The study could help recommend the best treatment for women with early-stage mucinous ovarian cancer

The study could help recommend the best treatment for women with early-stage mucinous ovarian cancer

A global study of mucinous ovarian cancer could help oncologists recommend the best treatment for women who are diagnosed with the disease early.

By examining two different “invasion patterns” — the way cancer cells invade ovarian tissue — through a microscope, oncologists can better predict which patients might have better or worse prognoses and tailor treatment accordingly. The finding was reported in an article published today in Clinical Cancer Research, a journal of the American Association for Cancer Research.

"Mucinous ovarian cancer is a rare type of ovarian cancer. It actually has more in common with gastrointestinal cancer and can be difficult to diagnose and difficult to treat if it has spread beyond the ovaries," says lead author Nicki Meagher, who has just completed her PhD thesis in the Molecular Oncology Group at the UNSW School of Clinical Medicine off.

She says that observing which of the two types of invasion patterns the cancer cells form could help specialists decide on treatment strategies.

We have shown for the first time that women with early-stage disease - that is, they have tumors that have not spread beyond the ovary - have a much worse chance of survival in the first two years after diagnosis if they have what we call an infiltration pattern of invasion.

Knowing this early in the disease allows us to identify patients who may benefit from additional chemotherapy after surgery to remove their ovaries.”

Nicki Meagher, lead author

The two invasion patterns are defined by the way the cancer cells organize themselves under the microscope. The infiltrative invasion pattern associated with poorer health outcomes shows that cancer cells spread unevenly and randomly throughout ovarian tissue. The other pattern is known as the expansile pattern, in which cells expand through the tissue in a more orderly manner and is associated with better prognosis.

To date, other studies have suggested that the infiltrative invasion pattern is associated with poorer patient outcomes, but no study had enough patients with early-stage cancer to reach statistical significance.

But the current study, which involved more than 100 researchers in Australia, Britain, Canada, Asia, Europe and the United States, was able to test this hypothesis in much larger numbers by examining tissue from 604 patients. In addition to invasion patterns, the researchers also looked for the expression of 19 genes, including THBS2 and TAGLN.

Professor Susan Ramus, who oversaw the global study and leads the Ovarian Tumor Tissue Analysis Consortium, says guidelines for treating women with early-stage mucinous ovarian cancer vary worldwide because of limited data on infiltrative invasion patterns linked to survival rates.

“In some parts of the world, for example, an infiltration pattern was recognized as an important characteristic and determined what treatment these women received,” says Professor Ramus.

"In other cases, the same treatment route is recommended for all patients. We hope that treatment guidelines can be adjusted after this large study and that we can target treatment to women who may have these more serious signs, even if they have been diagnosed." early stages.”

The researchers also found that women with higher expression of two genes, THBS2 and TAGLN, in their tumors had worse overall survival.

“We hope this can help explain some of the biology that may be down the road,” says Ms. Meagher.

“Another possibility could be that knowledge of the expression of these genes could help in the development of targeted drugs.”

The researchers are part of a broad network of experts who want to conduct a validation study to further investigate these genomic markers as a basis for a targeted treatment strategy.

Source:

University of New South Wales

Reference:

Meagher, N.S., et al. (2022) Gene expression profiles of ovarian mucinous tumors and comparison with upper and lower gastrointestinal tumors identify markers associated with adverse outcomes. Clinical cancer research. doi.org/10.1158/1078-0432.CCR-22-1206.

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