Stem Cell scientists have revealed the origins of ovarian cancer by modeling Fallopian tube tissues, allowing them to characterize how a genetic mutation puts women at high risk for this cancer. The created tissues, known as “organoids”, have the potential to predict which women will develop ovarian cancer years or even decades in advance. If confirmed, these findings could open doors to early detection and prevention, something impossible today in ovarian cancer.

Ovarian cancer is the main cause of gynecologic cancer death in developed countries. In part because symptoms are often subtle and most tumors are detected when they are in advanced stages and have spread past the ovaries. While the risk of developing ovarian cancer throughout life is less than 2% for the general female population, the estimated risk for women who carry a mutation in the gene known as BRCA-1 is between 35 and 70%. Ovarian cancer is a disease that has always been seen as an aggressive type of cancer with steep survival odds. However, a recent study found that for women in all ovarian cancer stages, survival rates have significantly increased from 1975 to 2011. Women had around 50% less chance of dying of ovarian cancer in 2006 than in 1975.

Faced with such steep odds, some women with BRCA-1 mutations choose to have their ovaries and Fallopian tubes surgically removed, even though they may never develop these types of cancer. The new study findings, published in the prestigious scientific journal Cell Reports, could help doctors identify which of these women have higher probabilities of developing ovarian cancer in the future, and which are not, and find new ways to block the process or treat the cancer.

The investigators have informed that they created these Fallopian tube organoids using they mayother recent investigations that indicate that ovarian cancer actually develops from cancerous lesions in the internal lining of the Fallopian tubes.

To reach their discoveries, the research team generated induced pluripotent stem cells (IPSCs), which can produce any type of cell. They started with blood samples taken from two groups of women: young ovarian cancer patients who had the BRCA-1 mutation and a control group of healthy women. Investigators then used the iPSCs to produce organoids modeling the lining of fallopian tubes and compared the organoids in the two groups.

They were surprised to find multiple cellular pathologies consistent with cancer development only in the organoids from the BRCA-1 patients. Additionally, Organoids derived from women with the most aggressive ovarian cancer displayed the most severe organoid pathology.

Besides showing how ovarian cancer is “seeded” in the fallopian tubes of women with mutated BRCA-1, the organoid technology potentially can be used to determine if a drug might work against the disease in an individual.  Each organoid carries the genes of the person who provided the blood sample, making it a “twin” of that person’s own fallopian tube linings. Multiple drugs can be tested on the organoids without exposing the patient to them.

This study shows an interesting use of IPSCs, getting closer than ever to the significant improvement of results for women with this common type of ovarian cancer. Building on these findings may one day allow us to provide early, lifesaving detection of ovarian cancer in women who carry the BRCA-1 mutation and create effective, individualized prevention and, if necessary, treatment strategies.

See also:
Cytoreductive Surgery for Ovarian Cancer
Ovarian Cancer Recurrence Surgery

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