Tumour biomarkers

What we do

Ovarian neoplasms are principally classified into epithelial tumours, sex cord stromal tumours, and germ cell tumours. Each group includes benign and malignant neoplasms and there are also tumours of uncertain malignant potential and borderline tumours. These tumours are encountered at different frequencies in clinical practice, with a largely proportionate inclusion in clinical and basic science studies.

Our group is interested in the identification of diagnostic and prognostic biomarkers and potential therapeutic targets for several types of tumours and in particular ovarian tumours. We have a special interest in borderline ovarian tumours and sex cord stromal tumours. Published work from our laboratory shows that there are molecular subtypes of serous borderline ovarian tumours with benign like and malignant like signatures. Continued work in this area will hopefully lead to the identification of predictive biomarkers for the biological behaviour of individual borderline tumours, as well as the identification of potential therapeutic targets for tumours showing aggressive behaviour; both of which remain to be unmet clinical needs. Similar challenges are also encountered in the management of some sex cord stromal tumours in addition to the need for the identification of robust diagnostic biomarkers for rare entities within this group, particularly ones that present with atypical histological features.

To explore this we analyse patient samples using a range of advanced techniques as well as techniques used in diagnostic histopathology laboratories to study the translational potential of our findings.

Our laboratory is privileged by always working on the basis of close collaboration between scientists and clinicians. This is very much embodied in our work on borderline ovarian tumours where we have been working for at least 10 years now in collaboration with clinical teams in several centres in the United Kingdom through a National multicentre study led by our group, in addition to our work with our colleagues in the multidisciplinary team of the West London Gynaecological Cancer Centre based at the Hammersmith and Queen Charlotte and Chelsea Hospitals. The aim of our work is to develop protocols for optimal care for patients with borderline ovarian tumours from primary diagnosis to personalised surgical procedures and follow-up plans and management of progressive disease.

In addition to our work on clinical specimens our group works on the thorough characterisation and development of in vitro models for our tumours of interest as a discovery tool to better understand tumour pathology and mechanisms underlying tumour development, progression and response to therapy.

Why it is important

Epithelial ovarian tumours are the commonest types of ovarian tumours and they affect women of different age groups, including young patients in the reproductive age group. Early diagnosis, precise tumour typing and stratification in terms of prognosis and eligibility to generic and targeted therapy are important aspects for tumour management.

How it can benefit patients

Borderline ovarian tumours usually affect women in the reproductive age group, and carry the potential for recurrence and progression to cancers that can happen after many years. Their management ideally requires radical surgery and long term follow up, both of which have serious effects on these young women in terms of potential loss of fertility and long term and health concern related anxiety. The same challenges are also shared by some sex cord stromal tumours.

Both of these entities are relatively understudied in comparison to the commoner and more aggressive types of ovarian tumours. Our work on these entities addresses questions and gaps of knowledge that have the potential to provide findings that contribute to evidence based personalised medical managment for these patients, matching the choice of therapy with what would work best for each individual patient.

Summary of current research

1. Development of in vitro models for low grade serous carcinoma and borderline ovarian tumours.
2. Characterisation of in vitro models of sex cord stromal tumours.
3. Studying the histogenesis, genomic changes and signalling pathways in uncommon ovarian tumours.