Molecular biology of epithelial ovarian cancer
Biología molecular del cáncer epitelial de ovario
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Introduction: epithelial ovarian cancer is a heterogeneous neoplasm with high mortality, characterized by diverse histological and molecular subtypes that determine its clinical behavior, prognosis, and therapeutic response. High-grade serous carcinoma is the most frequent subtype and is associated with diagnosis at advanced stages and a high recurrence rate.
Methods: a narrative review of the scientific literature was conducted focusing on the histopathological, molecular, and therapeutic aspects of epithelial ovarian cancer, with particular emphasis on molecular characterization, advances in targeted therapies, and the emerging role of liquid biopsy.
Results: high-grade serous carcinoma exhibits marked genomic instability, ubiquitous TP53 mutations, and alterations in the homologous recombination repair pathway, particularly germline or somatic mutations in BRCA1/2. These findings have enabled the incorporation of PARP inhibitors as a therapeutic strategy. Other less frequent subtypes—endometrioid, clear cell, mucinous, and low-grade serous carcinomas—display distinct molecular profiles, with recurrent mutations in ARID1A, PIK3CA, KRAS, or CTNNB1, which carry specific prognostic and therapeutic implications. Transcriptomic classification proposed by The Cancer Genome Atlas (TCGA) identifies immunoreactive, mesenchymal, proliferative, and differentiated subtypes, reflecting the biological complexity of the tumor. In addition, maintenance strategies with targeted therapies, such as bevacizumab and PARP inhibitors (olaparib, niraparib, and rucaparib), have demonstrated improved outcomes in selected patients. Liquid biopsy is emerging as a promising tool for dynamic disease monitoring and early detection of recurrence.
Conclusions: integration of clinical, molecular, and tumor microenvironment information is essential to advance toward truly personalized management of epithelial ovarian cancer, optimizing therapeutic selection and improving clinical outcomes.
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