The Landscape and Therapeutic Implications of Molecular Profiles in Epithelial Ovarian Cancer

Epithelial ovarian cancer (EOC) affects 43,000 women worldwide every year and has a five-year survival rate of 30%. Mainstay treatment is extensive surgery and chemotherapy. Outcomes could be improved by molecular profiling. We conducted a review of the literature to identify relevant publications o...

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Veröffentlicht in:Journal of clinical medicine 2020-07, Vol.9 (7), p.2239
Hauptverfasser: Dion, Ludivine, Carton, Isis, Jaillard, Sylvie, Nyangoh Timoh, Krystel, Henno, Sébastien, Sardain, Hugo, Foucher, Fabrice, Levêque, Jean, de la Motte Rouge, Thibault, Brousse, Susie, Lavoué, Vincent
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container_issue 7
container_start_page 2239
container_title Journal of clinical medicine
container_volume 9
creator Dion, Ludivine
Carton, Isis
Jaillard, Sylvie
Nyangoh Timoh, Krystel
Henno, Sébastien
Sardain, Hugo
Foucher, Fabrice
Levêque, Jean
de la Motte Rouge, Thibault
Brousse, Susie
Lavoué, Vincent
description Epithelial ovarian cancer (EOC) affects 43,000 women worldwide every year and has a five-year survival rate of 30%. Mainstay treatment is extensive surgery and chemotherapy. Outcomes could be improved by molecular profiling. We conducted a review of the literature to identify relevant publications on molecular and genetic alterations in EOC. Approximately 15% of all EOCs are due to BRCA1 or BRCA2 mutations. Four histologic subtypes characterized by different mutations have been described: serous, endometrioid, mucinous, and clear-cell. Between 20–30% of high-grade serous EOCs have a BRCA mutation. Tumors with BRCA mutations are unable to repair double-strand DNA breaks, making them more sensitive to platinum-based chemotherapy and to PolyAdenosine Diphosphate-Ribose Polymerase (PARP) inhibitors. Olaparib is a PARP inhibitor with proven efficacy in BRCA-mutated ovarian cancer, but its effectiveness remains to be demonstrated in tumors with a BRCAness (breast cancer) profile (i.e., also including sporadic tumors in patients with deficient DNA repair genes). A universally accepted molecular definition of BRCAness is required to identify optimal theranostic strategies involving PARP inhibitors. Gene expression analyses have led to the identification of four subgroups of high-grade serous EOC: mesenchymal, proliferative, differentiated, and immunoreactive. These subtypes are not mutually exclusive but are correlated with prognosis. They are not yet used in routine clinical practice. A greater understanding of EOC subtypes could improve patient management.
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subjects Anemia
Breast cancer
Cancer therapies
Cell cycle
Chemotherapy
Classification
Clinical medicine
Clinical trials
DNA methylation
Genes
Kinases
Life Sciences
Medical prognosis
Mutation
Ovarian cancer
Review
Surgery
Tumors
Womens health
title The Landscape and Therapeutic Implications of Molecular Profiles in Epithelial Ovarian Cancer
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