Molecular Diagnostics in Ovarian Cancer: Position Statement of the Interregional Organization of Molecular Geneticists in Oncology and Oncohematology
##article.numberofdownloads## 4
##article.numberofviews## 16
pdf (Русский)

Keywords

ovarian cancer
molecular diagnostic
targeted therapy

How to Cite

Kekeeva, T. Y., Imyanitov, E., Demidova, I., Drui, A., Filipenko , M., Tsaur , G., & Tsukanov , A. (2025). Molecular Diagnostics in Ovarian Cancer: Position Statement of the Interregional Organization of Molecular Geneticists in Oncology and Oncohematology. Voprosy Onkologii, 71(4), OF–2259. https://doi.org/10.37469/0507-3758-2025-71-4-OF-2259

Abstract

Malignant epithelial ovarian tumors represent a heterogeneous group of neoplasms encompassing five principal histological subtypes: high-grade serous carcinoma, low-grade serous carcinoma, endometrioid carcinoma, clear cell carcinoma, and mucinous carcinoma. These distinct subtypes exhibit significant differences in their molecular profiles, cellular origins, hereditary predisposition patterns, invasive and metastatic behaviors, chemosensitivity, and clinical outcomes. This comprehensive review consolidates current knowledge about each histotype, discusses recent breakthroughs in disease understanding, and establishes priorities for molecular genetic investigations aimed at enhancing therapeutic strategies and patient prognosis.​

https://doi.org/10.37469/0507-3758-2025-71-4-OF-2259
##article.numberofdownloads## 4
##article.numberofviews## 16
pdf (Русский)

References

Kurman R., Carcangiu M., Harrington C., et al. WHO Classification of Tumours of Female Reproductive Organs, 4th Edition. WHO/IARC Classification of Tumours. 2014; 6. Lyon: IARC Publications.

Prat J. New insights into ovarian cancer pathology. Ann Oncol. 2012; 23(10): x111-117.-DOI: 10.1093/annonc/mds300.

Jung H., Lee S., Hong J., Chun Y. Interobserver diagnostic reproducibility in advanced‐stage endometrial carcinoma. J Pathol Transl Med. 2021; 55(1): 43‐52.-DOI: 10.4132/jptm.2020.10.04.

Kobel M., Luo L., Grevers X., et al. Ovarian carcinoma histotype: strengths and limitations of integrating morphology with immunohistochemical predictions. Int J Gynecol Pathol. 2019; 38(4): 353-362.-DOI: 10.1097/PGP.0000000000000530.

Hollis R., Thomson J., Stanley B., et al. Molecular stratification of endometrioid ovarian carcinoma predicts clinical outcome. Nat Commun. 2020; 11: 4995.-DOI: 10.1038/s41467-020-18819-5.

Alwafai Z., Heinz M., Fazeli S., et al. Accuracy of endometrial sampling in the diagnosis of endometrial cancer: a multicenter retrospective analysis of the JAGO-NOGGO. BMC Cancer. 2024; 24: 380.-DOI: 10.1186/s12885-024-12127-7.

Manning-Geist B., Gordhandas S., Liu Y., et al. MAPK pathway genetic alterations are associated with prolonged overall survival in low-grade serous ovarian carcinoma. Clin Cancer Res. 2022; 28(20): 4456-4465.-DOI: 10.1158/1078-0432.CCR-21-4183.

Bolton K., Chen D., Fuente R., et al. Molecular Subclasses of Clear Cell Ovarian Carcinoma and Their Impact on Disease Behavior and Outcomes. Clin Cancer Res. 2022; 28(22): 4947-4956.-DOI: 10.1158/1078-0432.CCR-21-3817.

Kindelberger D., Lee Y., Miron A., et al. Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: Evidence for a causal relationship. Am J Surg Pathol. 2007; 31(2): 161-169.-DOI: 10.1097/01.pas.0000213335.40358.47.

Данилова Н., Андреева Ю., Королев А., et al. Роль диспластических изменений эпителия маточной трубы в гистогенезе рака яичников. Архив патологии. 2014; 4: 9-14.- URL: https://www.mediasphera.ru/issues/arkhiv-patologii/2014/4/1000419552014041009. [Danilova N., Andreeva Y., Korolev A., et al. Role of dysplastic changes in the uterine tubal epithelium in the histogenesis of ovarian cancer. Russian Journal of Archive of Pathology. 2014; 76(4): 9‑14.-URL: https://www.mediasphera.ru/issues/arkhiv-patologii/2014/4/1000419552014041009 (In Rus)].

Bell D., Berchuck A., Birrer M., et al. Integrated genomic analyses of ovarian carcinoma. Cancer Genome Atlas Research Network. Nature. 2011; 474(7353): 609-615.-DOI: 10.1038/nature10166.

Ray-Coquard I., Pautier P., Pignata S., et al. Olaparib plus bevacizumab as first-line maintenance in ovarian cancer. N Engl J Med. 2019; 381: 2416-2428.-DOI: 10.1056/NEJMoa1911361.

Silwal-Pandit L., Langerod A., Borresen-Dale A. TP53 mutations in breast and ovarian cancer. Cold Spring Harb Perspect Med. 2017; 7(1): a026252.-DOI: 10.1101/cshperspect.a026252.

Rempel E., Kluck K., Beck S., et al. Pan-cancer analysis of genomic scar patterns caused by homologous repair deficiency (HRD). NPJ Precis Oncol. 2022; 6: 36.-DOI: 10.1038/s41698-022-00276-6.

Kekeeva T., Andreeva Y., Tanas A., et al. HRD testing of ovarian cancer in routine practice: what are we dealing with? Int J Mol Sci. 2023; 24(13): 10497.-DOI: 10.3390/ijms241310497.

Gonzalez D., Stenzinger A. Homologous recombination repair deficiency (HRD): From biology to clinical exploitation. Genes Chromosomes Cancer. 2021; 60: 299-302.-DOI: 10.1002/gcc.22939.

Takaya H., Nakai H., Takamatsu S., et al. Homologous recombination deficiency status-based classification of high-grade serous ovarian carcinoma. Sci Rep. 2020; 10: 2757.-DOI: 10.1038/s41598-020-59671-3.

Chang H., Pannunzio N., Adachi N., Lieber M. Non-homologous DNA end joining and alternative pathways to double-strand break repair. Nat Rev Mol Cell Biol. 2017; 18(8): 495-506.-DOI: 10.1038/nrm.2017.48.

Du W., Amarachintha S., Wilson A., et al. Hyper-active non-homologous end joining selects for synthetic lethality resistant and pathological Fanconi anemia hematopoietic stem and progenitor cells. Sci Rep. 2016; 6: 22167.-DOI: 10.1038/srep22167.

Coleman R., Oza A., Lorusso D., et al. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017; 390: 1949-1961.-DOI: 10.1016/S0140-6736(17)32440-6.

Coleman R., Fleming G., Brady M., et al. Veliparib with first-line chemotherapy and as maintenance therapy in ovarian cancer. N Engl J Med. 2019; 381: 2403-2415.-DOI: 10.1056/NEJMoa1909707.

Gonzalez-Martin A., Pothuri B., Vergote I., et al. Niraparib in patients with newly diagnosed advanced ovarian cancer. N Engl J Med. 2019; 381: 2391-2402.-DOI: 10.1056/NEJMoa1910962.

Willers H., Taghian A., Luo C., et al. Utility of DNA repair protein foci for the detection of putative BRCA1 pathway defects in breast cancer biopsies. Mol Cancer Res. 2009; 7: 1304-1309.-DOI: 10.1158/1541-7786.MCR-09-0149.

Castroviejo‐Bermejo M., Cruz C., Llop‐Guevara A., et al. A RAD51 assay feasible in routine tumor samples calls PARP inhibitor response beyond BRCA mutation. EMBO Mol Med. 2018; 10(12): e9172.-DOI: 10.15252/emmm.201809172.

Batalini F., Gulhan D., Mao V., et al. Mutational signature 3 detected from clinical panel sequencing is associated with responses to olaparib in breast and ovarian cancers. Clin Cancer Res. 2022; 28(21): 4714-4723.-DOI: 10.1158/1078-0432.CCR-22-0749.

Davies H., Glodzik D., Morganella S., et al. HRDetect is a predictor of BRCA1 and BRCA2 deficiency based on mutational signatures. Nat Med. 2017; 23(4): 517-525.-DOI: 10.1038/nm.4292.

Alexandrov L., Kim J., Haradhvala N., et al. The repertoire of mutational signatures in human cancer. Nature. 2020; 578(7793): 94-101.-DOI: 10.1038/s41586-020-1943-3.

Leibowitz B., Dougherty B., Bell J., et al. Validation of genomic and transcriptomic models of homologous recombination deficiency in a real-world pan-cancer cohort. BMC Cancer. 2022; 22(1): 587.-DOI: 10.1186/s12885-022-09669-z.

Peng G., Lin C., Mo W., et al. Genome-wide transcriptome profiling of homologous recombination DNA repair. Nat Commun. 2014; 5: 3361.-DOI: 10.1038/ncomms4361.

Guffanti F., Mengoli I., Damia G. Current HRD assays in ovarian cancer: differences, pitfalls, limitations, and novel approaches. Front Oncol. 2024; 14: 1405361.-DOI: 10.3389/fonc.2024.1405361.

Russell H., McCluggage G. A multistep model for ovarian tumorigenesis: the value of mutation analysis in the KRAS and BRAF genes. J Pathol. 2004; 203(2): 617-619.-DOI: 10.1002/path.1563.

Jang J., Yanaihara N., Pujade-Lauraine E., et al. Update on rare epithelial ovarian cancers: based on the Rare Ovarian Tumors Young Investigator Conference. J Gynecol Oncol. 2017; 28(4): e54.-DOI: 10.3802/jgo.2017.28.e54.

Cheasley D., Nigam A., Zethoven M., et al. Genomic analysis of low-grade serous ovarian carcinoma to identify key drivers and therapeutic vulnerabilities. J Pathol. 2021; 253(1): 41-54.-DOI: 10.1002/path.5545.

Grisham R., Slomovitz B., Andrews N., et al. Low-grade serous ovarian cancer: expert consensus report on the state of the science. Int J Gynecol Cancer. 2023; 33(9): 1331-1344.-DOI: 10.1136/ijgc-2023-004610.

Etemadmoghadam D., Azar W., Lei Y., et al. EIF1AX and NRAS Mutations Co-occur and Cooperate in Low-Grade Serous Ovarian Carcinomas. Cancer Res. 2017; 77: 4268-4278.

Monk B., Grisham R., Banerjee S., et al. MILO/ENGOT-ov11: Binimetinib Versus Physician's Choice Chemotherapy in Recurrent or Persistent Low-Grade Serous Carcinomas of the Ovary, Fallopian Tube, or Primary Peritoneum. J Clin Oncol. 2020; 38(32): 3753-3762.-DOI: 10.1200/JCO.20.01164.

Gershenson D., Miller A., Brady W., et al. Trametinib versus standard of care in patients with recurrent low-grade serous ovarian cancer (GOG 281/LOGS): an international, randomised, open-label, multicentre, phase 2/3 trial. Lancet. 2022; 399(10324): 541-553.-DOI: 10.1016/S0140-6736(21)02175-9.

Salama A., Li S., Macrae E., et al. Dabrafenib and trametinib in patients with tumors with BRAF V600E mutations: Results of the NCI-MATCH trial subprotocol H. J Clin Oncol. 2020; 38: 3895-3904.-DOI: 10.1200/JCO.20.00762.

Pierson W., Peters P., Chang M., et al. An integrated molecular profile of endometrioid ovarian cancer. Gynecol Oncol. 2020; 157(1): 55-61.-DOI: 10.1016/j.ygyno.2020.02.011.

Ryan N., Evans D., Green K., Crosbie E. Pathological features and clinical behavior of Lynch syndrome-associated ovarian cancer. Gynecol Oncol. 2017; 144(3): 491-495.-DOI: 10.1016/j.ygyno.2017.01.005.

Hanley G., McAlpine J., Miller D., et al. A population-based analysis of germline BRCA1 and BRCA2 testing among ovarian cancer patients in an era of histotype-specific approaches to ovarian cancer prevention. BMC Cancer. 2018; 18: 254.-DOI: 10.1186/s12885-018-4153-8.

Alsop K., Fereday S., Meldrum C., et al. BRCA mutation frequency and patterns of treatment response in brca mutation-positive women with ovarian cancer: A report from the Australian Ovarian Cancer Study Group. J Clin Oncol. 2012; 30(21): 2654-2663.-DOI: 10.1200/JCO.2011.39.8545.

Ma X., Dong L., Liu X., et al. POLE/POLD1 mutation and tumor immunotherapy. J Exp Clin Cancer Res. 2022; 41(1): 216.-DOI: 10.1186/s13046-022-02422-1.

Hoang L., McConechy M., Kobel M., et al. Polymerase epsilon exonuclease domain mutations in ovarian endometrioid carcinoma. Int J Gynecol Cancer. 2015; 25(7): 1187-1193.-DOI: 10.1097/IGC.0000000000000492.

Gadducci A., Multinu F., Cosio S., et al. Clear cell carcinoma of the ovary: Epidemiology, pathological and biological features, treatment options and clinical outcomes. Gynecol Oncol. 2021; 162(3): 741-750.-DOI: 10.1016/j.ygyno.2021.06.033.

Iida Y., Okamoto A., Hollis R., et al. Clear cell carcinoma of the ovary: a clinical and molecular perspective. Int J Gynecol Cancer. 2021; 31: 605-616.-DOI: 10.1136/ijgc-2020-001656.

Okamoto A., Glasspool R., Mabuchi S., et al. Gynecologic Cancer InterGroup (GCIG) consensus review for clear cell carcinoma of the ovary. Int J Gynecol Cancer. 2014; 24: S20-25.-DOI: 10.1097/IGC.0000000000000289.

Itamochi H., Oishi T., Oumi N., et al. Whole-genome sequencing revealed novel prognostic biomarkers and promising targets for therapy of ovarian clear cell carcinoma. Br J Cancer. 2017; 117: 717-724.-DOI: 10.1038/bjc.2017.228.

Shibuya Y., Tokunaga H., Saito S., et al. Identification of somatic genetic alterations in ovarian clear cell carcinoma with next generation sequencing. Genes Chromosomes Cancer. 2018; 57: 51-60.-DOI: 10.1002/gcc.22507.

Caumanns J., Wisman G., Berns K., et al. ARID1A mutant ovarian clear cell carcinoma: a clear target for synthetic lethal strategies. Biochim Biophys Acta Rev Cancer. 2018; 1870: 176-184.-DOI: 10.1016/j.bbcan.2018.07.005.

Matulonis U., Shapira-Frommer R., Santin A., et al. Antitumor activity and safety of pembrolizumab in patients with advanced recurrent ovarian cancer: results from the phase II KEYNOTE-100 study. Ann Oncol. 2019; 30(7): 1080-1087.-DOI: 10.1093/annonc/mdz135.

Ngoi N., Heong V., Ow S., et al. A multicenter phase II randomized trial of durvalumab (MEDI-4736) versus physician's choice chemotherapy in recurrent ovarian clear cell adenocarcinoma (MOCCA). Int J Gynecol Cancer. 2020; 30(8): 1239-1242.-DOI: 10.1136/ijgc-2020-001604.

Kristeleit R., Clamp A., Gourley C., et al. Efficacy of pembrolizumab monotherapy (PM) for advanced clear cell gynaecological cancer (CCGC): Phase II PEACOCC trial. Ann. Oncol. 2022; 33: S783.-DOI: 10.1016/j.annonc.2022.07.649.

Banerjee S., Leary A., Stewart J., et al. ATR inhibitor alone (ceralasertib) or in combination with olaparib in gynaecological cancers with ARID1A loss or no loss: Results from the ENGOT/GYN1/NCRI ATARI trial. ESMO Open. 2023; 8(1): 1100814.-DOI: 10.1016/j.esmoop.2023.100814.

Gore M., Hackshaw A., Brady W., et al. An international, phase III randomized trial in patients with mucinous epithelial ovarian cancer (mEOC/GOG 0241) with long-term follow-up: and experience of conducting a clinical trial in a rare gynecological tumor. Gynecol Oncol. 2019; 153: 541-548.-DOI: 10.1016/j.ygyno.2019.03.256.

Zaino R., Brady M., Lele S., et al. Advanced stage mucinous adenocarcinoma of the ovary is both rare and highly lethal: a Gynecologic Oncology Group study. Cancer. 2011; 117: 554-562.-DOI: 10.1002/cncr.25460.

Ryland G., Hunter S., Doyle M., et al. Mutational landscape of mucinous ovarian carcinoma and its neoplastic precursors. Genome Med. 2015; 7(1): 87.-DOI: 10.1186/s13073-015-0210-y.

Hada T., Miyamoto M., Ohtsuka Y., et al. Genetic analysis for mucinous ovarian carcinoma with infiltrative and expansile invasion and mucinous borderline tumor: a retrospective analysis. Diagn Pathol. 2023; 18(1): 49.-DOI: 10.1186/s13000-023-01340-w.

Bekaii-Saab T., Yaeger R., Spira A., et al. Adagrasib in Advanced Solid Tumors Harboring a KRASG12C Mutation. J Clin Oncol. 2023; 41: 4097-4106.-DOI: 10.1200/JCO.23.00434.

Nugawela D., Gorringe K. Targeted therapy for mucinous ovarian carcinoma: evidence from clinical trials. Int J Gynecol Cancer. 2022; 33(1): 102-108.-DOI: 10.1136/ijgc-2022-003658.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

© АННМО «Вопросы онкологии», Copyright (c) 2025