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Ovarian cancer

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.

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Figure 1: Histological subtypes of ovarian cancer.
Figure 2: DNA repair mechanisms and ovarian cancer.
Figure 3: CT scans from a patient with stage IV ovarian cancer.
Figure 4: Tumour burden in ovarian cancer.

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Acknowledgements

U.A.M. has received research support from the Ovarian Cancer Research Foundation, the Breast Cancer Research Foundation and the US Department of Defense. A.S. has received research support from the US National Institute of Health (CA109298, P50 CA083639 and P50 CA098258).

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Introduction (U.A.M.); Epidemiology (J.S. and B.E.H.); Mechanisms/pathophysiology (A.K.S., B.E.H. and U.A.M.); Diagnosis, screening and prevention (J.S., B.Y.K. and U.A.M.); Management (U.A.M. and B.Y.K.); Quality of life (L.F.); Outlook (all authors); Overview of the Primer (U.A.M.).

Corresponding author

Correspondence to Ursula A. Matulonis.

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Competing interests

U.A.M. has served as a consultant for AstraZeneca, ImmunoGen, Pfizer, Genentech and Merck. All other authors declare no competing interests.

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Matulonis, U., Sood, A., Fallowfield, L. et al. Ovarian cancer. Nat Rev Dis Primers 2, 16061 (2016). https://doi.org/10.1038/nrdp.2016.61

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