Ovarian and Endometrial Cancer

Group Leader: Dr Sudha Sundar

Overview

My research programme investigates clinical challenges in patients with gynaecological cancer combining secondary research/clinical trials/studies and translational research, particularly incorporating stratified medicine.

Our Research Group

Our research programme encompasses 3 overlapping themes of research interest.

Ovarian cancer
Around 6,500 women were diagnosed with ovarian cancer in the UK, making it the second most common gynaecological cancer. Mortality rates are poor, with only 42.9% surviving 5 years after diagnosis (CRUK statistics). One research stream focuses on risk stratification for ovarian cancer by incorporating new serum markers. The other focuses on improving therapy for ovarian cancer. I am currently investigating the use of Metformin, a well-tolerated anti-diabetic drug in serous ovarian cancer establishing clinical trials with survival and translational endpoints to identify biomarkers of response. Extensive surgical techniques have been shown to significantly improve survival in ovarian cancer. Ongoing studies evaluate the short term and long term outcomes, including quality of life from such surgery.

Endometrial cancer
Cancer of the uterus is the most common gynaecological cancer in the UK, with the lifetime risk of developing uterine cancer of 1 in 46 for women in the UK.  Poor prognostic histotypes of uterine cancer contribute to 10% of the incidence of endometrial cancer but up to 50% of mortality from endometrial cancer. My group showed, for the first time that the increase in incidence in endometrial cancer (up by 40% over the last decade) was confined to oestrogen driven low risk endometrial cancer, whereas mortality from Type 2 non oestrogen driven cancer had increased in that time (Evans et al, 2011). I am now exploring novel treatments for uterine serous cancer with collaborators. I am also currently establishing clinical trials in endometroid endometrial cancer survivors evaluating weight loss strategies.

Systematic reviews and diagnostic test evaluations
Another research strand focuses on the evaluation of diagnostic tests in gynaecological cancer in collaboration with teams of systematic reviewers and health economic experts. This work has received substantial funding from NIHR and will inform practice change by the NHS in implementation of these tests and referral pathways for gynaecological cancer.

Recent Publications

Sundar S et al. A systematic review evaluating the relationship between progression free survival and post progression survival in advanced ovarian cancer. Gynecol Oncol. 2012 125(2):493-9.

Voss MA et al. Should grade 3 endometrioid endometrial carcinoma be considered a type 2 cancer-a clinical and pathological evaluation. Gynecol Oncol. 2012
124(1):15-20
.

Jadoon BA et al. Analysis of outcome in women with borderline glandular change on cervical cytology. Eur J Obstet Gynecol Reprod Biol. 2009 Nov;147(1):83-5.