Prognosis Of Ovarian Cancer Patients Research Articles

Abstract 4135: Plasma miRNAs as potential predictive/prognostic biomarker for ovarian cancer

Abstract Background: Ovarian cancer is the fifth leading cause of cancer death in women worldwide. While the survival rates of women with early stage ovarian cancer are high, most cases are diagnosed late. Due to asymptomatic development and few screening options, almost 70% of women present at late stages of carcinogenesis. Sensitive, non-invasive biomarkers that can facilitate disease detection, staging and prediction of therapeutic outcome are highly desirable to improve survival rate and help to determine optimized treatment for ovarian cancer. The small non-coding RNAs, microRNAs (miRNAs), have recently been identified as critical regulators for various diseases including cancer and may represent a novel class of cancer biomarkers. The purpose of this study was to identify and validate circulating microRNAs in human plasma for use as such biomarkers in ovarian cancer. Methods/ Principle findings: We scan the circulating plasma miRNAs by Taqman Low Density Array, then identify and validated 30 markers in plasma samples among 70 cases and 70 controls by real-time PCR assay. Promising associations were evaluated in a second stage, comprising 150 cases and 150 controls. We found that compared with normal, there are 9 miRNAs (miR-205, miR-200a, miR-184, miR-34a*, miR-141, miR-483-5p, miR-193b*, let-7e*, miR-363*) expressed higher in ovarian cancer group, while the miR-98 and let-7f have the lower levels in ovarian cancer. Compared with early stage cases (stage I), there is only miR-483-5p expressed higher in advanced stages (stage II-IV). Receiver operating characteristic (ROC) analysis was used to evaluate the sensitivity and specificity of candidate plasma microRNA markers. We observed that combination of these identified miRNAs and CA-125, a widely used marker for ovarian cancer, further improved the accuracy of detection. Furthermore, our analysis showed that high levels of plasma miR-483-5p or low levels of let-7f predicted poor prognosis of ovarian cancer patients, consistent with the expression of miRNAs in ovarian cancer tissues. Conclusions/Significance: We propose that plasma miRNAs (miR-205, miR-200a, miR-184, miR-34a*, miR-141, miR-483-5p, miR-193b*, let-7e*, miR-363*) are potential biomarkers that complements CA-125 in detecting ovarian cancer; miR-483-5p and let-7f may predict the prognosis of ovarian cancer. It may provide new avenues for the detection, diagnosis, and therapy of this deadly disease. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4135. doi:1538-7445.AM2012-4135

Folate Intake and Methylenetetrahydrofolate Reductase Gene Polymorphisms as Predictive and Prognostic Biomarkers for Ovarian Cancer Risk

Folic acid and methylenetetrahydrofolate reductase (MTHFR) may affect the development of human cancer. However, few studies have evaluated folate intake and MTHFR in susceptibility to and prognosis of patients with ovarian cancer. We conducted a prospective case-control study in 215 ovarian cancer patients and 218 controls (all Chinese) between Jan. 2004 and Jan. 2007. MTHFR C677T genotyping was done by PCR-RFLP. All patients were followed up until Dec. 2010. We found a 2.43-fold increased risk of ovarian cancer among MTHFR 677TT carriers, and a decreased risk of ovarian cancer in individuals with high folate intake (OR = 0.54, 95% CI = 0.32–0.94). Cox regression survival analysis showed that among the ovarian cancer patients, those carrying the 677TT genotype had a higher risk of death (HR = 2.17, 95% CI = 1.20–4.79), while high folate intake was associated with a lower risk of death (HR = 0.43, 95% CI = 0.33–0.88). Moreover, MTHFR 677CC carriers with higher folate intake showed a lower risk of death from ovarian cancer (HR = 0.32, 95% CI = 0.27–0.82). In summary, high folate intake may lessen susceptibility and improve the prognosis of ovarian cancer patients, while the MTHFR 677TT genotype appears to increase ovarian cancer risk and worsen its prognosis in a Chinese population.

Abstract C154: microRNA and targets in the poor prognosis of ovarian cancer patients.

Abstract Epithelial ovarian cancer (EOC) is the most important cause of gynecologic malignancy-related mortality in women. Ovarian clear cell carcinoma (CC) has a poor survival rates and ovarian papillary serous carcinoma (PSC) has a high incidence in the EOC. To get the insight of possible regulator and pathway that may involved in the EOC prognosis and progress, patient samples of CC, PSC and normal ovarian or oviduct tissues were employed in the study. Total 48 human tumor samples and 6 normal ovarian and oviduct tissues were obtained from the patients who were surgically treated for ovarian cancer or other disease at the Obstetrics and Gynecology Hospital, Dalian China. The tissue was further fixed by formalin and embedded by paraffin as routine. Total RNA that enriched miRNAs was extracted from the FFPE tissue by using the Ambion mirVana microRNA isolation kit (Ambion, Austin TX). The quality of total RNA was assessed using the Agilent Bioanalyzer (Agilent Technologies, Santa Clara CA). Quantitative Real-Time polymerase chain reaction (qRT-PCR) assays were formatted into a TaqMan low-density array (TLDA; Applied Biosystems), which was performed at the Shannon McCormack Advanced Molecular Diagnostics Laboratory Research Services, Dana Farber Cancer Institute, Harvard Clinic and Translational Science Center. The normalized microarray data were managed and analyzed by Statminer version 3.0. The targets of miRNA were predicted by using computational approaches, the MicroCosmTargets version 5 and miRBase. The pathway was analyzed by commercial available Ingenuity software. Finally the target predicted was validated by qRT-PCR and imunohistochemistry. The results showed that 101 miRNAs are differentially expressed in the patients of CC compared with PSC, of which 86 (85%) miRNAs were down-regulated in CC patients, suggesting a majority of regulators in the poor prognosis of CC are tumor suppressors. The key miRNAs that were down-expressed in CC patients are miR-9, miR-202, miR-488, miR-509–5p and up-expressed are miR-217, and miR-550. Hundred of gene targets and protein target on the pathways were predicted, but the top targets are enhancer of polycomb homolog 1 (EPC1) and mycophyta (c-MYC), which were validated by qRT-PCR assay at mRNA level and confirmed by immunohistochemistry at molecules level. We identified the key miRNAs that differentially expressed in patients of CC and PSC tumors, predicted and validated the most popular targets regulated by the key miRNAs, indicating the possible regulation gene and pathway for EOC prognosis. This work was supported by the Ministry of Science and Technology of China, Program No. 2008DFA30720 to Shiying Cui. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr C154.

Circulating tumor cells predict progression free survival and overall survival in patients with relapsed/recurrent advanced ovarian cancer

Objective Serial circulating tumor cell (CTC) counts have demonstrated predictive and prognostic value in patients with metastatic breast, colorectal, and prostate cancer. In a phase III study of pegylated liposomal doxorubicin (PLD) with trabectedin vs. PLD for relapsed ovarian cancer, we evaluated the correlation, if any, between numbers of CTCs and progression free survival, (PFS) and overall survival (OS). Methods CTCs were isolated from peripheral blood (10 mL) using the CellSearch system and reagents (Veridex). A CTC is defined as EpCAM+, cytokeratin+, CD45−, and is positive for the nuclear stain DAPI. The normal reference range for CellSearch is < 2 CTC/7.5 mL of blood. Hazard ratios adjusted for known prognostic factors were estimated by Cox regression. Results Two-hundred sixteen patients had baseline CTC measurements of which 111 (51.4%) were randomized to the trabectedin + PLD arm; 143/216 patients (66.2%) were platinum-sensitive. Thirty-one of 216 patients (14.4%) had 2 or more CTCs detected prior to the start of therapy (range 2–566). Univariate Cox regression analyses indicated that patients with ≥ 2 CTCs prior to therapy had 1.89- ( p = 0.003) and 2.06-fold ( p = 0.003) higher risk for progression and death respectively. Multivariate analyses that include baseline CA-125, platinum sensitivity status, largest diameter lesion, number of tumor lesions, ECOG PS, and tumor grade show that patients with elevated baseline CTC had 1.58- ( p = 0.058) and 1.54-fold ( p = 0.096) higher risk for progression and death respectively. Conclusions Results from this study indicate that elevated numbers of CTCs impart an unfavorable prognosis for ovarian cancer patients.

Prognostic effect of epidermal growth factor receptor gene mutations and the aberrant phosphorylation of Akt and ERK in ovarian cancer

(Objectives) We herein assessed the influence of Epidermal Growth Factor Receptor (EGFR) gene mutations on EGFR expression levels, downstream mediators such as Akt or ERK, and overall survival in patients with ovarian cancer. Study Design) EGFR mutation status was analyzed by direct sequencing in 102 Japanese ovarian cancer patients. The EGFR expression, phosphorylated Akt (pAkt), and phosphorylated ERK (pERK) were determined by immunohistochemistry. (Results) Twenty-nine EGFR gene mutations were detected in 24 of 102 patinets (23.5%). EGFR mutations were observed in 27.9% (19/68) in serous adenocarcinomas, 15.0% (3/20) in clear cell adenocarcinomas, and 66.7% (2/3) in mucinous adenocarcinomas, while no mutations were observed in endometrioid adenocarcinomas (0/11). Protein expression of EGFR, pAkt, and pERK were detected in 47 (46.1%), 49 (48%), and 17 (16.7%) of patients, respectively. EGFR gene mutations, EGFR and pERK expression were not associated with a poor prognosis. In a multivariate analysis, a High pAkt expression was found to be a significant predictor for both the progression free survival (p=0.017) and overall survival (P=0.025). (Conclusion) EGFR gene mutations were frequently observed in not only non-small-cell lung cancer (NSCLC), but also in ovarian cancer in Japanese patients. the selective EGFR inhibitor Gefitinib might therefore offer some benefit in patients with EGFR mutations in ovarian cancer. Our results indicate that the Akt, but not necessarily EGFR, is one of the most important target in the response of the platinum-based chemotherapy and prognosis for ovarian cancer patients.

Lysophosphatidic acid‐induced expression of periostin in stromal cells: Prognoistic relevance of periostin expression in epithelial ovarian cancer

Lysophosphatidic acid (LPA) is a bioactive lipid crucial for the initiation and progression of ovarian cancer. Identification of LPA-induced biomarkers is necessary for predicting prognosis of ovarian cancer patients. Here we report periostin, an extracellular matrix protein, as an LPA-induced protein in stromal cells and as a prognostic marker in patients with epithelial ovarian cancer (EOC). In human EOC tissues, periostin was mainly expressed in cancer-associated stromal fibroblasts, but not in cancer cells. The expression levels of periostin highly correlated with poor survival and tumor recurrence of ovarian cancer patients. Treatment of human adipose tissue-derived stromal cells with LPA or conditioned media from human ovarian adenocarcinoma cell lines, such as SK-OV-3 and OVCAR-3, induced expression of periostin. The periostin expression induced by cancer-conditioned media was abrogated by silencing of the LPA receptor 1 expression using small hairpin RNA lentivirus. Recombinant periostin stimulated adhesion and invasion of SK-OV-3 human ovarian adenocarcinoma cells and induced expression of matrix metalloprotease-2 in the cancer cells. These results suggest that LPA is associated with the expression of periostin in cancer-associated fibroblasts of EOC.

Impact of platinum‐based chemotherapy on circulating nucleic acid levels, protease activities in blood and disseminated tumor cells in bone marrow of ovarian cancer patients

There is an unmet need for biomarkers for the prediction and monitoring of anticancer therapies. Here, we measured the concentrations of nucleosomes and DNA, protease and caspase activities in serum of 62 patients with ovarian cancer before and after first-line carboplatin/taxane-based chemotherapy and of 28 healthy individuals by Cell Death Detection ELISA, PicoGreen, Protease Fluorescent Detection Kit and Caspase-Glo3/7 Assay, respectively. By immunocytochemistry, we analyzed bone marrow (BM) aspirates for disseminated tumor cells (DTCs) using the monoclonal antibody A45-B/B3. The measurements in blood and BM were correlated to clinical outcome (median follow-up time: 18 months). Significant correlations between circulating nucleosome and DNA concentrations (p = 0.0001), nucleosome concentrations and caspase activities (p = 0.031) and circulating DNA concentrations and protease activities (p = 0.0001) were detected. Before therapy, the occurrence of DTCs correlated with increasing serum protease activities (p = 0.030) and higher tumor stages (p = 0.029), and after therapy, it correlated with a higher risk of relapse (p = 0.040). Higher protease activities in serum were associated with advanced tumor stages (p = 0.045). We observed a significant relationship between residual tumor load of >1 cm after primary surgery and serum DNA levels (p = 0.0001), and both parameters were associated with a higher risk of relapse (p = 0.0001 and p = 0.020, respectively) and a poorer overall survival (p = 0.021 and p = 0.010, respectively). These findings suggest that the residual tumor load might contribute to elevated DNA levels in blood. Serum DNA levels together with BM status for DTCs have the potential to become suitable biomarkers to predict the prognosis of ovarian cancer patients undergoing platinum-based chemotherapy.

Cotargeting of VEGFR-1 and -3 and angiopoietin receptor Tie2 reduces the growth of solid human ovarian cancer in mice

Despite optimal surgery and chemotherapy, the prognosis of ovarian cancer patients remains poor and new treatments are urgently needed. Solid tumors require the formation of new vessels for growth and metastasis. In the present study, we have used soluble vascular endothelial growth factor (sVEGF) receptors sVEGFR-1 and -3, soluble receptors Tie1 and Tie2 and their combinations in an ovarian cancer xenograft model. Human ovarian cancer cells were injected intraperitoneally into nude mice (n=42) and magnetic resonance imaging (MRI) was used for confirming tumors before gene delivery. Treatment with combined AdsVEGFR-1, AdsVEGFR-3 and AdsTie2 significantly decreased the size of the intraperitoneal tumors compared with the controls (AdLacZ; P=0.038) with significantly less microvessels and vascular area. Unexpectedly, treatment with combined AdsTie1 and AdsTie2 led to a dramatic shortening of the survival which was not observed in the groups receiving either of the soluble receptors alone (P=0.031). The only difference to other treatments was liver toxicity observed after the combined Tie receptor treatment. In conclusion, combined inhibition of VEGFR-1, VEGFR-3 and Tie2 pathways was safe and provided efficient therapy for ovarian cancer in mice.

ULBP2 and RAET1E NKG2D ligands are independent predictors of poor prognosis in ovarian cancer patients

The human activating immune receptor, NKG2D, binds to a diverse array of cellular ligands of the MIC and unique long 16 (UL16)-binding protein (ULBP)/retinoic acid early transcript (RAET) family. NKG2D is thought to participate in anticancer immune responses. By using tissue microarrays representing over 300 patients with defined clinicopathological factors, we present the first comprehensive screen of the expression of all NKG2D ligands in primary ovarian cancers. NKG2D ligands were expressed by the majority of tumors; however, the level of expression varied considerably. By categorizing each tumor as having negative, low or high expression, it was shown that high expression of several NKG2D ligands is inversely correlated with disease survival. Patients whose tumors had high expression of RAET1E (p = 0.037), ULBP1 (p = 0.036) and ULBP3 (p = 0.004) surviving a median of 11, 14 and 11 months, respectively, compared with disease-specific survival of 29, 30 and 25 months in patients whose tumors showed no expression of these ligands. These results contrast with previous findings showing that high level NKG2D ligand expression is associated with good prognosis in colorectal cancer and suggest a fundamental difference in the involvement of NKG2D-mediated immunity in these two types of cancer. By using multivariate analysis, the factors retaining independent prognostic significance were International Federation of Gynecologists and Obstetricians stage (p < 0.001), presence of residual disease (p = 0.003), ULBP2 (p = 0.042) and RAET1E (p = 0.030).

Expression of bone morphogenetic protein-2 and its receptors in epithelial ovarian cancer and their influence on the prognosis of ovarian cancer patients

BackgroundTo determine the expression of bone morphogenetic protein-2 (BMP-2) and its receptors BMPRIA, BMPRIB, and BMPRII in epithelial ovarian cancer (EOC) and to analyze their influence on the prognosis of ovarian cancer patients.MethodsSemi-quantitative RT-PCR and western blot were applied to detect the expression of BMP-2 and its receptors BMPRIA, BMPRIB, and BMPRII in EOC, benign ovarian tumors, and normal ovarian tissue at the mRNA and protein levels. Immunohistochemistry was used to determine the expression of BMP-2 and its receptors in 100 patients with EOC to analyze their influence on the five-year survival rate and survival time of ovarian cancer patients.Results(1) The mRNA and protein expression levels of BMP-2, BMPRIB, and BMPRII in ovarian cancer tissue were remarkably lower than those in benign ovarian tumors and normal ovarian tissue, while no significant differences in BMPRIA expression level was found among the three kinds of tissues. (2) The five-year survival rate and the average survival time after surgery of EOC patients with positive expression of BMP-2, BMPRIB, and BMPRII were remarkably higher than those of patients with negative expression of BMP-2, BMPRIB, and BMPRII. BMPRIA expression was not associated with the five-year survival rate or with the average survival time of ovarian cancer patients.ConclusionsBMP-2, BMPRIB, and BMPRII exhibited low expression in EOC tissue, and variation or loss of expression may indicate poor prognosis for ovarian cancer patients.

Abstract 5048: TAp73a enhances the cellular chemosensitivity to cisplatin in ovarian cancer cells

Abstract Ovarian cancer is the most lethal gynecological malignancy. Most ovarian cancer patients relapse and subsequently die due to the development of resistance to chemotherapy. Strategies for overcoming resistance to chemotherapy and improving prognosis of ovarian cancer patients are very critical. P73, one member of the tumor suppressor p53 family, shares highly structural and functional similarity to p53. Established evidence showed that p73 mediated cellular sensitivity to chemotherapeutic agents in some human tumor cells. However, the role of p73 in the regulation of cellular response to DNA damaging agents in ovarian cancer is still poorly understood, and the function of the transcriptionally active isoform TAp73 as a tumor suppressor is still controversial. The aim of the present study was to examine the effect of TAp73a on cellular response to commonly used chemotherapeutic agent cisplatin in ovarian cancer cells. We established TAp73a overexpressed stable clones in two ovarian cancer cell lines: OVCA433 (wild-type p53) and SKOV3 (null p53). We found that TAp73a enhanced chemosensitivity of ovarian cancer cells to cisplatin by inhibiting cell growth and inducing cell cycle arrest and apoptosis in wild-type p53 OVCA433 cells. Additionally, TAp73a up-regulated the p53 expression and its downstream genes: PUMA, NOXA, p53AIP1, and down-regulated the phosphorylation of Akt as assessed by western blotting. The accumulation of p53 protein induced by TAp73a was found at the post-transcriptional level. Co-immunoprecipitation assay demonstrated that TAp73a directly bound to p53 protein, suggesting that such interaction might block the degradation of p53 protein in OVCA433 cells. In p53-null SKOV3 cells, the increase of chemosensitivity induced by TAp73a was also observed, indicating that TAp73a also functioned independent of p53 by up-regulating the cell cycle inhibitor p21 expression. In conclusion, these results suggested that TAp73a might play an important role in the enhancement of cellular sensitivity to chemotherapeutic drug cisplatin in ovarian cancer cells through p53 dependent and independent pathways. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5048.

Nanomolecular Targeting of Dendritic Cells for Ovarian Cancer Therapy

Epithelial ovarian cancer, the most lethal gynecologic cancer in the western world, is responsible for the death of more than 15,000 Americans per year [1]. Despite significant advances in the understanding of tumor cell biology in the last 30 years, current treatments against metastatic carcinoma, the stage at which most ovarian cancers are diagnosed, lead to a 5-year survival rate of only 30%. The main challenge for improving the prognosis of ovarian cancer patients is the failure of the current standard approach of surgical debulking followed by chemotherapy to eradicate initially chemosensitive tumors, which leads to development of drug resistant tumors and systematic relapse [2]. To improve the very poor prognosis in most ovarian cancers will require a combination of novel strategies for early detection and more effective treatments for ovarian cancers diagnosed at a late stage. One area showing promise for improved treatment is developing strategies to foster anti-tumor immune responses that could block the relapse that generally follows standard treatment.

1325 Regulation of Tissue factor (TF) in colorectal cancer: association with KRAS

Serial circulating tumor cell (CTC) counts have demonstrated predictive and prognostic value in patients with metastatic breast, colorectal, and prostate cancer. In a phase III study of pegylated liposomal doxorubicin (PLD) with trabectedin vs. PLD for relapsed ovarian cancer, we evaluated the correlation, if any, between numbers of CTCs and progression free survival, (PFS) and overall survival (OS).CTCs were isolated from peripheral blood (10 mL) using the CellSearch system and reagents (Veridex). A CTC is defined as EpCAM+, cytokeratin+, CD45−, and is positive for the nuclear stain DAPI. The normal reference range for CellSearch is < 2 CTC/7.5 mL of blood. Hazard ratios adjusted for known prognostic factors were estimated by Cox regression.Two-hundred sixteen patients had baseline CTC measurements of which 111 (51.4%) were randomized to the trabectedin + PLD arm; 143/216 patients (66.2%) were platinum-sensitive. Thirty-one of 216 patients (14.4%) had 2 or more CTCs detected prior to the start of therapy (range 2–566). Univariate Cox regression analyses indicated that patients with ≥ 2 CTCs prior to therapy had 1.89- (p = 0.003) and 2.06-fold (p = 0.003) higher risk for progression and death respectively. Multivariate analyses that include baseline CA-125, platinum sensitivity status, largest diameter lesion, number of tumor lesions, ECOG PS, and tumor grade show that patients with elevated baseline CTC had 1.58- (p = 0.058) and 1.54-fold (p = 0.096) higher risk for progression and death respectively.Results from this study indicate that elevated numbers of CTCs impart an unfavorable prognosis for ovarian cancer patients.

Treatment of recurrent epithelial ovarian cancer.

Epidemiologic analysis reveals that the mortality rate from ovarian cancer is continuously decreasing due to the improvement of surgery and chemotherapy. However, the prognosis of ovarian cancer patients is still unsatisfactory overall considering that only 30% of patients are alive after five years. In fact, although surgery and first-line systemic chemotherapy induces complete and partial response in up to 80% of patients with about a 25% pathological complete remission rate, recurrences occur in the majority of patients. The role of surgery in recurrent disease has been recently studied and many patients can receive an optimal secondary cytoreduction. Most of the recurrent patients are subject to a number of treatment regimens that, although palliative in nature, are also able to prolong survival. Important results have been obtained in particular in platinum-sensitive recurrent disease where a platinum-based chemotherapy is able to prolong progression-free survival and overall survival. Overall, our armamentarium for the treatment of progressive or recurrent ovarian cancer is significantly richer than in the past, and in many patients it is possible to achieve our goal of controlling the chronic behavior of the disease.

BMP-2 signaling in ovarian cancer and its association with poor prognosis

BackgroundWe previously observed the over-expression of BMP-2 in primary cultures of epithelial ovarian cancer (EOC) cells as compared to normal epithelial cells based on Affymetrix microarray profiling [1]. Here we investigate the effect of BMP-2 on several parameters of ovarian cancer tumorigenesis using the TOV-2223, TOV-1946 and TOV-112D EOC cell lines.MethodsWe treated each EOC cell line with recombinant BMP-2 and assayed various parameters associated with tumorigenesis. More specifically, cell signaling events induced by BMP-2 treatment were investigated by western-blot using anti-phosphospecific antibodies. Induction of Id1, Snail and Smad6 mRNA expression was investigated by real time RT-PCR. The ability of cells to migrate was tested using the scratch assay. Cell-cell adhesion was analyzed by the ability of cells to form spheroids. We also investigated BMP-2 expression in tissue samples from a series of EOC patients.ResultsTreatment of these cell lines with recombinant BMP-2 induced a rapid phosphorylation of Smad1/5/8 and Erk MAPKs. Increased expression of Id1, Smad6 and Snail mRNAs was also observed. Only in the TOV-2223 cell line were these signaling events accompanied by an alteration in cell proliferation. We also observed that BMP-2 efficiently increased the motility of all three cell lines. In contrast, BMP-2 treatment decreased the ability of TOV-1946 and TOV-112D cell lines to form spheroids indicating an inhibition of cell-cell adhesion. The expression of BMP-2 in tumor tissues from patients was inversely correlated with survival.ConclusionThese results suggest that EOC cell secretion of BMP-2 in the tumor environment contributes to a modification of tumor cell behavior through a change in motility and adherence. We also show that BMP-2 expression in tumor tissues is associated with a poorer prognosis for ovarian cancer patients.

Low expression of Foxo3a is Associated with Poor Prognosis in Ovarian Cancer Patients

To investigate whether Foxo3a expression is correlated with p27kip1 protein levels as well as how it might be clinically relevant, we evaluated the expression of Foxo3a in several ovarian tumors. Immunohistochemical analysis was performed in 63 cases of ovarian tumors. Ten cases were evaluated by Western blot analysis. There was a correlation observed between Foxo3a over-expression and clinic pathological parameters (p = 0.032). Kaplan-Meier survival analysis showed that Foxo3a low expression was significantly associated with poor prognosis of patients. It may be a useful prognostic marker and target in ovarian cancer.

Nuclear expression of epidermal growth factor receptor is a novel prognostic value in patients with ovarian cancer

The epidermal growth factor receptor (EGFR) has previously been detected in the nucleus of cancer cells and primary tumors. We have reported that EGFR translocates from the plasma membrane to the nucleus. Accumulation of nuclear EGFR is linked to increased DNA synthesis and proliferation; however, the pathological significance of nuclear EGFR is not completely understood. Here, we sought to determine the predictive value of EGFR for the survival of ovarian cancer patients, through the examination of 221 cases of ovarian cancer tissues by immunohistochemical analysis to determine nuclear EGFR expression. In addition, we also examined cyclin D1 and Ki-67 through immunohistochemisty. Furthermore, we examined nuclear EGFR levels in ovarian cancer cell lines treated with EGF, and primary ovarian tumor tissue using immunofluorescence analysis. Nuclear fractions extracted from serum-starved cells treated with or without EGF were subjected to SDS-PAGE and Western blot analyses. We found that 28.3% of the cohort had high levels of nuclear EGFR, while 22.5% had low levels of nuclear EGFR, and 49.2% were negative for nuclear EGFR. Importantly, there was an inverse correlation between high nuclear EGFR, cyclin D1, and Ki-67 with overall survival (P < 0.01, P < 0.09, P < 0.041). Additionally, nuclear EGFR correlated positively with increased levels of cyclin D1 and Ki-67, both indicators for cell proliferation. Our findings indicate a pathological significance of nuclear EGFR that might be important for predicting clinical prognosis of ovarian cancer patients.

Amplification of MDS1/EVI1 and EVI1, Located in the 3q26.2 Amplicon, Is Associated with Favorable Patient Prognosis in Ovarian Cancer

Increased copy number involving chromosome 3q26 is a frequent and early event in cancers of the ovary, lung, head and neck, cervix, and BRCA1 positive and basal breast cancers. The p110alpha catalytic subunit of phosphoinositide-3-kinase (PI3KCA) and protein kinase Ciota (PKCiota) have previously been shown as functionally deregulated by 3q copy number increase. High-resolution array comparative genomic hybridization of 235 high-grade serous epithelial ovarian cancers using contiguous bacterial artificial chromosomes across 3q26 delineated an approximately 2 Mb-wide region at 3q26.2 encompassing PDCD10 to MYNN (chr3:168722613-170908630). Ecotropic viral integration site-1 (EVI1) and myelodysplastic syndrome 1 (MDS1) are located at the center of this region, and their DNA copy number increases are associated with at least 5-fold increased RNA transcript levels in 83% and 98% of advanced ovarian cancers, respectively. Moreover, MDS1/EVI1 and EVI1 protein levels are increased in ovarian cancers and cancer cell lines. EVI1 and MDS1/EVI1 gene products increased cell proliferation, migration, and decreased transforming growth factor-beta-mediated plasminogen activator inhibitor-1 promoter activity in ovarian epithelial cells. Intriguingly, the increases in EVI1 DNA copy number and MDS1/EVI1 transcripts are associated with improved patient outcomes, whereas EVI1 transcript levels are associated with a poor patient survival. Thus, the favorable patient prognosis associated with increased DNA copy number seems to be as a result of high-level expression of the fusion transcript MDS1/EVI1. Collectively, these studies suggest that MDS1/EVI1 and EVI1, previously implicated in acute myelogenous leukemia, contribute to the pathophysiology of epithelial ovarian cancer.

10th Biennial Helene Harris Memorial Trust Meeting

Improving the prognosis of ovarian cancer patients is a major challenge to scientists and clinicians. At a recent multidisciplinary meeting in Washington DC, advances in identification of precursor lesions, progress in disease biomarkers and animal models, the promise of nanotechnology, and strategies for manipulation of the innate and adaptive immune response offered prospects for real progress in this difficult-to-treat disease.

Hepsin shows inhibitory effects through apoptotic pathway on ovarian cancer cell lines

In light of the poor prognosis for ovarian cancer patients, the research continues for innovative and efficacious treatment modalities. Along with surgical and chemotherapeutic regimens, gene therapy has emerged as one of the leading contenders in the treatment armamentarium. Hepsin is a type II transmembrane serine protease originally identified in the human liver as a cDNA clone. However, the biological function of Hepsin expression remains unclear. Apoptotic cell was increasingly common among higher proportions of Hepsin transfectants. We discovered that first-time stable transfectants of Hepsin significantly inhibited cell growth in the monolayer, anchorage-independent cell growth in the soft agar in vitro, and tumorigenicity in vivo in ovarian cancer cell lines. These results demonstrated that Hepsin has a potential therapeutic effect that inhibits through up-regulation of p53-dependent apoptosis and caspase-3, -6, and -7 activations. Our findings in this study identify Hepsin as a target for new approaches in ovarian cancer treatment.