Somatic Genetic Development in Epithelial Ovarian Cancer

  • Kate Lawrenson
  • Susan J. Ramus
  • Simon A. Gayther
Chapter
Part of the Cancer Genetics book series (CANGENETICS)

Summary

The genetic and biological mechanisms that underlie the somatic development of epithelial ovarian cancers remain poorly understood. For many other tumour types, there is substantial evidence of an ordered series of stages in neoplastic development, driven by the accumulation of somatic genetic changes and the deregulation of specific biological pathways [1]. For ovarian cancer, there is still debate in the published literature about the tissue type from which epithelial ovarian cancers originate and the nature of the precursor lesions.

The picture for ovarian cancer is complicated by disease heterogeneity; epithelial ovarian cancers, which represent 90% of malignant ovarian tumours, comprise multiple different histological subtypes, the most common being serous, mucinous, endometrioid and clear cell tumours. There is now substantial evidence to suggest that different pathways of mutagenesis exist for each tumour subtype. In part, this lack of understanding of the aetiology of the disease has contributed to the lack of substantial improvement in long-term survival for patients diagnosed with ovarian cancer for more than three decades.

The therapeutic options for patients diagnosed with ovarian cancer are also limited, consisting broadly of aggressive cytoreductive surgery and platinum-based combination chemotherapy. As with many other tumour types, it is hoped that detailed analysis of the evolution of ovarian cancers will lead to the identification of novel therapeutic approaches that can improve treatment and outcome. For example, it seems likely that the molecular genetic “signatures” of tumours will reflect underlying biology and aetiological heterogeneity of the disease. Conceivably, by identifying genetic profiles that predict disease outcome, it will be possible to tailor each individual’s treatment to improve their survival. It is also critical that there is a greater understanding of the functional complexities of ovarian tumour development in order to identify novel therapeutic targets and develop better treatments.

The purpose of this article is to review the current understanding of somatic changes that underlie the initiation and development of epithelial ovarian cancers, and to discuss the prospects of using this knowledge to improve treatment and long-term survival for patients with the disease.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Kate Lawrenson
    • 1
  • Susan J. Ramus
    • 1
  • Simon A. Gayther
    • 2
  1. 1.Translational Research LaboratoryUCL EGA Institute for Women’s Health, University College LondonLondonUK
  2. 2.Gynaecological Cancer Research LaboratoriesUCL EGA Institute for Women’s Health, The Paul O’Gorman Building, University College LondonLondonUK

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