New knowledge about OC

Kinesin superfamily proteins in ovarian cancer: from molecular mechanisms to clinical applications

https://tinyurl.com/3d9f6z4v

Understanding the cellular changes that occur in ovarian cancer is essential for developing a cure. This review examines the action of microtubule motor proteins, which are crucial for controlling cell division and maintaining normal cell function.

In ovarian cancer, one of these motor proteins, called Kinesin, is disrupted. This disruption leads to uncontrolled cell division, metastasis, and chemoresistance.

The review highlights that increased intracellular amounts of Kinesin-like proteins are associated with a more aggressive clinical course and a lower survival rate for women with ovarian cancer. The authors suggest that this change in microtubular activity could be a valuable target for precision therapy.

Better informed consent needed

Navigating dual risks: Ovarian cancer prevention and cardiovascular health in patients with hereditary cancer syndromes

https://tinyurl.com/3z46f2tp

Premature menopause is a health hazard. It has long-term implications for the quality of life and health including adverse effects on cardiovascular well-being.

For women with inherited genetic mutations such as BRCA1&2 this means a dilemma. They have a choice of reducing the risk of ovarian cancer by surgical resection of Fallopian tubes and ovaries but need to understand the possible long-term adverse effects.

This review article shows the benefits of risk reduction surgery with a decreased risk of ovarian cancer of up to 96%. After surgery there is an immediate menopause. This has been shown to significantly increase the likelihood of cardiovascular disease which is the leading cause of death for women. The risk has been shown to be 2 to 3 times greater when compared to women who experience a normal menopause at the usual age.

Other side effects of premature menopause such as osteoporosis, dementia, and loss of libido are well known. Cardiovascular adverse effect does not have the same prominence and has only recently been acknowledged by the American College of Cardiology as a “risk enhancing factor”. This lack of understanding has resulted in poor informed consent, with many women not being told of the risk before surgery.

Ethnic disparity of care

Homologous recombination deficiency and survival in ovarian high-grade serous carcinoma by self-reported race

https://tinyurl.com/5e7mf9cb

The benefits of personalised chemo for women with ovarian cancer are obvious. However, this benefit is not being applied equally to all ethnic groups, with black women being less likely to have genetic testing and personalised chemo using PARP inhibitors.

Initially used for women with the BRCA mutation, PARP inhibitors are effective in improving survival for all women who have the metabolic defect of Homologous Recombination Deficiency (HRD).

This study compares survival for women with HRD (about 50% of all ovarian cancer), to those without. The subgroups of HRD women were divided into self-reported race. All women with HRD have a better survival chance, white women survival is improved by 62%, black women do less well with a 32% reduction in death from ovarian cancer.

The authors suggest a difference in genetic mutation for black women, who show more variations of unknown significance, and lower rates of testing, leading to disparity of care.

It’s not just your genotype

Exploring causal relationships between brain imaging-derived phenotypes and ovarian cancer risk: a bidirectional Mendelian randomization

https://tinyurl.com/yhfkpwyb

One of the perplexing aspects of ovarian cancer is why there is individual variation between those who do have cancer and those who don’t. It would be expected that women with high risk due to genetic mutation such as BRCA2 would all eventually succumb to breast or ovarian cancer. However, many (about 20%), do not. This study suggests that brain structure and function may be part of the reason this is so.

Magnetic Resonance Imaging (MRI) is able in a non-invasive way to identify different brain shapes and anatomy. Using data from the UK Biobank study it has been possible to identify 12 distinct varieties of brain anatomy which have an influence on ovarian cancer. Further investigation suggested distinct areas of brain cortex variation, with the right medial cortex being protective, and the right pre-central gyrus being harmful.

Why this is so remains unclear, different areas of the brain have various immunological and psychological effects. Ovarian cancer is more likely for women with immune compromise or depression. There is uncertainty as to whether these changes represent cause or effect, but the findings suggest new variables in cancer study.