Trials and papersOvarian cancer

For someone offered the test, these are the numbers that describe what a result means in an NHS population: about 1 in 100 tests came back positive each year, between 46 and 58 in 100 positives were cancer, and a negative result left about 1 in 100 with an undetected cancer within the year. The test found between a quarter and a third of all cancers diagnosed in a screening round, and about half to two thirds of the 12 cancer types it was designed to find. Whether finding them this way reduces late-stage diagnoses is the primary question, and this paper says only that the answer was no; the primary-endpoint paper had not appeared on Europe PMC by 23 September 2026.

The study is a hypothesis-generating signal that justifies a prospective controlled trial. It does not establish that an RGCC assay improves survival or that its recommendations outperform standard oncology care.

For a patient with a gynaecological cancer, the specialists who would run such a trial say the evidence does not exist yet.

Capturing tumour vesicles by a surface marker before reading their RNA is feasible; it was tested for detection, not residual disease.

Proof of principle in three cancers from a small case-control set; it is not a screening result.

Women with newly diagnosed advanced ovarian cancer should have their tumour tested for BRCA mutations and homologous recombination deficiency, because those who are HRD-positive gain years of additional disease control and better survival from adding olaparib to bevacizumab maintenance. Those who are HRD-negative gain nothing from olaparib in this combination and should not be exposed to its toxicity and cost. HRD testing has become a routine part of ovarian cancer care as a result.

Every woman diagnosed with advanced high-grade ovarian cancer should be tested for BRCA mutations at diagnosis, because those who carry one should receive two years of olaparib after chemotherapy, which greatly extends the time in remission and improves long-term survival. The plateau in the survival curves suggests some patients are cured by this approach. Toxicity is mostly anaemia, fatigue and nausea, and the two-year limit appears sufficient.

Free medicines do not make cancer free. Lost earnings, travel and the costs the health service does not cover reach patients in a universal system too, and in this analysis they tracked with survival. The same Naples group went on to build PROFFIT, an Italian questionnaire for measuring financial toxicity, with AIRC funding.