Predicting the Response of Advanced Cervical and Ovarian Tumors to Therapy

Vanessa Harry, Fiona Jane Gilbert, David Parkin

Research output: Contribution to journalLiterature review

18 Citations (Scopus)

Abstract

The management of advanced cervical and ovarian cancers remains a significant challenge as many women fail to respond to recommended therapy, resulting in disease progression and ultimately patient death. Because of tumor heterogeneity, it is rare for all cancers of a particular type to respond to a specific therapy; and, as a result, many patients receive treatment from which they derive little or no benefit, leading to increased morbidity and undue costs. A marker that could rapidly predict or forecast disease outcome would clearly be beneficial in allowing the administration of a tailored regime for each patient while reducing toxicity and cost. Traditional prognostic factors of tumor size, grade, and stage are not ideal for predicting patient outcome, whereas the use of in vitro assays to detect chemosensitivity or resistance has not yet translated into routine clinical practice. Similarly, biomarkers and tumor markers vary in their predictive ability. DNA array technology offers great promise in predicting the response to therapy based on gene expression profiles, and can allow for targeted therapies against specific molecular alterations that cause disease. Imaging techniques, particularly those with the ability to characterize biological tissues and provide functional, structural, and molecular information, have the potential to noninvasively integrate physical and metabolic information. These include F-18-fluorodeoxyglucose positron emission tomography, dynamic contrast-enhanced magnetic resonance imaging, and diffusion weighted magnetic resonance imaging, all techniques that attempt to evaluate and predict therapy response and so influence clinical outcome. This review examines different methods of predicting the response to treatment in advanced cervical and ovarian tumors.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to describe why prediction of response to therapy for cervical and ovarian cancers is important, describe obstacles to use of in vitro assays to predict outcomes for therapy for ovarian and cervical cancers, and explain potentially new predictive markers.

Original languageEnglish
Pages (from-to)548-560
Number of pages13
JournalObstetrical & Gynecological Survey
Volume64
Issue number8
DOIs
Publication statusPublished - Aug 2009

Keywords

  • squamous-cell carcinoma
  • positron-emission-tomography
  • contrast-enhanced MRI
  • gene-expression profiles
  • cyclooxygenase-2 COX-2 expression
  • color doppler sonography
  • breast-cancer patients
  • S-transferase-PI
  • in-vitro assay
  • neoadjuvant chemotherapy

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