Ovarian Carcinoma Research Articles

Molecular characterization of ovarian squamous cell carcinoma originating from mature teratoma.

Squamous cell carcinoma (SCC) of the ovary, an uncommon form of gynecologic cancer, typically originates from the malignant transformation of a pre-existing mature ovarian teratoma (MOT). However, due to its rarity, the molecular pathways driving its development are not well understood. To address this knowledge gap, we performed molecular inversion probe (MIP) array analysis and targeted sequencing of 275 cancer susceptibility genes on 11 ovarian SCC samples derived from MOTs. Additionally, we conducted the same molecular tests on two samples of ovarian metastases of SCCs that originated from primary sites outside the ovary, specifically, one from endometrial cancer and one from cervical SCC. Utilizing MIP arrays, we identified failures in meiosis I and II, as well as instances of endoreduplication within haploid ova, in five, two, and four samples of ovarian SCCs arising from MOTs, respectively. Notably, such alterations were absent in samples of ovarian metastases, implying that primary ovarian SCCs may derive from teratoma cells. Targeted sequencing identified TP53 as the most frequently mutated gene in ovarian SCCs, occurring in 82% of cases. This was followed by mutations in PIK3CA (36%), PTEN (27%), and KMT2D (27%). Furthermore, mutations in CDKN2A and copy number loss of 9p21.3 were observed in 54.5% of the cohort. In summary, our study elucidates the germ cell origin of ovarian SCC and provides a comprehensive analysis of its genomic landscape, which may assist in differential diagnosis and inform the development of targeted therapies with potential clinical benefits. KEY MESSAGES: Failures in meiosis I/II and endoreduplication found in primary ovarian SCCs. Ovarian SCCs may derive from germ cells in mature teratomas. Alterations absent in ovarian metastases from SCC aid differential diagnosis. TP53 mutations found in 82% of ovarian SCC cases. CDKN2A mutations and 9p21.3 loss observed in 54.5% of ovarian SCC cohort.

Primary Mucinous Ovarian Carcinoma: Insight into a Rare Histology and Impact of Pattern of Infiltration on Oncological Outcomes

Primary Mucinous Ovarian Carcinoma: Insight into a Rare Histology and Impact of Pattern of Infiltration on Oncological Outcomes

Differential Infiltration of Key Immune T-Cell Populations Across Malignancies Varying by Immunogenic Potential and the Likelihood of Response to Immunotherapy

Background: Solid tumors vary by the immunogenic potential of the tumor microenvironment (TME) and the likelihood of response to immunotherapy. The emerging literature has identified key immune cell populations that significantly impact immune activation or suppression within the TME. This study investigated candidate T-cell populations and their differential infiltration within different tumor types as estimated from mRNA co-expression levels of the corresponding cellular markers. Methods: We analyzed the mRNA co-expression levels of cellular biomarkers that define stem-like tumor-infiltrating lymphocytes (TILs), tissue-resident memory T-cells (TRM), early dysfunctional T-cells, late dysfunctional T-cells, activated-potentially anti-tumor (APA) T-cells and Butyrophilin 3A (BTN3A) isoforms, utilizing clinical and transcriptomic data from 1892 patients diagnosed with melanoma, bladder, ovarian, or pancreatic carcinomas. Real-world data were collected under the Total Cancer Care Protocol and the Avatar® project (NCT03977402) across 18 cancer centers. Furthermore, we compared the survival outcomes following immune checkpoint inhibitors (ICIs) based on immune cell gene expression. Results: In melanoma and bladder cancer, the estimated infiltration of APA T-cells differed significantly (p = 4.67 × 10−12 and p = 5.80 × 10−12, respectively) compared to ovarian and pancreatic cancers. Ovarian cancer had lower TRM T-cell infiltration than melanoma, bladder, and pancreatic (p = 2.23 × 10−8, 3.86 × 10−28, and 7.85 × 10−9, respectively). Similar trends were noted with stem-like, early, and late dysfunctional T-cells. Melanoma and ovarian expressed BTN3A isoforms more than other malignancies. Higher densities of stem-like TILs; TRM, early and late dysfunctional T-cells; APA T-cells; and BTN3A isoforms were associated with increased survival in melanoma (p = 0.0075, 0.00059, 0.013, 0.005, 0.0016, and 0.041, respectively). The TRM gene signature was a moderate predictor of survival in the melanoma cohort (AUROC = 0.65), with similar findings in testing independent public datasets of ICI-treated patients with melanoma (AUROC 0.61–0.64). Conclusions: Key cellular elements related to immune activation are more heavily infiltrated within ICI-responsive versus non-responsive malignancies, supporting a central role in anti-tumor immunity. In melanoma patients treated with ICIs, higher densities of stem-like TILs, TRM T-cells, early dysfunctional T-cells, late dysfunctional T-cells, APA T-cells, and BTN3A isoforms were associated with improved survival.

MiR-449, identified through antiandrogen exposure, mitigates functional biomarkers associated with ovarian cancer risk

The involvement of the androgen receptor (AR) pathway in developing epithelial ovarian cancer is increasingly acknowledged. However, the specific mechanisms by which anti-androgen agents, such as flutamide, may prevent ovarian cancer and their efficacy remain unknown. This study was initiated by investigating the impact of flutamide on miRNA expression in women at high risk (HR) for ovarian cancer. Ovarian and tubal tissues, free from ovarian, tubal, peritoneal cancers, and serous tubal intraepithelial carcinoma (STIC), were collected from untreated and flutamide-treated HR women as well as low-risk (LR) women controls. We performed miRNA sequencing on these 3 sample cohorts and observed that flutamide normalized miRNA levels in HR tissues, notably upregulating the miR-449 family to levels seen in LR tissues. In subsequent tests in primary ovarian epithelial cells and ovarian cancer cell lines (SKOV3 and Hey), flutamide also increased miR-449a and miR-449b-5p levels. Introducing mimics of these miRNAs reduced the mRNA and protein levels of AR and colony-stimulating factor 1 receptor (CSF1R, also known as c-fms), both of which are known contributors to ovarian cancer progression, with emerging evidence also supporting their roles in ovarian cancer initiation. Ovarian cancer cell migration was inhibited upon introducing miR-449a and miR-449b-5p mimics. Together, our study suggests a novel dual-inhibitory mechanism of flutamide on the AR pathway (AR expression suppression in addition to direct androgen antagonism) and supports its chemopreventive potential in ovarian cancer, especially for HR patients with low miR-449 expression.

Immunohistochemical Expression and Significance of Preferentially Expressed Antigen in Melanoma (PRAME) in Gynecological Tumors: A Single-institution Retrospective Analysis.

Although preferentially expressed antigen in melanoma (PRAME) has been used as a diagnostic marker for malignant melanoma (MM), it is also expressed in various other malignancies. PRAME expression is rarely reported in female genital tumors. This study aimed to evaluate PRAME expression and its significance in gynecological malignancies. We conducted PRAME immunostaining in 135 specimens, including 85 endometrial carcinomas (ECs), five uterine sarcomas (USs), 28 cervical carcinomas (CCs), and 17 ovarian carcinomas (OCs). PRAME immunoreactivity was evaluated using a semi-quantitative histoscore method. PRAME was expressed in 82 (96.5%) ECs, 15 (88.2%) OCs, three (60.0%) USs, and eight (28.6%) CCs, with mean histoscores of 174.6, 108.9, 32.2, and 27.5, respectively. EC exhibited elevated PRAME expression levels compared to other tumors, with immunoreactivity being higher in endometrial endometrioid carcinoma (EEC) than that in other EC types. Grade 1 EEC exhibited higher PRAME expression levels than grade 2-3 EECs. PRAME over-expression in gynecological tumors supports the notion that this marker should not be regarded as specific to MM alone. EC exhibited higher PRAME expression than CC and OC, and low-grade EEC displayed higher PRAME immunoreactivity than other EC types. Our findings suggest that PRAME immunostaining can be useful to distinguish EEC from ovarian endometrioid carcinoma and endocervical adenocarcinoma. PRAME over-expression can also help differentiate non-aggressive EC from aggressive EC.

Assessing pathogenicity of mismatch repair variants of uncertain significance by molecular tumor analysis

Functional analyses are the main method to classify mismatch repair (MMR) gene variants of uncertain significance (VUSs). However, the pathogenicity remains unclear for many variants because of conflicting results between clinical, molecular, and functional data. In this study, we evaluated whether whole exome sequencing (WES) could add another layer of evidence to elucidate the pathogenicity of MMR variants with conflicting interpretations. WES was performed on formalin-fixed paraffin-embedded tumor tissue of eight patients with a constitutional MMR VUS (seven families), including eight colorectal and two endometrial carcinomas and one ovarian carcinoma. Cell-free CIMRA assays were performed to assign Odds of Pathogenicity to these VUSs. In four families, seven tumors showed MMR deficiency-associated mutational signatures, supporting the pathogenicity of the VUS. Moreover, somatic (second) MMR hits identified in the WES data were found to explain MMR staining patterns when the MMR staining was discordant with the reported germline MMR gene variant. In conclusion, WES did not significantly reclassify VUS in these cases but clarified some phenotypic aspects such as age of onset and explanations in case of discordant MMR stainings.

Incidence and risk factors of silent deep venous thromboembolism before interval debulking surgery in ovarian cancer patients, a tertiary centre experience

ObjectiveTo determine the prevalence and risk factors for the development of asymptomatic venous thromboembolism (VTE) in ovarian cancer patients who underwent interval cytoreductive surgery after finishing neoadjuvant chemotherapy. MethodsThis is a prospective observational trial. Female patients with pathologically proven ovarian cancer who received neoadjuvant chemotherapy without clinical evidence of VTE were included. ResultsA total of 107 patients were enrolled in this study. The mean age was 53.37 years, and the mean body mass index (BMI) was 34.11 kg/m2. Seven (6.5 %) patients suffered from silent VTE, as documented by bilateral Doppler ultrasound in the pre- and postoperative settings. The mean age of the patients in the VTE group was 56.17 years, and their mean body mass index was 31.71 Kg/m2. Their median serum CA125 concentration was elevated (325.6 units/ml). On the other hand, the median D-dimer level was elevated by 678 ng/ml fibrinogen equivalent units (FEUs) in the same group of patients. In the present study, comorbidities did not influence the incidence of VTE, as the 7 patients who were diagnosed with VTE did not have any comorbidities. Most of the patients who were diagnosed with serous adenocarcinoma (71.4 %) or stage IIIc disease (57.1 %) were most likely to develop VTE. ConclusionSilent VTE is more prevalent in patients with advanced-stage ovarian cancer and serous carcinomas

Somatic mutation of targeted sequencing identifies risk stratification in advanced ovarian clear cell carcinoma

BackgroundOvarian clear cell carcinoma (OCCC) is a unique subtype of epithelial ovarian cancer. Advanced OCCC display a poor prognosis. Therefore, we aimed to make risk stratification for precise medicine. MethodsWe performed a large next generation sequencing (NGS) gene panel on 44 patients with OCCC in FIGO stage II-IV. Then, by machine learning algorithms, including extreme gradient boosting (XGBoost), random survival forest (RSF), and Cox regression, we screened for feature genes associated with prognosis and constructed a 5-gene panel for risk stratification. The prediction efficacy of the 5-gene panel was compared with FIGO stage and residual disease by receiver operating characteristic curve and decision curve analysis. ResultsThe feature mutated genes related to prognosis, selected by machine learning algorithms, include MUC16, ATM, NOTCH3, KMT2A, and CTNNA1. The 5-gene panel can effectively distinguish the prognosis, as well as platinum response, of advanced OCCC in both internal and external cohorts, with the predictive capability superior to FIGO stage and residual disease. ConclusionsMutations in genes, including MUC16, ATM, NOTCH3, KMT2A, and CTNNA1, were associated with the poor prognosis of advanced OCCC. The risk stratification according to these genes demonstrated acceptable prediction power of prognosis and platinum response, suggesting the potential to be a novel target for precision medicine.

Characterizing the genomic landscape through the lens of FOLR1 status in low and high grade serous ovarian carcinoma

ObjectiveTargeted therapy in folate receptor alpha (FOLR1)-positive high grade serous ovarian carcinoma (HGSOC) is now a mainstay for platinum-resistant disease. However, the rate of FOLR1-positivity in low grade serous ovarian carcinoma (LGSOC) is not well documented. Less common than HGSOC, LGSOC tends to respond poorly to traditional platinum-based chemotherapeutic regimens, particularly in recurrence. Thus, there is an urgent need to identify molecular targets that may assist in identifying more efficacious treatments for LGSOC. In this work, we assessed the genomic and transcriptomic landscapes in FOLR1-positive/negative LGSOC compared to its high-grade counterpart. MethodsUsing a large precision oncology database, next-generation sequencing and immunohistochemistry was performed on a cohort of 281 LGSOC and 5086 HGSOC. Associated MAPK activation was calculated based on NGS results and patient survival analysis was completed stratified by molecular alteration. ResultsCompared with LGSOC (24.6 %), HGSOC tumors have significantly higher prevalence of FOLR1+ status (43.5 %) and significantly higher PD-L1+ status. Conversely, LGSOC had higher prevalence of KRAS and NRAS mutations, with a near exclusivity for BRAF mutation compared to HGSOC. FOLR1- LGSOC and HGSOC had similar prevalences of T cell-inflamed tumors, though FOLR1+ LGSOC had a significantly lower prevalence of T-Cell inflamed tumors than FOLR1+ HGSOC. MAPK activation, quantified via MAPK activation score (MPAS), was significantly higher in low-grade tumors compared to HGSOC, yet no difference between FOLR1+ vs FOLR1- LGSOC was observed. ConclusionsThough less than in high-grade disease, a notable portion of low-grade tumors were FOLR1+, suggesting FOLR1 expression in LGSOC could be a viable target for this rare histology, particularly in the recurrent setting.

Intraperitoneal immunotherapy with denileukin diftitox (ONTAK) in recurrent refractory ovarian cancer

BackgroundDenileukin diftitox (ONTAK) is a diphtheria/IL-2R fusion protein able to deplete regulatory T cells in peripheral blood. Regulatory T cells in the local immune microenvironment have been shown to be associated with poor prognosis in ovarian cancer. This study examined whether denileukin diftitox (ONTAK) could be safely administered intraperitoneal in patients with advanced refractory ovarian cancer and assessed its effects on regulatory T cells and tumor associated cytokines in ascites and peripheral blood. Patients and methodsA phase I dose escalation study of intraperitoneal denileukin diftitox (ONTAK) enrolled 10 patients with advanced, refractory ovarian carcinoma at 3 doses (5 μg/kg, 15 μg/kg, and 25 μg/kg). Serial CA-125 measurements assessed clinical response. Regulatory T cells were quantified using RT-PCR and cytokine levels measured by Luminex. ResultsThe maximum tolerated dose was 15 μg/kg with a dose limiting toxicity observed in 1 out of 6 patients in the expansion group. The majority of adverse events were transient grades 1–2. One patient treated at the 25 μg/kg dose experienced cytokine storm with prolonged hospitalization. 3 patients had decreases in CA-125 after treatment but none met criteria for partial response. Treatment with denileukin diftitox (ONTAK) decreased regulatory T cells in peripheral blood and ascites. Treated patients did not show any significant changes in IL-8, TGF-β, sIL2Ra in ascites or peripheral blood. ConclusionsDenileukin diftitox (ONTAK) can be safely administered intraperitoneally to recurrent refractory ovarian cancer patients. Regulatory T cells were reduced in ascites and peripheral blood, but there were no significant changes in cytokine levels.Clinical Trial Registration:ClinicalTrials.gov # NCT00357448

Germline BRCA pathogenic variants and hematologic adverse events in patients with ovarian carcinoma receiving PARP inhibitors: a retrospective cohort study.

Patients with a germline BRCA pathogenic variant (gBRCA-PV) and advanced high grade ovarian carcinoma (aHGOC) experience higher hematologic adverse events (HAEs) when receiving platinum salts and ionizing radiations, compared to non-carriers, due to a possible higher susceptibility of the hemopoietic stem cells to DNA targeting agents. However, the incidence of PARP inhibitor (PARPi)-related HAEs according to the gBRCA-PV status is currently unknown. We conducted a single-center retrospective cohort study to describe the occurrence of HAEs in patients with aHGOC receiving ≥8 weeks of maintenance PARPi in any line of therapy, comparing gBRCA-PVs carriers to non-carriers. HAEs were manually identified by searching the patients' electronic medical records and classified by CTCAE v5.0. The main endpoint was the incidence rate of any HAE (ie, anaemia, neutropenia, or thrombocytopenia) of grade 2 or more (G ≥ 2). One hundred and sixty-six patients were included; 95 (57%) had a gBRCA-PV. In total, 162 incident cases of G ≥ 2 HAEs were reported over 255.3 person-years. The incidence rates of G ≥ 2 HAEs were 1003/1000 person-years in gBRCA-PV carriers and 993/1000 person-years in non-carriers. No difference in the incidence rate of G ≥ 2 HAEs emerged comparing gBRCA-PV carriers to non-carriers (crude-incidence rate ratio [IRR]: 1.01; 95% CI: 0.72, 1.43; P = .96), even after adjusting for the type of PARPi (Mantel-Haenszel IRR: 0.99; 95% CI: 0.67, 1.46). Patients with aHGOC and a gBRCA-PV do not experience higher PARPi-related HAEs compared to non-gBRCA-PV carriers, unlike platinum salt-related HAEs.

Genetic and therapeutic heterogeneity shape the baseline and longitudinal immune ecosystem of ovarian clear cell carcinoma

BackgroundOvarian clear cell carcinoma (OCCC) is a rare and chemo-resistant subtype of ovarian cancer. While immunotherapy has demonstrated effectiveness in some OCCC cases, the mechanisms for heterogeneous immunoreactivity and potential...

Diagnostic Utility of Metalloproteinases from Collagenase Group (MMP-1, MMP-8 and MMP-13) in Biochemical Diagnosis of Ovarian Carcinoma

Background: Ovarian carcinoma (OC) has an unfavorable prognosis due to lack of screening and an asymptomatic course. New diagnostic methods are being sought to enable earlier diagnosis of this condition. The purpose of this study was to determine the diagnostic utility of collagenases (MMP-1, MMP-8 and MMP-13) in the diagnosis of OC compared to HE4 and CA125 and the ROMA. Methods: The study group consisted of 120 patients with OC, the control group: 70 patients with benign ovarian lesions (BLs) and 50 healthy women (HS). MMP-1, MMP-8 and MMP-13 were determined by ELISA and HE4 and CA125 by CMIA. Results: OC patients had higher levels of MMP-1 and MMP-13 compared to the BL and HS groups. MMP-1 (SE: 81.66%; SP: 94%; PPV: 97.02%; NPV: 68.11%; AUC: 0.9625) and MMP-13 (SE: 77.50%; SP: 94%; PPV: 96.875%; NPV: 63.51%; AUC: 0.917) showed similar or higher diagnostic values to routine markers (HE4: SE:85%; SP: 92%; PPV: 96.22%; NPV: 71.875%; AUC: 0.943; CA125: SE: 80%; SP: 98%; PPV: 98.96%; NPV: 67.12%; AUC: 0.909) and the ROMA (SE: 90.83%; SP: 94%; PPV: 97.32%; NPV: 81.03%; AUC: 0.955). Performing combined analyses of individual MMPs and MMPs with ROMA was associated with further increases in diagnostic parameters. Conclusions: MMP-1 and MMP-13 have shown preliminary potential as diagnostic markers and auxiliary markers to ROMA in biochemical diagnosis of OC.

Coordinated protein modules define DNA damage responses to carboplatin at single cell resolution in human ovarian carcinoma models.

Tubo-ovarian high-grade serous carcinoma (HGSC) is the most lethal gynecological malignancy and frequently responds to platinum-based chemotherapy because of common genetic and somatic impairment of DNA damage repair (DDR) pathways. The mechanisms of clinical platinum resistance are diverse and poorly molecularly defined. Consequently, there are no biomarkers or medicines that improve patient outcomes. Herein we use single cell mass cytometry (CyTOF) to systematically evaluate the phosphorylation and abundance of proteins known to participate in the DNA damage response (DDR). Single cell analyses of highly characterized HGSC cell lines that phenocopy human patients show that cells with comparable levels of intranuclear platinum, a proxy for carboplatin uptake, undergo different cell fates. Unsupervised analyses revealed a continuum of DDR responses. Decompositional methods were used to identify eight distinct protein modules of carboplatin resistance and sensitivity at single cell resolution. CyTOF profiling of primary and secondary platinum-resistance patient models shows that a complex DDR sensitivity module is strongly associated with response, suggesting it as a potential tool to clinically characterize complex drug resistance phenotypes.

Nanoliposomes Meet Folic Acid: A Precision Delivery System for Bleomycin in Cancer Treatment

Overview: The targeted administration of anticancer therapies, particularly through folate receptor (FR)-mediated targeting, enhances treatment effectiveness while minimizing side effects. This study assesses the therapeutic potential of folate-targeted liposomal bleomycin (FL-BLM) against traditional forms in treating human ovarian carcinoma and oral cancer. Methods: FL-BLM was created using the thin film hydration technique with folic acid integration for active targeting. Its efficacy was compared to non-targeted liposomal bleomycin (L-BLM) and traditional bleomycin (BLM) using the MTT assay and flow cytometry to measure G2/M phase cell cycle arrest. Results: FL-BLM demonstrated significantly greater effectiveness in reducing cell viability and inducing G2/M phase arrest in oral cancer cells (HN cells, OECM-1) and ovarian cancer cells (A2780CP) compared to L-BLM and BLM, indicating successful folate-mediated targeting. Conclusions: FL-BLM effectively targets and inhibits FR-overexpressing cancer cells, particularly in both cancers. This supports the potential of folate-mediated targeting in liposomal drug delivery systems for improving drug delivery and reducing toxicity. Future research should further explore FR-targeted therapies across various cancer types

Predictive impact of clinical factors on chemosensitivity in advanced high-grade serous ovarian carcinoma according to chemotherapy response score

The use of neoadjuvant chemotherapy (NAC) as a first-line therapy for advanced high-grade serous ovarian carcinoma (HGSOC) has increased. However, several studies have reported NAC-induced platinum resistance. This study aimed to evaluate the predictive impact of clinical factors on chemotherapy response score (CRS) and to select patients who would respond well to NAC. This multicenter retrospective (study included patients treated between January 2016 and December 2021). International Federation of Gynecology and Obstetrics stage IIIC and IV HGSOC patients were eligible. Institutionally strict complete resectability criteria were used in the present study. Pathological slides were scored according to the CRS criteria. Among 172 patients with HGSOC, 87 (50.6%) had stage IIIC disease and 85 (49.4%) had stage IV disease. And 35 (20.4%) had CRS1, 103 patients were CRS2 (59.9%), and 34 patients were CRS3 (19.7%). Compared with CRS1, simultaneous metastases to distant lymph nodes and solid organs confirmed by imaging were associated with a 75% reduction in CRS2 (odds ratio = 0.25; 95% confidence interval: 0.09–0.70; P = .008). And breast cancer susceptibility gene 1/2 mutation was positively (odds ratio = 8.41; 95% confidence interval: 2.25–31.52; P = .002) associated with CRS3 compared to CRS1. Patients with CRS3 had significantly longer progression-free survival (PFS), with median PFS of 9.8, 14.8, and 27.0 months for CRS of 1, 2, and 3, respectively (P < .001). Overall survival was also prolonged in patients with CRS3 (P < .001). Germline breast cancer susceptibility gene 1/2 mutation was a predictor of CRS3 and a good prognostic factor for the survival rate. Simultaneous metastasis to distant lymph nodes and solid organs is a predictor of CRS1. CRS inversely correlated with PFS and overall survival.

Arachidonic acid impairs natural killer cell functions by disrupting signaling pathways driven by activating receptors and reactive oxygen species

BackgroundHigh levels of the polyunsaturated fatty acid arachidonic acid (AA) within the ovarian carcinoma (OC) microenvironment correlate with reduced relapse-free survival. Furthermore, OC progression is tied to compromised immunosurveillance, partially attributed to the impairment of natural killer (NK) cells. However, potential connections between AA and NK cell dysfunction in OC have not been studied.MethodsWe employed a combination of phosphoproteomics, transcriptional profiling and biological assays to investigate AA’s impact on NK cell functions.ResultsAA (i) disrupts interleukin-2/15-mediated expression of pro-inflammatory genes by inhibiting STAT1-dependent signaling, (ii) hampers signaling by cytotoxicity receptors through disruption of their surface expression, (iii) diminishes phosphorylation of NKG2D-induced protein kinases, including ERK1/2, LYN, MSK1/2 and STAT1, and (iv) alters reactive oxygen species production by transcriptionally upregulating detoxification. These modifications lead to a cessation of NK cell proliferation and a reduction in cytotoxicity.ConclusionOur findings highlight significant AA-induced alterations in the signaling network that regulates NK cell activity. As low expression of several NK cell receptors correlates with shorter OC patient survival, these findings suggest a functional linkage between AA, NK cell dysfunction and OC progression.

Tissue factor pathway inhibitor 2 (TFPI2) is a potential serum biomarker for clear cell renal carcinoma.

Renal and ovarian clear cell carcinoma (CCC) are both characterized by a clear cytoplasm and exhibit similar genomic alterations and clinical characteristics. We hypothesized that both CCCs may share clinical biomarker. Tissue factor pathway inhibitor 2 (TFPI2), a serine protease inhibitor, has emerged as a promising serum biomarker for ovarian CCC, and we evaluated the efficacy of TFPI2 as a biomarker for renal cell carcinoma (RCC). Serum samples were collected from patients with RCC and healthy volunteers, and TFPI2 levels were measured. Expression of TFPI2 in each cell type was evaluated using single-cell RNA sequencing. Survival analyses according to TFPI2 expression levels were performed based on publicly available databases. Serum TFPI2 was significantly elevated in patients with RCC compared to healthy volunteers, particularly those with clear cell histology. Metastatic RCC tumors exhibited higher TFPI2 than localized RCCs. Moreover, higher TFPI2 correlated with higher Fuhrman grades in clear cell RCC. Publicly available databases showed an association between TFPI2 expression and overall survival, particularly in clear cell RCC. Single-cell RNA sequencing confirmed TFPI2 expression in clear cell RCC and normal kidney tubular epithelial cells. TFPI2 has emerged as a potential serum biomarker for RCC, offering avenues for improved detection and prognostication.

Evaluation of the recently established Dutch nationwide Archipelago of Ovarian Cancer Research biobank

Fundamental and translational research in ovarian cancer aims to enhance understanding of disease mechanisms and improve treatment and survival outcomes. To support this, we established the Dutch multicenter, interdisciplinary Archipelago of Ovarian Cancer Research (AOCR) infrastructure, which includes a nationwide biobank. In this study, we share our experiences in establishing the infrastructure, offer guidance for similar initiatives, and evaluate the AOCR patient cohort. Key challenges included obtaining Data Protection Impact Assessment (DPIA) clearance, drafting the consortium agreement, and securing ethical approval from all hospitals. Over three years, 1093 patients were enrolled across 17 hospitals, resulting in the collection of 1339 tissue samples and 2280 blood samples. Of the 523 patients with currently available clinical and pathological data, 74 % (n = 387) had primary ovarian cancer. Among these patients, 73.4 % was diagnosed with high-grade serous ovarian carcinoma, and 80.9 % presented with advanced-stage disease. Surgery was performed on 93 % of patients with primary ovarian cancer, and chemotherapy was administered to 90.4 % of these patients. In conclusion, the AOCR biobank has established a robust foundation for future fundamental and translational ovarian cancer research. This manuscript provides valuable insights and guidance for developing future research infrastructures and biobanks, and contains detailed information about the AOCR patient cohort to date.

Repurposing colforsin daropate to treat MYC-driven high-grade serous ovarian carcinomas.

High-grade serous ovarian cancer (HGSOC) is one of the deadliest cancers for women, with a low survival rate, no early detection biomarkers, a high rate of recurrence, and few therapeutic options. Forskolin, an activator of cyclic AMP signaling, has several anticancer activities, including against HGSOC, but has limited use in vivo. Its water-soluble derivative, colforsin daropate, has the same mechanism of action as forskolin and is used to treat acute heart failure. Here, we investigated the potential of colforsin daropate as a treatment for HGSOC. We found that colforsin daropate induced cell cycle arrest and apoptosis in cultured HGSOC cells and spheroids but had negligible cytotoxicity in immortalized, nontumorigenic fallopian tube secretory cells and ovarian surface epithelial cells. Colforsin daropate also prevented HGSOC cells from invading ovarian surface epithelial cell layers in culture. In vivo, colforsin daropate reduced tumor growth, synergized with cisplatin (a standard chemotherapy in ovarian cancer care), and improved host survival in subcutaneous and intraperitoneal xenograft models. These antitumor effects of colforsin daropate were mediated in part by its reduction in the abundance and transcriptional activity of the oncoprotein c-MYC, which is often increased in HGSOC. Our findings demonstrate that colforsin daropate may be a promising therapeutic that could be combined with conventional therapies to treat HGSOC.