Ovarian cancer

Survival rates might still be relatively low, but researchers are making valuable inroads into understanding the disease.

After their breakthrough approval for ovarian cancer, attention has turned to how these drugs can benefit more people.

Providing equal access to care will not by itself equalize outcomes between Black and white women.

Vaginal microbes influence the health of the reproductive system, but do they play a part in ovarian tumours?

As the fallopian tubes come to the fore as the source of the most common form of ovarian cancer, researchers and clinicians are devising strategies to prevent the disease.

Combining existing drugs with the targeting of biological features of ovarian tumours could extend life when platinum chemotherapy fails.

Standardizing medical data collection across the globe could yield valuable insights into the distribution of this often-fatal disease.

Knowing you have a genetic mutation that puts you at risk of ovarian cancer can be life-saving. But with complex decisions awaiting anyone who has a disease variant, many people are choosing not to be tested.

Gynaecological cancer researcher Usha Menon explains why ovarian tumours have proved so difficult to detect early.

ATM, BRCA1, BRCA2, CHEK2, PALB2 and TP53 are all established breast cancer susceptibility genes. Over the past 30 years, many other genes have been proposed as candidates. In these two large studies, the candidacy of several questionable genes has been largely resolved, and a final list of ten genes for breast and, importantly, ovarian cancer risk has emerged.

Poly(ADP-ribose) polymerase (PARP) inhibitors are approved for patients with several forms of cancer, predominantly those harbouring loss-of-function BRCA1/2 mutations or other homologous recombination defects. Nonetheless, most patients receiving PARP inhibitors will ultimately develop resistance to PARP inhibitors, resulting in disease progression. In this Review, the authors describe the mechanisms of resistance to PARP inhibitors and discuss the potential treatment strategies that might overcome these effects.

Bast et al. discuss the early detection of ovarian cancer in the context of the recent UKCTOCS screening trial. The authors suggest potential reasons why the trial failed to achieve a reduction in mortality and outline next steps in the development of biomarkers and imaging modalities to detect ovarian cancer.

Recent preclinical and clinical research has led to exciting advances related to high-grade serous ovarian cancer, from examining its cellular origins to gaining insight into DNA-damage-repair mechanisms that may be leveraged for therapies. Furthermore, studies have demonstrated clinical benefit for inhibition of the polymerase PARP and modulation of the cell cycle, and have identified molecular features related to therapeutic response.

In 2018, the SOLO1 trial set a new standard of care with maintenance olaparib substantially extending progression-free survival (PFS) in women with newly-diagnosed BRCA1/2-mutated advanced-stage ovarian cancer. Herein, we summarize trials of first-line poly(ADP-ribose) polymerase (PARP) inhibition beyond BRCA1/2 mutations, including combination strategies, and discuss the optimum use of PARP inhibition in advanced-stage ovarian cancer.

Utilising identical genetic aberrations but targeting different cells, Zhang and colleagues seek to uncover how the cell of origin influences high-grade serous ovarian cancer biology, metastasis and response to treatment.

Synthetic biomarkers are an emerging class of diagnostics that amplify disease signals for sensitive and specific detection of early-stage cancers. This Review discusses the rationale and design of biofluid-based synthetic biomarkers as well as translational challenges and future directions.