Ovarian cancer

Abstract

Ovarian cancer is not a single disease and can be subdivided into at least five different 2 histological subtypes that have different identifiable risk factors, cells of origin, molecular compositions, clinical features and treatments. Ovarian cancer is a global problem, is typically diagnosed at late stage, and has no effective screening strategy. Standard treatments for newly diagnosed cancer consist of cytoreductive surgery and platinum-based chemotherapy. In recurrent cancer, chemotherapy, anti-angiogenic agents, and poly (ADP ribose) polymerase (PARP) inhibitors are used and immunological therapies are currently being tested. High-grade serous carcinoma (HGSC) is the most commonly diagnosed form of ovarian cancer and is typically very responsive to platinum-based chemotherapy at diagnosis. However, in addition to the other histologies, HGSCs frequently relapse and become increasingly resistant to chemotherapy.Consequently, understanding the mechanisms underlying platinum resistance and finding ways to overcome them are active areas of study in ovarian cancer. Significant progress has been made in identifying genes associated with high risk of ovarian cancer (such as BRCA1 and BRCA2) as well as a precursor lesion of HGSC called a serous tubal intraepithelial carcinoma, which hold promise for identifying individuals at high risk of developing the disease and for developing prevention strategies. Competing interestsU.A.M. has served as a consultant for AstraZeneca, ImmunoGen, Pfizer, Genentech, and Merck.

Pathogenesis and heterogeneity of ovarian cancer

“…In addition to the BRCA genes, there are several inherited DNA repair genes that likely contribute to HRD when mutated. These include genes in the Fanconi anemia complex, the RAD51 paralogs ( RAD51B , RAD51C , and RAD51D ), BRIP1 , BARD1 , PALB2 , as well as RAD50 , CHEK2 , ATR , and ATM [74–76]. These alterations collectively display HRD and are often described as having a ‘BRCAness’ phenotype [77,78] because of the genomic instability associated with BRCA dysfunction [65 ▪▪ ,79–81].…”

Bevacizumab combined with platinum–taxane chemotherapy as first-line treatment for advanced ovarian cancer: a prospective observational study of safety and efficacy in Japanese patients (JGOG3022 trial)

“…The underlying reasons are that about 90% of ovarian cancer is epithelial carcinoma, with approximately 50% of epithelial ovarian cancers being Stage III or Stage IV advanced disease at diagnosis [2]. …”

CREB5 promotes tumor cell invasion and correlates with poor prognosis in epithelial ovarian cancer

“…In the US, approximately 22,280 new cases are diagnosed every year, and approximately 14,240 women were predicted to have died of ovarian cancer in 2016 (2). Despite the rapid development of surgical and chemotherapeutic techniques, the 5-year survival rate of patients at an advanced stage of ovarian cancer is <30% due to drug resistance, relapse, and the lack of effective early screening and diagnostic methods (3).…”