High-grade serous ovarian cancer: the clone wars.

BACKGROUND: The last 5 years' studies using next-generation sequencing provided evidences that many types of solid tumors present spatial and temporal genetic heterogeneity and are composed of multiple populations of genetically distinct subclones that evolve over time following a pattern of branched evolution. The evolutionary nature of cancer has been proposed as the major contributor to drug resistance and treatment failure. In this review, we present the current state of knowledge about the clonal evolution of high-grade serous ovarian cancer and discuss the challenge that clonal evolution poses for efforts to achieve an optimal cancer control. METHODS: A systemic search of peer-reviewed articles published between August 2007 and October 2016 was performed using PUBMED and Google Scholar database. RESULTS AND CONCLUSIONS: Recent studies using next-generation sequencing have allowed us to look inside the evolutionary nature of high-grade serous ovarian cancer, which in the light of current evidence can explain the relapsing course of the disease frequently observed in the clinical practice. Since only minimal improvement in the survival of patients treated with standard therapy has been observed in the last decade, novel molecular targeted therapies are of great interest in high-grade serous ovarian cancer. However, both spatial and temporal intratumoral genetic heterogeneity is a major challenge for personalized medicine, and greater knowledge of the molecular rules that drive tumor evolution through space and time is required to achieve a long-term clinical benefit from personalized therapy.

[VEGF--targeted therapy for the treatment of cervical cancer --literature review]. / Terapia celowana ukierunkowana na VEGF w leczeniu raka szyjki macicy--przeglad pismiennictwa.

Cervical cancer is the third most common malignancy and the fourth leading cause of cancer-related death among women worldwide. Advances in the knowledge about molecular mechanisms of carcinogenesis have created opportunities for greater use of targeted therapies in contemporary oncology In view of the unsatisfactory results of advanced cervical cancer treatment and a well-documented role of the vascular endothelial growth factor (VEGF) family members in pathogenesis and progression of cervical cancer, the use of VEGF-targeted therapy in the treatment of cervical cancer offers interesting possibilities. The efficacy of bevacizumab, a monoclonal antibody neutralizing VEGF-A in the treatment of cervical cancer was first suggested in 2006 by a small retrospective analysis and confirmed in several Phase II clinical trials. Preliminary results of the randomized phase III studies presented at this year's ASCO (American Society of Clinical Oncology) conference shed new light on the role of VEGF-targeted therapy in the treatment of cervical cancer as they demonstrated that addition of bevacizumab to chemotherapy is associated with significantly improved overall survival in the group of patients with persistent, recurrent or metastatic cervical cancer.