Abstract
Epithelial ovarian cancer (EOC) is one of the major increasing lethal malignancies of the gynecological tract, mostly due to delayed diagnosis and chemoresistance, as well as its very heterogeneous genetic makeup. Application of high-throughput molecular technologies, gene expression microarrays, and powerful preclinical models has provided a deeper understanding of the molecular characteristics of EOC. Therefore, molecular markers have become a potent tool in EOC management, including prediction of aggressiveness, prognosis, and recurrence, and identification of novel therapeutic targets. In addition, biomarkers derived from genomic/epigenomic alterations (e.g., gene mutations, copy number aberrations, and DNA methylation) enable targeted treatment of affected signaling pathways in advanced EOC, thereby improving the effectiveness of traditional treatments. This review outlines the molecular landscape and discusses the impacts of biomarkers on the detection, diagnosis, surveillance, and therapeutic targets of EOC. These findings focus on the necessity to translate these potential biomarkers into clinical practice.
Highlights
Epithelial ovarian cancer (EOC) represent a group of heterogeneous diseases with different precursor lesions, molecular alterations, and should be taken into consideration when choosing adjuvant therapeutic agents based on the current concept of targeted therapy
Activation of the STAT3/STAT5 pathway regulates a variety of cellular processes, such as tumor cell growth, survival, invasion, cancer stem cell-like characteristics, angiogenesis, drug-resistance, degradation of extracellular matrix, and epithelial-mesnechymal tion was shown by dashed arrows
Recent studies showed that several genetic predictors (Table 2) of treatment outcomes in EOC patients were identified from new high-throughput genomic techniques, including genome-wide association studies (GWASs), whole-exome sequencing (WES), whole-genome sequencing (WGS), DNA copy number aberrations (CNAs), and epigenetic alterations
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. HGSC is the most common type (70%) and accounts for most deaths of EOCs. Approximately 75% of all women with EOCs are diagnosed when the cancer has spread into the peritoneal surface, corresponding to International Federation of Gynecology and Obstetrics (FIGO) stages IIIc and IV. A recently published phase 3 trial using maintanance PARPi olaparib therapy in paients with platinum-sensitive relapsed ovarian cancer carrying BRCA1/2 mutation showed a median overall survival benefit of 12.9 months with a median follow-up perioid of about. A statistical significance was not accomplished which may be due to crossover and use of post-progresssion therapies [9] a comprehensive understanding of the mechanisms and molecular profiles is needed to improve clinical management and identify new therapeutic targets of EOC. We provide an updated overview of the different molecular profiles described for EOC and discuss their roles in current and future management of this malignancy
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