MOLECULAR APPROACHES TO DIAGNOSIS AND MANAGEMENT OF OVARIAN-CANCER

The recent advances in the understanding of the pathogenesis of ovaria n cancer have been helpful in addressing issues in diagnosis, prognosi s and management. The study of ovarian tumours by novel techniques suc h as immunohistochemistry, fluorescent irt situ hybridisation, compara tive genomic hybridisation, polymerase chain reaction and new tumour m arkers have aided the evaluation and application of new concepts into clinical practice. The correlation of novel surrogate tumour specific features with response to treatment and outcome in patients has define d prognostic factors which may allow the future design of tailored the rapy based on a molecular profile of the tumour. These have also been used to design new approaches to therapy such as antibody targeting an d gene therapy. The delineation of roles of c-erbB2, c-fms and other n ovel receptor kinases in the pathogenesis of ovarian cancer has led in itially to the development of anti-c-erbB2 monoclonal antibody therapy . The discovery of BRCA1 and BRCA2 genes will have an impact in the di agnosis and the prevention of familial ovarian cancer. The important r ole played by recessive genes such as p53 in cancer has raised the pos sibility of restoration of gene function by gene therapy. Although the pathological diagnosis of ovarian cancer is still confirmed principal ly on morphological features, addition of newer investigations will in creasingly be useful in addressing difficult diagnostic problems. The increasingly rapid pace of discovery of genes important in disease, ma kes it imperative that the evaluation of their contribution in the pat hogenesis of ovarian cancer is undertaken swiftly, thus improving the overall management of patients and their outcome.