Epithelial ovarian cancer

Abstract

Epithelial ovarian cancer (EOC) generally presents at an advanced stage and is the most common cause of gynecologic cancer death. Treatment requires expert multidisciplinary care. Population based screening has been ineffective to date but new approaches for early diagnosis and prevention that leverage molecular genomics are in development. Initial therapy includes surgery and adjuvant therapy. EOC is composed of distinct histologic subtypes with unique genomic characteristics, which are improving the precision and effectiveness of therapy, allowing discovery of predictors of response such as BRCA1/2 mutations, homologous recombination (HR) deficiency for DNA damage response pathway inhibitors, or resistance (CCNE1). Rapidly evolving techniques to measure genomic changes in tumour and blood allow assessment of sensitivity and emergence of resistance to therapy, and may be accurate indicators of residual disease. Recurrence unfortunately remains usually incurable, and patient symptom control and quality of life are key considerations at that time. Treatments for recurrence have to be designed from a patient's perspective, and incorporate meaningful measures of benefit. Urgent progress is needed to develop evidence and consensus-based treatment guidelines for each subgroup, and requires close international cooperation in conducting clinical trials through academic research groups such as the Gynecologic Cancer Intergroup.

Prophylactic salpingectomy for prevention of ovarian cancer at the time of elective laparoscopic cholecystectomy

“…The rate of acceptance of attempted salpingectomy was 62 per cent at the three centres that entered the largest number of patients. Indications for cholecystectomy were cholelithiasis (98), gallbladder dyskinesia (6) or both (1).…”

Gravity-based microfiltration reveals unexpected prevalence of circulating tumor cell clusters in ovarian and colorectal cancer

“…The five-year survival in EOC is ~45%, owing to late diagnosis and lack of effective therapy (Lheureux et al, 2019). Yet in many cases, the initial response to therapy is good and accompanied by a drop of CA125, but relapse often occurs within 6-24 months, indicating the need for better indicators of therapeutic response.…”

Functionalized Folate-Modified Graphene Oxide/PEI siRNA Nanocomplexes for Targeted Ovarian Cancer Gene Therapy

“…Ovarian cancer is the leading gynecological cause of death in the world and is usually associated with poor clinical outcomes due to the difficulties of early diagnosis and therapy [1][2][3]. Unfortunately, conventional chemotherapeutic agents exhibit inherent limitations such as nonspecific distribution, poor bioavailability, rapid blood clearance, and poor solubility in physiological environments [4].…”