Clinical value of molecular changes in ovarian carcinoma

Abstract

Studies carried out on cell lines and ovarian cancer xenografts have indicated that some disturbances of the expression of some groups of genes in cancer cells have a role in the efficacy of chemotherapy, including the response to given groups of drugs. Cisplatin is a DNA-da-maging agent. On the basis of the data obtained from cell lines the level of the expression of TP53, BCL and BAX proteins affects the response of the ovarian cancer to cisplatin, however this effect has not been confirmed in clinical studies. In the last few years, in the framework of a multi-centre project, we have investigated a group of 233 patients with ovarian cancer treated with cisplatin regimen (cisplatin plus cyclophos-phamide). We have shown that ovarian carcinomas with TP53 protein accumulation (TP53+) and those without accumulation (TP53-) constitute separate biological groups. In our studies the TP53 status had an impact on the clinical value of other proteins such as BAX and BCL-2, as well as of some clinical factors, eg. residual tumor size or clinical stage. BCL-2 expression had a negative influence on complete remission only in the TP53(-) group. On the other hand, the risk of a relapse was lower for the higher BAX expression in the TP53 (+) group. Now we have embarked on similar studies on a group of patients treated with taxanes. In the future, the evaluation of molecular markers may provide a basis for a more individualised chemotherapy of ovarian cancer patients.