Liquid biopsy

Advances in application of circulating tumour DNA in ovarian cancer

https://tinyurl.com/7exeuddu

One of the hoped for new tools in the management and diagnosis of ovarian cancer is the availability of a liquid biopsy. By this is meant a test which uses bodily fluid, usually blood, to determine the presence of ovarian cancer together with the type.

Circulating tumour DNA (ctDNA) may well provide this tool, this is a fragment of cancer DNA which is released by cancer cells when they die and are destroyed. 

     The presence of ctDNA may be shown with genotyping either of the known gene (exon) or the whole genome. This new gene information is much more readily available as PCR testing which became commonplace during the recent pandemic. Early diagnosis and rapid detection of recurrence may be possible if ctDNA testing becomes widespread.

Survival predictor

Genetic characterization of primary and metastatic high-grade serous ovarian cancer tumours reveals distinct features associated with survival

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10318066/

Why certain women with ovarian cancer survive longer remains a mystery. This article looks at gene signatures of primary and metastatic tumour of ovarian cancer for two groups: 16 short term survivors and 23 long term survivors.

Both the genetic signature; genome, and the RNA signature; transcriptome were determined by exon new sequence genetic sampling. 

The findings from this small survey showed that primary and metastatic tumours were more similar for short term survivors than longer survivors, who showed more variation. Differences were also noted in the transcriptomes. The role of RNA messenger proteins is a new tool in the assessment of ovarian cancer. It is suggested by the authors that the transcriptome differences between short term and long term survivors may be a good indicator for clinical management.

What’s best?

Optimal First-Line Medico-Surgical Strategy in Ovarian Cancers: Are We There Yet?

https://tinyurl.com/nvxsh2br

 

       Complete clearance of ovarian cancer at the initial surgery is well known as the most important determinant of overall survival. The definition of complete clearance is changing, currently being no visible remnant larger than 2.5mm (CC1). 

       How this is achieved is the topic of ongoing trials to determine whether surgery should be delayed until neoadjuvant chemo is complete. Previous studies have shown no adverse effect of such delay.

       This review suggests that patient assessment should determine the treatment course. The young and fit may benefit from surgery first. Those less well may have fewer adverse post-operative effects when the tumour size is reduced before surgery.