A worldwide study into mucinous ovarian cancer could help oncologists recommend the most effective treatment for ladies who’re diagnosed early with the condition.

By looking down a microscope for 2 different ‘patterns of invasion’ – the way in which that cancer cells invade ovarian tissue – oncologists can higher predict which patients could have higher or worse prognoses and may goal treatment accordingly. The finding was reported in a paper published today in Clinical Cancer Research, a journal of the American Association for Cancer Research.

“Mucinous ovarian cancer is a rare kind of ovarian cancer. It actually has more in common with gastrointestinal cancers, and could be hard to diagnose and hard to treat once it has spread beyond the ovaries,” says lead creator Nicki Meagher, who has just accomplished her PhD within the Molecular Oncology group, UNSW School of Clinical Medicine.

She says that observing which of the 2 forms of invasion patterns that the cancer cells form could help specialists choose treatment strategies.

We have shown for the primary time that girls who’ve early-stage disease – meaning they’ve tumors that have not spread beyond the ovary – have much poorer survival probabilities in the primary two years from diagnosis in the event that they have what we call an infiltrative pattern of invasion.

Knowing this within the early stage of the disease means we are able to discover patients who may benefit from additional chemotherapy following surgery to remove their ovaries.”

Nicki Meagher, Lead Writer

The 2 patterns of invasion are defined by the way in which the cancer cells organize themselves when viewed under a microscope. The infiltrative pattern of invasion related to poorer health outcomes shows cancer cells spreading in an uneven, haphazard way through the ovarian tissue. The opposite pattern is referred to as expansile, where cells expand through tissue in a more orderly manner, and is related to higher prognoses.

Up until now, other studies had suggested that the infiltrative pattern of invasion was related to poorer patient outcomes, but no study had large enough numbers of patients with early-stage cancer to achieve statistical significance.

But the present study, that involved greater than 100 researchers in Australia, UK, Canada, Asia, Europe and the US, was in a position to test this hypothesis in much larger numbers by examining the tissue of 604 patients. The researchers also searched for the expression of 19 genes including THBS2 and TAGLN along with the patterns of invasion.

Professor Susan Ramus who oversaw the worldwide study and heads the Ovarian Tumour Tissue Evaluation consortium says that guidelines on how you can treat women with early-stage mucinous ovarian cancer have differed world wide resulting from limited data on infiltrative patterns of invasion related to survival rates.

“For instance, in some parts of the world, an infiltrative pattern was acknowledged as a very important feature and determined what treatment those women receive,” Professor Ramus says.

“Whereas in others, all patients are really helpful for a similar pathway of treatment. We hope that after this huge study treatment guidelines could be aligned and that we are able to goal treatment for ladies who could have these more serious indicators, even in the event that they are diagnosed in early stages.”

The researchers also noted that girls with higher expression of two genes, THBS2 and TAGLN of their tumors, had poorer overall survival.

“We’re hoping that this will give you the option to assist explain a few of the biology potentially down the track,” says Ms Meagher.

“One other avenue might be that knowledge of expression of those genes could assist in developing targeted drugs.”

The researchers are a part of a large network of experts who plan to perform a validation study to further investigate these genomic markers as the premise for a targeted treatment strategy.

Source:

University of Latest South Wales

Journal reference:

Meagher, N.S., et al. (2022) Gene expression profiling of mucinous ovarian tumors and comparison with upper and lower gastrointestinal tumors identifies markers related to opposed outcomes. Clinical Cancer Research. doi.org/10.1158/1078-0432.CCR-22-1206.