Ovarian cancer

Nat Rev Dis Primers. 2016 Aug 25;2:16061. doi: 10.1038/nrdp.2016.61.

Abstract

Ovarian cancer is not a single disease and can be subdivided into at least five different 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 a 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 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 at diagnosis is typically very responsive to platinum-based chemotherapy. 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. Substantial progress has been made in identifying genes that are associated with a high risk of ovarian cancer (such as BRCA1 and BRCA2), as well as a precursor lesion of HGSC called serous tubal intraepithelial carcinoma, which holds promise for identifying individuals at high risk of developing the disease and for developing prevention strategies.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use
  • BRCA2 Protein / analysis
  • BRCA2 Protein / blood
  • CA-125 Antigen / analysis
  • CA-125 Antigen / blood
  • Contraceptives, Oral, Hormonal / adverse effects
  • Contraceptives, Oral, Hormonal / therapeutic use
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / standards
  • Female
  • Genetic Predisposition to Disease / epidemiology
  • Genetic Predisposition to Disease / genetics
  • Gynecologic Surgical Procedures / methods
  • Humans
  • Mass Screening / methods
  • Mass Screening / standards*
  • Membrane Proteins / analysis
  • Membrane Proteins / blood
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / physiopathology*
  • Ovariectomy / adverse effects
  • Parity / physiology
  • Platinum / pharmacokinetics
  • Platinum / therapeutic use
  • Risk Factors
  • Sterilization, Tubal / adverse effects
  • Ubiquitin-Protein Ligases / analysis
  • Ubiquitin-Protein Ligases / blood

Substances

  • Antineoplastic Agents
  • BRCA2 Protein
  • BRCA2 protein, human
  • CA-125 Antigen
  • Contraceptives, Oral, Hormonal
  • MUC16 protein, human
  • Membrane Proteins
  • Platinum
  • BRAP protein, human
  • Ubiquitin-Protein Ligases