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Barnard ME, Meeks H, Jarboe EA, Albro J, Camp NJ, Doherty JA. Familial risk of epithelial ovarian cancer after accounting for gynaecological surgery: a population-based study. J Med Genet 2023; 60:119-127. [PMID: 35534206 PMCID: PMC9643667 DOI: 10.1136/jmedgenet-2021-108402] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/14/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Uptake of risk-reducing surgery has increased among women at high risk of epithelial ovarian cancer. We sought to characterise familial risk of epithelial ovarian cancer histotypes in a population-based study after accounting for gynaecological surgeries, including bilateral oophorectomy. METHODS We compared risk of epithelial ovarian cancer in relatives of 3536 epithelial ovarian cancer cases diagnosed in 1966-2016 and relatives of 35 326 matched controls. We used Cox competing risk models, incorporating bilateral oophorectomy as a competing risk, to estimate the relative risk of ovarian cancer in first-degree (FDR), second-degree (SDR) and third-degree (TDR) relatives from 1966 to 2016. We also estimated relative risks in time periods before (1966-1994, 1995-2004) and after (2005-2016) formal recommendations were made for prophylactic oophorectomy among women with pathogenic variants in BRCA1/2. RESULTS The relative risks of epithelial ovarian cancer in FDRs, SDRs and TDRs of cases versus controls were 1.68 (95% CI 1.39 to 2.04), 1.51 (95% CI 1.30 to 1.75) and 1.34 (95% CI 1.20 to 1.48), respectively. Relative risks were greatest for high-grade serous, mucinous and 'other epithelial' histotypes. Relative risks were attenuated for case FDRs, but not for SDRs or TDRs, from 2005 onwards, consistent with the timing of recommendations for prophylactic surgery. CONCLUSION Familial risk of epithelial ovarian cancer extends to TDRs, especially for high-grade serous and mucinous histotypes. Distant relatives share genes but minimal environment, highlighting the importance of germline inherited genetics in ovarian cancer aetiology. Increased ovarian cancer risk in distant relatives has implications for counselling and recommendations for prophylactic surgeries that, from our data, appear only to reach FDRs.
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Affiliation(s)
- Mollie E Barnard
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA .,Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Huong Meeks
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Elke A Jarboe
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA,Departments of Pathology and Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
| | - James Albro
- Intermountain Biorepository, Intermountain Healthcare, Salt Lake City, Utah, USA,Department of Pathology, Intermountain Medical Center, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Nicola J Camp
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA,Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Jennifer A Doherty
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA,Departments of Population Health Sciences and Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
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Zheng Q, Ying Q, Ren Z, Zhang Q, Lu D, Wang H, Wei W. First-degree family history of prostate cancer is associated the risk of breast cancer and ovarian cancer. Medicine (Baltimore) 2021; 100:e23816. [PMID: 33530178 PMCID: PMC10545021 DOI: 10.1097/md.0000000000023816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 10/26/2020] [Accepted: 11/19/2020] [Indexed: 02/05/2023] Open
Abstract
ABSTRACT The evidence for associations between family history of prostate cancer and the risk of breast cancer and ovarian cancer is inconclusive. The first systematic review and meta-analysis of studies was conducted to assess the risk of breast cancer and ovarian cancer associated with a family history of prostate cancer.A literature search was conducted using MEDLINE, Embase and Web of science databases up to January 31, 2019. Data were screened and extracted independently by 2 reviewers. The pooled risk ratio (RR) and its 95% confidence interval (CI) were calculated using random-effects models. The GRADE approach was used to assess the quality of evidence.Nine observational studies including 8,011,625 individuals were included in the meta-analysis. The meta-analysis showed that family history of prostate cancer in first-degree relatives was associated with an increased risk of breast cancer (RR 1.12, 95%CI 1.09 to 1.14) with moderate quality evidence, subgroup analysis showed consistent results. Compared with no family history of prostate cancer, history of prostate cancer in first-degree relatives was associated with a slight risk of ovarian cancer (1.10, 95%CI 1.01 to 1.20) with moderate quality evidence. Family history of prostate cancer among sibling was associated with a 17% increased risk of ovarian cancer (95% CI 1.03 to 1.34), however, no significant association was found between family history of prostate cancer among parent and risk of ovarian cancer (RR 1.19, 95% CI 0.84 to 1.70).This review demonstrates that women with a family history of prostate cancer in first-degree relatives was associated with an increased risk of breast cancer and ovarian cancer. These findings may aid in screening, earlier detection and treatment of women with a family history of prostate cancer in first-degree relatives.
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Affiliation(s)
- QiongFei Zheng
- Department of Rehabilitation, Qianjiang Central Hospital of, Chongqing, Qianjiang
| | - Qinli Ying
- Department of Rehabilitation, Qianjiang Central Hospital of, Chongqing, Qianjiang
| | - ZhengJu Ren
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University
| | - Qin Zhang
- Department of Radiology, Chongqing Traditional Chinese Medicine Hospital, Chongqing
| | - DongLiang Lu
- Department of Urology, Shenzhen Hospital of Southern Medical University, Shenzhen
| | - HongBai Wang
- Department of Rehabilitation, Qianjiang Central Hospital of, Chongqing, Qianjiang
| | - WuRan Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Zhang X, Sheng Y, Li B, Wang Q, Liu X, Han J. Ovarian cancer derived PKR1 positive exosomes promote angiogenesis by promoting migration and tube formation in vitro. Cell Biochem Funct 2020; 39:308-316. [PMID: 32876972 DOI: 10.1002/cbf.3583] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/16/2020] [Accepted: 08/01/2020] [Indexed: 12/15/2022]
Abstract
Cancer cell derived exosomes play important roles in cancer progression and modulation of the tumour microenvironment. This study aims to investigate the role of prokineticin receptor 1 (PKR1) positive exosomes on angiogenesis. In the present study, PKR1 expression in tumour samples from ovarian cancer patients were examined firstly. Then, two ovarian cancer cell lines, namely A2780 and HO-8910 cells, were used to isolate and obtain the PKR1 positive exosomes from the serum free medium. The function analysis of PKR1 positive exosomes on angiogenesis was conducted by cell proliferation and migration assay, tube formation analysis, and tumour volume assay. The results showed that PKR1 expression was down regulated in tumour samples of ovarian cancer patients compared with adjacent normal tissues. The intracellular expression of PKR1 could be detected in A2780 and HO-8910 cells. And, the isolated exosomes from the serum free medium were confirmed by transmission electron microscopic and NTA analysis, as well as the co-presence of PKR1 with exosome marker CD63. The function analysis of PKR1 positive exosomes on angiogenesis demonstrated the uptake of PKR1 positive exosomes by human umbilical vein endothelial cells through immunofluorescence staining. The angiogenesis assays in vitro indicated that PKR1 positive exosomes promoted migration and tube formation of HUVECs but not proliferation. The endogenous PKR1 was also verified to help to enhance migration and promote tube formation of vascular endothelial cells, which might involved in the phosphorylation of STAT3. Additionally, The tumour volume from exosomes treated A2780 tumour-bearing mice was significantly increased compared with the control group, accompanied with the induced PKR1 expression and phosphorylation of STAT3 level. SIGNIFICANCE OF THE STUDY: This study proved the important role of PKR1 positive exosomes released from ovarian cancer cells on promoting angiogenesis. The data indicated that PKR1 derived from ovarian cancer cells could act as an important tumour associated antigen and biomolecular factor for cellular communication in tumour microenvironment.
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Affiliation(s)
- XiaoYan Zhang
- Laboratory of Microvascular Biopathology, Institute of Microcirculation, Chinese Academy of Sciences, Peking Union Medical College, Beijing, China
| | - YouMing Sheng
- Microhemodynamics Laboratory, Institute of Microcirculation, Chinese Academy of Sciences, Peking Union Medical College, Beijing, China
| | - BingWei Li
- Laboratory of Microvascular Biopathology, Institute of Microcirculation, Chinese Academy of Sciences, Peking Union Medical College, Beijing, China
| | - Qin Wang
- Microhemodynamics Laboratory, Institute of Microcirculation, Chinese Academy of Sciences, Peking Union Medical College, Beijing, China
| | - XueTing Liu
- Laboratory of Microvascular Biopathology, Institute of Microcirculation, Chinese Academy of Sciences, Peking Union Medical College, Beijing, China
| | - JianQun Han
- Microhemodynamics Laboratory, Institute of Microcirculation, Chinese Academy of Sciences, Peking Union Medical College, Beijing, China
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Dragani TA. Difficulties in establishing a causal link between chemical exposures and cancer cannot be overcome by court assessments. Hum Exp Toxicol 2020; 39:1095-1107. [PMID: 32153198 DOI: 10.1177/0960327120911426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Scientific data are often used in lawsuits to prove, or dismiss, causation by a claimed factor of a claimed disease. Recent media reports of million-dollar compensations awarded to some cancer patients who had been exposed to certain chemical substances motivated me to examine how solid the causal links really were. Here, I discuss the limitations of epidemiological research on cancer causation and highlight how new knowledge of cancer genetics makes it unrealistic to expect that cancer causation can be clearly demonstrated. I then present two exposure-cancer cases, namely talcum powder-ovarian cancer and glyphosate-non-Hodgkin lymphoma, that led to civil lawsuits decided, in the United States, in favor of the claimants. Both these cancers have several risk factors, among which the claimed exposure presents only a minor, if any, increased risk. Through these cases, I explain why the use of epidemiological data is inappropriate to define causal associations in complex diseases like cancer. I close by suggesting a fairer approach, called proportional liability, to resolving future cancer litigation cases.
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Affiliation(s)
- T A Dragani
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Kwon JS, Tinker AV, Hanley GE, Pansegrau G, Sun S, Carey MS, Schrader I. BRCA mutation testing for first-degree relatives of women with high-grade serous ovarian cancer. Gynecol Oncol 2019; 152:459-464. [DOI: 10.1016/j.ygyno.2018.10.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/25/2018] [Accepted: 10/15/2018] [Indexed: 12/20/2022]
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Zheng G, Yu H, Kanerva A, Försti A, Sundquist K, Hemminki K. Familial risks of ovarian cancer by age at diagnosis, proband type and histology. PLoS One 2018; 13:e0205000. [PMID: 30281663 PMCID: PMC6169923 DOI: 10.1371/journal.pone.0205000] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 09/18/2018] [Indexed: 01/15/2023] Open
Abstract
Ovarian cancer is a heterogeneous disease. Data regarding familial risks for specific proband, age at diagnosis and histology are limited. Such data can assist genetic counseling and help elucidate etiologic differences among various histologic types of ovarian malignancies. By using the Swedish Family-Cancer Database, we calculated relative risks (RRs) for detailed family histories using a two-way comparison, which implied e.g. estimation of RRs for overall ovarian cancer when family history was histology-specific ovarian cancer, and conversely, RRs for histology-specific ovarian cancer when family history was overall ovarian cancer. In families of only mother, only sisters or both mother and sisters diagnosed with ovarian cancer, cancer risks for ovary were 2.40, 2.59 and 10.40, respectively; and were higher for cases diagnosed before the age of 50 years. All histological types showed a familial risk in two-way analyses, except mucinous and sex cord-stromal tumors. RRs for concordant histology were found for serous (2.47), endometrioid (3.59) and mucinous ovarian cancers (6.91). Concordant familial risks were highest for mucinous cancer; for others, some discordant associations, such as endometrioid-undifferentiated (9.27) and serous-undifferentiated (4.80), showed the highest RRs. Familial risks are high for early-onset patients and for those with multiple affected relatives. Sharing of different histological types of ovarian cancer is likely an indication of the complexity of the underlying mechanisms.
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Affiliation(s)
- Guoqiao Zheng
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- * E-mail:
| | - Hongyao Yu
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anna Kanerva
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
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Zheng G, Yu H, Kanerva A, Försti A, Sundquist K, Hemminki K. Familial Ovarian Cancer Clusters with Other Cancers. Sci Rep 2018; 8:11561. [PMID: 30069056 PMCID: PMC6070489 DOI: 10.1038/s41598-018-29888-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/12/2018] [Indexed: 12/20/2022] Open
Abstract
Familial risk of ovarian cancer is well-established but whether ovarian cancer clusters with other cancers and the clusters differ by histology remains uncertain. Using data from the Swedish Family-Cancer Database, we explored familial associations of ovarian cancer with other cancers with a novel approach; relative risk for (histology-specific) ovarian cancer was estimated in families with patients affected by other cancers, and conversely, risks for other cancers in families with (histology-specific) ovarian cancer patients. Eight discordant cancers were associated with ovarian cancer risk, of which family history of breast cancer showed a dose-response (P-trend <0.0001). Conversely, risks of eight types of cancer increased in families with ovarian cancer patients, and dose-responses were shown for risks of liver (P-trend = 0.0083) and breast cancers (P-trend <0.0001) and cancer of unknown primary (P-trend = 0.0157). Some cancers were only associated with histology-specific ovarian cancers, e.g. endometrial cancer was only associated with endometrioid type but with highest significance. Novel associations with virus-linked cancers of the nose and male and female genitals were found. The results suggest that ovarian cancer shares susceptibility with a number of other cancers. This might alert genetic counselors and challenge approaches for gene and gene-environment identification.
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Affiliation(s)
- Guoqiao Zheng
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. .,Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
| | - Hongyao Yu
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Anna Kanerva
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA.,Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Izumo, Japan
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden
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Ukawa S, Tamakoshi A, Mori M, Ikehara S, Shirakawa T, Yatsuya H, Iso H. Association between average daily television viewing time and the incidence of ovarian cancer: findings from the Japan Collaborative Cohort Study. Cancer Causes Control 2018; 29:213-219. [PMID: 29340890 DOI: 10.1007/s10552-018-1001-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/06/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE Seventy-five percent of epidemiological studies have reported that sedentary behavior is associated with ovarian cancer incidence. Although Japan has one of the most sedentary populations, with median sitting times of 7 h/day, this association has not been investigated. This study aimed to elucidate the association between average daily television (TV) viewing time, which is a major sedentary behavior, and the incidence of ovarian cancer in a large-scale nationwide cohort study in Japan. METHODS A total of 34,758 female participants aged 40-79 years without a history of cancer at baseline were included in the study. The inverse probability weighted competing risk model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for the incidence of ovarian cancer. RESULTS During a median follow-up of 19.4 years, 59 participants developed ovarian cancer (ICD-10: C56), 2,706 participants developed other types of cancer, and 4,318 participants died. Participants who watched TV for ≥ 5 h/day were more likely to develop ovarian cancer than those who watched TV for < 2 h/day (HR 2.15; 95% CI 1.54-2.99). CONCLUSION Our findings suggest that reducing the amount of time spent sedentarily may be beneficial for preventing ovarian cancer.
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Affiliation(s)
- Shigekazu Ukawa
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15 W7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15 W7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Mitsuru Mori
- Hokkaido Chitose College of Rehabilitation, Hokkaido, Japan
| | - Satoyo Ikehara
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Hygiene and Public Health, Osaka Medical College, Osaka, Japan
| | - Toru Shirakawa
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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Zhang N, Qiu J, Zheng T, Zhang X, Hua K, Zhang Y. Goserelin promotes the apoptosis of epithelial ovarian cancer cells by upregulating forkhead box O1 through the PI3K/AKT signaling pathway. Oncol Rep 2017; 39:1034-1042. [PMID: 29286125 PMCID: PMC5802025 DOI: 10.3892/or.2017.6159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 12/04/2017] [Indexed: 02/02/2023] Open
Abstract
Gonadotropins, including luteinizing hormone (LH) and follicle stimulating hormone (FSH), are conducive to the growth of ovarian cancer based on the ‘gonadotropin theory’ and are regulated by gonadotropin-releasing hormone (GnRH). The present study was carried out to investigate the effect of goserelin, a GnRH agonist, on the apoptosis of epithelial ovarian cancer (EOC) cells and the underlying in vitro and in vivo mechanisms. Through flow cytometry, Hoechst staining and TUNEL staining, we demonstrated that goserelin promoted the apoptosis of EOC cells both in vitro and in vivo. Through human apoptosis gene PCR array, we verified that the promotion of EOC cell apoptosis by goserelin was linked to the upregulation of members of the tumor necrosis factor (TNF) and TNF receptor superfamilies, which have been identified as downstream targets of forkhead box O1 (FOXO1). Goserelin enhanced FOXO1 expression, and siRNA-mediated knockdown of FOXO1 abrogated the induction of apoptosis by goserelin. Moreover, goserelin decreased AKT activity, and FOXO1 upregulation by goserelin was dependent on the phosphatidylinositol 3-kinase (PI3K)/AKT pathway. In vivo, the expression of key factors in the PI3K/AKT/FOXO1 pathway was consistent with that observed in vitro. In conclusion, our data suggested that goserelin may promote EOC cell apoptosis by upregulating FOXO1 through the PI3K/AKT signaling pathway. We believe that GnRH agonists may be potential antitumor agents, and key factors in the PI3K/AKT-FOXO1 pathway may also be novel therapeutic targets for the treatment of EOC.
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Affiliation(s)
- Ning Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, P.R. China
| | - Junjun Qiu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, P.R. China
| | - Tingting Zheng
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, P.R. China
| | - Xiaodan Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, P.R. China
| | - Keqin Hua
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, P.R. China
| | - Ying Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, P.R. China
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Jessmon P, Boulanger T, Zhou W, Patwardhan P. Epidemiology and treatment patterns of epithelial ovarian cancer. Expert Rev Anticancer Ther 2017; 17:427-437. [PMID: 28277806 DOI: 10.1080/14737140.2017.1299575] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION While ovarian cancer (OC) is relatively rare, it remains one of the most fatal cancers. Lack of robust screening methods for eOC lead to detection of most cases at advanced stages, and most patients relapse following initial treatment. Areas covered: This review summarizes epidemiology and treatment patterns of epithelial ovarian cancer (eOC). MEDLINE, EMBASE, conference proceedings, and the Cochrane Library were searched using key terms and Medical Subject Headings for ovarian cancer, treatment patterns, and epidemiology to identify articles published from 2005-2015. Expert commentary: To improve early detection, future studies should focus on the identification of biomarkers that can detect asymptomatic disease. Following diagnosis and eventual relapse, response to first-line platinum appears to guide physicians' choice of subsequent therapies, but we do not understand what patients ultimately receive or its relationship to categories of response to first-line platinum. Improved understanding of later-line treatment patterns, by initial response to platinum, could correlate with overall outcomes among relapsed patients and promote development of more effective treatment guidelines. Novel treatment approaches, such as immunotherapies, would fulfill a need for an effective strategy against advanced stages of OC that results in fewer toxic side effects.
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Affiliation(s)
- Philip Jessmon
- a Truven Health Analytics , an IBM Company , Ann Arbor , MI , USA
| | - Talia Boulanger
- b Truven Health Analytics , an IBM Company , Cambridge , MA , USA
| | - Wei Zhou
- c Merck Sharpe & Dohme Corporation, a subsidiary of Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Pallavi Patwardhan
- c Merck Sharpe & Dohme Corporation, a subsidiary of Merck & Co., Inc ., Kenilworth , NJ , USA
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Jervis S, Song H, Lee A, Dicks E, Tyrer J, Harrington P, Easton DF, Jacobs IJ, Pharoah PPD, Antoniou AC. Ovarian cancer familial relative risks by tumour subtypes and by known ovarian cancer genetic susceptibility variants. J Med Genet 2014; 51:108-13. [PMID: 24277755 DOI: 10.1136/jmedgenet-2013-102015] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Family history is one of the most important risk factors for epithelial ovarian cancer (EOC). Little is known, however, on how EOC familial relative risks (FRRs) vary by factors such as tumour subtype or the combined effects of common EOC susceptibility alleles. In addition, no data currently exist on the FRRs associated with EOC after exclusion of BRCA1 or BRCA2 mutation carriers. METHODS EOC FRRs were computed from observed EOCs in relatives of 1548 patients with EOC recruited between 1999 and 2010 from a population-based cohort study with known BRCA1 and BRCA2 mutation status and tumour subtype, compared with the number expected in the general population. RESULTS The EOC FRR to all first-degree relatives was estimated to be 2.96 (95% CI 2.35 to 3.72) but there was no evidence of difference in the FRRs for mothers, sisters and daughters. There was significant evidence that the FRR for relatives of patients with EOC diagnosed under age 50 years is higher than that for older patients (4.72 (95% CI 3.21 to 6.95) and 2.53 (95% CI 1.91 to 3.35), p-diff=0.0052) and a suggestion that the FRR in relatives of patients with serous disease is higher than that for non-serous tumours (3.64 (95% CI 2.72 to 4.87) and 2.25 (95% CI 1.56 to 3.26), p-diff=0.0023). The FRR to relatives of cases without a deleterious mutation in BRCA1 or BRCA2 was estimated to be over twice that of the general population (2.24 (95% CI 1.71 to 2.94)). BRCA1 and BRCA2 mutations were estimated to account for about 24% of the EOC FRR to first-degree relatives. FRRs were found to increase with increasing polygenic risk score of the index patient, although the trend was not significant. CONCLUSIONS These estimates could be useful in the counselling of relatives of patients with ovarian cancer.
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Affiliation(s)
- Sarah Jervis
- Department of Public and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
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Teerlink CC, Albright FS, Lins L, Cannon-Albright LA. A comprehensive survey of cancer risks in extended families. Genet Med 2012; 14:107-14. [PMID: 22237439 DOI: 10.1038/gim.2011.2] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Cancer is familial; yet known cancer predisposition genes, as well as recognized environmental factors, explain only a small percentage of familial cancer clusters. This population-based description of cancer clustering describes patterns of cancer coaggregation suggestive of a genetic predisposition. METHODS Using a computerized genealogy of Utah families linked to a statewide cancer registry, we estimated the relative risks for 36 different cancer sites in first-, second-, and third-degree relatives of cancer cases, for each cancer site individually, and between cancer sites. We estimated the sex- and birth-year-specific rates for cancer using 1 million individuals in the resource. We applied these rates to groups of cases or relatives and compared the observed and expected numbers of cancers to estimate relative risks. RESULTS Many cancer sites show significantly elevated relative risks among distant relatives for cancer of the same site, strongly supporting a heritable contribution. Multiple combinations of cancer sites were observed among first-, second-, and third-degree relatives, suggesting the existence of heritable syndromes involving more than one cancer site. CONCLUSION This complete description of coaggregation of cancer by site in a well-defined population provides a set of observations supporting heritable cancer predispositions and may support the existence of genetic factors for many different cancers.
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Affiliation(s)
- Craig C Teerlink
- Division of Genetic Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
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Bibliography. Opbstetric and gynecological anesthesia. Current world literature. Curr Opin Anaesthesiol 2012; 25:389-92. [PMID: 22552532 DOI: 10.1097/aco.0b013e328354632f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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