Gene Expression Profiles in Ovarian Cancer Tissues as a Potential Tool to Predict Platinum-based Chemotherapy Resistance

Abstract

Background/aim: Ovarian cancer (OC) is one of the leading gynecological causes of death among women. The current standard treatment for OC is debulking surgery followed by platinum-based chemotherapy treatments; however, despite initial success to treatment many patients experience relapses. Currently, there are no available tests to predict sensitivity or resistance to chemotherapy. The aim of this review is to investigate the literature regarding prediction of chemotherapy resistance in patients with OC using gene expression patterns.

Materials and methods: The literature research on PubMed resulted in a total of 490 articles published from November 20^th, 2018, to November 20^th, 2024. We selected only the original studies that described the comparison of mRNA profiles between platinum-sensitive and -resistant OC patients. Studies were included if mRNA expression was measured in human tissue by gene expression microarray, RNA sequencing and quantitative real-time PCR.

Results: Forty-four articles were included covering data from discovery cohorts obtained from hospitals and universities, as well as additional data obtained from online datasets from Gene Expression Omnibus and The Cancer Genome Atlas Program that provided either single- or multiple mRNA signatures that could discriminate between chemotherapy-sensitive and chemotherapy-resistant OC patients. OCs at all stages and histological subtypes were used but most articles included exclusively high-grade serous OC patients.

Conclusion: mRNA-based biomarkers to predict chemotherapy resistance in patients have not yet been clinically implemented, but many differentially expressed genes between chemotherapy-resistant and -sensitive patients have been reported, such as ABCG2, DOCK4, DUSP1, DUSP4, DUSP5, GADD45B, HELQ, HOXA9, KLF4, and NR4A1, which could be compelling biomarker candidates for further studies.

Keywords: Ovarian cancer; mRNA; platinum-based chemotherapy resistance; scoping review.