred in all patients during cytotoxic treatment. Rarefaction also occurred in the subgroup who received anti angiogenic inhibitors and was correlated with a rise in blood pressure. Baseline SCD was strongly associated with the outcome of debulking surgery.
Conclusion: In this thesis I have demonstrated a dynamic change in SCD during cytotoxic and anti angiogenic treatment in women with ovarian cancer. Although this data requires validation in larger studies, it can be postulated that SCD could be useful as a biomarker of response to treatment and cancer outcomes and act as a surrogate marker of angiogenesis in cancer. It is a reproducible, cheap and non-invasive investigation that is acceptable to patients and shows promise in helping to guide treatment and prognostic information in the era of personalised medicine.
|Date of Award||23 Mar 2021|
|Supervisor||Harry H Mellor (Supervisor) & Claire L Newton (Supervisor)|