Can We Predict Chemotherapy Response in Ovarian Cancer? ADAMTS Gene Family Mutations

In this article, in light of a new scientific study, we will try to answer whether genetic testing can identify in advance which ovarian cancer patients will respond better to chemotherapy.

Ovarian cancer is the 2nd most common gynecological cancer in women after breast cancer. It usually occurs at older ages, with a median age at diagnosis of 63. A woman's lifetime risk of ovarian cancer is approximately %1.4. Because "ovarian cancer," arising in the ovaries, is generally diagnosed after spreading to other organs, it can be described as the gynecological cancer causing the most deaths.

Successful ovarian cancer treatment consists of surgery followed by chemotherapy and, rarely when considered necessary, radiotherapy. Almost all women with ovarian cancer undergo surgery and chemotherapy. Although cancer cells are removed surgically, tiny remnants called micrometastases may spread from the ovary to other abdominal regions and distant parts of the body. These may not be detectable with existing tests. Surgery is a regional treatment and cannot completely eliminate micrometastases. Additional systemic treatment is therefore administered using chemotherapy. Chemotherapy and surgery are thus the two most important components of ovarian cancer treatment. Chemotherapy success naturally directly affects treatment outcomes. However, its success is not the same in every patient; many factors can influence it, including age, overall physical performance, disease extent, previous chemotherapy, and response to those treatments. This variability has prompted scientists to investigate the subject.

On 11.06.2015, a new study published in JAMA Oncology, a respected oncology journal, broadened our understanding of identifying in advance which patients will obtain more successful results from ovarian cancer chemotherapy.

The BRCA1 and BRCA2 genes in humans have tumor-suppressing roles. In normal cells, BRCA1 and BRCA2 maintain the stability of genetic material, DNA, and prevent uncontrolled cell growth. Mutations in these genes are associated with hereditary breast and ovarian cancers. BRCA mutations account for approximately %20 of ovarian cancer, and it has long been known that patients with these mutations respond better to chemotherapy. The study mentioned above excluded patients with BRCA mutations and focused within the remaining patient group on those responding well to platinum-based chemotherapy .

Platinum-based chemotherapy drugs form the basis of drug treatment for advanced ovarian cancer. Identifying which patients respond better to them is an important step in the increasingly familiar field of personalized treatment (personalized treatment).

The study was based on analysis of The Cancer Genome Atlas Project data. DNA from ovarian cancer patients who responded well to chemotherapy and showed no disease deterioration was examined and screened for new gene mutations . The study ultimately found that ovarian cancer patients with mutations in the ADAMTS gene family responded better to chemotherapy .

Many Ovarian Cancers Tend to Recur

Recurrent cancer is cancer that returns after a period following completely successful treatment. Ovarian cancer has a relatively high tendency to recur. Many ovarian cancer patients experience recurrence; in light of current knowledge, its main cause appears to be chemotherapy resistance .

In conclusion, ADAMTS mutations, independently of BRCA mutations, may contribute to early recognition of chemotherapy-resistant ovarian cancer and provide important clinical outcomes.