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Have We Been Wrong About Ovarian Cancer?

By LIDA TUNESI

Most patients who die of ovarian cancer—70-80%–have high-grade serous ovarian carcinoma, or HGSOC. Patients with this particular type of the disease often have poor prognoses and higher risk of relapse.

Recently, researchers have tried to identify subtypes of HGSOC tumors, hoping that this would allow for development of subtype-specific treatments. Now, in an example of science correcting itself, a study says these classifications aren’t accurate.

The paper was published in Cancer Research and provides a new model for formation of HGSOC tumors. Postdoctoral fellows Ludwig Geistlinger and Sehyun Oh, research associate Marcel Ramos, CUNY alumnus Lucas Schiffer, and Professor Levi Waldron (Graduate School of Public Health and Health Policy) were authors on the study.

Waldron’s group had previously analyzed different classification methods, looking at which tumors easily fit into a subtype and which are harder to classify. But their new study shows that the whole idea behind these classifications is wrong.

An HGSOC tumor can change over time to fit different subtypes, the authors say. As they change, they can also develop properties that don’t fit subtype definitions. To make things even more complicated, HGSOC tumors are actually made up of tumor subclones, and different subclones can have properties from different subtypes.

Altogether, the study shows that the subtypes, which were based on the set of RNA that each tumor’s DNA codes for, don’t accurately represent the complexity of HGSOC. This also means that subtype-specific treatments are not viable.

“Unfortunately, previous ideas of discrete subtypes were overly simplistic and unlikely to progress our understanding, prevention, or treatment of this disease,” Waldron told CUNY SPH. “Fortunately, with the clearer picture emerging of tumor heterogeneity, and the rapid development of technologies to help understand it, we are well-positioned to make progress.”