1
|
Zhang J, He W, Zhang Z, Dong H, Deng X, Wen Q, Li D. Skin metastasis from ovarian cancer with somatic BRCA1 mutation: A case report and literature review. Oncol Lett 2024; 28:348. [PMID: 38872856 PMCID: PMC11170256 DOI: 10.3892/ol.2024.14481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/08/2024] [Indexed: 06/15/2024] Open
Abstract
Skin metastasis from ovarian cancer is rare, and its prognosis is poor. Effective therapeutic strategies are currently lacking, but the combination of various treatment methods shrink the tumor and relieve symptoms. The present study reports a rare case of advanced ovarian cancer with skin metastases and intestinal wall thickening, along with a BRCA1 DNA repair associated (BRCA1) mutation. After standard first-line treatment and non-standard second-line treatment, the patient developed skin metastases. The patient's skin itching, pain and lesions were completely relieved after administering bevacizumab in combination with paclitaxel and carboplatin. After 4 months, skin metastases recurred along with anal distension during maintenance treatment with oral poly(ADP ribose) polymerase (PARP) inhibitors. The patient was treated again with bevacizumab combined with docetaxel, and the anal distension was significantly relieved. Angiogenesis therapy combined with chemotherapy is effective, but that the disease-free survival time is short, and PARP inhibitor maintenance effect is limited even in cases with a BRCA1 gene mutation.
Collapse
Affiliation(s)
- Jingheng Zhang
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
- Department of Oncology, Luzhou People's Hospital, Luzhou, Sichuan 646000, P.R. China
| | - Wenfeng He
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Zhenhua Zhang
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Hui Dong
- Department of Pathology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xiangyu Deng
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Qinglian Wen
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
- Department of Radiotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610044, P.R. China
| | - Dan Li
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| |
Collapse
|
2
|
Sadlecki P, Walentowicz-Sadlecka M. Molecular landscape of borderline ovarian tumours: A systematic review. Open Med (Wars) 2024; 19:20240976. [PMID: 38859878 PMCID: PMC11163159 DOI: 10.1515/med-2024-0976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/09/2024] [Accepted: 05/05/2024] [Indexed: 06/12/2024] Open
Abstract
Borderline ovarian tumours (BOTs) show intriguing characteristics distinguishing them from other ovarian tumours. The aim of the systematic review was to analyse the spectrum of molecular changes found in BOTs and discuss their significance in the context of the overall therapeutic approach. The systematic review included articles published between 2000 and 2023 in the databases: PubMed, EMBASE, and Cochrane. After a detailed analysis of the available publications, we qualified for the systematic review: 28 publications on proto-oncogenes: BRAF, KRAS, NRAS, ERBB2, and PIK3CA, 20 publications on tumour suppressor genes: BRCA1/2, ARID1A, CHEK2, PTEN, 4 on adhesion molecules: CADM1, 8 on proteins: B-catenin, claudin-1, and 5 on glycoproteins: E-Cadherin. In addition, in the further part of the systematic review, we included eight publications on microsatellite instability and three describing loss of heterozygosity in BOT. Molecular changes found in BOTs can vary on a case-by-case basis, identifying carcinogenic mutations through molecular analysis and developing targeted therapies represent significant advancements in the diagnosis and treatment of ovarian malignancies. Molecular studies have contributed significantly to our understanding of BOT pathogenesis, but substantial research is still required to elucidate the relationship between ovarian neoplasms and extraneous disease, identify accurate prognostic indicators, and develop targeted therapeutic approaches.
Collapse
Affiliation(s)
- Pawel Sadlecki
- Medical Department, University of Science and Technology, Bydgoszcz, Poland
- Department of Obstetrics and Gynecology, Regional Polyclinical Hospital, Grudziadz, Poland
| | - Malgorzata Walentowicz-Sadlecka
- Medical Department, University of Science and Technology, Bydgoszcz, Poland
- Department of Obstetrics and Gynecology, Regional Polyclinical Hospital, Grudziadz, Poland
| |
Collapse
|
3
|
Gao L, Huang T, Zhong L, Peng L, Huang Z, Lu Y. Fertility-Sparing Surgery and Adjuvant Chemotherapy with Trastuzumab Result in Complete Remission in a Young Woman with Rare Primary Mucinous Ovarian Cancer due to ERBB2 Co-amplification with CDK12 and Chromosome 11q13.3 Amplicon: A Case Report and Literature Review. Reprod Sci 2024; 31:1626-1631. [PMID: 38216775 DOI: 10.1007/s43032-023-01443-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/19/2023] [Indexed: 01/14/2024]
Abstract
Primary mucinous ovarian carcinoma (PMOC) is a rare tumor, accounting for approximately 3% of all epithelial ovarian cancers (EOCs), with clinical risk factors and biologic features distinct from that of EOC. The prognosis for women with recurrent and high-grade PMOC remains poor, likely related to a poor response to conventional chemotherapy for EOC. A 27-year-old Chinese woman sought medical attention in January 2021 for abdominal distention from a large pelvic mass. After extensive investigations and workup, she was diagnosed with PMOC of the right ovary. Following multidisciplinary team (MDT) discussions, the patient underwent fertility-sparing surgery (FSS) (abdominal left adnexectomy, right partial oophorectomy, pelvic lymph node dissection, para-aortic lymph node dissection, omentectomy) as she yearned to preserve her fertility and the contralateral ovary appeared normal. Deep genetic analyses revealed ERBB2 co-amplification with CDK12 and chromosome 11q13.3 amplicon. Treatment with fertility-sparing surgery and adjuvant chemotherapy with trastuzumab results in complete remission. This novel strategy utilizing precise diagnostics and characterization of the histo-type of rare tumors allowed personalized targeting with optimum drug response for women who yearn fertility preservation and remission from the disease, especially when there is very limited clinical experience on management of such rare ovarian tumors.
Collapse
Affiliation(s)
- Lvfen Gao
- Department of Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Ting Huang
- Department of Clinical Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Lijuan Zhong
- Department of Clinical Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Lilin Peng
- Department of Clinical Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Zhongwei Huang
- Department of Obstetrics & Gynaecology, NUHS Tower Block Level 12, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.
| | - Yuanzhi Lu
- Department of Clinical Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China.
| |
Collapse
|
4
|
Maddaloni M, Farra R, Dapas B, Felluga F, Benedetti F, Berti F, Drioli S, Vidali M, Cemazar M, Kamensek U, Brancolini C, Murano E, Maremonti F, Grassi M, Biasin A, Rizzolio F, Cavarzerani E, Scaggiante B, Bulla R, Balduit A, Ricci G, Zito G, Romano F, Bonin S, Azzalini E, Baj G, Tierno D, Grassi G. In Vitro and In Vivo Evaluation of the Effects of Drug 2c and Derivatives on Ovarian Cancer Cells. Pharmaceutics 2024; 16:664. [PMID: 38794326 PMCID: PMC11125437 DOI: 10.3390/pharmaceutics16050664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The identification of novel therapeutic strategies for ovarian cancer (OC), the most lethal gynecological neoplasm, is of utmost urgency. Here, we have tested the effectiveness of the compound 2c (4-hydroxy-2,6-bis(4-nitrobenzylidene)cyclohexanone 2). 2c interferes with the cysteine-dependent deubiquitinating enzyme (DUB) UCHL5, thus affecting the ubiquitin-proteasome-dependent degradation of proteins. METHODS 2c phenotypic/molecular effects were studied in two OC 2D/3D culture models and in a mouse xenograft model. Furthermore, we propose an in silico model of 2c interaction with DUB-UCHL5. Finally, we have tested the effect of 2c conjugated to several linkers to generate 2c/derivatives usable for improved drug delivery. RESULTS 2c effectively impairs the OC cell line and primary tumor cell viability in both 2D and 3D conditions. The effectiveness is confirmed in a xenograft mouse model of OC. We show that 2c impairs proteasome activity and triggers apoptosis, most likely by interacting with DUB-UCHL5. We also propose a mechanism for the interaction with DUB-UCHL5 via an in silico evaluation of the enzyme-inhibitor complex. 2c also reduces cell growth by down-regulating the level of the transcription factor E2F1. Eventually, 2c activity is often retained after the conjugation with linkers. CONCLUSION Our data strongly support the potential therapeutic value of 2c/derivatives in OC.
Collapse
Affiliation(s)
- Marianna Maddaloni
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, 34149 Trieste, Italy; (M.M.); (R.F.); (B.D.); (F.M.); (B.S.)
| | - Rossella Farra
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, 34149 Trieste, Italy; (M.M.); (R.F.); (B.D.); (F.M.); (B.S.)
| | - Barbara Dapas
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, 34149 Trieste, Italy; (M.M.); (R.F.); (B.D.); (F.M.); (B.S.)
| | - Fulvia Felluga
- Department of Chemical and Pharmaceutical Sciences (DSCF), University of Trieste, 34127 Trieste, Italy; (F.F.); (F.B.); (F.B.); (S.D.); (M.V.)
| | - Fabio Benedetti
- Department of Chemical and Pharmaceutical Sciences (DSCF), University of Trieste, 34127 Trieste, Italy; (F.F.); (F.B.); (F.B.); (S.D.); (M.V.)
| | - Federico Berti
- Department of Chemical and Pharmaceutical Sciences (DSCF), University of Trieste, 34127 Trieste, Italy; (F.F.); (F.B.); (F.B.); (S.D.); (M.V.)
| | - Sara Drioli
- Department of Chemical and Pharmaceutical Sciences (DSCF), University of Trieste, 34127 Trieste, Italy; (F.F.); (F.B.); (F.B.); (S.D.); (M.V.)
| | - Mattia Vidali
- Department of Chemical and Pharmaceutical Sciences (DSCF), University of Trieste, 34127 Trieste, Italy; (F.F.); (F.B.); (F.B.); (S.D.); (M.V.)
| | - Maja Cemazar
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Zaloska 2, SI-1000 Ljubljana, Slovenia; (M.C.); (U.K.)
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
| | - Urska Kamensek
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Zaloska 2, SI-1000 Ljubljana, Slovenia; (M.C.); (U.K.)
| | - Claudio Brancolini
- Laboratory of Epigenomics, Department of Medicine, University of Udine, Piazzale Kolbe 4, 33100 Udine, Italy;
| | | | - Francesca Maremonti
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, 34149 Trieste, Italy; (M.M.); (R.F.); (B.D.); (F.M.); (B.S.)
| | - Mario Grassi
- Department of Engineering and Architecture, University of Trieste, Via Valerio 6/A, 34127 Trieste, Italy; (M.G.); (A.B.)
| | - Alice Biasin
- Department of Engineering and Architecture, University of Trieste, Via Valerio 6/A, 34127 Trieste, Italy; (M.G.); (A.B.)
| | - Flavio Rizzolio
- Pathology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy;
- Department of Molecular Sciences and Nanosystems, Ca’ Foscari University of Venice, 30172 Venice, Italy;
| | - Enrico Cavarzerani
- Department of Molecular Sciences and Nanosystems, Ca’ Foscari University of Venice, 30172 Venice, Italy;
| | - Bruna Scaggiante
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, 34149 Trieste, Italy; (M.M.); (R.F.); (B.D.); (F.M.); (B.S.)
| | - Roberta Bulla
- Department of Life Sciences, University of Trieste, 34127 Trieste, Italy; (R.B.); (G.B.)
| | - Andrea Balduit
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (A.B.); (G.R.); (G.Z.); (F.R.)
| | - Giuseppe Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (A.B.); (G.R.); (G.Z.); (F.R.)
- Department of Medical, Surgical and Health Science, University of Trieste, 34129 Trieste, Italy; (S.B.); (E.A.)
| | - Gabriella Zito
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (A.B.); (G.R.); (G.Z.); (F.R.)
| | - Federico Romano
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (A.B.); (G.R.); (G.Z.); (F.R.)
| | - Serena Bonin
- Department of Medical, Surgical and Health Science, University of Trieste, 34129 Trieste, Italy; (S.B.); (E.A.)
| | - Eros Azzalini
- Department of Medical, Surgical and Health Science, University of Trieste, 34129 Trieste, Italy; (S.B.); (E.A.)
| | - Gabriele Baj
- Department of Life Sciences, University of Trieste, 34127 Trieste, Italy; (R.B.); (G.B.)
| | - Domenico Tierno
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, 34149 Trieste, Italy; (M.M.); (R.F.); (B.D.); (F.M.); (B.S.)
| | - Gabriele Grassi
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, 34149 Trieste, Italy; (M.M.); (R.F.); (B.D.); (F.M.); (B.S.)
- Department of Medical, Surgical and Health Science, University of Trieste, 34129 Trieste, Italy; (S.B.); (E.A.)
| |
Collapse
|
5
|
Perrone C, Angioli R, Luvero D, Giannini A, Di Donato V, Cuccu I, Muzii L, Raspagliesi F, Bogani G. Targeting BRAF pathway in low-grade serous ovarian cancer. J Gynecol Oncol 2024; 35:35.e104. [PMID: 38768941 DOI: 10.3802/jgo.2024.35.e104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/14/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024] Open
Abstract
Mutations in genes encoding for proteins along the RAS-RAF-MEK-ERK pathway have been detected in a variety of tumor entities including ovarian carcinomas. In the recent years, several inhibitors of this pathway have been developed, whose antitumor potential is currently being assessed in different clinical trials. Low grade serous ovarian carcinoma, is a rare gynecological tumor which shows favorable overall survival, compared to the general ovarian cancer population, but worrying resistance to conventional chemotherapies. The clinical behavior of low grade serous ovarian carcinoma reflects the different gene profile compared to high-grade serous carcinoma: KRAS/BRAF mutations. BRAF inhibitors as single agents were approved for the treatment of BRAF mutated tumors. Nevertheless, many patients face progressive disease. The understanding of the mechanisms of resistance to BRAF inhibitors therapy and preclinical studies showing that BRAF and mitogen-activated protein kinase kinase (MEK) inhibitors combined therapy delays the onset of resistance compared to BRAF inhibitor single agent, led to the clinical investigation of combined therapy. The aim of this paper is to review the efficacy and safety of the combination of BRAF plus MEK inhibitors on ovarian carcinomas, in particularly focusing on low grade serous ovarian carcinoma.
Collapse
Affiliation(s)
- Chiara Perrone
- Department of Gynecological, Obstetrical and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Roberto Angioli
- Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Daniela Luvero
- Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Andrea Giannini
- Department of Gynecological, Obstetrical and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Violante Di Donato
- Department of Gynecological, Obstetrical and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Ilaria Cuccu
- Department of Gynecological, Obstetrical and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Ludovico Muzii
- Department of Gynecological, Obstetrical and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesco Raspagliesi
- Gynecologic Oncologic Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Giorgio Bogani
- Gynecologic Oncologic Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
| |
Collapse
|
6
|
Santoro A, Angelico G, Inzani F, Arciuolo D, d'Amati A, Addante F, Travaglino A, Scaglione G, D'Alessandris N, Valente M, Tinnirello G, Raffone A, Narducci N, Piermattei A, Cianfrini F, Bragantini E, Zannoni GF. The emerging and challenging role of PD-L1 in patients with gynecological cancers: An updating review with clinico-pathological considerations. Gynecol Oncol 2024; 184:57-66. [PMID: 38295614 DOI: 10.1016/j.ygyno.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/06/2024] [Accepted: 01/21/2024] [Indexed: 02/02/2024]
Abstract
Over recent years, there has been significant progress in the development of immunotherapeutic molecules designed to block the PD-1/PD-L1 axis. These molecules have demonstrated their ability to enhance the immune response by prompting T cells to identify and suppress neoplastic cells. PD-L1 is a type 1 transmembrane protein ligand expressed on T lymphocytes, B lymphocytes, and antigen-presenting cells and is considered a key inhibitory checkpoint involved in cancer immune regulation. PD-L1 immunohistochemical expression in gynecological malignancies is extremely variable based on tumor stage and molecular subtypes. As a result, a class of monoclonal antibodies targeting the PD-1 receptor and PD-L1, known as immune checkpoint inhibitors, has found successful application in clinical settings. In clinical practice, the standard method for identifying suitable candidates for immune checkpoint inhibitor therapy involves immunohistochemical assessment of PD-L1 expression in neoplastic tissues. The most commonly used PD-L1 assays in clinical trials are SP142, 28-8, 22C3, and SP263, each of which has been rigorously validated on specific platforms. Gynecologic cancers encompass a wide spectrum of malignancies originating from the ovaries, uterus, cervix, and vulva. These neoplasms have shown variable response to immunotherapy which appears to be influenced by genetic and protein expression profiles, including factors such as mismatch repair status, tumor mutational burden, and checkpoint ligand expression. In the present paper, an extensive review of PD-L1 expression in various gynecologic cancer types is discussed, providing a guide for their pathological assessment and reporting.
Collapse
Affiliation(s)
- Angela Santoro
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Giuseppe Angelico
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, Catania, Italy
| | - Frediano Inzani
- Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Italy
| | - Damiano Arciuolo
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Antonio d'Amati
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Francesca Addante
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Antonio Travaglino
- Pathology Unit, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
| | - Giulia Scaglione
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Nicoletta D'Alessandris
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Michele Valente
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Giordana Tinnirello
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, Catania, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Nadine Narducci
- Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Alessia Piermattei
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Federica Cianfrini
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Emma Bragantini
- Department of Pathology, Santa Chiara Hospital, Trento, Italy
| | - Gian Franco Zannoni
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy.
| |
Collapse
|
7
|
Wang Q, Cao SH, Li YY, Zhang JB, Yang XH, Zhang B. Advances in precision therapy of low-grade serous ovarian cancer: A review. Medicine (Baltimore) 2024; 103:e34306. [PMID: 38669365 PMCID: PMC11049748 DOI: 10.1097/md.0000000000034306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/19/2023] [Indexed: 04/28/2024] Open
Abstract
Low-grade serous ovarian carcinoma (LGSOC) is a rare subtype of ovarian cancer that accounts for approximately 6% to 10% of serous ovarian cancers. The clinical treatment of LGSOC is similar to that of high-grade serous ovarian carcinoma, however, its clinical and molecular characteristics are different from those of high-grade serous ovarian carcinoma. This article reviews the research on gene diagnosis, surgical treatment, chemotherapy, and biological therapy of LGSOC, providing reference for clinical diagnosis and treatment of LGSOC. Surgery is the cornerstone of LGSOC treatment and maximum effort must be made to achieve R0 removal. Although LGSOC is not sensitive to chemotherapy, postoperative platinum-based combination chemotherapy remains the first-line treatment option for LGSOC. Additional clinical trials are needed to confirm the clinical benefits of chemotherapy and explore new chemotherapy protocols. Hormone and targeted therapies may also play important roles. Some patients, particularly those with residual lesions after treatment, may benefit from hormone maintenance therapy after chemotherapy. Targeted therapies, such as MEKi, show good application prospects and are expected to change the treatment pattern of LGSOC. Continuing to further study the genomics of LGSOC, identify its specific gene changes, and combine traditional treatment methods with precision targeted therapy based on second-generation sequencing may be the direction for LGSOC to overcome the treatment bottleneck. In future clinical work, comprehensive genetic testing should be carried out for LGSOC patients to accumulate data for future scientific research, in order to find more effective methods and drugs for the treatment of LGSOC.
Collapse
Affiliation(s)
- Qing Wang
- Department of Obstetrics and Gynecology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Sheng-Han Cao
- Graduate School of Bengbu Medical University, Bengbu, Anhui, China
| | - Yan-Yu Li
- Department of Obstetrics and Gynecology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Jing-Bo Zhang
- Department of Obstetrics and Gynecology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Xin-Hui Yang
- Department of Obstetrics and Gynecology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Bei Zhang
- Department of Obstetrics and Gynecology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| |
Collapse
|
8
|
Inoue D, Hoshino H, Chen YY, Yamamoto M, Kogami A, Fukushima M, Khoo KH, Akama TO, Yoshida Y, Kobayashi M. Structural Elucidation and Prognostic Relevance of 297-11A-Sulfated Glycans in Ovarian Carcinoma. J Transl Med 2024; 104:102057. [PMID: 38582455 DOI: 10.1016/j.labinv.2024.102057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024] Open
Abstract
Ovarian carcinoma is usually diagnosed at an advanced stage with peritoneal dissemination and/or lymph node metastasis, and the prognosis for such advanced carcinoma is very poor. Therefore, new biomarkers to predict patient prognosis are needed. Miyamoto et al. previously showed that keratan sulfate (KS) detected by the 5D4 monoclonal antibody was expressed in ovarian carcinoma. However, the detailed structure of such KS was not determined, and the biological significance of this finding remained to be clarified. We previously generated the 297-11A monoclonal antibody, which recognizes galactose (Gal)-6-O-sulfated N-acetyllactosamine (LacNAc) located at the nonreducing terminus. Because the 297-11A epitope overlaps with that of 5D4, here we chose to use the 297-11A antibody as a tool to analyze KS and related structures. We conducted immunohistochemical analysis of 98 ovarian carcinoma cases with 297-11A antibody combined with a series of glycosidases and performed mass spectrometry analysis of the human serous ovarian carcinoma cell line OVCAR-3 to deduce the glycan structure of 297-11A-sulfated glycans. We also performed western blot analysis to assess a potential association of 297-11A-sulfated glycans with the mucin core protein mucin 16 (MUC16; also known as cancer antigen 125 (CA125)). Finally, we examined the relationship between 297-11A expression and patient prognosis. Consequently, 297-11A-sulfated glycans were primarily expressed in serous and endometrioid carcinomas and poorly expressed in mucinous and clear cell carcinomas. We reveal that structurally, 297-11A-sulfated glycans expressed in ovarian carcinoma are O-glycans carrying partially sialylated, Gal-6-O-sulfated LacNAc and that these glycans are likely displayed on MUC16 mucin core proteins. Of clinical importance is that expression of 297-11A-sulfated glycans correlated with shorter progression-free survival in patients. Thus, 297-11A-sulfated glycans may serve as a predictor of ovarian carcinoma recurrence.
Collapse
Affiliation(s)
- Daisuke Inoue
- Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan; Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan
| | - Hitomi Hoshino
- Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan
| | - Ya-Ying Chen
- Institute of Biochemical Sciences, National Taiwan University, Taipei, Taiwan
| | - Makoto Yamamoto
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan
| | - Akiya Kogami
- Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan
| | - Mana Fukushima
- Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan
| | - Kay-Hooi Khoo
- Institute of Biochemical Sciences, National Taiwan University, Taipei, Taiwan; Institute of Biological Chemistry, Academia Sinica, Taipei, Taiwan
| | - Tomoya O Akama
- Department of Pharmacology, Kansai Medical University, Hirakata, Japan
| | - Yoshio Yoshida
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan
| | - Motohiro Kobayashi
- Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
| |
Collapse
|
9
|
Shylasree TS, Mahajan D, Chaturvedi A, Menon S, Gupta S, Thakur M, Poddar P, Maheshwari A. Clinicopathological and Oncological Outcomes of Borderline Mucinous Tumours of Ovary: a Large Case Series. Indian J Surg Oncol 2024; 15:88-94. [PMID: 38511015 PMCID: PMC10948702 DOI: 10.1007/s13193-023-01849-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/13/2023] [Indexed: 03/22/2024] Open
Abstract
The objective is to study the clinico-demographic profile, treatment patterns and oncological outcomes in borderline mucinous tumours of the ovary. Retrospective cohort analysis was carried out between January 2017 and December 2019 for patients with a diagnosis of borderline mucinous tumours of the ovary who were treated at our centre. Kaplan-Meier method was used for the estimation of the probability of DFS and OS. Univariate and multivariate analyses based on the Cox proportional hazard model were performed to identify factors associated with DFS and OS. A p-value ≤ 0.05 in a two-tailed test was considered statistically significant. The study population included 75 patients and the median follow-up time for the entire cohort was 24 months. The 5-year DFS for the entire cohort was 79.6% and OS was 90.5%, whereas for stage I disease, 5-year OS was 92.6% as opposed to 60% in the advanced stage. On univariate analysis, only the stage of the disease had a significant association with DFS and OS. Fertility-preserving surgeries had no impact on OS or DFS, and hence, it is suggested that fertility-sparing surgeries may be considered a viable option in young patients with mucinous ovarian tumours. Borderline mucinous tumours of the ovary have excellent survival outcomes and fertility-sparing surgeries should be done whenever feasible.
Collapse
Affiliation(s)
- T. S. Shylasree
- Department of Gynecological Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Room No 1211, Homi Bhabha Block, Dr. Ernst Borges Marg, Parel, Mumbai, 400012 Maharashtra India
- Royal Aberdeen Infirmary, Foresthill Estate, Aberdeen, Scotland
| | - Devyani Mahajan
- Department of Gynecological Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Room No 1211, Homi Bhabha Block, Dr. Ernst Borges Marg, Parel, Mumbai, 400012 Maharashtra India
| | - Aditi Chaturvedi
- Department of Gynecological Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Room No 1211, Homi Bhabha Block, Dr. Ernst Borges Marg, Parel, Mumbai, 400012 Maharashtra India
| | - Santosh Menon
- Department of Gynecological Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Room No 1211, Homi Bhabha Block, Dr. Ernst Borges Marg, Parel, Mumbai, 400012 Maharashtra India
| | - Stuti Gupta
- Department of Gynecological Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Room No 1211, Homi Bhabha Block, Dr. Ernst Borges Marg, Parel, Mumbai, 400012 Maharashtra India
| | - Meenakshi Thakur
- Department of Gynecological Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Room No 1211, Homi Bhabha Block, Dr. Ernst Borges Marg, Parel, Mumbai, 400012 Maharashtra India
| | - Pabashi Poddar
- Department of Gynecological Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Room No 1211, Homi Bhabha Block, Dr. Ernst Borges Marg, Parel, Mumbai, 400012 Maharashtra India
| | - Amita Maheshwari
- Department of Gynecological Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Room No 1211, Homi Bhabha Block, Dr. Ernst Borges Marg, Parel, Mumbai, 400012 Maharashtra India
| |
Collapse
|
10
|
Villa P, Bounous VE, Amar ID, Bernardini F, Giorgi M, Attianese D, Ferrero A, D’Oria M, Scambia G. Hormone Replacement Therapy in Post-Menopause Hormone-Dependent Gynecological Cancer Patients: A Narrative Review. J Clin Med 2024; 13:1443. [PMID: 38592285 PMCID: PMC10932409 DOI: 10.3390/jcm13051443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Advances in the treatment of gynecological cancer have led to improvements in survival but also an increase in menopausal symptoms, especially in young women with premature iatrogenic menopause. METHODS A narrative review was performed to clarify the possibility of prescribing hormone replacement therapy (HRT) after hormone-dependent gynecological cancers (ovarian cancer [OC], cervical adenocarcinoma [AC], and endometrial cancer [EC]). RESULTS HRT can be prescribed to patients with early-stage, grade I-II OC who experience bothersome menopausal symptoms non-responsive to alternative non-hormone therapy after optimal surgery. Caution should be exercised in administering HRT after serous borderline tumors and endometrioid OC, and HRT is not recommended in low-grade serous OC. HRT is not contraindicated in AC survivors. After surgery for EC, HRT can be prescribed in women with early-stage low-grade EC. There is not enough data to give indications to patients with advanced EC. CONCLUSIONS HRT can be discussed with patients, evaluating the risks and benefits of hormone-dependent gynecological cancer. Counseling should be performed by gynecologic oncologists experienced in the management of these patients.
Collapse
Affiliation(s)
- Paola Villa
- Department of Women and Child’s Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.V.); (I.D.A.); (F.B.)
| | - Valentina Elisabetta Bounous
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (M.G.); (D.A.); (A.F.)
| | - Inbal Dona Amar
- Department of Women and Child’s Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.V.); (I.D.A.); (F.B.)
| | - Federica Bernardini
- Department of Women and Child’s Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.V.); (I.D.A.); (F.B.)
| | - Margherita Giorgi
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (M.G.); (D.A.); (A.F.)
| | - Daniela Attianese
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (M.G.); (D.A.); (A.F.)
| | - Annamaria Ferrero
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (M.G.); (D.A.); (A.F.)
| | | | - Giovanni Scambia
- Department of Women and Child’s Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.V.); (I.D.A.); (F.B.)
| |
Collapse
|
11
|
Zheng G, Faber MT, Baandrup L, Kjaer SK. Paracetamol use and risk of epithelial ovarian cancer: A nationwide nested case-control study. BJOG 2024; 131:290-299. [PMID: 37551038 DOI: 10.1111/1471-0528.17632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/11/2023] [Accepted: 07/23/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE To investigate whether paracetamol use is associated with a reduced risk of epithelial ovarian cancer (EOC). DESIGN A nationwide nested case-control study. SETTING Danish female population. POPULATION A total of 9589 EOC cases diagnosed from 2000 to 2019 were age-matched with 383 549 randomly selected female controls using risk set sampling. METHODS Paracetamol use, reproductive history, history of medication and history of surgery were retrieved from Danish national registers. Paracetamol use was defined as at least two prescriptions for up to 1 year before the index date, and was further classified according to recency, duration, cumulative dose and intensity of dose. MAIN OUTCOME MEASURES Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals for the association between paracetamol and EOC risk, overall and by histological subtypes. RESULTS 'Ever' use of paracetamol was associated with a reduced EOC risk after adjusting for potential confounding factors (OR 0.92, 95% CI 0.87-0.97). The association was only significant among recent users (OR 0.89, 95% CI 0.84-0.95). The risk declined further with the increasing level of cumulative dose and intensity; women from the group with a high cumulative dose and a high intensity had a 13% (OR 0.87, 95% CI 0.80-0.94) and 14% (OR 0.86, 95% CI 0.79-0.93) reduced risk, respectively. In the histological subtype analysis, reduced risk with 'ever' use was most pronounced for serous and clear cell tumours. CONCLUSIONS Paracetamol use was associated with a decreased risk of EOC in a dose-response manner. Future studies are needed to validate the findings and investigate the mechanisms behind the association.
Collapse
Affiliation(s)
- Guoqiao Zheng
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mette Tuxen Faber
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Louise Baandrup
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
12
|
Wang J, Zheng F, Wang D, Yang Q. Regulation of ULK1 by WTAP/IGF2BP3 axis enhances mitophagy and progression in epithelial ovarian cancer. Cell Death Dis 2024; 15:97. [PMID: 38286802 PMCID: PMC10824720 DOI: 10.1038/s41419-024-06477-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/31/2024]
Abstract
There is a pressing need for innovative therapeutic strategies for patients with epithelial ovarian cancer (EOC). Previous studies have shown that UNC-51-like kinase 1 (ULK1), a serine/threonine kinase, is crucial in regulating cellular autophagy and mitophagy across various tumor types. However, the clinical implications, biological functions, and potential mechanisms of ULK1 in EOC remain poorly understood. This study demonstrates that ULK1 expression is upregulated in EOC tissue samples and EOC cell lines, with increased ULK1 expression correlating with poor prognosis. Functionally, overexpressed ULK1 enhances the proliferation and migration abilities of EOC cells both in vitro and in vivo. Mechanistically, ULK1 was identified as an m6A target of WTAP. WTAP-mediated m6A modification of ULK1 enhanced its mRNA stability in an IGF2BP3-dependent manner, leading to elevated ULK1 expression and enhanced mitophagy in EOC. In summary, our research reveals that the WTAP/IGF2BP3-ULK1 axis significantly influences protective mitophagy in EOC, contributing to its progression. Therefore, the regulatory mechanisms and biological function of ULK1 identify it as a potential molecular target for therapeutic intervention in EOC.
Collapse
Affiliation(s)
- Jiao Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Fei Zheng
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Dandan Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Qing Yang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
| |
Collapse
|
13
|
Liu Y, Geng F, Zhang H, Xue J, Chu R. The impact of lymphadenectomy on ovarian clear cell carcinoma: a systematic review and meta-analysis. World J Surg Oncol 2024; 22:37. [PMID: 38287354 PMCID: PMC10823682 DOI: 10.1186/s12957-024-03324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/23/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Ovarian clear cell carcinoma (OCCC) shares treatment strategies with epithelial ovarian cancer (EOC). Due to OCCC's rarity, there's a lack of prospective studies on its surgery, resulting in heterogeneous and limited existing data. This study aims to clarify the prognostic significance of lymphadenectomy in OCCC patients. METHODS We systematically searched Web of Science, Scopus, PubMed, and Google Scholar until July 2023 for studies investigating lymphadenectomy's effects on OCCC patients. We calculated pooled hazard ratios (HR) with 95% confidence intervals (CI). This study is registered in PROSPERO (CRD42021270460). RESULTS Among 444 screened articles, seven studies (2883 women) met inclusion criteria. Our analysis revealed that lymphadenectomy significantly improved disease-specific survival (DSS) (HR = 0.76, 95%CI = 0.60-0.95, P = 0.02) and disease-free survival (DFS) (HR = 0.58, 95%CI = 0.34-0.99, P = 0.05). However, it did not significantly affect overall survival (OS) (HR = 0.80, 95%CI = 0.60-1.06, P = 0.12) or progression-free survival (PFS) (HR = 0.95, 95%CI = 0.64-1.42, P = 0.79). Notably, some earlier studies reported no survival benefit, warranting cautious interpretation. CONCLUSION Lymphadenectomy does not significantly enhance OS and PFS for OCCC but does improve DFS and DSS. Tailoring treatment to individual patient profiles is imperative for optimal outcomes. Precise preoperative or intraoperative lymph node metastasis detection is essential for identifying candidates benefiting from lymphadenectomy. Collaborative international efforts and an OCCC database are pivotal for refining future treatment strategies.
Collapse
Affiliation(s)
- Yan Liu
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Feng Geng
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hongyang Zhang
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jing Xue
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ran Chu
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
| |
Collapse
|
14
|
Blackman A, Rees AC, Bowers RR, Jones CM, Vaena SG, Clark MA, Carter S, Villamor ED, Evans D, Emanuel AJ, Fullbright G, Long DT, Spruill L, Romeo MJ, Helke KL, Delaney JR. MYC is sufficient to generate mid-life high-grade serous ovarian and uterine serous carcinomas in a p53-R270H mouse model. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.24.576924. [PMID: 38352443 PMCID: PMC10862747 DOI: 10.1101/2024.01.24.576924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Genetically engineered mouse models (GEMM) have fundamentally changed how ovarian cancer etiology, early detection, and treatment is understood. However, previous GEMMs of high-grade serous ovarian cancer (HGSOC) have had to utilize genetics rarely or never found in human HGSOC to yield ovarian cancer within the lifespan of a mouse. MYC, an oncogene, is amongst the most amplified genes in HGSOC, but it has not previously been utilized to drive HGSOC GEMMs. We coupled Myc and dominant negative mutant p53-R270H with a fallopian tube epithelium-specific promoter Ovgp1 to generate a new GEMM of HGSOC. Female mice developed lethal cancer at an average of 15.1 months. Histopathological examination of mice revealed HGSOC characteristics including nuclear p53 and nuclear MYC in clusters of cells within the fallopian tube epithelium and ovarian surface epithelium. Unexpectedly, nuclear p53 and MYC clustered cell expression was also identified in the uterine luminal epithelium, possibly from intraepithelial metastasis from the fallopian tube epithelium (FTE). Extracted tumor cells exhibited strong loss of heterozygosity at the p53 locus, leaving the mutant allele. Copy number alterations in these cancer cells were prevalent, disrupting a large fraction of genes. Transcriptome profiles most closely matched human HGSOC and serous endometrial cancer. Taken together, these results demonstrate the Myc and Trp53-R270H transgene was able to recapitulate many phenotypic hallmarks of HGSOC through the utilization of strictly human-mimetic genetic hallmarks of HGSOC. This new mouse model enables further exploration of ovarian cancer pathogenesis, particularly in the 50% of HGSOC which lack homology directed repair mutations. Histological and transcriptomic findings are consistent with the hypothesis that uterine serous cancer may originate from the fallopian tube epithelium.
Collapse
|
15
|
Zuckerbrot-Schuldenfrei M, Aviel-Ronen S, Zilberberg A, Efroni S. Ovarian cancer is detectable from peripheral blood using machine learning over T-cell receptor repertoires. Brief Bioinform 2024; 25:bbae075. [PMID: 38483254 PMCID: PMC10938541 DOI: 10.1093/bib/bbae075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/17/2024] [Accepted: 02/07/2024] [Indexed: 03/17/2024] Open
Abstract
The extraordinary diversity of T cells and B cells is critical for body maintenance. This diversity has an important role in protecting against tumor formation. In humans, the T-cell receptor (TCR) repertoire is generated through a striking stochastic process called V(D)J recombination, in which different gene segments are assembled and modified, leading to extensive variety. In ovarian cancer (OC), an unfortunate 80% of cases are detected late, leading to poor survival outcomes. However, when detected early, approximately 94% of patients live longer than 5 years after diagnosis. Thus, early detection is critical for patient survival. To determine whether the TCR repertoire obtained from peripheral blood is associated with tumor status, we collected blood samples from 85 women with or without OC and obtained TCR information. We then used machine learning to learn the characteristics of samples and to finally predict, over a set of unseen samples, whether the person is with or without OC. We successfully stratified the two groups, thereby associating the peripheral blood TCR repertoire with the formation of OC tumors. A careful study of the origin of the set of T cells most informative for the signature indicated the involvement of a specific invariant natural killer T (iNKT) clone and a specific mucosal-associated invariant T (MAIT) clone. Our findings here support the proposition that tumor-relevant signal is maintained by the immune system and is coded in the T-cell repertoire available in peripheral blood. It is also possible that the immune system detects tumors early enough for repertoire technologies to inform us near the beginning of tumor formation. Although such detection is made by the immune system, we might be able to identify it, using repertoire data from peripheral blood, to offer a pragmatic way to search for early signs of cancer with minimal patient burden, possibly with enhanced sensitivity.
Collapse
Affiliation(s)
| | - Sarit Aviel-Ronen
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel and Sheba Medical Center, Tel-Hashomer, Ramat Gan 526200, Israel
| | - Alona Zilberberg
- The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan 5290002, Israel
| | - Sol Efroni
- The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan 5290002, Israel
| |
Collapse
|
16
|
Nobel SMN, Swapno SMMR, Hossain MA, Safran M, Alfarhood S, Kabir MM, Mridha MF. Modern Subtype Classification and Outlier Detection Using the Attention Embedder to Transform Ovarian Cancer Diagnosis. Tomography 2024; 10:105-132. [PMID: 38250956 PMCID: PMC11154515 DOI: 10.3390/tomography10010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Ovarian cancer, a deadly female reproductive system disease, is a significant challenge in medical research due to its notorious lethality. Addressing ovarian cancer in the current medical landscape has become more complex than ever. This research explores the complex field of Ovarian Cancer Subtype Classification and the crucial task of Outlier Detection, driven by a progressive automated system, as the need to fight this unforgiving illness becomes critical. This study primarily uses a unique dataset painstakingly selected from 20 esteemed medical institutes. The dataset includes a wide range of images, such as tissue microarray (TMA) images at 40× magnification and whole-slide images (WSI) at 20× magnification. The research is fully committed to identifying abnormalities within this complex environment, going beyond the classification of subtypes of ovarian cancer. We proposed a new Attention Embedder, a state-of-the-art model with effective results in ovarian cancer subtype classification and outlier detection. Using images magnified WSI, the model demonstrated an astonishing 96.42% training accuracy and 95.10% validation accuracy. Similarly, with images magnified via a TMA, the model performed well, obtaining a validation accuracy of 94.90% and a training accuracy of 93.45%. Our fine-tuned hyperparameter testing resulted in exceptional performance on independent images. At 20× magnification, we achieved an accuracy of 93.56%. Even at 40× magnification, our testing accuracy remained high, at 91.37%. This study highlights how machine learning can revolutionize the medical field's ability to classify ovarian cancer subtypes and identify outliers, giving doctors a valuable tool to lessen the severe effects of the disease. Adopting this novel method is likely to improve the practice of medicine and give people living with ovarian cancer worldwide hope.
Collapse
Affiliation(s)
- S. M. Nuruzzaman Nobel
- Department of Computer Science and Engineering, Bangladesh University of Business and Technology, Dhaka 1216, Bangladesh; (S.M.N.N.); (S.M.M.R.S.); (M.A.H.)
| | - S M Masfequier Rahman Swapno
- Department of Computer Science and Engineering, Bangladesh University of Business and Technology, Dhaka 1216, Bangladesh; (S.M.N.N.); (S.M.M.R.S.); (M.A.H.)
| | - Md. Ashraful Hossain
- Department of Computer Science and Engineering, Bangladesh University of Business and Technology, Dhaka 1216, Bangladesh; (S.M.N.N.); (S.M.M.R.S.); (M.A.H.)
| | - Mejdl Safran
- Department of Computer Science, College of Computer and Information Sciences, King Saud University, P.O. Box 51178, Riyadh 11543, Saudi Arabia;
| | - Sultan Alfarhood
- Department of Computer Science, College of Computer and Information Sciences, King Saud University, P.O. Box 51178, Riyadh 11543, Saudi Arabia;
| | - Md. Mohsin Kabir
- Superior Polytechnic School, University of Girona, 17071 Girona, Spain;
| | - M. F. Mridha
- Department of Computer Science, American International University-Bangladesh, Dhaka 1229, Bangladesh;
| |
Collapse
|
17
|
Luo Y, Pan R, Rao H, Chen X, Yang H. Association Between Germline BRCA1/2 Gene Variants and Clinicopathological Features of Ovarian Cancer. Int J Gen Med 2024; 17:75-84. [PMID: 38226182 PMCID: PMC10789571 DOI: 10.2147/ijgm.s445660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024] Open
Abstract
Objective To investigate the relationship between BRCA1/2 gene mutation and clinicopathological features in ovarian cancer patients, so as to develop precise individualized treatment plan for patients. Methods Patients diagnosed with ovarian cancer between January 2018 and July 2023 who underwent BRCA1/2 genetic testing were retrospectively analyzed. The clinicopathological characteristics (age, body mass index (BMI), family history of ovarian cancer, pregnancy history, menopause status, tumor size, histopathology, Federation of Gynecology and Obstetrics (FIGO) staging, and ascites) of non-carriers and BRCA1/2 variant carriers were compared. Logistic regression analysis was used to explore the relationship between BRCA1/2 variants and clinicopathological characteristics of ovarian cancer. Results A total of 284 ovarian cancer patients were collected, and the subjects were divided into two groups, 197 non-carriers and 87 BRCA1/2 variants carriers. The proportion of serous ovarian carcinoma in BRCA1/2 variant carriers is higher than that in non-BRCA variant carriers (78.2% vs 60.9%, p=0.015). There were 51 patients with BRCA pathogenic or likely pathogenic variant, 22 patients with BRCA likely benign variant, and 14 patients with BRCA variants of uncertain significance (VUS). The proportion of serous ovarian carcinoma in patients with BRCA pathogenic/likely pathogenic variant is higher than that in patients with BRCA likely benign variant and BRCA VUS (94.1% vs 50.0% and 64.3%. p<0.001). There were no statistically significant differences in BMI, family history of ovarian cancer, pregnancy history, menopause status, maximum diameter of the tumor lesion, FIGO stage, and ascites among patients with different grades of variants. Multivariate logistic regression analysis showed that serous ovarian carcinoma was related to BRCA mutation (Serous carcinoma vs non-serous carcinoma: OR 2.145, 95% CI: 1.044-4.407) (p=0.038). Conclusion Patients with BRCA1 variant develop ovarian cancer at a younger age than those with the BRCA2 variant. The proportion of FIGO stage III-IV in patients with BRCA pathogenic + likely pathogenic variant was significantly higher than those in patients with other variants. Germline BRCA1/2 variants were most frequently identified in serous ovarian carcinoma patients.
Collapse
Affiliation(s)
- Yu Luo
- Department of Gynaecology, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People’s Hospital, Meizhou, People’s Republic of China
| | - Ru Pan
- Department of Gynaecology, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People’s Hospital, Meizhou, People’s Republic of China
| | - Hui Rao
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People’s Hospital, Meizhou, People’s Republic of China
- Department of Laboratory Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Xing Chen
- Data Center, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Haikun Yang
- Department of Gynaecology, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People’s Hospital, Meizhou, People’s Republic of China
| |
Collapse
|
18
|
Frąszczak K, Barczyński B. The Role of Cancer Stem Cell Markers in Ovarian Cancer. Cancers (Basel) 2023; 16:40. [PMID: 38201468 PMCID: PMC10778113 DOI: 10.3390/cancers16010040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open
Abstract
Ovarian cancer is the most lethal gynaecological cancer and the eighth most common female cancer. The early diagnosis of ovarian cancer remains a clinical problem despite the significant development of technology. Nearly 70% of patients with ovarian cancer are diagnosed with stages III-IV metastatic disease. Reliable diagnostic and prognostic biomarkers are currently lacking. Ovarian cancer recurrence and resistance to chemotherapy pose vital problems and translate into poor outcomes. Cancer stem cells appear to be responsible for tumour recurrence resulting from chemotherapeutic resistance. These cells are also crucial for tumour initiation due to the ability to self-renew, differentiate, avoid immune destruction, and promote inflammation and angiogenesis. Studies have confirmed an association between CSC occurrence and resistance to chemotherapy, subsequent metastases, and cancer relapses. Therefore, the elimination of CSCs appears important for overcoming drug resistance and improving prognoses. This review focuses on the expression of selected ovarian CSC markers, including CD133, CD44, CD24, CD117, and aldehyde dehydrogenase 1, which show potential prognostic significance. Some markers expressed on the surface of CSCs correlate with clinical features and can be used for the diagnosis and prognosis of ovarian cancer. However, due to the heterogeneity and plasticity of CSCs, the determination of specific CSC phenotypes is difficult.
Collapse
Affiliation(s)
| | - Bartłomiej Barczyński
- 1st Chair and Department of Oncological Gynaecology and Gynaecology, Medical University in Lublin, 20-081 Lublin, Poland;
| |
Collapse
|
19
|
Wang L, Li X, Wang Y, Li G, Dai S, Cao M, Meng Z, Ren S. Endometriosis and epithelial ovarian cancer: a two-sample Mendelian randomization analysis. Sci Rep 2023; 13:21992. [PMID: 38082154 PMCID: PMC10713650 DOI: 10.1038/s41598-023-49276-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
Endometriosis, a prevalent condition, has long been recognized as a chronic and debilitating ailment affecting an estimated 1790 million women worldwide. Observational studies have established a correlation between endometriosis and ovarian cancer. Thus, we endeavored to employ Two-Sample Mendelian Randomization, utilizing summary statistics from a Genome-Wide Association Study of endometriosis and epithelial ovarian cancer, with genetic markers serving as proxies for epithelial ovarian cancer. The analysis revealed a significant correlation between these entities, with an odds ratio (OR) of 1.23 (95% CI 1.11-1.36). Upon histotype-specific examination, robust evidence emerged for an association of endometriosis with the risk of endometrioid carcinoma (OR 1.49, 95% CI 1.24-1.81), clear cell carcinoma (OR 2.56, 95% CI 1.75-3.73), and low malignant potential tumors (OR 1.28, 95% CI 1.08-1.53). These findings provide a theoretical framework for prospective investigations aimed at enhancing the potential therapeutic efficacy of managing endometriosis in averting the onset and progression of ovarian cancer.
Collapse
Affiliation(s)
- Li Wang
- Department of Gynecology & Obstetrics, Liaocheng People's Hospital, School of Medicine, Liaocheng University, Liaocheng, China
| | - Xuri Li
- Department of Gynecology, Qingdao Traditional Chinese Medicine Hospital, Qingdao Hiser Hospital Affiliated of Qingdao University, Qingdao, China
| | - Yan Wang
- Department of Medical Record Management, Fourth People's Hospital of Liaocheng, Liaocheng, China
| | - Guofeng Li
- Department of Physical Treatment, Fourth People's Hospital of Liaocheng, Liaocheng, China
| | - Shuzhen Dai
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mengying Cao
- Department of Gynecology & Obstetrics, Liaocheng People's Hospital, School of Medicine, Liaocheng University, Liaocheng, China
| | - Zhen Meng
- Department of Gynecology & Obstetrics, Liaocheng People's Hospital, School of Medicine, Liaocheng University, Liaocheng, China
- Biomedical Laboratory, School of Medicine, Liaocheng University, Liaocheng, China
| | - Songtao Ren
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, China.
| |
Collapse
|
20
|
Veneziani AC, Gonzalez-Ochoa E, Alqaisi H, Madariaga A, Bhat G, Rouzbahman M, Sneha S, Oza AM. Heterogeneity and treatment landscape of ovarian carcinoma. Nat Rev Clin Oncol 2023; 20:820-842. [PMID: 37783747 DOI: 10.1038/s41571-023-00819-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/04/2023]
Abstract
Ovarian carcinoma is characterized by heterogeneity at the molecular, cellular and anatomical levels, both spatially and temporally. This heterogeneity affects response to surgery and/or systemic therapy, and also facilitates inherent and acquired drug resistance. As a consequence, this tumour type is often aggressive and frequently lethal. Ovarian carcinoma is not a single disease entity and comprises various subtypes, each with distinct complex molecular landscapes that change during progression and therapy. The interactions of cancer and stromal cells within the tumour microenvironment further affects disease evolution and response to therapy. In past decades, researchers have characterized the cellular, molecular, microenvironmental and immunological heterogeneity of ovarian carcinoma. Traditional treatment approaches have considered ovarian carcinoma as a single entity. This landscape is slowly changing with the increasing appreciation of heterogeneity and the recognition that delivering ineffective therapies can delay the development of effective personalized approaches as well as potentially change the molecular and cellular characteristics of the tumour, which might lead to additional resistance to subsequent therapy. In this Review we discuss the heterogeneity of ovarian carcinoma, outline the current treatment landscape for this malignancy and highlight potentially effective therapeutic strategies in development.
Collapse
Affiliation(s)
- Ana C Veneziani
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Eduardo Gonzalez-Ochoa
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Husam Alqaisi
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Ainhoa Madariaga
- Medical Oncology Department, 12 De Octubre University Hospital, Madrid, Spain
| | - Gita Bhat
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Marjan Rouzbahman
- Department of Laboratory Medicine and Pathobiology, Toronto General Hospital, Toronto, Ontario, Canada
| | - Suku Sneha
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Amit M Oza
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
21
|
Mauro LJ, Spartz A, Austin JR, Lange CA. Reevaluating the Role of Progesterone in Ovarian Cancer: Is Progesterone Always Protective? Endocr Rev 2023; 44:1029-1046. [PMID: 37261958 PMCID: PMC11048595 DOI: 10.1210/endrev/bnad018] [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: 12/16/2022] [Revised: 05/04/2023] [Accepted: 05/31/2023] [Indexed: 06/03/2023]
Abstract
Ovarian cancer (OC) represents a collection of rare but lethal gynecologic cancers where the difficulty of early detection due to an often-subtle range of abdominal symptoms contributes to high fatality rates. With the exception of BRCA1/2 mutation carriers, OC most often manifests as a post-menopausal disease, a time in which the ovaries regress and circulating reproductive hormones diminish. Progesterone is thought to be a "protective" hormone that counters the proliferative actions of estrogen, as can be observed in the uterus or breast. Like other steroid hormone receptor family members, the transcriptional activity of the nuclear progesterone receptor (nPR) may be ligand dependent or independent and is fully integrated with other ubiquitous cell signaling pathways often altered in cancers. Emerging evidence in OC models challenges the singular protective role of progesterone/nPR. Herein, we integrate the historical perspective of progesterone on OC development and progression with exciting new research findings and critical interpretations to help paint a broader picture of the role of progesterone and nPR signaling in OC. We hope to alleviate some of the controversy around the role of progesterone and give insight into the importance of nPR actions in disease progression. A new perspective on the role of progesterone and nPR signaling integration will raise awareness to the complexity of nPRs and nPR-driven gene regulation in OC, help to reveal novel biomarkers, and lend critical knowledge for the development of better therapeutic strategies.
Collapse
Affiliation(s)
- Laura J Mauro
- Department of Animal Science-Physiology, University of Minnesota, Saint Paul, MN 55108, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Angela Spartz
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Julia R Austin
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Carol A Lange
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Departments of Medicine (Division of Hematology, Oncology & Transplantation) and Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA
| |
Collapse
|
22
|
Dolivet E, Gaichies L, Jeanne C, Bazille C, Briand M, Vernon M, Giffard F, Leprêtre F, Poulain L, Denoyelle C, Vigneron N, Fauvet R. Synergy of the microRNA Ratio as a Promising Diagnosis Biomarker for Mucinous Borderline and Malignant Ovarian Tumors. Int J Mol Sci 2023; 24:16016. [PMID: 37958997 PMCID: PMC10649586 DOI: 10.3390/ijms242116016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Epithelial ovarian cancers (EOCs) are a heterogeneous collection of malignancies, each with their own developmental origin, clinical behavior and molecular profile. With less than 5% of EOC cases, mucinous ovarian carcinoma is a rare form with a poor prognosis and a 5-year survival of 11% for advanced stages (III/IV). At the early stages, these malignant forms are clinically difficult to distinguish from borderline (15%) and benign (80%) forms with a better prognosis due to the large size and heterogeneity of mucinous tumors. Improving their diagnosis is therefore a challenge with regard to the risk of under-treating a malignant form or of unnecessarily undertaking radical surgical excision. The involvement of microRNAs (miRNAs) in tumor progression and their potential as biomarkers of diagnosis are becoming increasingly recognized. In this study, the comparison of miRNA microarray expression profiles between malignant and borderline tumor FFPE samples identified 10 down-regulated and 5 up-regulated malignant miRNAs, which were validated by individual RT-qPCR. To overcome normalization issues and to improve the accuracy of the results, a ratio analysis combining paired up-regulated and down-regulated miRNAs was performed. Although 21/50 miRNA expression ratios were significantly different between malignant and borderline tumor samples, any ratio could perfectly discriminate the two groups. However, a combination of 14 pairs of miRNA ratios (double ratio) showed high discriminatory potential, with 100% of accuracy in distinguishing malignant and borderline ovarian tumors, which suggests that miRNAs may hold significant clinical potential as a diagnostic tool. In summary, these ratio miRNA-based signatures may help to improve the precision of histological diagnosis, likely to provide a preoperative diagnosis in order to adapt surgical procedures.
Collapse
Affiliation(s)
- Enora Dolivet
- ANTICIPE UMR (1086) (Interdisciplinary Research Unit for Cancers Prevention and Treatment), BioTICLA Laboratory (Precision Medicine in Ovarian Carcinoma), Federative Structure 4207 Normandie Oncologie, Université de Caen Normandie, Inserm, F-14000 Caen, France; (L.G.); (M.B.); (M.V.); (F.G.); (L.P.); (C.D.); (N.V.); (R.F.)
- Unicancer, Comprehensive Cancer Center F. Baclesse, 3 Avenue Général Harris, F-14000 Caen, France;
| | - Léopold Gaichies
- ANTICIPE UMR (1086) (Interdisciplinary Research Unit for Cancers Prevention and Treatment), BioTICLA Laboratory (Precision Medicine in Ovarian Carcinoma), Federative Structure 4207 Normandie Oncologie, Université de Caen Normandie, Inserm, F-14000 Caen, France; (L.G.); (M.B.); (M.V.); (F.G.); (L.P.); (C.D.); (N.V.); (R.F.)
- Unicancer, Comprehensive Cancer Center F. Baclesse, 3 Avenue Général Harris, F-14000 Caen, France;
| | - Corinne Jeanne
- Unicancer, Comprehensive Cancer Center F. Baclesse, 3 Avenue Général Harris, F-14000 Caen, France;
| | - Céline Bazille
- Department of Pathology, Caen University Hospital, F-14000 Caen, France;
| | - Mélanie Briand
- ANTICIPE UMR (1086) (Interdisciplinary Research Unit for Cancers Prevention and Treatment), BioTICLA Laboratory (Precision Medicine in Ovarian Carcinoma), Federative Structure 4207 Normandie Oncologie, Université de Caen Normandie, Inserm, F-14000 Caen, France; (L.G.); (M.B.); (M.V.); (F.G.); (L.P.); (C.D.); (N.V.); (R.F.)
- Unicancer, Comprehensive Cancer Center F. Baclesse, 3 Avenue Général Harris, F-14000 Caen, France;
- Unicancer, Comprehensive Cancer Center F. Baclesse, Biological Ressources Centre OvaRessouces, F-14000 Caen, France
| | - Mégane Vernon
- ANTICIPE UMR (1086) (Interdisciplinary Research Unit for Cancers Prevention and Treatment), BioTICLA Laboratory (Precision Medicine in Ovarian Carcinoma), Federative Structure 4207 Normandie Oncologie, Université de Caen Normandie, Inserm, F-14000 Caen, France; (L.G.); (M.B.); (M.V.); (F.G.); (L.P.); (C.D.); (N.V.); (R.F.)
- Unicancer, Comprehensive Cancer Center F. Baclesse, 3 Avenue Général Harris, F-14000 Caen, France;
| | - Florence Giffard
- ANTICIPE UMR (1086) (Interdisciplinary Research Unit for Cancers Prevention and Treatment), BioTICLA Laboratory (Precision Medicine in Ovarian Carcinoma), Federative Structure 4207 Normandie Oncologie, Université de Caen Normandie, Inserm, F-14000 Caen, France; (L.G.); (M.B.); (M.V.); (F.G.); (L.P.); (C.D.); (N.V.); (R.F.)
- Unicancer, Comprehensive Cancer Center F. Baclesse, 3 Avenue Général Harris, F-14000 Caen, France;
- Services Unit PLATON, Virtual’his Core Facility, Université de Caen Normandie, F-14000 Caen, France
| | - Frédéric Leprêtre
- CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41—UAR 2014—PLBS, University of Lille, F-59000 Lille, France;
| | - Laurent Poulain
- ANTICIPE UMR (1086) (Interdisciplinary Research Unit for Cancers Prevention and Treatment), BioTICLA Laboratory (Precision Medicine in Ovarian Carcinoma), Federative Structure 4207 Normandie Oncologie, Université de Caen Normandie, Inserm, F-14000 Caen, France; (L.G.); (M.B.); (M.V.); (F.G.); (L.P.); (C.D.); (N.V.); (R.F.)
- Unicancer, Comprehensive Cancer Center F. Baclesse, 3 Avenue Général Harris, F-14000 Caen, France;
- Unicancer, Comprehensive Cancer Center F. Baclesse, Biological Ressources Centre OvaRessouces, F-14000 Caen, France
| | - Christophe Denoyelle
- ANTICIPE UMR (1086) (Interdisciplinary Research Unit for Cancers Prevention and Treatment), BioTICLA Laboratory (Precision Medicine in Ovarian Carcinoma), Federative Structure 4207 Normandie Oncologie, Université de Caen Normandie, Inserm, F-14000 Caen, France; (L.G.); (M.B.); (M.V.); (F.G.); (L.P.); (C.D.); (N.V.); (R.F.)
- Unicancer, Comprehensive Cancer Center F. Baclesse, 3 Avenue Général Harris, F-14000 Caen, France;
| | - Nicolas Vigneron
- ANTICIPE UMR (1086) (Interdisciplinary Research Unit for Cancers Prevention and Treatment), BioTICLA Laboratory (Precision Medicine in Ovarian Carcinoma), Federative Structure 4207 Normandie Oncologie, Université de Caen Normandie, Inserm, F-14000 Caen, France; (L.G.); (M.B.); (M.V.); (F.G.); (L.P.); (C.D.); (N.V.); (R.F.)
- Unicancer, Comprehensive Cancer Center F. Baclesse, 3 Avenue Général Harris, F-14000 Caen, France;
- Unicancer, Comprehensive Cancer Center F. Baclesse, Calvados General Tumor Registry, F-14000 Caen, France
| | - Raffaèle Fauvet
- ANTICIPE UMR (1086) (Interdisciplinary Research Unit for Cancers Prevention and Treatment), BioTICLA Laboratory (Precision Medicine in Ovarian Carcinoma), Federative Structure 4207 Normandie Oncologie, Université de Caen Normandie, Inserm, F-14000 Caen, France; (L.G.); (M.B.); (M.V.); (F.G.); (L.P.); (C.D.); (N.V.); (R.F.)
- Department of Obstetrics and Reproductive Medicine, Université de Caen Normandie, F-14000 Caen, France
| |
Collapse
|
23
|
Nguyen NT, Raetz A, Montoya D, Schilling V, Tong C, Brooks RA, Leiserowitz G, Chien J. Targeting RAS-ERK pathway alterations with MEK inhibitors to improve chemosensitivity in high grade serous ovarian cancers. Gynecol Oncol 2023; 178:69-79. [PMID: 37806229 DOI: 10.1016/j.ygyno.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 09/06/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Assess if MEK inhibitor blockade of RAS-ERK pathway adaptive response in high grade serous ovarian cancers (HGSOC) improves platinum sensitivity. METHODS Three HGSOC cell lines and three patient derived organoid (PDOs) samples from ascites of platinum resistant HGSOC patients were collected. Cell lines and PDOs were exposed to carboplatin and MEK inhibitors cobimetinib or trametinib. Cytotoxic effects of MEK inhibitors alone or combined with carboplatin were established. Western blots demonstrated RAS-ERK pathway blockage after MEK inhibitor treatment. RNA sequencing assessed gene expression after MEK inhibitor treatment. Cell line NF1 gene knockdown was performed with corresponding chemosensitivity levels. RESULTS High carboplatin IC50 levels indicated platinum resistance in cell lines and PDOs. Cobimetinib induced cytotoxicity in cell lines and PDOs, while trametinib was less effective. Western blot confirmed MEK-ERK pathway blockage at minimal concentrations of MEK inhibitors in cell lines and PDOs. Phosphorylated-ERK levels of untreated cells indicated higher levels of RAS-ERK pathway activation in OVSAHO and OVCAR7 compared to OVCAR3. OVSAHO harbors a NF1 mutation and had highest levels of RAS-ERK activation. Cotreatment with carboplatin and MEK inhibitors showed varying synergistic cytotoxic effects at different combinations. Synergistic effect was most prominent in the OVSAHO carboplatin and cobimetinib combination. RNA sequencing identified downregulation of c-MYC and FOXM1 gene expression after MEK inhibitor treatment. NF1 gene knockdown showed an acquired increased IC50 compared to parental cells. CONCLUSION MEK inhibitors block RAS-ERK pathways in platinum resistant HGSOC cells and PDOs. MEK inhibitors with carboplatin have select synergistic effects which may indicate a strategy to improve platinum sensitivity.
Collapse
Affiliation(s)
- Nancy T Nguyen
- University of California Davis, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, USA.
| | - Alan Raetz
- University of California Davis, Department of Biochemistry and Molecular Medicine, USA
| | - Dennis Montoya
- University of California Davis, Department of Biochemistry and Molecular Medicine, USA
| | - Vincent Schilling
- University of California Davis, Department of Biochemistry and Molecular Medicine, USA
| | - Caili Tong
- University of California Davis, Department of Biochemistry and Molecular Medicine, USA
| | - Rebecca A Brooks
- University of California Davis, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, USA
| | - Gary Leiserowitz
- University of California Davis, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, USA
| | - Jeremy Chien
- University of California Davis, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, USA; University of California Davis, Department of Biochemistry and Molecular Medicine, USA
| |
Collapse
|
24
|
Avramenko AS, Flanagan JM. An epigenetic hypothesis for ovarian cancer prevention by oral contraceptive pill use. Clin Epigenetics 2023; 15:165. [PMID: 37853473 PMCID: PMC10585871 DOI: 10.1186/s13148-023-01584-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Ovarian cancer is the second most common gynecological cancer type after uterine cancers. In 2020, according to worldwide statistics, there were more than 313,000 new cases of ovarian cancer. Most concerning with ovarian cancer is the poor overall survival, with only 30% of patients surviving for longer than 5 years after diagnosis. The reason for this poor outcome includes late diagnosis due to non-specific symptoms and a lack of any highly effective biomarkers of the early stages of ovarian carcinogenesis. However, it is important to note that some modifiable lifestyle factors can be preventative [pregnancy, breastfeeding and combined oral contraceptives pill (COCP) use]. RESULTS There is now increasing data reporting the role of epigenetic changes, which are detectable in ovarian cancer tumors, suggesting the possibility that epigenetics may also play a key role in the mechanism of long-term effective prevention of ovarian cancer. To our knowledge, there is a lack of high-quality data on the molecular mechanisms of ovarian cancer prevention, although several hypotheses have been proposed. CONCLUSIONS This review focusses on the evidence for a proposed novel hypothesis-that COCPs act as a chemoprevention through the impact on the epigenome of the cells of origin of ovarian cancer-fallopian tubes epithelium.
Collapse
Affiliation(s)
- Anna S Avramenko
- Division of Cancer, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, 4th Floor IRDB, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - James M Flanagan
- Division of Cancer, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, 4th Floor IRDB, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK.
| |
Collapse
|
25
|
Azzalini E, Stanta G, Canzonieri V, Bonin S. Overview of Tumor Heterogeneity in High-Grade Serous Ovarian Cancers. Int J Mol Sci 2023; 24:15077. [PMID: 37894756 PMCID: PMC10606847 DOI: 10.3390/ijms242015077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Ovarian cancers encompass a group of neoplasms originating from germinal tissues and exhibiting distinct clinical, pathological, and molecular features. Among these, epithelial ovarian cancers (EOCs) are the most prevalent, comprising five distinct tumor histotypes. Notably, high-grade serous ovarian cancers (HGSOCs) represent the majority, accounting for over 70% of EOC cases. Due to their silent and asymptomatic behavior, HGSOCs are generally diagnosed in advanced stages with an evolved and complex genomic state, characterized by high intratumor heterogeneity (ITH) due to chromosomal instability that distinguishes HGSOCs. Histologically, these cancers exhibit significant morphological diversity both within and between tumors. The histologic patterns associated with solid, endometrioid, and transitional (SET) and classic subtypes of HGSOCs offer prognostic insights and may indicate specific molecular profiles. The evolution of HGSOC from primary to metastasis is typically characterized by clonal ITH, involving shared or divergent mutations in neoplastic sub-clones within primary and metastatic sites. Disease progression and therapy resistance are also influenced by non-clonal ITH, related to interactions with the tumor microenvironment and further genomic changes. Notably, significant alterations occur in nonmalignant cells, including cancer-associated fibroblast and immune cells, during tumor progression. This review provides an overview of the complex nature of HGSOC, encompassing its various aspects of intratumor heterogeneity, histological patterns, and its dynamic evolution during progression and therapy resistance.
Collapse
Affiliation(s)
- Eros Azzalini
- Department of Medical Sciences (DSM), University of Trieste, 34149 Trieste, Italy; (E.A.); (G.S.); (V.C.)
| | - Giorgio Stanta
- Department of Medical Sciences (DSM), University of Trieste, 34149 Trieste, Italy; (E.A.); (G.S.); (V.C.)
| | - Vincenzo Canzonieri
- Department of Medical Sciences (DSM), University of Trieste, 34149 Trieste, Italy; (E.A.); (G.S.); (V.C.)
- Pathology Unit, Centro di Riferimento Oncologico (CRO) IRCCS, Aviano-National Cancer Institute, 33081 Pordenone, Italy
| | - Serena Bonin
- Department of Medical Sciences (DSM), University of Trieste, 34149 Trieste, Italy; (E.A.); (G.S.); (V.C.)
| |
Collapse
|
26
|
Duus AH, Zheng G, Baandrup L, Faber MT, Kjær SK. Risk of ovarian cancer after salpingectomy and tubal ligation: Prospects on histology and time since the procedure. Gynecol Oncol 2023; 177:125-131. [PMID: 37683548 DOI: 10.1016/j.ygyno.2023.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE Recent theories propose that most epithelial ovarian cancer (EOC), depending on histological type, originate from other gynecological tissues and involve the ovary secondarily. According to these theories, any protective effect of salpingectomy and tubal ligation may vary by histological type. The study aim was to examine the association between salpingectomy and tubal ligation, respectively, and risk of EOC, with a focus on associations specific for histological types. METHODS We identified EOC cases and matching controls in national registries and gathered information on surgical procedures and potential confounders. Conditional logistic regression was used to estimate odds ratio (OR) with 95% confidence interval (CI) of EOC related to salpingectomy and tubal ligation, respectively, overall and stratified by histological type. Furthermore, we investigated the association according to timing of the procedures. RESULTS Our study comprised 16,822 EOC cases. Each case was matched with 40 controls. There was an overall EOC risk reduction after unilateral (OR = 0.73; 95% CI: 0.60-0.87) and bilateral salpingectomy (OR = 0.46; 95% CI: 0.31-0.67). A slight risk reduction was seen among women with previous tubal ligation (OR = 0.91; 95% CI: 0.83-0.99). For salpingectomy, the risk reduction increased with increasing time since the surgical procedure and was only present among women younger than 50 years at salpingectomy. Unilateral and bilateral salpingectomy was associated with a risk reduction for most histological types. CONCLUSION The association between previous salpingectomy and reduced risk of several histological subtypes of EOC supports the suggested theories about the site of origin of EOC and may be of clinical importance.
Collapse
Affiliation(s)
- Alberte Hjorth Duus
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark
| | - Guoqiao Zheng
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark
| | - Louise Baandrup
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark
| | - Mette Tuxen Faber
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark
| | - Susanne K Kjær
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet University Hospital, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
27
|
Fujiwara S. Clinical perspectives of rare ovarian tumors: clear cell ovarian cancer. Jpn J Clin Oncol 2023; 53:664-672. [PMID: 37288485 DOI: 10.1093/jjco/hyad057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 06/09/2023] Open
Abstract
Ovarian clear cell carcinoma (OCCC) is a rare and distinct histological type of epithelial ovarian carcinoma in terms of its histopathological, clinical and genetic features. Patients with OCCC are younger and diagnosed at earlier stages than those with the most common histological type-high-grade serous carcinoma. Endometriosis is considered a direct precursor of OCCC. Based on preclinical data, the most frequent gene alternations in OCCC are mutations of AT-rich interaction domain 1A and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha. The prognosis of patients with early-stage OCCC is favorable, whereas patients at an advanced stage or who have the recurrent disease have a dismal prognosis due to OCCC's resistance to standard platinum-based chemotherapy. Despite a lower rate of response due to its resistance to standard platinum-based chemotherapy, the treatment strategy for OCCC resembles that of high-grade serous carcinoma, which includes aggressive cytoreductive surgery and adjuvant platinum-based chemotherapy. Alternative treatment strategies, including biological agents based on molecular characteristics specific to OCCC, are urgently needed. Furthermore, due to its rarity, well-designed collaborative international clinical trials are needed to improve oncologic outcomes and the quality of life in patients with OCCC.
Collapse
Affiliation(s)
- Satoe Fujiwara
- Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| |
Collapse
|
28
|
Hasbay E, Görgülü G, Sanci M, Özamrak BG. Role of magnetic resonance imaging in the differentiation of mucinous ovarian carcinoma and mucinous borderline ovarian tumors. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230110. [PMID: 37466596 DOI: 10.1590/1806-9282.20230110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 04/27/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE This study was carried out to investigate the differentiation of mucinous borderline ovarian tumor from mucinous ovarian carcinoma using magnetic resonance imaging. METHODS We evaluated 77 women patients who underwent abdominal magnetic resonance imaging due to pelvic mass. magnetic resonance imaging was reviewed by an experienced radiologist. A total of 70 women patients were included in the study. The magnetic resonance imaging features were retrospectively evaluated and compared between the two pathologies. RESULTS There was no difference between the two groups in terms of maximum tumor size. Age at diagnosis was 56.29±11.92 in the mucinous ovarian carcinoma group and 44.74±13.60 in the mucinous borderline ovarian tumor group (p<0.05). A significant difference was found between the two groups, and it was observed that mucinous borderline ovarian tumors appeared in the younger age group compared to mucinous ovarian carcinomas. Presence of ascites, peritoneal dissemination, lymphadenopathy, and mural nodules was found significantly more frequently in mucinous ovarian carcinomas than in mucinous borderline ovarian tumors. Honeycomb appearance was found more frequently in mucinous borderline ovarian tumor patients than in mucinous ovarian carcinoma patients. CONCLUSION magnetic resonance imaging findings of these two pathologies overlapped considerably. Compared with mucinous borderline ovarian tumors, mucinous ovarian carcinomas frequently had mural nodules larger than 5 mm, larger tumor size, peritoneal dissemination, and abnormal ascites.
Collapse
Affiliation(s)
- Ebru Hasbay
- University of Health Sciences, Tepecik Education and Research Hospital Center, Department of Radiology - Izmir, Turkey
| | - Gökşen Görgülü
- University of Health Sciences, Tepecik Education and Research Hospital Center, Department of Gynaecologic Oncology - Izmir, Turkey
| | - Muzaffer Sanci
- University of Health Sciences, Tepecik Education and Research Hospital Center, Department of Gynaecologic Oncology - Izmir, Turkey
| | - Birsen Gizem Özamrak
- University of Health Sciences, Tepecik Education and Research Hospital Center, Department of Pathology - Izmir, Turkey
| |
Collapse
|
29
|
Pizarro D, Romero I, Pérez-Mies B, Redondo A, Caniego-Casas T, Carretero-Barrio I, Cristóbal E, Gutiérrez-Pecharromán A, Santaballa A, D'Angelo E, Hardisson D, Vieites B, Matías-Guiu X, Estévez P, Guerra E, Prat J, Poveda A, López-Guerrero JA, Palacios J. The Prognostic Significance of Tumor-Infiltrating Lymphocytes, PD-L1, BRCA Mutation Status and Tumor Mutational Burden in Early-Stage High-Grade Serous Ovarian Carcinoma-A Study by the Spanish Group for Ovarian Cancer Research (GEICO). Int J Mol Sci 2023; 24:11183. [PMID: 37446361 DOI: 10.3390/ijms241311183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Early stages are under-represented in studies on the molecular and immune features of high-grade serous ovarian carcinoma (HGSOC), and specific studies focused on early-stage HGSOC are required for a better prognostic stratification and to personalize chemotherapy. The aim of this study was to determine the prognostic significance of CD8+ and CD4+ tumor-infiltrating lymphocytes (TILs), tumoral cell PD-L1 expression, BRCA mutational status and tumor mutation burden (TMB) in early-stage HGSOC. A retrospective study was performed on stage I and II HGSOC from the Molecular Reclassification of Early Stages of Ovarian Cancer (RECLAMO) cohort from the Spanish Group of Ovarian Cancer Research (GEICO). Centralized histological typing was performed based on morphological and immunohistochemical features. Intraepithelial (i) and stromal (s) CD8+ and CD4+ T cells and PD-L1 were evaluated on tissue microarrays by immunohistochemistry. BRCA1 and BRCA2 mutation status and TMB were analyzed in tumor DNA using next-generation sequencing. The study included 124 tumors. High iCD8+ (>20 TILs/core), low/intermediate CD4+ (<20 TILs/core) and high CD8+/CD4+ ratio (>35/core) were associated with favorable outcomes. Tumor cell PD-L1 expression (TPS ≥ 1) was present in only 8% of tumors. In total, 11 (16%) and 6 (9%) out of 69 HGSOC tested carried pathogenic or likely pathogenic BRCA1 or BRCA2 mutations, respectively. Median TMB of 40 tumors analyzed was 5.04 mutations/Mb and only 6 tumors had 10 or more mutations/Mb. BRCA status and TMB were not associated with TILs or prognosis. When compared with studies on advanced HGSOC, our results suggested that prognostic variables differed according to stage and that more studies focused on early stages of HGSOC are needed to better stratify these tumors.
Collapse
Affiliation(s)
- David Pizarro
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
| | - Ignacio Romero
- Instituto Valenciano de Oncología, 46009 Valencia, Spain
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
| | - Belén Pérez-Mies
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá, 28801 Alcalá de Henares, Spain
| | - Andrés Redondo
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Oncology Department, University Hospital La Paz, IdiPAZ, 28046 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz, 28029 Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
| | - Tamara Caniego-Casas
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá, 28801 Alcalá de Henares, Spain
| | - Eva Cristóbal
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Ana Santaballa
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Oncology Department, University Hospital La Fe, 46026 Valencia, Spain
| | - Emanuela D'Angelo
- Department of Medical, Oral, and Biotechnological Sciences, University "G.D'Annunzio" of Chieti-Pescara, 66013 Chieti, Italy
| | - David Hardisson
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz, 28029 Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
- Pathology Department, University Hospital La Paz, 28046 Madrid, Spain
| | - Begoña Vieites
- Pathology Department, University Hospital Virgen del Rocío, 41013 Sevilla, Spain
| | - Xavier Matías-Guiu
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Pathology and Medical Oncology Departments, Hospital Universitari Arnau de Vilanova, IRBLLEIDA, University of Lleida, 25003 Lleida, Spain
- Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, 08007 Barcelona, Spain
| | - Purificación Estévez
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Oncology Department, University Hospital Virgen del Rocío, 41013 Sevilla, Spain
- Seville Biomedical Research Institute (IBIS), 41013 Sevilla, Spain
| | - Eva Guerra
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Oncology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
| | - Jaime Prat
- Pathology Department, Emeritus Faculty, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Andrés Poveda
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Initia Oncología, Hospital Quironsalud Valencia, 46010 Valencia, Spain
| | - José Antonio López-Guerrero
- Instituto Valenciano de Oncología, 46009 Valencia, Spain
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
| | - José Palacios
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá, 28801 Alcalá de Henares, Spain
| |
Collapse
|
30
|
Talbot T, Lu H, Aboagye EO. Amplified therapeutic targets in high-grade serous ovarian carcinoma - a review of the literature with quantitative appraisal. Cancer Gene Ther 2023; 30:955-963. [PMID: 36804485 PMCID: PMC9940086 DOI: 10.1038/s41417-023-00589-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/05/2023] [Accepted: 01/17/2023] [Indexed: 02/22/2023]
Abstract
High-grade serous ovarian carcinoma is a unique cancer characterised by universal TP53 mutations and widespread copy number alterations. These copy number alterations include deletion of tumour suppressors and amplification of driver oncogenes. Given their key oncogenic roles, amplified driver genes are often proposed as therapeutic targets. For example, development of anti-HER2 agents has been clinically successful in treatment of ERBB2-amplified tumours. A wide scope of preclinical work has since investigated numerous amplified genes as potential therapeutic targets in high-grade serous ovarian carcinoma. However, variable experimental procedures (e.g., choice of cell lines), ambiguous phenotypes or lack of validation hinders further clinical translation of many targets. In this review, we collate the genes proposed to be amplified therapeutic targets in high-grade serous ovarian carcinoma, and quantitatively appraise the evidence in support of each candidate gene. Forty-four genes are found to have evidence as amplified therapeutic targets; the five highest scoring genes are CCNE1, PAX8, URI1, PRKCI and FAL1. This review generates an up-to-date list of amplified therapeutic target candidates for further development and proposes comprehensive criteria to assist amplified therapeutic target discovery in the future.
Collapse
Affiliation(s)
- Thomas Talbot
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120NN, London, UK
| | - Haonan Lu
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120NN, London, UK
| | - Eric O Aboagye
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120NN, London, UK.
| |
Collapse
|
31
|
Haque R, Lee J, Chung JY, Shin HY, Kim H, Kim JH, Yun JW, Kang ES. VGLL3 expression is associated with macrophage infiltration and predicts poor prognosis in epithelial ovarian cancer. Front Oncol 2023; 13:1152991. [PMID: 37342190 PMCID: PMC10277618 DOI: 10.3389/fonc.2023.1152991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 05/09/2023] [Indexed: 06/22/2023] Open
Abstract
Background/objective High-grade serous ovarian carcinoma (HGSOC) is the most common histologic type of epithelial ovarian cancer (EOC). Due to its poor survival outcomes, it is essential to identify novel biomarkers and therapeutic targets. The hippo pathway is crucial in various cancers, including gynaecological cancers. Herein, we examined the expression of the key genes of the hippo pathway and their relationship with clinicopathological significance, immune cells infiltration and the prognosis of HGSOC. Methods The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) data were curated to analyse the mRNA expression as well as the clinicopathological association and correlation with immune cell infiltration in HGSOC. The protein levels of significant genes in the HGSOC tissue were analysed using Tissue Microarray (TMA)-based immunohistochemistry. Finally, DEGs pathway analysis was performed to find the signalling pathways associated with VGLL3. Results VGLL3 mRNA expression was significantly correlated with both advanced tumor stage and poor overall survival (OS) (p=0.046 and p=0.003, respectively). The result of IHC analysis also supported the association of VGLL3 protein with poor OS. Further, VGLL3 expression was significantly associated with tumor infiltrating macrophages. VGLL3 expression and macrophages infiltration were both found to be independent prognostic factors (p=0.003 and p=0.024, respectively) for HGSOC. VGLL3 was associated with four known and three novel cancer-related signalling pathways, thus implying that VGLL3 is involved in the deregulation of many genes and pathways. Conclusion Our study revealed that VGLL3 may play a distinct role in clinical outcomes and immune cell infiltration in patients with HGSOC and that it could potentially be a prognostic marker of EOC.
Collapse
Affiliation(s)
- Razaul Haque
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Seoul, Republic of Korea
- School of Medicine, Sungkyunkwan University, Suwon, Republic of Korea
| | - Jaebon Lee
- School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Joon-Yong Chung
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Ha-Yeon Shin
- Department of Obstetrics and Gynaecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyosun Kim
- Department of Obstetrics and Gynaecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Hoon Kim
- Department of Obstetrics and Gynaecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Won Yun
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Seoul, Republic of Korea
- School of Medicine, Sungkyunkwan University, Suwon, Republic of Korea
- Cell and Gene Therapy Institute, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| |
Collapse
|
32
|
Marketkar S, Sung CJ, Quddus MR. Simultaneous p53 and KRAS mutation in a high-grade serous carcinoma with deceptive appearance of a low-grade carcinoma. A case report. Gynecol Oncol Rep 2023; 47:101197. [PMID: 37251787 PMCID: PMC10209119 DOI: 10.1016/j.gore.2023.101197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/31/2023] Open
Abstract
Low-grade and high-grade serous carcinomas have unique clinical, morphological, underlying molecular alterations, and vastly different biologic behavior (Prat et al., 2018, Vang et al., 2009). The differentiation into high and low-grade serous carcinoma is important for clinical management and prognosis and is easily recognized by practicing pathologists. High-grade serous carcinoma is characterized by marked nuclear atypia and pleomorphism, frequent, often atypical mitosis with papillary or three-dimensional clusters, p53 mutation, and block-like p16 staining. In contrast, low-grade serous carcinomas have a different morphologic appearance with micropapillary formation, small nests of tumor cells having low to intermediate grade nuclei, and absence of significant mitosis. Low-grade serous carcinoma is often associated with micropapillary variant of ovarian serous borderline tumor. The low-grade serous carcinoma shows wild type p53 expression, patchy p16 staining, and often K-RAS, N-RAS, and/or B-RAF mutation. Here we report a case of mullerian high grade serous with a deceptive morphology resembling low-grade serous carcinoma with micropapillary features and moderate nuclear atypia. However, the tumor is simultaneously p53 and K-RAS mutated. This case illustrates three critical issues; a) potential to be mistaken as a low-grade serous carcinoma because of morphologic appearance and relative uniform cytologic feature. b). raise the question of true progression of low-grade to high-grade serous carcinoma, a rare phenomenon as described in the literature, and c). whether the biologic behavior and/or response to therapy would differ from the classic forms.
Collapse
|
33
|
Gomes FDC, Figueiredo ERL, Araújo END, Andrade EMD, Carneiro CDL, Almeida GMD, Dias HAAL, Teixeira LIB, Almeida MT, Farias MFD, Linhares NA, Fonseca NLD, Pereira YDS, Melo-Neto JSD. Social, Genetics and Histopathological Factors Related to Titin ( TTN) Gene Mutation and Survival in Women with Ovarian Serous Cystadenocarcinoma: Bioinformatics Analysis. Genes (Basel) 2023; 14:genes14051092. [PMID: 37239452 DOI: 10.3390/genes14051092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/11/2023] [Accepted: 03/18/2023] [Indexed: 05/28/2023] Open
Abstract
Several factors may increase the risk of development of ovarian cancer. In this study, we investigated the relationship between social, genetic, and histopathologic factors in women with ovarian serous cystadenocarcinoma and titin (TTN) mutations, whether the TTN gene mutation may be a predictor, and its impact on mortality and survival in these patients. A total of 585 samples from patients with ovarian serous cystadenocarcinoma were collected from The Cancer Genome Atlas and PanCancer Atlas through the cBioPortal for analysis of social, genetic, and histopathological factors. Logistic regression was used to investigate whether TTN mutation could be a predictor, and the Kaplan-Meier method was applied to analyze survival time. TTN mutation frequency did not differ between age at diagnosis, tumor stage, and race, and was related to increased Buffa hypoxia score (p = 0.004), mutation count (p < 0.0001), Winter hypoxia Score (p = 0.030), nonsynonymous tumor mutation burden (TMB) (p < 0.0001), and reduced microsatellite instability sensor score (p = 0.010). The number of mutations (p < 0.0001) and winter hypoxia score (p = 0.008) were positively associated with TTN mutations, and nonsynonymous TMB (p < 0.0001) proved to be a predictor. Mutated TTN affects the score of genetic variables involved in cancer cell metabolism in ovarian cystadenocarcinoma.
Collapse
Affiliation(s)
- Fabiana de Campos Gomes
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
- Faculty of Medicine CERES (FACERES), São José do Rio Preto 15090-305, SP, Brazil
| | - Eric Renato Lima Figueiredo
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Ediane Nunes De Araújo
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Edila Monteiro De Andrade
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Carlos Diego Lisbôa Carneiro
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Gabriel Mácola De Almeida
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Helana Augusta Andrade Leal Dias
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Lucélia Inoue Bispo Teixeira
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Manuela Trindade Almeida
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Mariusa Fernandes De Farias
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Natália Albim Linhares
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Natasha Lima Da Fonseca
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - Yago Dos Santos Pereira
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| | - João Simão de Melo-Neto
- Postgraduate Program in Health, Environment and Society in the Amazon (PPGSAS), Federal University of Pará (UFPA), Street Augusto Corrêa, 01, University City: José Silveira Neto, Health sector: Guamá, Belém 66075-110, PA, Brazil
| |
Collapse
|
34
|
Gaitskell K, Rogozińska E, Platt S, Chen Y, Abd El Aziz M, Tattersall A, Morrison J. Angiogenesis inhibitors for the treatment of epithelial ovarian cancer. Cochrane Database Syst Rev 2023; 4:CD007930. [PMID: 37185961 PMCID: PMC10111509 DOI: 10.1002/14651858.cd007930.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Many women, and other females, with epithelial ovarian cancer (EOC) develop resistance to conventional chemotherapy drugs. Drugs that inhibit angiogenesis (development of new blood vessels), essential for tumour growth, control cancer growth by denying blood supply to tumour nodules. OBJECTIVES To compare the effectiveness and toxicities of angiogenesis inhibitors for treatment of epithelial ovarian cancer (EOC). SEARCH METHODS We identified randomised controlled trials (RCTs) by searching CENTRAL, MEDLINE and Embase (from 1990 to 30 September 2022). We searched clinical trials registers and contacted investigators of completed and ongoing trials for further information. SELECTION CRITERIA RCTs comparing angiogenesis inhibitors with standard chemotherapy, other types of anti-cancer treatment, other angiogenesis inhibitors with or without other treatments, or placebo/no treatment in a maintenance setting, in women with EOC. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. Our outcomes were overall survival (OS), progression-free survival (PFS), quality of life (QoL), adverse events (grade 3 and above) and hypertension (grade 2 and above). MAIN RESULTS We identified 50 studies (14,836 participants) for inclusion (including five studies from the previous version of this review): 13 solely in females with newly-diagnosed EOC and 37 in females with recurrent EOC (nine studies in platinum-sensitive EOC; 19 in platinum-resistant EOC; nine with studies with mixed or unclear platinum sensitivity). The main results are presented below. Newly-diagnosed EOC Bevacizumab, a monoclonal antibody that binds vascular endothelial growth factor (VEGF), given with chemotherapy and continued as maintenance, likely results in little to no difference in OS compared to chemotherapy alone (hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.88 to 1.07; 2 studies, 2776 participants; moderate-certainty evidence). Evidence is very uncertain for PFS (HR 0.82, 95% CI 0.64 to 1.05; 2 studies, 2746 participants; very low-certainty evidence), although the combination results in a slight reduction in global QoL (mean difference (MD) -6.4, 95% CI -8.86 to -3.94; 1 study, 890 participants; high-certainty evidence). The combination likely increases any adverse event (grade ≥ 3) (risk ratio (RR) 1.16, 95% CI 1.07 to 1.26; 1 study, 1485 participants; moderate-certainty evidence) and may result in a large increase in hypertension (grade ≥ 2) (RR 4.27, 95% CI 3.25 to 5.60; 2 studies, 2707 participants; low-certainty evidence). Tyrosine kinase inhibitors (TKIs) to block VEGF receptors (VEGF-R), given with chemotherapy and continued as maintenance, likely result in little to no difference in OS (HR 0.99, 95% CI 0.84 to 1.17; 2 studies, 1451 participants; moderate-certainty evidence) and likely increase PFS slightly (HR 0.88, 95% CI 0.77 to 1.00; 2 studies, 2466 participants; moderate-certainty evidence). The combination likely reduces QoL slightly (MD -1.86, 95% CI -3.46 to -0.26; 1 study, 1340 participants; moderate-certainty evidence), but it increases any adverse event (grade ≥ 3) slightly (RR 1.31, 95% CI 1.11 to 1.55; 1 study, 188 participants; moderate-certainty evidence) and may result in a large increase in hypertension (grade ≥ 3) (RR 6.49, 95% CI 2.02 to 20.87; 1 study, 1352 participants; low-certainty evidence). Recurrent EOC (platinum-sensitive) Moderate-certainty evidence from three studies (with 1564 participants) indicates that bevacizumab with chemotherapy, and continued as maintenance, likely results in little to no difference in OS (HR 0.90, 95% CI 0.79 to 1.02), but likely improves PFS (HR 0.56, 95% CI 0.50 to 0.63) compared to chemotherapy alone. The combination may result in little to no difference in QoL (MD 0.8, 95% CI -2.11 to 3.71; 1 study, 486 participants; low-certainty evidence), but it increases the rate of any adverse event (grade ≥ 3) slightly (RR 1.11, 1.07 to 1.16; 3 studies, 1538 participants; high-certainty evidence). Hypertension (grade ≥ 3) was more common in arms with bevacizumab (RR 5.82, 95% CI 3.84 to 8.83; 3 studies, 1538 participants). TKIs with chemotherapy may result in little to no difference in OS (HR 0.86, 95% CI 0.67 to 1.11; 1 study, 282 participants; low-certainty evidence), likely increase PFS (HR 0.56, 95% CI 0.44 to 0.72; 1 study, 282 participants; moderate-certainty evidence), and may have little to no effect on QoL (MD 6.1, 95% CI -0.96 to 13.16; 1 study, 146 participants; low-certainty evidence). Hypertension (grade ≥ 3) was more common with TKIs (RR 3.32, 95% CI 1.21 to 9.10). Recurrent EOC (platinum-resistant) Bevacizumab with chemotherapy and continued as maintenance increases OS (HR 0.73, 95% CI 0.61 to 0.88; 5 studies, 778 participants; high-certainty evidence) and likely results in a large increase in PFS (HR 0.49, 95% CI 0.42 to 0.58; 5 studies, 778 participants; moderate-certainty evidence). The combination may result in a large increase in hypertension (grade ≥ 2) (RR 3.11, 95% CI 1.83 to 5.27; 2 studies, 436 participants; low-certainty evidence). The rate of bowel fistula/perforation (grade ≥ 2) may be slightly higher with bevacizumab (RR 6.89, 95% CI 0.86 to 55.09; 2 studies, 436 participants). Evidence from eight studies suggest TKIs with chemotherapy likely result in little to no difference in OS (HR 0.85, 95% CI 0.68 to 1.08; 940 participants; moderate-certainty evidence), with low-certainty evidence that it may increase PFS (HR 0.70, 95% CI 0.55 to 0.89; 940 participants), and may result in little to no meaningful difference in QoL (MD ranged from -0.19 at 6 weeks to -3.40 at 4 months). The combination increases any adverse event (grade ≥ 3) slightly (RR 1.23, 95% CI 1.02 to 1.49; 3 studies, 402 participants; high-certainty evidence). The effect on bowel fistula/perforation rates is uncertain (RR 2.74, 95% CI 0.77 to 9.75; 5 studies, 557 participants; very low-certainty evidence). AUTHORS' CONCLUSIONS Bevacizumab likely improves both OS and PFS in platinum-resistant relapsed EOC. In platinum-sensitive relapsed disease, bevacizumab and TKIs probably improve PFS, but may or may not improve OS. The results for TKIs in platinum-resistant relapsed EOC are similar. The effects on OS or PFS in newly-diagnosed EOC are less certain, with a decrease in QoL and increase in adverse events. Overall adverse events and QoL data were more variably reported than were PFS data. There appears to be a role for anti-angiogenesis treatment, but given the additional treatment burden and economic costs of maintenance treatments, benefits and risks of anti-angiogenesis treatments should be carefully considered.
Collapse
Affiliation(s)
- Kezia Gaitskell
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Sarah Platt
- Obstetrics and Gynaecology, St Mary's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Department of Gynaecological Oncology, St. Michael's Hospital, Bristol, UK
| | - Yifan Chen
- Oxford Medical School, University of Oxford, Oxford, UK
| | | | | | - Jo Morrison
- Department of Gynaecological Oncology, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, UK
| |
Collapse
|
35
|
Tierno D, Azzalini E, Farra R, Drioli S, Felluga F, Lazzarino M, Grassi G, Dapas B, Bonin S. Nanomechanical Characterization of Ovarian Cancer Cell Lines as a Marker of Response to 2c Treatment. Int J Mol Sci 2023; 24:ijms24087230. [PMID: 37108391 PMCID: PMC10139025 DOI: 10.3390/ijms24087230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Epithelial ovarian cancers (EOCs) are a heterogeneous group of tumors with different molecular and clinical features. In past decades, few improvements have been achieved in terms of EOC management and treatment efficacy, such that the 5-year survival rate of patients remained almost unchanged. A better characterization of EOCs' heterogeneity is needed to identify cancer vulnerabilities, stratify patients and adopt proper therapies. The mechanical features of malignant cells are emerging as new biomarkers of cancer invasiveness and drug resistance that can further improve our knowledge of EOC biology and allow the identification of new molecular targets. In this study, we determined the inter and intra-mechanical heterogeneity of eight ovarian cancer cell lines and their association with tumor invasiveness and resistance to an anti-tumoral drug with cytoskeleton depolymerization activity (2c).
Collapse
Affiliation(s)
- Domenico Tierno
- Department of Medical Sciences (DSM), University of Trieste, 34149 Trieste, Italy
| | - Eros Azzalini
- Department of Medical Sciences (DSM), University of Trieste, 34149 Trieste, Italy
| | - Rossella Farra
- Department of Life Sciences (DSV), University of Trieste, 34128 Trieste, Italy
| | - Sara Drioli
- Department of Chemical and Pharmaceutical Sciences (DSCF), University of Trieste, 34127 Trieste, Italy
| | - Fulvia Felluga
- Department of Chemical and Pharmaceutical Sciences (DSCF), University of Trieste, 34127 Trieste, Italy
| | - Marco Lazzarino
- Consiglio Nazionale delle Ricerche, Istituto Officina dei Materiali (IOM), 34149 Trieste, Italy
| | - Gabriele Grassi
- Department of Life Sciences (DSV), University of Trieste, 34128 Trieste, Italy
| | - Barbara Dapas
- Department of Life Sciences (DSV), University of Trieste, 34128 Trieste, Italy
| | - Serena Bonin
- Department of Medical Sciences (DSM), University of Trieste, 34149 Trieste, Italy
| |
Collapse
|
36
|
Ring LL, Baandrup L, Zheng G, Gottschau M, Dehlendorff C, Mellemkjær L, Kjaer SK. Hysterectomy and risk of epithelial ovarian cancer by histologic type, endometriosis, and menopausal hormone therapy. Cancer Epidemiol 2023; 84:102359. [PMID: 37054550 DOI: 10.1016/j.canep.2023.102359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND This nationwide, register-based case-control study investigated the association between hysterectomy and risk of epithelial ovarian cancer according to histology and by history of endometriosis and menopausal hormone therapy (MHT) use. METHODS From the Danish Cancer Registry, all women registered with epithelial ovarian cancer at age 40-79 years during 1998-2016 were identified (n = 6738). Each case was sex- and age-matched to 15 population controls using risk-set sampling. Information on previous hysterectomy on benign indication and potential confounders was retrieved from nationwide registers. Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for the association between hysterectomy and ovarian cancer according to histology, endometriosis, and use of MHT. RESULTS Hysterectomy was not associated with risk of epithelial ovarian cancer overall (OR=0.99; 95% CI 0.91 -1.09) but was associated with reduced risk of clear cell ovarian cancer (OR=0.46; 95% CI 0.28-0.78). In stratified analyses, decreased ORs associated with hysterectomy were seen in women with endometriosis (OR=0.74; 95% CI 0.50-1.10) and in non-users of MHT (OR=0.87; 95% CI 0.76-1.01). In contrast, among long-term MHT users, hysterectomy was associated with increased odds for ovarian cancer (OR=1.20; 95% CI 1.03-1.39). CONCLUSION Hysterectomy was not associated with epithelial ovarian cancer overall but with reduced risk of clear cell ovarian cancer. Our findings may suggest a reduced risk of ovarian cancer after hysterectomy in women with endometriosis and in MHT non-users. Interestingly our data pointed to an increased ovarian cancer risk associated with hysterectomy among long-term users of MHT.
Collapse
Affiliation(s)
- Linea Landgrebe Ring
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Louise Baandrup
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Guoqiao Zheng
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mathilde Gottschau
- Unit of Diet, Cancer and Health, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christian Dehlendorff
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Lene Mellemkjær
- Unit of Diet, Cancer and Health, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| |
Collapse
|
37
|
Lebreton C, Quesada S, Bini M, Babin G, Rossi L, Chopin N, Croce S, Hartog C, Renaud T, Gaillard AL, Petit A, Serre AA, Trédan O, Rowinski E, Cockenpot V, Treilleux I, Rousset-Jablonski C, Méeus P, Guyon F, Ray-Coquard I. [Treatments for rare ovarian tumors: What's new?]. Bull Cancer 2023:S0007-4551(23)00151-0. [PMID: 37045734 DOI: 10.1016/j.bulcan.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 04/14/2023]
Abstract
Even if each rare ovarian tumor (ROT) has a low incidence, the sum of all these entities represents almost the half of all ovarian neoplasms. Thus, development of dedicated clinical trial emerged as a prerequisite to improve their managements. Owing to the spreading of dedicated institutional networks and (supra)national collaborations, the number of clinical trials has increased the past few years, with different types of trials; while some focused on specific molecular features, others assessed innovative molecules. Furthermore, relevant randomized clinical trials were designed as a mean to position new treatment options. Currently, innovative molecular-driven trials, based on master protocol trials are emerging and may shed light towards the improvement of personalized medicine regarding ROT.
Collapse
Affiliation(s)
- Coriolan Lebreton
- Institut Bergonié, département d'oncologie médicale, Bordeaux, France; University of Bordeaux, ARTiSt Lab, Inserm U1312, Bordeaux, France.
| | - Stanislas Quesada
- Institut régional du cancer de Montpellier, département d'oncologie médicale, Montpellier, France
| | - Marta Bini
- Instituto Nazionale dei Tumori, Milano, Italie
| | - Guillaume Babin
- University of Bordeaux, ARTiSt Lab, Inserm U1312, Bordeaux, France; Institut Bergonié, département de chirurgie, Bordeaux, France
| | - Léa Rossi
- Centre Léon-Bérard, département de chirurgie, Lyon, France
| | - Nicolas Chopin
- Centre Léon-Bérard, département de chirurgie, Lyon, France
| | - Sabrina Croce
- Institut Bergonié, département de biopathologie, Bordeaux, France; University of Bordeaux, SARCOTARGET Lab, Inserm U1312, Bordeaux, France
| | - Cécile Hartog
- University of Bordeaux, ARTiSt Lab, Inserm U1312, Bordeaux, France; Centre Léon-Bérard, département de chirurgie, Lyon, France
| | - Tiphaine Renaud
- Institut Bergonié, département de gynécologie médicale, Bordeaux, France
| | | | - Adeline Petit
- Institut Bergonié, département de radiothérapie et curiethérapie, Bordeaux, France
| | - Anne-Agathe Serre
- Centre Léon-Bérard, département de radiothérapie et curiethérapie, Lyon, France
| | - Olivier Trédan
- Centre Léon-Bérard, département d'oncologie médicale, Lyon, France
| | - Elise Rowinski
- Centre Léon-Bérard, département d'oncologie médicale, Lyon, France
| | | | | | | | - Pierre Méeus
- Centre Léon-Bérard, département de chirurgie, Lyon, France
| | - Frédéric Guyon
- Institut Bergonié, département de chirurgie, Bordeaux, France
| | - Isabelle Ray-Coquard
- Centre Léon-Bérard, département d'oncologie médicale, Lyon, France; University of Claude-Bernard Lyon 1, health services and performance research lab (EA 7425 HESPER), Lyon, France
| |
Collapse
|
38
|
Mhatre A, Koroth J, Manjunath M, Kumar S S, Gawari R, Choudhary B. Multi-omics analysis of the Indian ovarian cancer cohort revealed histotype-specific mutation and gene expression patterns. Front Genet 2023; 14:1102114. [PMID: 37091785 PMCID: PMC10117685 DOI: 10.3389/fgene.2023.1102114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/22/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction: In India, OVCa is women’s third most common and lethal cancer type, accounting for 6.7% of observed cancer incidences. The contribution of somatic mutations, aberrant expression of gene and splice forms in determining the cell fate, gene networks, tumour-specific variants, and the role of immune fraction infiltration have been proven essential in understanding tumorigenesis. However, their interplay in OVCa in a histotype-specific manner remains unclear in the Indian context. In the present study, we aimed to unravel the Indian population histotype-specific exome variants, differentially expressed gene modules, splice events and immune profiles of OVCa samples.Methods: We analysed 10 tumour samples across 4 ovarian cancer histotypes along with 2 normal patient samples. This included BCFtool utilities and CNVkit for exome, WGCNA and DESeq2 for obtaining differential module hub genes and dysregulated miRNA targets, CIBERSORTx for individual immune profiles and rMATS for tumour specific splice variants.Result: We identified population-specific novel mutations in Cancer Gene Census Tier1 and Tier2 genes. MUC16, MUC4, CIITA, and NCOR2 were among the most mutated genes, along with TP53. Transcriptome analysis showed significant overexpression of mutated genes MUC16, MUC4, and CIITA, whereas NCOR2 was downregulated. WGCNA revealed histotype-specific gene hubs and networks. Among the significant pathways, alteration in the immune system was one of the pathways, and immune profiling using CIBERSORTx revealed histotype-specific immune cell fraction. miRNA analysis revealed miR-200 family, miR-200a and miR-429 were upregulated in HGSOCs.Splice factor abrasion caused splicing perturbations, with the most abundant alternative splice event being exon skipping and the most spliced gene, SNHG17. Pathway analysis of spliced genes revealed translational elongation and Base excision repair as the pathways altered in OVCa.Conclusion: Integrated exome, transcriptome, and splicing patterns revealed different population-specific molecular signatures of ovarian cancer histotypes in the Indian Cohort.
Collapse
Affiliation(s)
- Anisha Mhatre
- Department of Biotechnology and Bioinformatics, Institute of Bioinformatics and Applied Biotechnology, Bangalore, Karnataka, India
| | - Jinsha Koroth
- Department of Biotechnology and Bioinformatics, Institute of Bioinformatics and Applied Biotechnology, Bangalore, Karnataka, India
| | - Meghana Manjunath
- Department of Biotechnology and Bioinformatics, Institute of Bioinformatics and Applied Biotechnology, Bangalore, Karnataka, India
- Graduate Student Registered Under Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Ramesh Gawari
- Kidwai Cancer Institute of Oncology, Bangalore, India
| | - Bibha Choudhary
- Department of Biotechnology and Bioinformatics, Institute of Bioinformatics and Applied Biotechnology, Bangalore, Karnataka, India
- *Correspondence: Bibha Choudhary,
| |
Collapse
|
39
|
Zou Y, Xu Y, Chen X, Zheng L. Advances in the application of immune checkpoint inhibitors in gynecological tumors. Int Immunopharmacol 2023; 117:109774. [PMID: 37012881 DOI: 10.1016/j.intimp.2023.109774] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Immune checkpoints are regulatory molecules that suppress immune effector cells, and are essential for maintaining tolerance, preventing autoimmune reactions, and minimizing tissue damage by controlling the duration and intensity of the immune responses. However, immune checkpoints are frequently upregulated during cancer and dampen the anti-tumor immune responses. Immune checkpoint inhibitors (ICIs) have been effective against multiple tumors, and have improved patients' survival outcomes. Recent clinical trials have also reported promising therapeutic effects of ICIs in some gynecological cancers. AIM To review the current research and future directions in the treatment of gynecological malignancies, including ovarian, cervical and endometrial cancers, using ICIs. CONCLUSION Currently, cervical and ovarian cancers are the only gynecological tumors that are treated by immunotherapeutic approaches. In addition, ICIs, chimeric antigen receptor (CAR)- and T cell receptor (TCR)-engineered T cells targeting endometrial tumors, especially those originating in the vulva and fallopian tubes, are under development. Nevertheless, the molecular mechanism underlying the effects of ICIs, especially in combination with chemotherapy, radiation therapy, anti-angiogenesis drugs and poly ADP ribose polymerase inhibitors (PARPi), needs to be elucidated. Furthermore, novel predictive biomarkers have to be identified in order to increase the therapeutic efficacy of ICIs while reducing adverse reactions.
Collapse
Affiliation(s)
- YingGang Zou
- Reproductive Medical Center, Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Ying Xu
- Reproductive Medical Center, Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - XiaoChen Chen
- Reproductive Medical Center, Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Lianwen Zheng
- Reproductive Medical Center, Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| |
Collapse
|
40
|
Buttitta F, Di Marino P, Felicioni L, Primavera FC, Ferro B, Zampacorta C, Pasciuto MP, Rossetti R, Tudini M, Marchetti A, D’Angelo E. BRCA gene amplification in primary peritoneal high-grade serous carcinoma patient with intrinsic resistance to platinum treatment: a case report. Pathologica 2023; 115:107-110. [PMID: 37114628 PMCID: PMC10462999 DOI: 10.32074/1591-951x-871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Platinum-based chemotherapy is the standard chemotherapy for high grade serous ovarian cancer and primary peritoneal high-grade serous carcinoma. PARP inhibitors have changed the paradigm of the treatment in platinum-sensitive ovarian cancers and primary peritoneal high-grade serous carcinoma with BRCA1/2 mutation or homologous recombination deficiency (HRD). Platinum-resistant ovarian and primary peritoneal high-grade serous carcinoma have a lower chance to treat and have worse outcomes. We described a case of patient with a platinum resistant primary peritoneal high-grade serous carcinoma with a rare somatic BRCA2 amplification. There are no guidelines for the treatment of ovarian cancer or primary peritoneal high-grade serous carcinoma with BRCA2 amplification. BRCA2 amplification could result in extreme homologous recombination repair (HRR) pathway efficiency and in less platinum sensitivity, which could be a molecular signature for platinum resistance. Free platinum chemotherapy regimens could be more effective in cases with BRCA2 amplification. Further studies are necessary to establish better approaches and strategies for oncological management and treatment in BRCA2 amplification high grade ovarian cancer and primary peritoneal high-grade serous carcinoma.
Collapse
Affiliation(s)
- Fiamma Buttitta
- Center for Advanced Studies and Technology (CAST), University Chieti-Pescara, Italy
- Diagnostic Molecular Pathology, Unit of Anatomic Pathology, SS Annunziata Hospital, Chieti, Italy
- Department of Medical, Oral, and Biotechnological Sciences University “G. D’Annunzio” of Chieti-Pescara
| | | | - Lara Felicioni
- Diagnostic Molecular Pathology, Unit of Anatomic Pathology, SS Annunziata Hospital, Chieti, Italy
| | | | - Benedetta Ferro
- Center for Advanced Studies and Technology (CAST), University Chieti-Pescara, Italy
- Diagnostic Molecular Pathology, Unit of Anatomic Pathology, SS Annunziata Hospital, Chieti, Italy
| | - Claudia Zampacorta
- Center for Advanced Studies and Technology (CAST), University Chieti-Pescara, Italy
- Diagnostic Molecular Pathology, Unit of Anatomic Pathology, SS Annunziata Hospital, Chieti, Italy
| | - Maria Paola Pasciuto
- Center for Advanced Studies and Technology (CAST), University Chieti-Pescara, Italy
- Diagnostic Molecular Pathology, Unit of Anatomic Pathology, SS Annunziata Hospital, Chieti, Italy
| | - Rebecca Rossetti
- Center for Advanced Studies and Technology (CAST), University Chieti-Pescara, Italy
| | | | - Antonio Marchetti
- Center for Advanced Studies and Technology (CAST), University Chieti-Pescara, Italy
- Diagnostic Molecular Pathology, Unit of Anatomic Pathology, SS Annunziata Hospital, Chieti, Italy
- Department of Medical, Oral, and Biotechnological Sciences University “G. D’Annunzio” of Chieti-Pescara
| | - Emanuela D’Angelo
- Center for Advanced Studies and Technology (CAST), University Chieti-Pescara, Italy
- Diagnostic Molecular Pathology, Unit of Anatomic Pathology, SS Annunziata Hospital, Chieti, Italy
- Department of Medical, Oral, and Biotechnological Sciences University “G. D’Annunzio” of Chieti-Pescara
| |
Collapse
|
41
|
Grabowska-Derlatka L, Derlatka P, Hałaburda-Rola M. Characterization of Primary Mucinous Ovarian Cancer by Diffusion-Weighted and Dynamic Contrast Enhancement MRI in Comparison with Serous Ovarian Cancer. Cancers (Basel) 2023; 15:cancers15051453. [PMID: 36900244 PMCID: PMC10000545 DOI: 10.3390/cancers15051453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
(1) Background. The purpose of this study is to evaluate the diagnostic accuracy of a quantitative analysis of diffusion-weighted imaging (DWI) and dynamic contrast enhanced (DCE) MRI of mucinous ovarian cancer (MOC). It also aims to differentiate between low grade serous carcinoma (LGSC), high-grade serous carcinoma (HGSC) and MOC in primary tumors. (2) Materials and Methods. Sixty-six patients with histologically confirmed primary epithelial ovarian cancer (EOC) were included in the study. Patients were divided into three groups: MOC, LGSC and HGSC. In the preoperative DWI and DCE MRI, selected parameters were measured: apparent diffusion coefficients (ADC), time to peak (TTP), and perfusion maximum enhancement (Perf. Max. En.). ROI comprised a small circle placed in the solid part of the primary tumor. The Shapiro-Wilk test was used to test whether the variable had a normal distribution. The Kruskal-Wallis ANOVA test was used to determine the p-value needed to compare the median values of interval variables. (3) Results. The highest median ADC values were found in MOC, followed by LGSC, and the lowest in HGSC. All differences were statistically significant (p < 0.000001). This was also confirmed by the ROC curve analysis for MOC and HGSC, showing that ADC had excellent diagnostic accuracy in differentiating between MOC and HGSC (p < 0.001). In the type I EOCs, i.e., MOC and LGSC, ADC has less differential value (p = 0.032), and TTP can be considered the most valuable parameter for diagnostic accuracy (p < 0.001). (4) Conclusions. DWI and DCE appear to be very good diagnostic tools in differentiating between serous carcinomas (LGSC, HGSC) and MOC. Significant differences in median ADC values between MOC and LGSC compared with those between MOC and HGSC indicate the usefulness of DWI in differentiating between less and more aggressive types of EOC, not only among the most common serous carcinomas. ROC curve analysis showed that ADC had excellent diagnostic accuracy in differentiating between MOC and HGSC. In contrast, TTP showed the greatest value for differentiating between LGSC and MOC.
Collapse
Affiliation(s)
- Laretta Grabowska-Derlatka
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a St., 02-097 Warsaw, Poland
| | - Pawel Derlatka
- Second Department Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-5966-512
| | - Marta Hałaburda-Rola
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a St., 02-097 Warsaw, Poland
| |
Collapse
|
42
|
McCabe A, Zaheed O, McDade SS, Dean K. Investigating the suitability of in vitro cell lines as models for the major subtypes of epithelial ovarian cancer. Front Cell Dev Biol 2023; 11:1104514. [PMID: 36861035 PMCID: PMC9969113 DOI: 10.3389/fcell.2023.1104514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/31/2023] [Indexed: 02/15/2023] Open
Abstract
Epithelial ovarian cancer (EOC) is the most fatal gynaecological malignancy, accounting for over 200,000 deaths worldwide per year. EOC is a highly heterogeneous disease, classified into five major histological subtypes-high-grade serous (HGSOC), clear cell (CCOC), endometrioid (ENOC), mucinous (MOC) and low-grade serous (LGSOC) ovarian carcinomas. Classification of EOCs is clinically beneficial, as the various subtypes respond differently to chemotherapy and have distinct prognoses. Cell lines are often used as in vitro models for cancer, allowing researchers to explore pathophysiology in a relatively cheap and easy to manipulate system. However, most studies that make use of EOC cell lines fail to recognize the importance of subtype. Furthermore, the similarity of cell lines to their cognate primary tumors is often ignored. Identification of cell lines with high molecular similarity to primary tumors is needed in order to better guide pre-clinical EOC research and to improve development of targeted therapeutics and diagnostics for each distinctive subtype. This study aims to generate a reference dataset of cell lines representative of the major EOC subtypes. We found that non-negative matrix factorization (NMF) optimally clustered fifty-six cell lines into five groups, putatively corresponding to each of the five EOC subtypes. These clusters validated previous histological groupings, while also classifying other previously unannotated cell lines. We analysed the mutational and copy number landscapes of these lines to investigate whether they harboured the characteristic genomic alterations of each subtype. Finally we compared the gene expression profiles of cell lines with 93 primary tumor samples stratified by subtype, to identify lines with the highest molecular similarity to HGSOC, CCOC, ENOC, and MOC. In summary, we examined the molecular features of both EOC cell lines and primary tumors of multiple subtypes. We recommend a reference set of cell lines most suited to represent four different subtypes of EOC for both in silico and in vitro studies. We also identify lines displaying poor overall molecular similarity to EOC tumors, which we argue should be avoided in pre-clinical studies. Ultimately, our work emphasizes the importance of choosing suitable cell line models to maximise clinical relevance of experiments.
Collapse
Affiliation(s)
- Aideen McCabe
- School of Biochemistry and Cell Biology, University College Cork, Cork, Ireland,The SFI Centre for Research Training in Genomics Data Science, Galway, Ireland
| | - Oza Zaheed
- School of Biochemistry and Cell Biology, University College Cork, Cork, Ireland,The SFI Centre for Research Training in Genomics Data Science, Galway, Ireland
| | - Simon Samuel McDade
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Kellie Dean
- School of Biochemistry and Cell Biology, University College Cork, Cork, Ireland,*Correspondence: Kellie Dean,
| |
Collapse
|
43
|
Sharma T, Nisar S, Masoodi T, Macha MA, Uddin S, Akil AAS, Pandita TK, Singh M, Bhat AA. Current and emerging biomarkers in ovarian cancer diagnosis; CA125 and beyond. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2023; 133:85-114. [PMID: 36707207 DOI: 10.1016/bs.apcsb.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Ovarian cancer (OC) is one of the most common causes of cancer-related death in women worldwide. Its five-year survival rates are worse than the two most common gynecological cancers, cervical and endometrial. This is because it is asymptomatic in the early stages and usually detected in the advanced metastasized stage. Thus, survival is increasingly dependent on timely diagnosis. The delay in detection is contributed partly by the occurrence of non-specific clinical symptoms in the early stages and the lack of effective biomarkers and detection approaches. This underlines the need for biomarker identification and clinical validation, enabling earlier diagnosis, effective prognosis, and response to therapy. Apart from the traditional diagnostic biomarkers for OC, several new biomarkers have been delineated using advanced high-throughput molecular approaches in recent years. They are currently being clinically evaluated for their true diagnostic potential. In this chapter, we document the commonly utilized traditional screening markers and recently identified emerging biomarkers in OC diagnosis, focusing on secretory and protein biomarkers. We also briefly reviewed the recent advances and prospects in OC diagnosis.
Collapse
Affiliation(s)
- Tarang Sharma
- Department of Medical Oncology, Dr. B.R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sabah Nisar
- Department of Human Genetics-Precision Medicine in Diabetes, Obesity and Cancer Program, Sidra Medicine, Doha, Qatar
| | - Tariq Masoodi
- Laboratory of Cancer immunology and genetics, Sidra Medicine, Doha, Qatar
| | - Muzafar A Macha
- Watson-Crick Centre for Molecular Medicine, Islamic University of Science and Technology, Jammu and Kashmir, India
| | - Shahab Uddin
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar; Laboratory Animal Research Center, Qatar University, Doha, Qatar
| | - Ammira Al-Shabeeb Akil
- Department of Human Genetics-Precision Medicine in Diabetes, Obesity and Cancer Program, Sidra Medicine, Doha, Qatar
| | - Tej K Pandita
- Center for Genomics and Precision Medicine, Texas A&M College of Medicine, Houston, TX, United States
| | - Mayank Singh
- Department of Medical Oncology, Dr. B.R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
| | - Ajaz A Bhat
- Department of Human Genetics-Precision Medicine in Diabetes, Obesity and Cancer Program, Sidra Medicine, Doha, Qatar.
| |
Collapse
|
44
|
Li J, Wang R, Liu Y, Wu Y, Han L, Zheng L, Bao Z. FKA-A NPs enhances PTX-A NPs efficacy to suppress ovarian cancer via regulating Skp2/YAP pathway. Fundam Clin Pharmacol 2023; 37:125-136. [PMID: 36028983 DOI: 10.1111/fcp.12828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/26/2022] [Accepted: 08/26/2022] [Indexed: 01/25/2023]
Abstract
Recurrence and distant metastasis after paclitaxel (PTX)-based chemotherapy in ovarian cancer (OC) patients remains a clinical obstacle. Flavokawain A (FKA) is a novel chalcone from kava plant that can induce G2/M arrest and inhibit invasion and metastasis in different tumor cells. In this study, we examined the effects and the molecular mechanism of sodium aescinate (Aes)-stabilized nanoparticles FKA-A NPs in enhancing the efficacy of PTX-A NPs in vitro and in vivo. We showed that FKA-A NPs combined with PTX-A NPs notably inhibited the proliferation and migration and reduced the expression of EMT-related markers in OCs. YAP nuclear translocation and its downstream signaling pathway were remarkably activated after PTX-A NPs treatment in OCs. FKA-A NPs obviously inhibited YAP nuclear translocation and reduced the transcriptional activity of YAP target genes. Simultaneously, FKA-A NPs dose and time dependently inhibited Skp2 expression in A2780 and Skov3 cells. In contrast, overexpression of Skp2 significantly attenuated the inhibition of FKA-A NPs on YAP nuclear translocation. In OC homograft mice, treatment with FKA-A NPs and PTX-A NPs significantly suppressed the growth of homograft tumor compared with PTX-A NPs but did not decrease mice's body weight. In summary, we demonstrate that FKA-A NPs enhance the efficacy of PTX-A NPs against OCs in vitro and in vivo via reducing Skp2 expression, thus suppressing YAP nuclear translocation and activity of its target genes.
Collapse
Affiliation(s)
- Juan Li
- Department of Clinical Pharmacy, The Second Hospital, Cheeloo College of medicine, Shandong University, Jinan, Shandong, China
| | - Rongmei Wang
- Department of Clinical Pharmacy, The Second Hospital, Cheeloo College of medicine, Shandong University, Jinan, Shandong, China
| | - Yongqing Liu
- Department of Clinical Pharmacy, The Second Hospital, Cheeloo College of medicine, Shandong University, Jinan, Shandong, China
| | - Yuqian Wu
- Cancer Center, The Second Hospital, Cheeloo College of medicine, Shandong University, Jinan, Shandong, China
| | - Leiqiang Han
- Department of Clinical Pharmacy, The Second Hospital, Cheeloo College of medicine, Shandong University, Jinan, Shandong, China
| | - Lei Zheng
- Department of Pharmacy, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zhengqiang Bao
- Cancer Center, The Second Hospital, Cheeloo College of medicine, Shandong University, Jinan, Shandong, China
| |
Collapse
|
45
|
Quesada S, Bini M, Lebreton C, Ray-Coquard I. Update on new treatments for rare ovarian tumours. Curr Opin Obstet Gynecol 2023; 35:27-33. [PMID: 36440753 PMCID: PMC9788923 DOI: 10.1097/gco.0000000000000836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW In spite of their rarity when considered individually, the sum of all rare ovarian tumours (ROT) represent almost half of all ovarian malignancies. As such, their appropriate inclusion within dedicated clinical trials is essential for enhanced management. RECENT FINDINGS Supported by institutional expert national (e.g. TMRG) and international (e.g. ESGO) networks and owing to national (e.g. ARCAGY-GINECO) and international (e.g. ENGOT) collaborations dedicated to clinical research, the last few years have shown increased number of clinical trials dedicated to ROT. These either were based on specific molecular features of ROT (e.g. expression of oestrogen receptors for low-grade serous ovarian carcinomas and anastrazole evaluation in the PARAGON trial) or on the evaluation of innovative therapies (e.g. pembrolizumab within the ROT cohort from the AcSé Pembrolizumab multicentric basket trial). Furthermore, recent years have also shown the advent of randomized clinical trials. For instance, the ALIENOR trial positioned weekly paclitaxel as a new option for relapsed sex cord-stromal tumours, while the GOG281/LOGS trial raised trametinib as a new standard-of-care option for recurrent low-grade serous carcinomas. SUMMARY The last few years have exhibited a paradigm shift towards the possibility to develop dedicated trials for ROT, owing to international collaborations supported by institutional networks. Current trials, molecular-driven and based on innovative designs, are highly promising, as they may bring ROT management towards more personalized medicine.
Collapse
Affiliation(s)
- Stanislas Quesada
- Centre Léon Bérard, Lyon, France
- Institut régional du Cancer de Montpellier, Montpellier, France
| | - Marta Bini
- Centre Léon Bérard, Lyon, France
- Instituto Nazionale dei Tumori, Milan, Italy
| | | | | |
Collapse
|
46
|
In Vitro Anticancer Activity of Novel Ciprofloxacin Mannich Base in Lung Adenocarcinoma and High-Grade Serous Ovarian Cancer Cell Lines via Attenuating MAPK Signaling Pathway. Molecules 2023; 28:molecules28031137. [PMID: 36770806 PMCID: PMC9921546 DOI: 10.3390/molecules28031137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/29/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023] Open
Abstract
Novel drugs are desperately needed in order to combat a significant challenge due to chemo-therapeutic resistance and bad prognosis. This research aimed to assess the anticancer activity of a newly synthesized ciprofloxacin Mannich base (CMB) on ovarian cancer (OVCAR-3) and lung cancer (A-549) cell lines and to investigate probable involved molecular mechanisms. The cytotoxic and pro-apoptotic impact of CMB on both cell lines was investigated using MTT assay, Annexin V assay, and cell cycle analysis, as well as caspase-3 activation. Western blotting was carried out to evaluate downstream targets of the MAPK pathway, while qRT PCR was used to evaluate the gene expression pattern of the p53/Bax/Bcl2 pathway. CMB treatment showed significantly reduced cell proliferation in both OVCAR-3 and A-549 cells with half maximum inhibitory concentration (IC50) = 11.60 and 16.22 µg/mL, respectively. CMB also induced apoptosis, S phase cell cycle arrest, and up-regulated expression of p53, p21, and Bax while down-regulated Bcl2 expression. CMB also halted cell proliferation by deactivating the MAPK pathway. In conclusion, CMB may be regarded as a potential antiproliferative agent for lung and ovarian cancers due to anti-proliferative and pro-apoptotic actions via inhibition of the MAPK pathway and p53/Bax/Bcl2.
Collapse
|
47
|
Chou HH, Fereday S, DeFazio A, Chang CL, Bowtell D, Hsu HC, Traficante N, Jeong SY, Cheng WF, Ariyarantne D, Tung T, Rajadhyaksha V, Lee WH, Brown D, Kim BG. Contrasting clinical characteristics and treatment patterns in women with newly diagnosed advanced-stage epithelial ovarian cancer in Australia, South Korea and Taiwan. J Gynecol Oncol 2023; 34:e3. [PMID: 36366810 DOI: 10.3802/jgo.2023.34.e3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/25/2022] [Accepted: 08/25/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The real-world INFORM study analyzed sociodemographics, treatment patterns and clinical outcomes for patients with newly diagnosed advanced epithelial ovarian cancer (EOC) in Australia, South Korea (S.Korea) and Taiwan preceding incorporation of poly(ADP-ribose) polymerase inhibitors into clinical practice. METHODS Retrospective data from patients diagnosed with EOC (high-grade serous EOC for Taiwan) between January 2014 and December 2018 with ≥12 months follow-up from diagnosis were analyzed descriptively. Survival was evaluated by Kaplan-Meier with two-sided 95% confidence interval (CI). RESULTS Of the 987 patients (Australia, 223; S.Korea, 513; Taiwan, 251), 98% received platinum-based chemotherapy (CT). In S.Korea and Taiwan 76.0% and 78.9% respectively underwent primary cytoreductive surgery; in Australia, 56.5% had interval debulking surgery. Bevacizumab was included in primary/maintenance therapy for 22.4%, 14.6% and 6.8% of patients in Australia, S.Korea and Taiwan, respectively. Patients receiving bevacizumab were high-risk (reimbursement policy) and achieved similar real-world progression-free survival (PFS) compared with CT only. Overall, the median real-world PFS (months; 95% CI) was similar across Australia (16.0 [14.63-18.08]), S.Korea (17.7 [16.18-19.27]) and Taiwan (19.1 [17.56-22.29]). CONCLUSION This study reveals poor prognosis despite differences in demographics and treatment patterns for patients with EOC across Asia-Pacific suggesting the need for biomarker-driven novel therapies to improve outcomes.
Collapse
Affiliation(s)
- Hung-Hsueh Chou
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Cancer Centre, Department of Oncology, The University of Melbourne, Parkville, Vic, Australia
| | - Anna DeFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, NSW, Australia.,The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Chih-Long Chang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital & Department of Medicine, MacKay Medical College, Taipei, Taiwan
| | - David Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Cancer Centre, Department of Oncology, The University of Melbourne, Parkville, Vic, Australia
| | - Heng-Cheng Hsu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan
| | - Nadia Traficante
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Cancer Centre, Department of Oncology, The University of Melbourne, Parkville, Vic, Australia
| | - Soo Young Jeong
- Department of Obstetrics and Gynecology, Kangnam Sacred Heart Hospital, The Hallym University School of Medicine, Seoul, Korea
| | - Wen-Fang Cheng
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | | | -
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Teresa Tung
- Medical Affairs, AstraZeneca International, Baar, Switzerland
| | | | - Won-Hee Lee
- Medical Affairs, AstraZeneca South Korea, Seoul, Korea
| | - David Brown
- Medical Affairs, AstraZeneca Australia, Macquarie Park, NSW, Australia
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| |
Collapse
|
48
|
Piao H, Wu M, Qin S, Tang Z, Zhou G, Wan X, Zuo X. Trametinib for patients with recurrent low-grade serous ovarian cancer: A cost-effectiveness analysis. Gynecol Oncol 2023; 168:17-22. [PMID: 36368128 DOI: 10.1016/j.ygyno.2022.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/21/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The GOG 281/LOGS trial found that trametinib prolonged progression-free survival (PFS) in patients with recurrent low-grade serous ovarian cancer (LGSOC), compared with standard of care (SOC). The current study aimed to evaluate the cost-effectiveness of trametinib versus standard of care for recurrent LGSOC from the US payer perspective. METHODS A Markov model was adopted to compare the cost and effectiveness of trametinib and standard of care group in patients with recurrent LGSOC. Life years (LYs), quality-adjusted LYs (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs) were calculated. One-way, and probabilistic sensitivity analyses were performed to explore the model robustness. RESULT Trametinib group provided an additional 0.58 QALYs (1.14 LYs) and an incremental cost of $248,214 compared with the SOC group. The incremental cost-effectiveness ratio was $424,097 per QALY. The results of one-way sensitivity analyses suggested that our model was sensitive to the hazard ratio of OS and PFS between trametinib and SOC group, utility of PFS and the cycle cost of trametinib. Probabilistic sensitivity analyses revealed that there was 6% probability of the trametinib group being cost-effective at a willingness-to-pay (WTP) threshold of $150,000 per QALY. CONCLUSIONS From the US payer perspective, trametinib is not cost-effective for patients with recurrent LGSOC at the assumed WTP threshold of $150,000 per QALY. Based on the value standpoint, price reduction of trametinib is expected to improve the cost-effectiveness of trametinib in patients with recurrent LGSOC.
Collapse
Affiliation(s)
- Huiling Piao
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Meiyu Wu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Shuxia Qin
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Zhiyao Tang
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Guangliang Zhou
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, China.
| | - Xiaocong Zuo
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha 410013, China.
| |
Collapse
|
49
|
Zhuang Y, Yang H. The Significance of Radiotherapy in Ovarian Clear Cell Carcinoma: A Systematic Review and Meta-Analysis. Cancer Control 2023; 30:10732748231179291. [PMID: 37236911 DOI: 10.1177/10732748231179291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE To assess the response rate and survival effect of adjuvant radiotherapy (RT) or chemoradiotherapy (CRT) during ovarian clear cell carcinoma (OCCC). METHODS We searched Web of Science, PubMed, Cochrane library electronic databases, Clinical Trials, WanFang Data and Chinese National Knowledge Infrastructure (CNKI) up to October 2022. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies. RESULTS We identified a total of 4259 patients from 14 studies met the inclusion criteria. The pooled response rate of residual tumors for RT/CRT was 80.0%, the pooled 5-year progression-free survival (PFS) ratio during RT/CRT group was 61.0%, and the pooled 5-year overall survival (OS) ratio during RT/CRT group was 68.0%; heterogeneity tests demonstrated significant difference between studies (I2 >50%). Cumulative results suggested adjuvant RT/CRT improved 5-year PFS ratio of OCCC patients (OR: 0.51 (95% CI: 0.42-.88), I2 = 22%, P = .009), had no impact on 5-year OS ratio (OR: 0.52 (95% CI: 0.19-1.44), I2 = 87%, P = .21); meta-regression of studies before and after 2000 found consistent results. Sub-analysis observed that adjuvant RT/CRT had no impact on 5-year OS ratio of early-stage (stage I + II) OCCC patients (OR: 0.67 (95% CI: 0.25-1.83), I2 = 85%, P = .44), but might improve 5-year OS ratio of advanced and recurrent OCCC patients (OR: 0.13(95% CI: 0.04-.44), P = .001). CONCLUSION This analysis suggested that adjuvant RT/CRT might improve oncologic outcomes of OCCC, especially for advanced and recurrent cases. Due to the inherent selective biases of retrospective studies enrolled in the meta-analysis, more convincing evidences based on prospective randomized controlled trials (RCTs) are urgently needed.
Collapse
Affiliation(s)
- Yuan Zhuang
- Department of Gynecology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Hua Yang
- Department of Gynecology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| |
Collapse
|
50
|
Kilanowska A, Ziółkowska A, Stasiak P, Gibas-Dorna M. cAMP-Dependent Signaling and Ovarian Cancer. Cells 2022; 11:cells11233835. [PMID: 36497095 PMCID: PMC9738761 DOI: 10.3390/cells11233835] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022] Open
Abstract
cAMP-dependent pathway is one of the most significant signaling cascades in healthy and neoplastic ovarian cells. Working through its major effector proteins-PKA and EPAC-it regulates gene expression and many cellular functions. PKA promotes the phosphorylation of cAMP response element-binding protein (CREB) which mediates gene transcription, cell migration, mitochondrial homeostasis, cell proliferation, and death. EPAC, on the other hand, is involved in cell adhesion, binding, differentiation, and interaction between cell junctions. Ovarian cancer growth and metabolism largely depend on changes in the signal processing of the cAMP-PKA-CREB axis, often associated with neoplastic transformation, metastasis, proliferation, and inhibition of apoptosis. In addition, the intracellular level of cAMP also determines the course of other pathways including AKT, ERK, MAPK, and mTOR, that are hypo- or hyperactivated among patients with ovarian neoplasm. With this review, we summarize the current findings on cAMP signaling in the ovary and its association with carcinogenesis, multiplication, metastasis, and survival of cancer cells. Additionally, we indicate that targeting particular stages of cAMP-dependent processes might provide promising therapeutic opportunities for the effective management of patients with ovarian cancer.
Collapse
Affiliation(s)
- Agnieszka Kilanowska
- Department of Anatomy and Histology, Collegium Medicum, University of Zielona Gora, 65-046 Zielona Gora, Poland
- Correspondence: ; Tel.: +48-683-283-148
| | - Agnieszka Ziółkowska
- Department of Anatomy and Histology, Collegium Medicum, University of Zielona Gora, 65-046 Zielona Gora, Poland
| | - Piotr Stasiak
- Department of Anatomy and Histology, Collegium Medicum, University of Zielona Gora, 65-046 Zielona Gora, Poland
| | - Magdalena Gibas-Dorna
- Department of Anatomy and Histology, Collegium Medicum, University of Zielona Gora, 65-046 Zielona Gora, Poland
| |
Collapse
|