The disease – which has a five-year survival rate of 35 percent – is rare, with approximately 1,200 women diagnosed in the Netherlands each year. Her gynecologic oncologist Jurgen Piek of the Catharina Hospital sees an average of two new patients every week. “That's because all the patients with this disease in the Brabant region are referred to the Catharina Hospital, since we have an oncology center here,” says Piek.

Flushing the abdominal cavity

Mabel underwent chemotherapy three times to shrink the tumors and metastases. She then had surgery to remove the remaining tumor tissue and to apply HIPEC. Piek: “During HIPEC surgery, the abdominal cavity is flushed with heated chemo for an hour and a half to target any remaining cancer cells.” This intensive surgery was followed by another three rounds of chemotherapy. “I was told during the bad new conversation that all of this takes about 30 weeks,” says Van Eck. Now – almost eleven months later – she is making a plan in consultation with the occupational health doctor to return to her workplace on floor 3 of Atlas.

Nanomedicines

The tumor in her abdomen suppresses the immune system, and even “hijacks” certain immune cells, causing tumor cells to multiply and possibly affect other organs. The team of TU/e professor of Precision Medicine Willem Mulder is developing nanomedicines that reprogram the immune system so that immune cells resume their normal functions and attack and dispose of tumor cells in a highly targeted manner. For now, Mabel is taking medication that affects her entire body. “But I feel fine, I’m still positive and I’m pushing forward.”

First of all, the medication development. Jurgen Piek and Willem Mulder met because the Catharina Hospital is setting up a study into the suppressed immune system in women with ovarian cancer in collaboration with the Mulder lab. In 2019, Mulder and colleagues from the Radboud University Nijmegen Medical Center founded a company focused on reprogramming the immune system for ovarian cancer. Independently, professor of Chemical Biology Luc Brunsveld’s group is developing anti-cancer molecules.

In terms of the efficiency of surgeries, there is also room for improvement. Piek is working with the Video Coding group in Electrical Engineering led by Peter de With and Fons van der Sommen to investigate whether it is possible to accurately predict – based on CT scan information from women with metastatic ovarian cancer – whether surgery is feasible and how invasive the procedure would be. It is not uncommon for the ovaries, uterus and all the cancerous tissue in the abdominal cavity to have to be removed.

Slow-release gel

And finally, drug delivery is being optimized. In December, the Dankers lab, led by Patricia Dankers, received nearly half a million euros from the Dutch Cancer Society (KWF) for research into peritoneal cancer, a disease that often develops due to metastases of ovarian tumors. The company UPyTher, a startup from the Dankers lab, is doing research on drug delivery in the abdominal cavity. They are developing a gel that functions as a depot, gradually releasing chemotherapy. This ensures that the tumors are exposed to the chemotherapy longer, making the treatment more effective. “The plan is to also start using this gel for women with ovarian cancer at the Catharina Hospital in the future,” says Piek.

That sounds like music to Mabel’s ears. “That slow-release gel would be a fantastic development. Because then the cancer could be treated in a targeted way. With chemo, that’s very difficult at the moment.” She emphasizes that if anyone from the TU/e community feels called to do something for ovarian cancer, they may contact her.