Genetic profiling in ovarian cancer

Abstract

Epithelial ovarian cancer (EOC) is a heterogeneous disease that consists of a wide variety of histological types with diverse molecular alterations and is the most lethal gynaecological cancer. Despite debulking surgery and platinum- and taxane-based chemotherapy, the prognosis remains poor. Traditional histological and clinical prognostic factors are insufficient to capture the complex cascade of events that drive the heterogeneous clinical behaviour of this disease. Recently, genomic analysis has confirmed this heterogeneity and has been shown to be a powerful tool to identify dysregulated gene expression, aberrantly activated pathways, and to discover unique molecular signatures among the different histological types of EOC. The promising results obtained to date confirm that genetic analysis might be useful in developing an individualized approach to the management patients with advanced EOC. Identification of the gene-expression profile of a patient could allow better understanding of the specific disease pathogenesis, enabling clinicians to predict an individual response to conventional treatments, ultimately allowing for patients to be triaged to more effective therapies specifically targeting the genetic pathway driving the disease. Major efforts are needed to acquire more accurate gene signatures that can predict chemotherapy resistance and to investigate new targeted smallmolecule drugs active with favourable toxicity profiles.