High-grade serous ovarian cancer (HGSOC) accounts for 70-80% of ovarian cancer deaths, and overall survival has not changed significantly for several decades. In this Opinion article, we outline a set of research priorities that we believe will reduce incidence and improve outcomes for women with this disease. This ‘roadmap’ for HGSOC was determined after extensive discussions at an Ovarian Cancer Action meeting in January 2015.

We have profiled, for the first time, an evolving human metastatic microenvironment, measuring gene expression, matrisome proteomics, cytokine and chemokine levels, cellularity, ECM organization and biomechanical properties, all on the same sample. Using biopsies of high-grade serous ovarian cancer (HGSOC) metastases that ranged from minimal to extensive disease, we show how non-malignant cell densities and cytokine networks evolve with disease progression. Multivariate integration of the different components allowed us to define for the first time, gene and protein profiles that predict extent of disease and tissue stiffness, whilst also revealing the complexity and dynamic nature of matrisome remodeling during development of metastases. Although we studied a single metastatic site from one human malignancy, a pattern of expression of 22 matrisome genes distinguished patients with a shorter overall survival in ovarian and twelve other primary solid cancers, suggesting that there may be a common matrix response to human cancer.

The CRS system is reproducible and shows prognostic significance for high-grade serous carcinoma. Implementation in international pathology reporting has been proposed by the International Collaboration on Cancer Reporting, and the system could potentially have an impact on patient care and research.

How do groups resist the apparently all encompassing discourse of management?Rejecting current theories of resistance as 're-appropriation' or 'micro-politics', we argue that resistance may be thought about as hegemonic struggle which are undertaken by social movements. We identify four major resistance movements that engage with management: unions, organizational misbehaviour, civic movements, and civic movement organizations. We argue that these forms of resistance differ in terms of location (civil society or workplace) and strategy (political or infra-political). We chart out the possible interconnections between these different modes of resistance and detail how these interconnections are established. By doing this, the paper provides a framework for understanding the many forms of resistance movements that seek to disrupt the hegemonic discourse of management.