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      Ovarian cancer: Current status and strategies for improving therapeutic outcomes

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          Abstract

          Of all the gynecologic tumors, ovarian cancer (OC) is known to be the deadliest. Advanced‐stages of OC are linked with high morbidity and low survival rates despite the immense amount of research in the field. Shortage of promising screening tools for early‐stage detection is one of the major challenges linked with the poor survival rate for patients with OC. In OC, therapeutic management is used with multidisciplinary approaches that includes debulking surgery, chemotherapy, and (rarely) radiotherapy. Recently, there is an increasing interest in using immunomodulation for treating OC. Relapse rates are high in this malignancy and averages around every 2‐years. Further treatments after the relapse are more intense, increasing the toxicity, resistance to chemotherapy drugs, and financial burden to patients with poor quality‐of‐life. A procedure that has been studied to help reduce the morbidity rate involves pre‐sensitizing cancer cells with standard therapy in order to produce optimal results with minimum dosage. Utilizing such an approach, platinum‐based agents are effective due to their increased response to platinum‐based chemotherapy in relapsed cases. These chemo‐drugs also help address the issue of drug resistance. After conducting an extensive search with available literature and the resources for clinical trials, information is precisely documented on current research, biomarkers, options for treatment and clinical trials. Several schemes for enhancing the therapeutic responses for OC are discussed systematically in this review with an attempt in summarizing the recent developments in this exciting field of translational/clinical research.

          Abstract

          This review article provides an in‐depth information on current treatment strategies and available clinical trials for ovarian cancer. Systematic review of strategies for enhancing the therapeutic response in ovarian carcinoma summarizing the recent developments in translational and clinical research.

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          Cancer regression and autoimmunity induced by cytotoxic T lymphocyte-associated antigen 4 blockade in patients with metastatic melanoma.

          Giao Phan, James Yang, Richard Sherry … (2003)
          Cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) is a critical immunoregulatory molecule (expressed on activated T cells and a subset of regulatory T cells) capable of down-regulating T cell activation. Blockade of CTLA-4 has been shown in animal models to improve the effectiveness of cancer immunotherapy. We thus treated 14 patients with metastatic melanoma by using serial i.v. administration of a fully human anti-CTLA-4 antibody (MDX-010) in conjunction with s.c. vaccination with two modified HLA-A*0201-restricted peptides from the gp100 melanoma-associated antigen, gp100:209-217(210M) and gp100:280-288(288V). This blockade of CTLA-4 induced grade III/IV autoimmune manifestations in six patients (43%), including dermatitis, enterocolitis, hepatitis, and hypophysitis, and mediated objective cancer regression in three patients (21%; two complete and one partial responses). This study establishes CTLA-4 as an important molecule regulating tolerance to "self" antigens in humans and suggests a role for CTLA-4 blockade in breaking tolerance to human cancer antigens for cancer immunotherapy.
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            Design of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.

            Philip C Prorok, Gerald Andriole, Robert Bresalier … (2000)
            The objectives of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial are to determine in screenees ages 55-74 at entry whether screening with flexible sigmoidoscopy (60-cm sigmoidoscope) can reduce mortality from colorectal cancer, whether screening with chest X-ray can reduce mortality from lung cancer, whether screening men with digital rectal examination (DRE) plus serum prostate-specific antigen (PSA) can reduce mortality from prostate cancer, and whether screening women with CA125 and transvaginal ultrasound (TVU) can reduce mortality from ovarian cancer. Secondary objectives are to assess screening variables other than mortality for each of the interventions including sensitivity, specificity, and positive predictive value; to assess incidence, stage, and survival of cancer cases; and to investigate biologic and/or prognostic characterizations of tumor tissue and biochemical products as intermediate endpoints. The design is a multicenter, two-armed, randomized trial with 37,000 females and 37,000 males in each of the two arms. In the intervention arm, the PSA and CA125 tests are performed at entry, then annually for 5 years. The DRE, TVU, and chest X-ray exams are performed at entry and then annually for 3 years. Sigmoidoscopy is performed at entry and then at the 5-year point. Participants in the control arm follow their usual medical care practices. Participants will be followed for at least 13 years from randomization to ascertain all cancers of the prostate, lung, colorectum, and ovary, as well as deaths from all causes. A pilot phase was undertaken to assess the randomization, screening, and data collection procedures of the trial and to estimate design parameters such as compliance and contamination levels. This paper describes eligibility, consent, and other design features of the trial, randomization and screening procedures, and an outline of the follow-up procedures. Sample-size calculations are reported, and a data analysis plan is presented.
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              Uptake of the anticancer drug cisplatin mediated by the copper transporter Ctr1 in yeast and mammals.

              Seiko Ishida, Jaekwon Lee, Dennis Thiele … (2002)
              Cisplatin is a chemotherapeutic drug used to treat a variety of cancers. Both intrinsic and acquired resistance to cisplatin, as well as toxicity, limit its effectiveness. Molecular mechanisms that underlie cisplatin resistance are poorly understood. Here we demonstrate that deletion of the yeast CTR1 gene, which encodes a high-affinity copper transporter, results in increased cisplatin resistance and reduced intracellular accumulation of cisplatin. Copper, which causes degradation and internalization of Ctr1 protein (Ctr1p), enhances survival of wild-type yeast cells exposed to cisplatin and reduces cellular accumulation of the drug. Cisplatin also causes degradation and delocalization of Ctr1p and interferes with copper uptake in wild-type yeast cells. Mouse cell lines lacking one or both mouse Ctr1 (mCtr1) alleles exhibit increased cisplatin resistance and decreased cisplatin accumulation in parallel with mCtr1 gene dosage. We propose that cisplatin uptake is mediated by the copper transporter Ctr1p in yeast and mammals. The link between Ctr1p and cisplatin transport may explain some cases of cisplatin resistance in humans and suggests ways of modulating sensitivity and toxicity to this important anticancer drug.
              Article 0 comments Cited 208 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Riyaz Basha:
                ORCID: https://orcid.org/0000-0002-4071-0993
                Riyaz.Basha@unthsc.edu
                Journal
                Journal ID (nlm-ta): Cancer Med
                Journal ID (iso-abbrev): Cancer Med
                Journal ID (doi): 10.1002/(ISSN)2045-7634
                Journal ID (publisher-id): CAM4
                Title: Cancer Medicine
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2045-7634
                Publication date (Electronic): 27 September 2019
                Publication date Collection: November 2019
                Volume: 8
                Issue: 16 ( doiID: 10.1002/cam4.v8.16 )
                Pages: 7018-7031
                Affiliations
                [ 1 ] Texas College of Osteopathic Medicine UNT Health Science Center Fort Worth TX USA
                [ 2 ] Miami Medical School Miami FL USA
                [ 3 ] Graduate School of Biomedical Sciences UNT Health Science Center Fort Worth TX USA
                [ 4 ] AdventHealth Cancer Institute Orlando FL USA
                Author notes
                [*] [* ] Correspondence

                Riyaz Basha, Department of Pediatrics & Women's Health, Texas College of Osteopathic Medicine, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA.

                Email: Riyaz.Basha@ 123456unthsc.edu

                Author information
                https://orcid.org/0000-0002-4071-0993
                Article
                Publisher ID: CAM42560
                DOI: 10.1002/cam4.2560
                PMC ID: 6853829
                PubMed ID: 31560828
                SO-VID: c86f7923-c2c9-424c-83b7-891d16efafe5
                Copyright © © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 22 May 2019
                Date revision received : 22 August 2019
                Date accepted : 24 August 2019
                Page count
                Figures: 4, Tables: 1, Pages: 14, Words: 9075
                Funding
                Funded by: NIMHD , open-funder-registry 10.13039/100006545;
                Award ID: 2U54 MD006882‐06
                Funded by: NCI , open-funder-registry 10.13039/100000054;
                Award ID: 1P20CA233355‐01
                Funded by: NHLBI , open-funder-registry 10.13039/100000050;
                Award ID: R25HL125447
                Categories
                Subject: Review
                Subject: Cancer Biology
                Subject: Reviews
                Custom metadata
                source-schema-version-number 2.0
                cover-date November 2019
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.2 mode:remove_FC converted:05.12.2019

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: biomarkers,clinical trials,ovarian cancer,ovarian cancer screening
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: biomarkers, clinical trials, ovarian cancer, ovarian cancer screening

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