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Ovarian cancer

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Table of Contents

Overview

Definition and Types

is a collective term for a group of diseases that originate in the ovaries, as well as in related areas such as the fallopian tubes and the peritoneum. The ovaries, which are two small organs located in the pelvis, are responsible for producing female hormones and eggs for reproduction.[2.1] There are several hereditary patterns associated with ovarian cancer, including cases where ovarian cancer occurs alone, in conjunction with , or alongside colon cancer. Women with a family of ovarian cancer or mutations in the BRCA1 or BRCA2 genes may be at an increased risk and are often advised to seek .[3.1] Ovarian cancer is known for its aggressive and is frequently diagnosed at advanced stages, making it the eighth most common cause of cancer death among women globally, and the fifth most common in regions such as Australia, North America, and Western Europe.[4.1] Recent research has indicated that may not solely originate in the ovaries; instead, many may begin in the distal end of the fallopian tubes.[6.1] This evolving understanding of the disease's origins is crucial for developing effective prevention and treatment . In terms of treatment, ovarian cancer is typically managed through a combination of and chemotherapy, with specific approaches tailored to the individual based on their overall health, the extent of the disease, and other factors.[7.1]

Risk Factors

Ovarian cancer risk factors can be categorized into genetic predispositions, demographic factors, and reproductive history. Approximately 20% of ovarian tumors exhibit hereditary susceptibility, with germline mutations in the BRCA1 and BRCA2 genes accounting for 65-85% of these cases.[20.1] Women with a BRCA1 mutation face a 39-46% risk of developing ovarian cancer by age 70, while those with a BRCA2 mutation have a risk ranging from 10-27% by the same age.[21.1] These genetic mutations not only elevate the risk for the individual but also have implications for family members, as they may indicate a hereditary cancer syndrome that could affect other relatives.[31.1] Demographic factors also play a significant role in ovarian cancer risk. Most women diagnosed with ovarian cancer are postmenopausal, typically at age 55 or older, with the incidence notably higher in women over 65 years of age.[26.1] The median age at diagnosis generally falls between 50 and 79 years.[26.1] Additionally, variations in ovarian cancer risk have been observed across different populations, influenced by reproductive factors such as the number of childbirths, use of oral contraceptives, and tubal ligation.[27.1] However, the underlying reasons for the majority of this variation remain largely unknown.[27.1] Reproductive history is another significant factor influencing ovarian cancer risk. Factors such as the number of childbirths, use of oral contraceptives, and surgical procedures like tubal ligation contribute to variations in risk, although the underlying reasons for most of this variation remain unclear.[27.1] A strong family history of breast or colorectal cancer may indicate a higher genetic risk for ovarian cancer, particularly if there is a family history of ovarian cancer or specific mutations in the BRCA1 or BRCA2 genes.[32.1] Genetic counseling may be recommended based on personal and family cancer history, which can help individuals understand and manage their risk for ovarian cancer and other related cancers.[33.1]

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History

Historical Context of Ovarian Cancer Research

The historical context of ovarian cancer research is characterized by key developments that have shaped our understanding and approach to the disease. A landmark event occurred in 2006 with the founding of the Ovarian Cancer Action Research Centre, the first dedicated facility in Europe for ovarian cancer research. This year also marked the initiation of Ovarian Cancer Awareness Month, which played a crucial role in the UK Department of Health's recognition of the four primary symptoms of ovarian cancer.[50.1] Between 1970 and 2005, the Gynecologic Oncology Group (GOG) conducted extensive clinical trials involving approximately 35,000 women, underscoring the significant efforts to advance treatment and understanding of ovarian cancer.[52.1] The identification of genetic factors has been pivotal, with research revealing that 65–85% of hereditary ovarian tumors are linked to BRCA gene mutations, which impair DNA repair mechanisms.[53.1] This genetic insight has been instrumental in shaping prevention and treatment strategies. The epidemiological trends of ovarian cancer have shifted over time. In high-income regions like Europe and North America, mortality rates have generally stabilized or decreased, particularly among younger and middle-aged women.[72.1] Conversely, rising incidence and mortality rates are observed in developing countries undergoing economic and lifestyle changes.[74.1] Despite these trends, the prognosis for ovarian cancer remains challenging, with five-year survival rates ranging from 30% to 50% in most countries.[75.1] Recent data indicate a decline in age-adjusted rates for new ovarian cancer cases by an average of 2.7% annually from 2012 to 2021, and a 2.4% annual decrease in death rates from 2013 to 2022.[76.1] These statistics highlight the ongoing need for research and public health initiatives to improve outcomes for women with ovarian cancer. The Gynecologic Cancer InterGroup (GCIG) has been influential in directing future research, as demonstrated by their 2021 conference focused on harmonizing clinical trial designs and addressing unmet needs in the field.[90.1]

Milestones in Treatment Development

Recent advancements in the treatment of ovarian cancer have significantly impacted patient outcomes, particularly through the development of and the approval of new drugs. In 2022, the first antibody-drug conjugate (ADC) for platinum-resistant ovarian cancer received accelerated approval from the U.S. Food and Drug Administration (FDA), marking a pivotal moment in the treatment landscape for this challenging condition.[71.1] ADCs have gained traction due to their ability to selectively deliver cytotoxic agents to tumor cells, enhancing efficacy and tolerability compared to traditional chemotherapy.[69.1] The treatment landscape for ovarian cancer has undergone significant changes over the past decade, primarily due to an improved understanding of the biological pathways involved and the introduction of poly (ADP-ribose) polymerase inhibitors (PARPi).[70.1] These advancements have led to better patient outcomes; however, it is important to note that approximately half of the women diagnosed with ovarian cancer still succumb to the disease within five years.[70.1] Recent clinical trials have played a crucial role in evaluating the efficacy of PARPi, including studies that have assessed olaparib as maintenance therapy for patients with platinum-sensitive relapsed ovarian cancer and BRCA1/2 mutations.[67.1] Additionally, the MEDIOLA study has explored the combination of olaparib with other agents such as durvalumab and bevacizumab in patients with non-germline BRCA-mutated platinum-sensitive relapsed ovarian cancer.[67.1] Despite these advancements, ongoing challenges remain, including and the need for novel predictive , as highlighted in recent reviews from the American Society of Clinical .[78.1] Moreover, ongoing clinical trials continue to explore strategies, including targeted drug combinations that show promise in enhancing treatment efficacy for advanced ovarian cancer.[81.1] The emphasis on genetic counseling and testing has also become integral to plans, as identifying pathogenic variants can significantly influence therapeutic decisions and surveillance strategies.[84.1] Despite these advancements, challenges remain, as approximately half of the women diagnosed with ovarian cancer succumb to the disease within five years.[70.1] Nevertheless, the landscape of ovarian cancer treatment is evolving, with a realistic hope for improved therapies and outcomes for patients in the future.[68.1]

Recent Advancements

New Therapeutic Approaches

Recent advancements in ovarian cancer treatment have introduced several innovative aimed at improving patient outcomes. One significant development is the ongoing research into designed to prevent the recurrence of ovarian cancer in patients with advanced disease. Researchers at the Mayo Clinic are focusing on a that targets tumors in individuals whose cancer has returned after surgery and chemotherapy, which represents a promising avenue for enhancing survival rates among affected patients.[93.1] In addition to , the use of novel magnetic has emerged as a groundbreaking for treating ovarian tumors. Researchers from Oregon State University have engineered a new type of magnetic that integrates a cancer-targeting , which could potentially revolutionize chemotherapy by improving directly to tumor sites.[100.1] This approach addresses the challenges associated with traditional chemotherapy, such as low efficiency and insufficient drug permeability.[97.1] Clinical trials are also exploring surgical strategies to reduce the risk of ovarian cancer in women with BRCA1 mutations. One ongoing trial is investigating whether the delayed removal of ovaries, following the removal of fallopian tubes, is as safe and effective as simultaneous removal of both structures.[95.1] Furthermore, various clinical trials are assessing the efficacy of combining chemotherapy with targeted therapies, such as the use of bevacizumab and pembrolizumab, in patients with recurrent ovarian cancer.[96.1] Despite these advancements, challenges remain in the recruitment and retention of participants for clinical trials. Factors such as the complexity of study protocols, lack of awareness about clinical trials, and sociocultural issues significantly hinder participant enrollment.[102.1] Addressing these barriers is crucial for the successful advancement of for ovarian cancer, particularly for underrepresented groups who may face additional obstacles in trial participation.[103.1]

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Symptoms And Diagnosis

Common Symptoms

Ovarian cancer is often referred to as a "silent disease" due to the mild and intermittent nature of its early symptoms, which can lead to delays in diagnosis and treatment.[144.1] Common symptoms include abdominal bloating, pelvic or abdominal pain, changes in appetite, and alterations in vaginal bleeding.[140.1] Additionally, gastrointestinal issues such as diarrhea and constipation are recognized as significant symptoms of ovarian cancer.[148.1] is also a commonly reported symptom, which can complicate the diagnosis as it may be mistaken for other less serious conditions.[141.1] of these symptoms is crucial, as recognizing them can significantly improve outcomes for those affected.[156.1] The overlap of these symptoms with those of less serious conditions can contribute to misdiagnosis, making it crucial for women to be vigilant about persistent signs.[147.1] Symptoms may initially be mild and intermittent, which can further complicate recognition.[144.1] Therefore, awareness of these symptoms is essential for early detection, as timely diagnosis significantly improves treatment outcomes.[156.1] Women with a family history of ovarian cancer or genetic predispositions, such as mutations in the BRCA1 or BRCA2 genes, should be particularly proactive in monitoring their health and seeking medical advice when experiencing these symptoms.[149.1] Overall, understanding and recognizing the common symptoms of ovarian cancer can empower women to advocate for their health and seek timely medical intervention.[145.1]

Diagnostic Procedures

Diagnostic procedures for ovarian cancer involve a combination of and specific tests aimed at identifying the presence of the disease. Healthcare providers typically begin the diagnostic process by conducting a thorough pelvic examination, which can help detect abnormal changes in the ovaries and uterus, such as unusual lumps or irregularities in size and shape.[169.1] This examination is crucial, as early detection significantly improves treatment outcomes; for instance, when ovarian cancer is diagnosed early, approximately 94% of patients can expect to live longer than five years post-diagnosis.[170.1] Healthcare providers play a crucial role in diagnosing ovarian cancer, beginning with a thorough assessment of symptoms and a pelvic exam. If ovarian cancer is suspected, imaging techniques such as or may be employed to visualize the ovaries and identify any abnormalities.[134.1] A key used in the diagnosis of ovarian cancer is Cancer Antigen 125 (CA-125), which is considered the gold standard tumor marker. Elevated levels of CA-125 are found in many women with ovarian cancer; however, it is important to note that high levels can also occur in various non-cancerous conditions, and some women may present with normal CA-125 levels in the early stages of the disease, indicating that this biomarker lacks specificity.[162.1] CA-125 is a glycoprotein encoded by the MUC16 gene on chromosome 19, and its upper limit of normal is set at 35 UI/ml. It is elevated in a significant percentage of different ovarian cancer types, including 85% of serous, 65% of endometrioid, 40% of clear-cell, 36% of undifferentiated, and only 12% of mucinous ovarian cancers.[165.1] The diagnosis of ovarian cancer is often confirmed during surgical procedures, where tissue samples can be obtained for histological examination.[134.1] Alarmingly, more than 70% of ovarian cancer cases are diagnosed at an advanced stage, with approximately 65% of all cases being advanced at the time of diagnosis.[161.1] This late diagnosis is primarily attributed to the nonspecific and often unrecognized early symptoms, which contribute to the disease's reputation as a silent killer.[161.1] Currently, there are very few biomarkers for ovarian cancer that exhibit high sensitivity for early-stage disease. Effective strategies for early detection must achieve a sensitivity greater than 75% and an extremely high specificity of 99.6% to ensure a positive predictive value of at least 10%.[164.1]

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Treatment Options

Surgical Interventions

Surgical interventions play a crucial role in the of ovarian cancer, particularly in the context of staging and . Laparoscopic staging surgery for ovarian cancer has been performed since 1993, with improvements in surgical outcomes attributed to the development of enhanced techniques. Recent studies have focused on the laparoscopic surgical outcomes for patients with stage I ovarian cancer, indicating a positive trend in surgical efficacy.[197.1] In early-stage ovarian cancer (ESOC), comprehensive surgical staging is recommended, which may involve advanced techniques such as surgery.[199.1] Traditionally, staging for clinical early-stage ovarian cancer has been conducted through laparotomy, which involves an extensive midline incision to expose the entire peritoneal cavity. However, advancements in laparoscopic techniques now allow for the standard staging procedure to be performed with less invasiveness.[200.1] This shift towards minimally invasive approaches is significant as it can lead to reduced times and improved patient outcomes. The future of surgical staging in ovarian cancer is an evolving field, with ongoing research aimed at refining surgical practices to enhance their accuracy and effectiveness.[198.1] The current treatment paradigm typically involves upfront surgical debulking followed by adjuvant platinum-based chemotherapy to eliminate any residual disease.[202.1] Primary debulking surgery (PDS) is particularly critical for patients with advanced ovarian cancer, while neoadjuvant chemotherapy (NACT) is often reserved for bulky stage III-IV patients who may not be optimal surgical candidates.[218.1] Timing is also a vital consideration in the surgical management of ovarian cancer. The interval between neoadjuvant chemotherapy and subsequent debulking surgery can impact treatment success and patient prognosis. Studies have investigated the prognostic relevance of the time to interval debulking surgery (TTS) and the timing of postoperative adjuvant chemotherapy, highlighting the importance of these factors in treatment planning.[219.1]

Chemotherapy and Targeted Therapies

Chemotherapy plays a crucial role in the treatment of ovarian cancer, often utilized in conjunction with surgery. The typical course of chemotherapy for epithelial ovarian cancer consists of 3 to 6 cycles, which are determined based on the cancer's stage and type. Each cycle involves a schedule of regular doses of medication followed by a rest period, with the specific drugs and their administration routes varying according to the treatment plan established by the healthcare team.[184.1] The determination of the most appropriate chemotherapy regimen for patients with ovarian cancer is influenced by several known factors, including cancer stage, histological type, tumor grade, residual tumor size after surgery, and the patient's chemosensitivity or chemoresistance. However, these factors present an incomplete picture of the and are frequently interrelated.[185.1] In the treatment of advanced ovarian cancer, it is recommended to use agents that do not exhibit cross-resistance to standard treatments such as carboplatin or paclitaxel. Options for such agents include gemcitabine, pegylated liposomal doxorubicin, and bevacizumab, particularly when further chemotherapy is deemed appropriate.[183.1] In addition to traditional chemotherapy, targeted therapies have emerged as promising options for improving patient outcomes. Recent advancements in have led to the development of treatments tailored to individual genetic tumor profiles, which can enhance the effectiveness of therapy and reduce resistance to drugs.[195.1] Notable examples include the use of PARP inhibitors, such as Olaparib, which have shown efficacy in patients with specific genetic mutations, such as BRCA1/2.[196.1]

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Epidemiology

Incidence and Prevalence

Ovarian cancer (OC) is a significant health concern, accounting for an estimated 239,000 new cases and 152,000 deaths worldwide annually, making it the seventh most commonly diagnosed cancer among women globally and the eighth leading cause of cancer mortality in this population.[223.1] The incidence of OC varies with age, as older women exhibit a higher risk; studies indicate that the likelihood of developing ovarian cancer increases significantly with advancing age.[224.1] Epithelial ovarian cancer, which is the most prevalent subtype, presents with various histological types that differ in their origins, , and associated risk factors.[222.1] The classification of ovarian cancer is based on the potential origin from one of the three main components of the ovary: epithelium, stroma, and germinal cells.[223.1] Certain reproductive factors have been identified as influencing the risk of developing ovarian cancer. For instance, there is a consistent inverse relationship between parity (the number of times a woman has given birth), use, and the risk of ovarian cancer.[220.1] Specifically, the use of oral contraceptives has been shown to significantly reduce the risk of ovarian cancer across most histological types.[236.1] Women with endometriosis experience a significant increase in the incidence of epithelial ovarian cancer, with rates escalating from 4.99 per 10,000 women under 30 years to 35.81 per 10,000 women over 50 years.[225.1] Additionally, germline mutations in the BRCA1 and BRCA2 genes are recognized as the most significant and well-characterized genetic risk factors for ovarian cancer, conferring a high lifetime risk of developing the disease.[239.1] Epidemiological data from large, unselected ovarian cancer populations indicate that the incidence rate of these deleterious mutations is approximately 12-14%.[238.1] These findings underscore the importance of genetic screening and risk assessment in women with a family history of ovarian cancer, particularly those with endometriosis.

Demographic Variations

Ovarian cancer exhibits significant demographic variations in its incidence and mortality rates across different populations and regions. Key risk factors associated with ovarian cancer include age, family history, reproductive history, and lifestyle factors such as and physical inactivity. Most women diagnosed with ovarian cancer are over the age of 55, particularly after menopause, indicating that age is a critical risk factor.[25.1] Additionally, a strong family history of breast cancer, particularly linked to inherited mutations in the BRCA1 or BRCA2 genes, significantly increases the risk of developing ovarian cancer.[234.1] The incidence and mortality rates of ovarian cancer exhibit significant demographic variations that are closely associated with factors. High-income countries report the highest incidence rates of ovarian cancer, while low- to middle-income countries experience the highest mortality rates.[233.1] This is influenced by several factors, including the Index (HDI), which has been shown to have a positive with both the incidence and mortality of ovarian cancer.[249.1] Additionally, higher incidence rates are linked to various risk factors prevalent in wealthier nations, such as higher GDP per capita, smoking, alcohol use, physical inactivity, obesity, , , and .[233.1] In contrast, regions with lower , particularly in Central Sub-Saharan Africa, report the lowest age-standardized incidence rates of ovarian cancer, although the highest mortality rates are observed in low- to middle-income countries.[233.1] Despite an overall decreasing trend in the incidence and mortality of ovarian cancer globally, a notable increase in incidence has been observed among younger females.[233.1] The global burden of ovarian cancer is projected to rise significantly, with the number of women dying from the disease expected to increase to 350,956, reflecting an increase of almost 70% from 2022.[248.1] Five-year survival rates for ovarian cancer vary considerably between countries; in more developed nations, these rates currently range from 36% to 46%, while in some less developed countries, the figures are much lower.[248.1] This variation in survival rates is influenced by several factors, including reproductive behaviors, healthcare resources, and health awareness.[250.1] It is suggested that countries with high incidence rates should enhance public health and implement active screening programs to address these .[250.1]

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Prevention Strategies

Lifestyle Modifications

play a significant role in the prevention of ovarian cancer, particularly in conjunction with other medical strategies. While there is no definitive method to prevent ovarian cancer, certain lifestyle choices have been associated with a lower risk of developing the disease. For instance, the use of birth control pills containing estrogen and progesterone for five or more years, as well as undergoing surgical procedures such as tubal ligation or hysterectomy, have been linked to a reduced likelihood of ovarian cancer.[270.1] Maintaining a healthy lifestyle is essential, as modifiable factors such as obesity, physical inactivity, and smoking significantly contribute to cancer and morbidity and mortality worldwide.[282.1] Recent epidemiological analyses from Australia have shown that higher diet quality after a diagnosis of ovarian cancer is associated with a 39% increase in survival rates.[293.1] Furthermore, research indicates that replacing sedentary time with light to moderate is linked to a reduced risk of cancer, with these associations remaining significant even after adjusting for demographic factors and other lifestyle variables.[294.1] These findings underscore the critical role of lifestyle modifications in improving and . Public health campaigns play a crucial role in raising awareness about ovarian cancer, particularly through initiatives like the Centers for and Prevention's Inside Knowledge: Get the Facts about Gynecologic Cancer campaign. This campaign is designed to educate women and healthcare providers about the risk factors, symptoms, recommended screening, and prevention strategies for ovarian cancer and other .[279.1] Given that there are currently no effective methods for preventing or screening for ovarian cancer, recognizing symptoms is essential for early detection.[280.1] Additionally, the World Fund and the American Institute for Cancer Research have released updated recommendations that emphasize the importance of a healthy diet and regular physical activity as key components of cancer prevention strategies.[295.1] These lifestyle modifications are integral to reducing the risk of developing various cancers, including ovarian cancer.

Genetic Testing and Prophylactic Surgery

for BRCA1 and BRCA2 mutations is a critical step for individuals with a family history of breast and ovarian cancers. It is essential for those considering testing to approach the decision thoughtfully, as the implications of a positive result can significantly affect personal circumstances, , , , privacy, and medical choices.[275.1] The BRCA gene test specifically identifies DNA changes that elevate the risk of breast and ovarian cancers, and individuals with a blood relative who has tested positive for such mutations should consider undergoing genetic testing.[276.1] The United States Preventive Services Task Force (USPSTF) recommends that clinicians conduct a familial risk assessment for women with personal or family of breast, ovarian, tubal, or peritoneal cancer, as well as those with ancestry linked to BRCA1/2 mutations.[278.1] This assessment is essential for identifying individuals who may benefit from genetic testing, which is recognized as a powerful tool for understanding and making informed health decisions.[277.1] However, the USPSTF advises against routine genetic counseling or testing for women whose personal or family history does not indicate a risk for harmful BRCA1/2 mutations.[278.1] Therefore, women with risk factors, such as a family history of breast cancer or early-onset breast cancer, are encouraged to discuss the possibility of genetic testing with a healthcare provider to make informed decisions regarding their health.[277.1] Risk-reducing salpingo-oophorectomy (RRSO) is a well-established preventive strategy that significantly lowers the risk of ovarian cancer, particularly in women with known genetic predispositions.[286.1] A has shown that RRSO can reduce the risk of future ovarian cancer by over 80% in high-risk women.[283.1] However, this procedure is not without its drawbacks; it induces premature menopause, which can lead to various short-term and long-term , including hot flashes, disturbances, and increased risks of and .[285.1] The effectiveness of RRSO is particularly pronounced in women with a lifetime ovarian cancer risk of 4% or greater, where it has been shown to be cost-effective, especially when hormone replacement therapy is utilized post-surgery.[287.1] Therefore, women contemplating RRSO should weigh the potential benefits against the risks and side effects, considering their individual health circumstances and family history.[285.1]

Living With Ovarian Cancer

Support Systems

Support systems play a crucial role in the lives of individuals diagnosed with ovarian cancer, providing emotional, psychological, and practical assistance throughout their journey. Many patients find solace in sharing their experiences within patient communities, where personal stories and artistic expressions help them come to terms with their diagnosis and realize they are not alone in their struggles.[311.1] This sense of community is vital, as it fosters connections among those affected by ovarian cancer, allowing them to share coping strategies and support one another. Healthcare professionals also emphasize the importance of hope and proactive treatment approaches. For instance, Dr. Courtney-Brooks highlights that despite the challenges posed by ovarian cancer, there are patients who have survived for five to ten years, and ongoing advancements in treatment options continue to emerge.[312.1] This optimistic perspective can be empowering for patients, encouraging them to engage actively with their treatment plans and support networks. Individual stories, such as that of Jodi, illustrate the multifaceted nature of living with ovarian cancer. Jodi recounts her journey through stage 4 ovarian cancer, detailing her experiences with chemotherapy and the emotional impact of losing her hair. She underscores the significance of having and a robust support system to navigate the complexities of her diagnosis.[313.1] Such not only provide insight into the personal challenges faced by patients but also highlight the critical role of emotional and practical support from family and friends. The aggressive nature of ovarian cancer, characterized by a high recurrence rate, necessitates a strong support system to help patients cope with the uncertainties of their condition.[314.1] Organizations dedicated to ovarian cancer awareness and support, such as OCRA, offer various programs that connect newly diagnosed patients with survivors, fostering a sense of community and shared experience.[321.1] These initiatives are essential in creating an environment where patients can find hope and encouragement. support is crucial for the of ovarian cancer patients, as those who seek emotional and social support report a higher and lower levels of .[325.1] Understanding the emotional toll of ovarian cancer and implementing coping strategies can help individuals navigate their journey with greater .[323.1] Essential steps in managing the psychological challenges associated with a cancer diagnosis include building a strong support network, expressing emotions, prioritizing self-care, and seeking professional help.[323.1] Mental health care for cancer patients is specialized, addressing unique challenges such as mortality fears and feelings of shame or self-doubt regarding mental health concerns.[330.1] By tailoring support to these specific emotional needs, mental health professionals can significantly aid ovarian cancer patients in coping with their treatment journey.[330.1]

Coping Mechanisms

Coping with ovarian cancer involves navigating a complex emotional landscape, as the diagnosis can significantly impact various aspects of life. Individuals often experience a range of emotions, including stress, anxiety, and feelings of being overwhelmed, particularly when faced with advanced stages of the disease.[328.1] Recognizing these emotions as normal and valid responses is crucial for patients, as it allows them to seek appropriate support and coping strategies.[327.1] To effectively navigate the emotional challenges associated with a diagnosis of advanced ovarian cancer, patients can employ several beneficial coping strategies. It is crucial for patients to stay on track with their treatment, as this can help foster a sense of control and purpose during a difficult time.[328.1] Engaging in open conversations with a counselor is also recommended, as it can assist patients in processing their feelings and developing healthier coping mechanisms.[328.1] Additionally, utilizing relaxation techniques can support mental health by alleviating feelings of stress and anxiety.[328.1] Furthermore, maintaining a positive outlook is emphasized as a vital component of coping, as it can enhance resilience and improve overall quality of life.[329.1] The Mays Cancer Center highlights that a positive outlook can significantly aid cancer patients in managing the emotional challenges they face throughout their treatment journey.[329.1] Support from friends, family, and community resources plays a significant role in the coping process. Patients are encouraged to lean on their support networks, which can include clergy or other trusted individuals, to foster a sense of connection and understanding.[328.1] Institutions like the Mays Cancer Center offer a variety of support services tailored to the needs of cancer patients and their families, further aiding in the emotional journey.[329.1] By implementing these strategies, individuals living with ovarian cancer can navigate their treatment journey with greater resilience and improved mental health.

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Research And Future Directions

Recent advancements in ovarian cancer research have focused on innovative treatment strategies and the identification of genetic factors influencing . One significant area of development is the use of antibody-drug conjugates (ADCs), which have gained traction for treating solid tumors, including ovarian cancer. In 2022, the first ADC was approved by the FDA specifically for ovarian cancer, marking a pivotal moment in treatment options for this disease.[354.1] Additionally, researchers are exploring a variety of new drugs and therapeutic approaches that target the hallmarks of cancer, such as self-sufficiency in growth signals, instability, and . Current clinical phase III studies are investigating these promising drugs, with showing beneficial effects for the first time in ovarian cancer.[355.1] Another promising avenue of research involves the development of vaccines aimed at preventing tumor recurrence in patients with advanced ovarian cancer. This initiative is being led by researchers at the Mayo Clinic, who are working on a vaccine designed to prevent the return of tumors in individuals whose cancer has recurred after surgery and chemotherapy.[353.1] Current research trends in ovarian cancer highlight the significant impact of genetic mutations on the disease's development and treatment outcomes. The low survival rates among ovarian cancer patients suggest that, in addition to BRCA1 and BRCA2 mutations, other genetic mutations may also contribute to the onset and progression of the disease.[368.1] Recent genomic studies have provided substantial evidence for the involvement of numerous additional genes in ovarian cancer, indicating a complex genetic landscape that influences treatment effectiveness.[368.1] This evolving understanding of the genetic factors associated with ovarian cancer underscores the need for continued research into targeted therapies that can improve patient outcomes. The of clinical trials in ovarian cancer is increasingly focused on addressing the heterogeneity of the disease, which encompasses variations in histologic subtypes and alterations. This focus is essential for encouraging novel and ensuring that design elements are relevant to the complexities of ovarian cancer.[362.1] Appropriate patient selection is fundamental in clinical research, as it shapes the of the trial and the relevance of its results. This process involves setting eligibility criteria for participant enrollment, which is critical for enhancing the integrity and applicability of research findings.[366.1] The Gynecologic Cancer InterGroup (GCIG) held its sixth Ovarian Cancer Conference on Clinical Research virtually in October 2021, where the goal was to achieve harmonization on the design elements of upcoming trials, select important questions for future studies, and identify unmet needs in ovarian cancer research.[364.1]

Future Challenges in Ovarian Cancer Management

The management of ovarian cancer faces several future challenges, particularly in the realm of early detection and the integration of emerging biomarkers into . One significant hurdle is the lack of reliable early detection methods, which complicates treatment strategies and underscores the need for approaches. Current clinical diagnostic tools exhibit limited efficacy in early ovarian cancer detection, making it imperative to develop new diagnostic techniques that can improve survival rates by facilitating earlier intervention.[361.1] The biological and molecular heterogeneity of ovarian cancer further complicates the translation of approaches into meaningful clinical outcomes. This complexity necessitates a nuanced understanding of the disease to effectively implement personalized treatment strategies.[358.1] Among the promising advancements, folate alpha (FOLR1) has emerged as a notable biomarker for ovarian cancer detection, showing elevated levels in patients compared to those with benign conditions. Its versatility in clinical applications highlights the potential for integrating such biomarkers into routine practice.[359.1] Moreover, groundbreaking advancements in biomarkers, algorithms, and (AI) are paving the way for a new era in ovarian cancer diagnosis. Researchers are increasingly leveraging advanced biomarkers and algorithm-based techniques to enhance early and accurate detection of the disease. The integration of these innovative approaches, including photoacoustic imaging and liquid biopsy, is revolutionizing ovarian cancer diagnosis and offers new avenues for improving patient outcomes.[360.1] However, the successful translation of these research findings into real-world applications remains a critical challenge that must be addressed to optimize ovarian cancer management in the future.[358.1]

References

cdc.gov favicon

cdc

https://www.cdc.gov/ovarian-cancer/about/index.html

[2] Ovarian Cancer Basics | Ovarian Cancer | CDC - Centers for Disease ... Ovarian cancer is a group of diseases that originates in the ovaries, or in the related areas of the fallopian tubes and the peritoneum. Women have two ovaries that are located in the pelvis, one on each side of the uterus. The ovaries make female hormones and produce eggs for reproduction. Women have two fallopian tubes that are a pair of long

aacr.org favicon

aacr

https://www.aacr.org/patients-caregivers/cancer/ovarian-cancer/

[3] Ovarian Cancer Overview - American Association for Cancer Research (AACR) Three hereditary patterns have been identified: ovarian cancer alone, ovarian and breast cancers, and ovarian and colon cancers. Women who have a family history of ovarian cancer, a family history of BRCA1 or BRCA2 gene mutations, or may have a higher risk of cancer for another reason are sometimes asked to undergo genetic counseling and

ncbi.nlm.nih.gov favicon

nih

https://www.ncbi.nlm.nih.gov/books/NBK606468/

[4] Ovarian cancer - World Cancer Report - NCBI Bookshelf Ovarian cancerovarian cancer is frequently aggressive and is generally detected at a late stage. It is the eighth most common cause of cancer death in women worldwide, and the fifth most common cause of cancer death in women in Australia, North America, and western Europe. ... Summary • Accumulating evidence suggests that the majority of

cancer.org favicon

cancer

https://www.cancer.org/cancer/types/ovarian-cancer/about/what-is-ovarian-cancer.html

[6] What is Ovarian Cancer | Ovarian Tumors and Cysts Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer and can spread. To learn more about how cancers start and spread, see What Is Cancer?. Ovarian cancers were previously believed to begin only in the ovaries, but recent evidence suggests that many ovarian cancers may actually start in the cells in the far (distal) end of

my.clevelandclinic.org favicon

clevelandclinic

https://my.clevelandclinic.org/health/diseases/4447-ovarian-cancer

[7] Ovarian Cancer: Symptoms, Diagnosis & Treatment - Cleveland Clinic Ovarian Cancer: Symptoms, Diagnosis & Treatment Ovarian Cancer Ovarian Cancer Healthcare providers treat ovarian cancer with surgery, chemotherapy and other cancer treatments. Ovarian Cancer Treatment What is ovarian cancer? If your healthcare provider suspects ovarian cancer, they’ll ask about your symptoms and perform a pelvic exam. Providers can diagnose ovarian cancer during surgery. What are the stages of ovarian cancer? There are four stages of ovarian cancer. Providers rarely use radiation therapy for treatment of ovarian cancer. After you’ve completed ovarian cancer treatment, your healthcare provider will want to see you regularly for observation. Ovarian Cancer Treatment After you’ve received ovarian cancer treatment, your healthcare provider will still see you for regular appointments. Ovarian Cancer Treatment

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https://pmc.ncbi.nlm.nih.gov/articles/PMC4449870/

[20] Hereditary Ovarian Cancer: Not Only BRCA 1 and 2 Genes Abstract. More than one-fifth of ovarian tumors have hereditary susceptibility and, in about 65-85% of these cases, the genetic abnormality is a germline mutation in BRCA genes. Nevertheless, several other suppressor genes and oncogenes have been associated with hereditary ovarian cancers, including the mismatch repair (MMR) genes in Lynch syndrome, the tumor suppressor gene, TP53, in the Li

acog.org favicon

acog

https://www.acog.org/womens-health/faqs/brca1-and-brca2-mutations

[21] BRCA1 and BRCA2 Mutations - ACOG The risk of ovarian cancer for the average American woman is about 2 percent in her lifetime. The estimated risk of ovarian cancer in women with a BRCA1 mutation is 39 to 46 percent by age 70. For women with a BRCA2 mutation, the risk of ovarian cancer by age 70 is 10 to 27 percent.

cancercenter.com favicon

cancercenter

https://www.cancercenter.com/cancer-types/ovarian-cancer/risk-factors

[25] Top Ovarian Cancer Causes & Factors That Put You at Risk What causes ovarian cancer? While the exact cause of ovarian cancer may not be known, several factors may increase the risk of developing the disease. The likelihood of developing the disease may be higher if a woman has one or more ovarian risk factors. One key risk factor is age. Most women who develop ovarian cancer are diagnosed after menopause, at age 55 or older, though patients in their

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https://pmc.ncbi.nlm.nih.gov/articles/PMC6500433/

[26] Ovarian cancer in the world: epidemiology and risk factors Demographic factor Age. The epithelial ovarian cancer is an age-related disease, and is considered mainly a postmenopausal disease. 10, 27 Increased incidence of this cancer is more pronounced in women over 65 years of age. 28 According to previous studies, median age at diagnosis is 50-79 years. 27, 29, 30 The relationship between age and the outcome of ovarian cancer is uncertain.

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cancer

https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-special-section-ovarian-cancer-2018.pdf

[27] PDF the variation in ovarian cancer risk is explained by differences in the prevalence of reproductive risk factors, such as number of childbirths, use of oral contraceptives, and tubal ligation, but the source of most of the variation remains unknown. 19. Race/Ethnicity. During 2010-2014, overall ovarian cancer incidence rates

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wustl

https://siteman.wustl.edu/treatment/cancer-types/ovarian/genetic-counseling-for-ovarian-cancer/

[31] Genetic Counseling for Ovarian Cancer | Siteman Cancer Center Identifying a genetic mutation can lead to improved, targeted treatment for you and can alert other family members who could be at risk. If one of your family members has a genetic mutation associated with ovarian cancer, you may want to consider genetic testing to see if you are affected, too.

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ovarian

https://ovarian.org/why-knowing-your-family-health-history-matters/

[32] Why Knowing Your Family Health History Matters - ovarian.org If you have a mother, sister, or daughter with ovarian cancer, or a family history of breast or colorectal cancer, you may have a higher genetic risk. Specific mutations in the BRCA1 and BRCA2 genes, for example, are linked to increased ovarian cancer risk. ... The role of genetic testing in ovarian cancer risk. If you find a pattern of cancer

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cdc

https://www.cdc.gov/breast-ovarian-cancer-hereditary/testing/index.html

[33] Genetic Testing for Hereditary Breast and Ovarian Cancer Your genetic counselor or other health care provider may recommend genetic testing based on your personal and family history of cancer, your ancestry, and whether you have a family member with a genetic mutation. Genetic test results may help you understand and manage your risk for breast, ovarian, and other cancers.

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ovarian

https://ovarian.org.uk/get-involved/campaigns/christmas-campaign-2024/timeline-of-ovarian-cancer-breakthroughs/

[50] Ovarian cancer breakthroughs | Ovarian Cancer Action 2006 | Major milestones for Ovarian Cancer Action. The Ovarian Cancer Action Research Centre, Europe's first dedicated ovarian cancer research centre, was established. The first-ever Ovarian Cancer Awareness Month was launched. Campaigning successfully led to the UK Department of Health recognising the four main symptoms of ovarian cancer.

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https://www.ncbi.nlm.nih.gov/books/NBK367622/

[52] Introduction and Background - Ovarian Cancers - NCBI Bookshelf Between 1970 and 2005, clinical trials of the Gynecologic Oncology Group (GOG) alone included approximately 35,000 women with ovarian cancer (DiSaia et al., 2006). In Initial National Priorities for Comparative Effectiveness Research (IOM, 2009), the committee offered two priorities that are relevant to ovarian cancer genetics: “Compare the effectiveness of adding information about new biomarkers (including genetic information) with standard care in motivating behavior change and improving clinical outcomes” and “Compare the effectiveness of genetic and biomarker testing and usual care in preventing and treating breast, colorectal, prostate, lung, and ovarian cancer, and possibly other clinical conditions for which promising biomarkers exist” (IOM, 2009, p.

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https://pmc.ncbi.nlm.nih.gov/articles/PMC7812238/

[53] Ovarian cancer: state of the art and perspectives of clinical research ... Ovarian cancer: state of the art and perspectives of clinical research Particularly, in about 65–85% of hereditary ovarian tumors, the genetic abnormality is a germline mutation in breast cancer genes (BRCA) that causes DNA repair defects. Non-epithelial ovarian cancers are histologically and clinically distinct uncommon tumors with more favorable prognosis than EOC. In this special series, we tried to review the state of the art of the diagnosis and treatment and share future challenges in ovarian cancer, although several areas warrant further research. Provenance and Peer Review: This article was commissioned by the editorial office, Annals of Translational Medicine for the series “Ovarian Cancer: State of the Art and Perspectives of Clinical Research”.

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https://www.nature.com/articles/s43018-023-00617-9

[67] Clinical and translational advances in ovarian cancer therapy Olaparib tablets as maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a final analysis of a double-blind, randomised, placebo-controlled, phase 3 trial. Phase II Study of Olaparib (O) plus Durvalumab (D) and Bevacizumab (B) (MEDIOLA): Initial Results in Patients (pts) with Non-Germline BRCA-Mutated (Non-gBRCAm) Platinum Sensitive Relapsed (PSR) Ovarian Cancer (OC) (ESMO, 2020). Combination ATR and PARP inhibitor (CAPRI): a phase 2 study of ceralasertib plus olaparib in patients with recurrent, platinum-resistant epithelial ovarian cancer. Phase II Study of Olaparib (O) plus Durvalumab (D) and Bevacizumab (B) (MEDIOLA): Initial Results in Patients (pts) with Non-Germline BRCA-Mutated (Non-gBRCAm) Platinum Sensitive Relapsed (PSR) Ovarian Cancer (OC) (ESMO, 2020). Combination ATR and PARP inhibitor (CAPRI): a phase 2 study of ceralasertib plus olaparib in patients with recurrent, platinum-resistant epithelial ovarian cancer.

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mayoclinic

https://connect.mayoclinic.org/blog/health-equity-research/newsfeed-post/ovarian-cancer-new-research-and-treatments/

[68] Ovarian cancer: New research and treatments - Mayo Clinic Connect Dr. Weroha advises ovarian cancer patients to seek care from gynecologic oncologists and explore clinical trials for access to cutting-edge treatments. "There is a realistic hope for better treatments in the future, even if your cancer recurs," he says. Learn more Learn more about ovarian cancer and find a clinical trial at Mayo Clinic.

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wiley

https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.35135

[69] Top advances of the year: Ovarian cancer - Lumish - 2024 - Cancer ... Over the past decade, ADCs have gained increasing traction for the treatment of solid tumors because of their ability to selectively deliver cytotoxic drugs to tumor cells, resulting in enhanced efficacy and tolerability relative to cytotoxic chemotherapy, and 2022 brought the first FDA approval for an ADC to treat ovarian cancer. 6, 7 Although

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC10581945/

[70] Treatment of Ovarian Cancer Beyond PARP Inhibition: Current and Future ... Improved understanding of the biologic pathways and introduction of poly (ADP-ribose) polymerase inhibitors (PARPi) during the last decade have changed the treatment landscape. This has improved outcomes, but unfortunately half the women with ovarian cancer still succumb to the disease within 5 years of diagnosis.

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https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35135

[71] Top advances of the year: Ovarian cancer - American Cancer Society Journals recent advances in systemic therapies over the past year highlighted in this re-view have prolonged survival for women with ovarian cancer. In 2022, the first antibody-drug conjugate for platinum‐resistant ovarian cancer received acceler-ated US Food and Drug Administration (FDA) approval. Confirmatorystudies

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annalsofoncology

https://www.annalsofoncology.org/article/S0923-7534(19

[72] Global trends and predictions in ovarian cancer mortality Over the last two decades, ovarian cancer mortality rates have tended to level off and decrease in several high-income European countries and North America, where rates were highest . The falls were greater in young and middle-aged women than in the elderly, and earlier and larger in the USA, the UK and northern Europe [ 5 ].

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https://pmc.ncbi.nlm.nih.gov/articles/PMC5365187/

[74] Epidemiology of ovarian cancer: a review - PMC - PubMed Central (PMC) Ovarian cancer incidence exhibits wide geographic variation. In most developed countries, largely including North America and Europe, OC incidence and mortality has gradually declined since the 1990s 4,36-40.Conversely, historically less developed countries with recent economic growth and lifestyle changes have seen increases in incidence and mortality rates.

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thelancet

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24

[75] Worldwide patterns and trends in ovarian cancer incidence by ... Although declining trends in OC incidence rates have been observed over the past few decades, particularly in high-income countries, 4 the prognosis for OC remains dismal, with age-standardized five-year net survival rates varying between 30% and 50% in most countries. 5 Consequently, there is an urgent need for an increased focus on both

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https://seer.cancer.gov/statfacts/html/ovary.html

[76] Cancer Stat Facts: Ovarian Cancer - Surveillance, Epidemiology, and End ... Using statistical models for analysis, age-adjusted rates for new ovarian cancer cases have been falling on average 2.7% each year over 2012-2021. Age-adjusted death rates have been falling on average 2.4% each year over 2013-2022. 5-year relative survival trends are shown below.

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healthbooktimes

https://onco-hema.healthbooktimes.org/article/91249-advancing-ovarian-cancer-treatment-the-latest-insights-on-parp-inhibitors-from-asco-2023

[78] Advancing Ovarian Cancer Treatment: The Latest Insights on PARP ... Drawing on the latest insights from the American Society of Clinical Oncology (ASCO 2023) annual congress, this review summarizes the data of the recent trials evaluating PARP inhibitors, as well as discusses remaining therapeutic challenges such as drug resistance and the quest for novel predictive biomarkers in OC.

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC7928025/

[81] Ovarian cancer: new strategies and emerging targets for the treatment ... In this review, we discuss new strategies that are emerging for the treatment of patients with advanced ovarian cancer across a broad range of mechanisms of action, outlining the rationale underlying the selection of new targets in ovarian cancer and the novel combination approaches currently being evaluated in clinical trials.

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wiley

https://onlinelibrary.wiley.com/doi/10.1002/jgc4.1374

[84] Risk assessment and genetic counseling for hereditary breast and ... 1 INTRODUCTION. Genetic counseling and testing have been an important part of cancer care for many years. The identification of pathogenic and likely pathogenic variants (P/LPV) in high- and moderate-penetrance genes can impact treatment strategies, surveillance, and preventative surgeries.

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https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(22

[90] Clinical research in ovarian cancer: consensus ... - The Lancet The Gynecologic Cancer InterGroup (GCIG) sixth Ovarian Cancer Conference on Clinical Research was held virtually in October, 2021, following published consensus guidelines. The goal of the consensus meeting was to achieve harmonisation on the design elements of upcoming trials in ovarian cancer, to select important questions for future study, and to identify unmet needs. All 33 GCIG member

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mayoclinic

https://cancerblog.mayoclinic.org/2024/05/01/ovarian-cancer-new-treatments-and-research/

[93] Ovarian cancer: New treatments and research Ovarian cancer: New treatments and research - Mayo Clinic Comprehensive Cancer Center Blog Ovarian cancer: New treatments and research Ovarian cancer: New treatments and research Ovarian Cancer Ovarian Cancer Diagnosis and Treatment, Ovarian Cancer, Research and Clinical Trials, Survivorship Ovarian cancer: New treatments and research Dr. Weroha says new treatments are helping more people survive ovarian cancer of all types, and researchers are studying new treatments and screening methods in clinical trials. Matthew Block, M.D., Ph.D., a Mayo Clinic medical oncologist, and Keith Knutson, Ph.D., a Mayo Clinic researcher, are developing a vaccine to prevent ovarian cancer tumors from returning in people with advanced ovarian cancer whose tumors have recurred after surgery and chemotherapy. Learn more about ovarian cancer and find a clinical trial at Mayo Clinic.

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cancer

https://www.cancer.gov/types/ovarian/research

[95] Advances in Ovarian Cancer Research - NCI - National Cancer Institute An ongoing NCI-supported clinical trial is testing whether removing the fallopian tubes but delaying removal of the ovaries will be as safe and effective to reduce the risk of ovarian cancer in women with BRCA1 mutations as removing both the ovaries and fallopian tubes at the same time. For women with advanced epithelial ovarian cancer that has come back after being in remission, clinical trials have studied the use of secondary surgery or surgery to remove more tumor after the initial surgery with varying results. Many NCI-funded researchers at the National Institutes of Health campus, and across the United States and the world, are seeking ways to address ovarian cancer more effectively.

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biomedcentral

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03826-w

[96] Promising new drugs and therapeutic approaches for treatment of ovarian ... OCEANS: a randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer: J Clin Oncol. Anlotinib combined with TQB2450 in patients with platinum-resistant or -refractory ovarian cancer: a multi-center, single-arm, phase 1b trial: Cell Rep Med. 2022; https://doi.org/10.1016/j.xcrm.2022.100689. ENGOT-OV43/KEYLYNK-001: a phase III, randomized, double-blind, active- and placebo-controlled study of pembrolizumab plus chemotherapy with olaparib maintenance for first-line treatment of BRCA-nonmutated advanced epithelial ovarian cancer: J Clin Oncol. ENGOT-OV44/FIRST study: a randomized, double-blind, adaptive, phase III study of standard of care (SOC) platinum-based therapy ± dostarlimab followed by niraparib ± dostarlimab maintenance as first-line (1L) treatment of stage 3 or 4 ovarian cancer (OC): J Clin Oncol.

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nih

https://pubmed.ncbi.nlm.nih.gov/39182385/

[97] Magnetically actuated cisplatin-loaded nanoparticle collectives enhance ... Chemotherapy is the main clinical treatment for ovarian cancer, but still faces challenges of low drug targeting efficiency and insufficient drug permeability. Drug-loaded nanoparticle collectives, which are actuated by magnetic field, could be targeted to a designated location and achieve targeted drug delivery.

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bioengineer

https://bioengineer.org/revolutionary-nanoparticles-with-distinct-designs-accelerate-heating-to-inhibit-ovarian-tumor-progression/

[100] Revolutionary Nanoparticles with Distinct Designs Accelerate Heating to ... In a groundbreaking advancement for cancer treatment, researchers from Oregon State University have engineered a novel type of magnetic nanoparticle designed to revolutionize chemotherapy, particularly for ovarian tumors. ... the integration of a cancer-targeting peptide into the nanoparticle design significantly contributes to the particles

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC7342339/

[102] Recruitment and retention of participants in clinical studies: Critical ... Recruitment and retention of participants in clinical studies: Critical issues and challenges - PMC Global data analysis of all terminated trials within Clinical Trials Database reported 55% of trials were terminated due to the single highest reason of low accrual rate. The average enrolment efficiency is also reported to be <40% for Phase III and IV trials. Globally, more than 80% of trials fail to enroll on time resulting into an extension of study and or addition of new study sites. Similarly, insufficient retention of the participants till study closeout is also a matter of concern. Professional associations websites and patient registries can share information about ongoing clinical trials (without disclosing the details) to facilitate participants recruitments.

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llu

https://clinicaltrials.llu.edu/sites/clinicaltrials.llu.edu/files/docs/current-challenges-in-clinical-trial-patient-recruitment-and-enrollment.pdf

[103] PDF Results from one study showed that a recommendation by their physician was the primary factor influencing patients’ decisions to enroll in a trial.”15 The National Cancer Institute succinctly details the following common perceived barriers that the medical community claims in regards to clinical trial participation.16 • Lack of awareness of appropriate clinical trials. … In our effort to include minorities and women in clinical research, the medical community must recognize that some people within these groups may be vulnerable or less advantaged and need special recruitment consideration and safeguards (NIH 1994b, Spilker and Cramer 1992).”30 The National Cancer Institute again explains several common barriers that underrepresented groups give as reasons to not become trial participants.31 • Long-standing fear, apprehension, and skepticism exist among some minority populations about medical research because of abuses that have happened in the past (e.g., the legacy of the Tuskegee syphilis study).

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clevelandclinic

https://my.clevelandclinic.org/health/diseases/4447-ovarian-cancer

[134] Ovarian Cancer: Symptoms, Diagnosis & Treatment - Cleveland Clinic Ovarian Cancer: Symptoms, Diagnosis & Treatment Ovarian Cancer Ovarian Cancer Healthcare providers treat ovarian cancer with surgery, chemotherapy and other cancer treatments. Ovarian Cancer Treatment What is ovarian cancer? If your healthcare provider suspects ovarian cancer, they’ll ask about your symptoms and perform a pelvic exam. Providers can diagnose ovarian cancer during surgery. What are the stages of ovarian cancer? There are four stages of ovarian cancer. Providers rarely use radiation therapy for treatment of ovarian cancer. After you’ve completed ovarian cancer treatment, your healthcare provider will want to see you regularly for observation. Ovarian Cancer Treatment After you’ve received ovarian cancer treatment, your healthcare provider will still see you for regular appointments. Ovarian Cancer Treatment

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medicalnewstoday

https://www.medicalnewstoday.com/articles/silent-signs-ovarian-cancer

[140] 6 silent signs of ovarian cancer: Missed or mistaken symptoms Signs of ovarian cancer include abdominal bloating, pelvic or abdominal pain, appetite changes, vaginal bleeding, diarrhea, and constipation. Learn more here.

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https://www.healthline.com/health/ovarian-cancer/silent-signs-ovarian-cancer

[141] Silent Signs of Ovarian Cancer: 7 Symptoms Not to Ignore Ovarian Cancer One of the most commonly reported symptoms among people with ovarian cancer is pain in their abdomen and pelvis. Back pain can be a symptom of ovarian cancer. Because there isn’t a regular screening test to detect early ovarian cancer and the symptoms overlap with other conditions, good treatment outcomes may depend partly on your ability to self-advocate. Here are answers to additional questions about ovarian cancer detection and symptoms. You may have to ask about ovarian cancer specifically because these symptoms are sometimes misdiagnosed at first — but do self-advocate. Ovarian cancer. Symptoms: Ovarian cancer. What is ovarian cancer? What are the symptoms of ovarian cancer?

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advancedovariancancer

https://advancedovariancancer.net/living/patient-misconceptions

[144] Misconceptions About Ovarian Cancer - AdvancedOvarianCancer.net Ovarian cancer is frequently referred to as a silent disease or killer due to the common symptoms most women experience. Some with ovarian cancer can experience symptoms that tend to be mild at first and come and go.

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houstonmethodist

https://www.houstonmethodist.org/blog/articles/2023/oct/5-common-warning-signs-of-ovarian-cancer-to-never-ignore/

[145] 5 Common Warning Signs of Ovarian Cancer to Never Ignore Dr. Zand says that knowing ovarian cancer symptoms, your family health history — especially for gynecological conditions such as ovarian cancer — and any personal risk factors can help women understand their risk and get help when they notice persistent signs. Ovarian cancer symptoms to watch out for 1. Bloating

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novanthealth

https://www.novanthealth.org/healthy-headlines/ovarian-cancer-symptoms-heres-what-women-should-watch-for

[147] Ovarian cancer symptoms: Here's what women should watch for Ovarian cancer symptoms: Here's what women should watch for. While there's no screening for this deadly cancer, there can be signs ... "The problem is the symptoms that are associated with ovarian cancer are a lot of the symptoms that women have anyway," Schneider said, pointing to pelvic pain, feeling full quicker than usual after

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mdanderson

https://www.mdanderson.org/cancerwise/my-first-symptoms-of-ovarian-cancer---signs-to-look-for-and-when-to-see-a-doctor.h00-159544479.html

[148] 'My first symptoms of ovarian cancer': Signs to look for and when to ... A new memory jogger for ovarian cancer symptoms. To learn more about ovarian cancer symptoms, as well as when to see a doctor, we consulted Jolyn Sharpe Taylor, M.D., a surgeon who specializes in gynecologic cancers. "Bloating, diarrhea and abdominal pain are three of the most common ovarian cancer symptoms," Taylor explains.

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vawomenshealth

https://vawomenshealth.com/posts/news/top-5-early-signs-of-ovarian-cancer-every-woman-should-know/

[149] Top 5 Early Signs of Ovarian Cancer Every Woman Should Know Women with a family history of ovarian cancer or genetic mutations (like BRCA1 or BRCA2) should be especially proactive about routine check-ups and screenings. Final Thoughts Ovarian cancer can sneak up on you—but staying attuned to your body and seeking help for persistent symptoms can significantly improve your chances of early detection

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bronsonhealth

https://www.bronsonhealth.com/health-news/understanding-ovarian-cancer-signs-and-prevention/

[156] Understanding Ovarian Cancer: Signs and Prevention Early detection can save lives, so it's important to know the warning signs. ... Recognizing the signs of ovarian cancer and taking preventive measures are vital steps in improving outcomes. Signs and Symptoms. Ovarian cancer symptoms are often mistaken for less serious conditions, which is why it's commonly referred to as the "silent

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC6436208/

[161] Biomarkers and algorithms for diagnosis of ovarian cancer: CA125, HE4 ... Ovarian cancer is the 5th leading cause of death for women with cancer worldwide. In more than 70% of cases, it is only diagnosed at an advanced stage. Our study aims to give an update on the biological markers for diagnosing ovarian cancer, specifically HE4, CA 125, RMI and ROMA algorithms.

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nih

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906658/

[162] Multi-biomarker panel signature as the key to diagnosis of ovarian cancer Cancer antigen-125 (CA-125) is the gold standard tumor marker found at abnormally high levels in the blood of many women in ovarian cancer. However, many non-cancerous conditions exhibit high levels of CA-125 and several women have normal CA-125 level in the early stage of ovarian cancer, suggesting CA-125 biomarker is not specific enough for

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sciencedirect

https://www.sciencedirect.com/science/article/pii/S0301211511002399

[164] An overview of biomarkers for the ovarian cancer diagnosis Currently, very few ovarian cancer biomarkers have high sensitivity for early-stage disease. Given the prevalence of ovarian cancer, strategies for early detection must have high sensitivity for early stage disease (>75%), as well as an extremely high specificity (99.6%) to attain a positive predictive value of at least 10% , . Such high

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733894/

[165] Current clinical application of serum biomarkers to detect ovarian cancer CA125. CA125 (cancer antigen 125) is a glycoprotein, encoded by MUC16 gene on chromosome 19. Its upper limit of normal value is set at 35 UI/ml. Expression of CA125 is elevated in 85% of serous, 65% of endometrioid, 40% of clear-cell, 36% of undifferentiated and only 12% of mucinous ovarian cancers [].For the last three decades it has become the most widespread biomarker of ovarian cancer.

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cancerscience

https://cancerscience.net/knowledgebase/why-is-a-pelvic-examination-important-for-cancer-detection

[169] Why is a Pelvic Examination Important for Cancer Detection? Regular pelvic examinations are vital for early detection of cancers such as cervical cancer, ovarian cancer, and uterine cancer. Detecting cancer at an early stage significantly improves the chances of successful treatment and survival. During a pelvic exam, a healthcare provider can identify abnormal changes, such as unusual lumps, irregular

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cancer

https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/detection.html

[170] How to Check for Ovarian Cancer | Ovarian Cancer Screening When ovarian cancer is found early, about 94% of patients live longer than 5 years after diagnosis. Ways to find ovarian cancer early Regular women's health exams. During a pelvic exam, the health care professional feels the ovaries and uterus for size, shape, and consistency. A pelvic exam can be useful because it can find some female cancers

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ascopubs

https://ascopubs.org/doi/10.1200/JCO.2016.68.6907

[183] Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer ... Treatment of advanced ovarian cancer has evolved over the past decade. ... However, if treatment with further chemotherapy is appropriate, then use of agents that do not have cross-resistance to carboplatin or paclitaxel (eg, gemcitabine, pegylated liposomal doxorubicin, or bevacizumab) would be recommended. ... to determine drug dosages and

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cancer

https://www.cancer.org/cancer/types/ovarian-cancer/treating/chemotherapy.html

[184] Chemotherapy for Ovarian Cancer - American Cancer Society The typical course of chemo for epithelial ovarian cancer involves 3 to 6 cycles of treatment, depending on the stage and type of ovarian cancer. A cycle is a schedule of regular doses of a drug, followed by a rest period. Different drugs have varying cycles; your doctor will let you know what schedule is planned for your chemo.

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC7930441/

[185] Ovarian cancer risk score predicts chemo-response and outcome in ... Currently known factors affecting prognosis in ovarian cancer include cancer stage, histological type, tumor grade, residual tumor size after surgery, and chemosensitivity or chemoresistance. However, these factors present an incomplete picture of the tumor biology and are frequently interrelated [ 5 ].

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lww

https://journals.lww.com/otm/fulltext/2022/02000/recent_advances_in_targeted_therapy_for_ovarian.3.aspx

[195] Recent advances in targeted therapy for ovarian cancer The global burden of ovarian cancer is gradually increasing while patients still suffer from relatively limited treatment options. With recent advances in the decoding of the molecular landscape of ovarian cancer, more options in targeted strategy were offered and can therefore be tailored in different clinical settings for individual patient.

nature.com favicon

nature

https://www.nature.com/articles/s43018-023-00617-9

[196] Clinical and translational advances in ovarian cancer therapy Olaparib tablets as maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a final analysis of a double-blind, randomised, placebo-controlled, phase 3 trial. Phase II Study of Olaparib (O) plus Durvalumab (D) and Bevacizumab (B) (MEDIOLA): Initial Results in Patients (pts) with Non-Germline BRCA-Mutated (Non-gBRCAm) Platinum Sensitive Relapsed (PSR) Ovarian Cancer (OC) (ESMO, 2020). Combination ATR and PARP inhibitor (CAPRI): a phase 2 study of ceralasertib plus olaparib in patients with recurrent, platinum-resistant epithelial ovarian cancer. Phase II Study of Olaparib (O) plus Durvalumab (D) and Bevacizumab (B) (MEDIOLA): Initial Results in Patients (pts) with Non-Germline BRCA-Mutated (Non-gBRCAm) Platinum Sensitive Relapsed (PSR) Ovarian Cancer (OC) (ESMO, 2020). Combination ATR and PARP inhibitor (CAPRI): a phase 2 study of ceralasertib plus olaparib in patients with recurrent, platinum-resistant epithelial ovarian cancer.

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sciencedirect

https://www.sciencedirect.com/science/article/pii/S1028455917302966

[197] Surgical and survival outcomes of laparoscopic staging surgery for ... Laparoscopic staging surgery for ovarian cancer has been performed since 1993 in our hospital . Our surgical outcomes have improved with the development of improved techniques. The aim of our study was to report on the recent laparoscopic surgical outcomes of patients with stage I ovarian cancer at our hospital retrospectively.

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biquantumarc

https://biquantumarc.com/articles/surgical-staging-ovarian-cancer/

[198] Understanding Surgical Staging in Ovarian Cancer The future of surgical staging in ovarian cancer is a critical area that can potentially reshape patient management and outcomes. With the ongoing evolution in medical technology and research, the emphasis is placed on refining surgical staging practices to enhance their accuracy and effectiveness.

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC9081786/

[199] Different Surgical Approaches for Early-Stage Ovarian Cancer Staging. A ... In early stage ovarian cancer (ESOC) comprehensive surgical staging is recommended. ... Minig L, Padilla Iserte P, Zorrero C, Zanagnolo V. Robotic surgery in women with ovarian cancer: surgical technique and evidence of clinical outcomes. ... Rawashdeh A, Giovinazzo F, Aljaiuossi A, et al. Laparoscopic right posterior sectionectomy (LRPS

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ajog

https://www.ajog.org/article/S0002-9378(13

[200] Staging laparoscopy for the management of early-stage ovarian cancer: a ... The traditional approach for staging of clinical early-stage ovarian cancer (EOC) is through laparotomy with an extended midline incision that exposes the whole peritoneal cavity. 6 However, due to recent advances in laparoscopic techniques and instruments, it is possible to perform the standard staging procedure for ovarian cancer

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC3250973/

[202] Laparoscopic Surgical Staging of Early Ovarian Cancer - PMC Ovarian cancer accounts for one-quarter of all malignancies of the female genital tract and is the most deadly of these malignancies. 1 The current treatment paradigm involves upfront surgical debulking followed by adjuvant platinum-based chemotherapy to eradicate any disease that may have persisted. 2, 3 Despite initial response rates of 70% to 80%, the majority of women with ovarian cancer

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biomedcentral

https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-021-00801-4

[218] Choosing the right timing for interval debulking surgery and ... Primary debulking surgery (PDS) is the main treatment for patients with advanced ovarian cancer, and neoadjuvant chemotherapy (NACT) is for bulky stage III-IV patients who are poor surgical candidates and/or for whom there is a low likelihood of optimal cytoreduction. NACT can increase the rate of complete cytoreduction, but this advantage has not translated to an improvement in survival.

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biomedcentral

https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-023-01164-8

[219] Timing of interval debulking surgery and postoperative chemotherapy ... To investigate the prognostic relevance of the time to interval debulking surgery (TTS) and the time to postoperative adjuvant chemotherapy (TTC) after the completion of neoadjuvant chemotherapy (NACT). A retrospective real-word study included 658 patients with histologically confirmed advanced epithelial ovarian cancer who received NACT at seven tertiary hospitals in China from June 2008 to

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https://pubmed.ncbi.nlm.nih.gov/26731563/

[220] Ovarian cancer: epidemiology and risk factors - PubMed Abstract The present overview of ovarian cancer epidemiology summarizes the main results for a network of case-control studies in Italy and from the Collaborative Group on Epidemiological Studies of Ovarian Cancer. There are consistent inverse relations between parity, oral contraceptive use and the risk of ovarian cancer. For other menstrual and hormonal factors (i.e. early age at menarche

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nih

https://pubmed.ncbi.nlm.nih.gov/28443200/

[222] Epidemiology of ovarian cancer: a review - PubMed Ovarian cancer (OC) is the seventh most commonly diagnosed cancer among women in the world and the tenth most common in China. Epithelial OC is the most predominant pathologic subtype, with five major histotypes that differ in origination, pathogenesis, molecular alterations, risk factors, and progn …

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nih

https://pubmed.ncbi.nlm.nih.gov/32648448/

[223] Epidemiology of ovarian cancer - PubMed Worldwide, ovarian cancer (OC) is the seventh most common type of malignant neoplasm in women and the eighth cause of mortality in them. The classification of OC is made by the possible origin of one of the three main components of the ovary: epithelium, stroma, and germinal cells. Due to this the m …

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https://pmc.ncbi.nlm.nih.gov/articles/PMC10477765/

[224] Epidemiology and risk factors for ovarian cancer - PMC | Bandera, et al., 2016 | Older age | As age increases women’s chances of having ovarian cancers increase. Following the definition of the main aim of the current study, we have used a set of keywords including ovarian cancer, aetiology of ovarian cancer, epidemiology, prevalence, incidence, morbidity, mortality and risk factor in the search for related articles. A previous study reported a 60% increase in the risk of ovarian cancer in a cohort of infertile women [standardized incidence ratio = 1.6 (95% CI: 0.8–2.9)], which is in line with later studies . Although earlier studies [28, 31,106–109] had shown a significant increase in the risk of ovarian cancer among women who used fertility drugs and in vitro fertilization (IVF) technology (Table 2), later studies denied such an association [110–112].

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https://pmc.ncbi.nlm.nih.gov/articles/PMC6500433/

[225] Ovarian cancer in the world: epidemiology and risk factors The incidence of epithelial ovarian cancer in women with endometriosis rises from 4.99 in less than 30 years to 35.81 in more than 50 years per 10,000 people per year.75 In a case-control study, researchers concluded that hyperestrogenism or exogenous is a risk factor for the onset of ovarian cancer after endometriosis.76 Cottreau et al77 believed that the use of danazol for the treatment of endometriosis is associated with a 3.2-times increased risk of ovarian cancer [1.2–8.5].

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC9102475/

[233] Worldwide Burden, Risk Factors, and Temporal Trends of Ovarian Cancer ... There were several major findings: (1) the highest mortality rates due to ovarian cancer were observed in low–middle-income countries, and its incidence was highest in countries with high-income levels; (2) higher incidence of ovarian cancer was associated with a higher GDP per capita, HDI, prevalence of smoking, alcohol use, physical inactivity, obesity, hypertension, diabetes, and lipid disorders; (3) although there was an overall decreasing trend of incidence and mortality of ovarian cancer over the past decade, a substantial increase in incidence was observed in younger females. The following are available online at https://www.mdpi.com/article/10.3390/cancers14092230/s1, Figure S1: The plots of incidence and mortality trends for each country, Figure S2: The graphs of the joinpoint regression output, Figure S3: AAPC of incidence of ovarian cancer aged 50 years and older, Figure S4: AAPC of incidence of ovarian cancer aged <50 years old, Figure S5: AAPC of incidence of ovarian cancer aged <40 years old.

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cancer

https://www.cancer.org/cancer/types/ovarian-cancer/causes-risks-prevention/risk-factors.html

[234] Ovarian Cancer Risk Factors Ovarian Cancer Risk Factors Researchers have discovered several risk factors that might increase a woman's chance of developing epithelial ovarian cancer. Factors that increase your risk of ovarian cancers If you have had breast cancer, you might also have an increased risk of developing ovarian cancer. A strong family history of breast cancer may be caused by an inherited mutation in the BRCA1 or BRCA2 genes and hereditary breast and ovarian cancer syndrome, which is linked to an increased risk of ovarian cancer. Factors that can lower risk of ovarian cancer Use of fertility drugs and risk of ovarian cancer. McLaughlin JR, et al; Hereditary Ovarian Cancer Clinical Study Group. Olsen CM, Green AC, Nagle CM, et al.; Australian Cancer Study Group (Ovarian Cancer) and the Australian Ovarian Cancer Study Group.

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emjreviews

https://www.emjreviews.com/oncology/article/brca-mutation-in-ovarian-cancer-implications-for-screening-diagnosis-and-preventive-measures-j130124/

[236] BRCA Mutation in Ovarian Cancer: Implications for Screening, Diagnosis ... Oral contraceptives (OCP) are associated with a significant reduction in risk of ovarian cancer and are an important preventive factor for most histological types. 44 A meta-analysis by Iodice et al., 45 provides evidence that in women with an ascertained germ line mutation in BRCA1 or BRCA2, OCPs reduce ovarian cancer risk and found no

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nih

https://pubmed.ncbi.nlm.nih.gov/26476542/

[238] Epidemiology of Patients with Ovarian Cancer with and Without a BRCA1/2 ... Carriers of deleterious mutations (defined as a harmful mutation) in either the BRCA1 or BRCA2 gene (BRCAm) have a significantly increased risk of developing ovarian cancer. Epidemiology data in large (>500 patients) unselected ovarian cancer populations suggest that the expected incidence rate for BRCAm in this population is 12-14 %.

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC5527889/

[239] The Contribution of BRCA1 and BRCA2 to Ovarian Cancer Germline mutations of the BRCA1 and BRCA2 genes confer a high life‐time risk of ovarian cancer. They represent the most significant and well characterised genetic risk factors so far identified for the disease. The frequency with which BRCA1/2

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worldovariancancercoalition

https://worldovariancancercoalition.org/about-ovarian-cancer/key-stats/

[248] Ovarian Cancer Key Stats The number of women dying from ovarian cancer each year is projected to increase to 350,956 an increase of almost 70% from 2022. Five-year ovarian cancer survival rates vary between countries. For example, in more developed countries, current rates range from 36% to 46%. However, in some countries the figure is much lower.

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC8283651/

[249] Worldwide incidence and mortality of ovarian cancer and Human ... Worldwide incidence and mortality of ovarian cancer and Human Development Index (HDI): GLOBOCAN sources and methods 2018 - PMC Human Development Index, incidence and mortality rates of ovarian cancer in the world in 2018. However, no statistically significant relationship was identified between gross national income per 1,000 capita, life expectancy at birth and expected years of schooling with the incidence and mortality of ovarian cancer (Tab. IV). The results of our study identified a positive correlation between human development index and the incidence and mortality of ovarian cancer. Our study could also indicate a positive and significant correlation between life expectancy index and the incidence and mortality of ovarian cancer (P < 0.05).

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thelancet

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24

[250] Worldwide patterns and trends in ovarian cancer incidence by ... Age-standardized ovarian cancer incidence rates per 100,000 person-years by histological subtypes, countries, and human development indices, 2013-2017. ... reproductive behaviors, healthcare resources, and health awareness. It is suggested that countries with high incidence should strengthen public health education, actively screen for

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cdc

https://www.cdc.gov/ovarian-cancer/prevention/index.html

[270] Reducing Risk for Ovarian Cancer | Ovarian Cancer | CDC There is no known way to prevent ovarian cancer, but these things are associated with a lower chance of getting ovarian cancer: Having used birth control pills that contain estrogen and progesterone for 5 or more years. Having had a tubal ligation (getting your tubes tied), both ovaries removed, both fallopian tubes removed, or a hysterectomy

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ct

https://portal.ct.gov/dph/public-health-genomics/genetic-testing-for-hereditary-breast-ovarian-cancer-what-you-should-know

[275] Genetic Testing for Hereditary Breast Ovarian Cancer What You Should Know These are some of the factors you should consider before getting tested. Genetic testing for BRCA1 and BRCA2 mutations involves taking a sample of your blood at a doctor's office or lab. Although the medical risks of genetic testing are small, test results may affect your emotions, family relationships, finances, privacy, and medical choices.

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mayoclinic

https://www.mayoclinic.org/tests-procedures/brca-gene-test/about/pac-20384815

[276] BRCA gene test for breast and ovarian cancer risk - Mayo Clinic BRCA gene test for breast and ovarian cancer risk - Mayo Clinic The BRCA gene test looks for DNA changes that increase the risk of breast cancer and ovarian cancer. The BRCA gene test looks for DNA changes that increase the risk of breast cancer and ovarian cancer. People with the following should consider genetic testing for genes that increase the risk of breast and ovarian cancers: A blood relative who had genetic testing and was found to have a gene change that increases the risk of breast cancer. There's no medical risk associated with the BRCA gene test or any other genetic test that looks for a risk of breast and ovarian cancers. BRCA gene mutations: Cancer risk and genetic testing.

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magview

https://magview.com/womens-health/understanding-genetic-testing-for-breast-cancer/

[277] Understanding Genetic Testing for Breast Cancer | MagView Takeaway: Make an Informed Decision About Genetic Testing. Genetic testing for breast cancer is a powerful tool for understanding your risk and making proactive health decisions. If you have risk factors like a family history of breast cancer or early-onset breast cancer, consider discussing genetic testing with a healthcare provider.

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aafp

https://www.aafp.org/pubs/afp/issues/2020/0215/p233.html

[278] Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA ... The USPSTF recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations with an appropriate brief familial risk assessment tool. The USPSTF recommends against routine risk assessment, genetic counseling, or genetic testing for women whose personal or family history or ancestry is not associated with potentially harmful BRCA1/2 gene mutations. Genetic risk assessment and BRCA1/2 mutation testing is a multistep process that begins with identifying patients with family or personal histories of breast, ovarian, tubal, or peritoneal cancer; family members with known harmful BRCA1/2 mutations; or ancestry associated with harmful BRCA1/2 mutations.

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC5742303/

[279] Ovarian Cancer Knowledge in Women and Providers Following Education ... The Centers for Disease Control and Prevention’s Inside Knowledge: Get the Facts about Gynecologic Cancer campaign was developed to raise awareness and educate women and providers about risk factors, symptoms, recommended screening, and prevention strategies for the five main gynecologic cancers, including ovarian cancer. Table 3 also shows public behavioral intentions and confidence with talking to their providers, friends, and family about ovarian cancer information before and after facilitated discussions of Inside Knowledge materials. Ovarian cancer awareness, provider confidence in talking to patients about ovarian cancer, and confidence of women in talking to providers, family, and friends about gynecologic cancer, and related behaviors increased in women and providers using Inside Knowledge campaign materials.

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nih

https://pubmed.ncbi.nlm.nih.gov/28646458/

[280] Ovarian Cancer Knowledge in Women and Providers Following ... - PubMed Because no effective methods for preventing or screening for ovarian cancer exist, symptom recognition is integral to its early detection. The Centers for Disease Control and Prevention's Inside Knowledge: Get the Facts about Gynecologic Cancer campaign was developed to raise awareness and educate women and providers about risk factors, symptoms, recommended screening, and prevention

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nih

https://pubmed.ncbi.nlm.nih.gov/27284267/

[282] Lifestyle changes and the risk of developing endometrial and ovarian ... Modifiable lifestyle factors, such as obesity, lack of physical activity, and smoking, contribute greatly to cancer and chronic disease morbidity and mortality worldwide. This review appraises recent evidence on modifiable lifestyle factors in the prevention of endometrial cancer (EC) and ovarian ca …

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC5920567/

[283] Ovarian cancer prevention in high risk women - PMC - PubMed Central (PMC) For women with known increased genetic risk of ovarian cancer, risk reducing salpingo-oophorectomy (RRSO) is a proven ovarian cancer prevention strategy (80-84). A 2009 meta-analysis including 10 studies demonstrated a greater than 80% reduction in future ovarian cancer following RRSO in high risk women ( 80 ).

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facingourrisk

https://www.facingourrisk.org/XRAY/risk-reducing-ovarian-cancer-surgery-and-QOL

[285] Risk-reducing ovarian cancer surgery and quality of life Risk-reducing salpingo-oophorectomy (RRSO) significantly lowers the risk of ovarian cancer but has several disadvantages. RRSO induces premature menopause with potential short-term (hot flashes, sleep disturbances, impaired sexual function) and long-term (risk of cardiovascular disease, osteoporosis , cognitive impairment) side effects.

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ascopubs

https://ascopubs.org/doi/10.1200/OP.21.00382

[286] Risk-Reducing Bilateral Salpingo-Oophorectomy for Ovarian Cancer: A ... Pathogenic germline variants underlie up to 20% of ovarian cancer (OC) and are associated with varying degrees of risk for OC. For mutations in high-penetrance genes such as BRCA1/2, the role of risk-reducing bilateral salpingo-oophorectomy (RRSO) in cancer prevention is well-established and improves mortality.However, in moderate-penetrance genes where the degree of risk for OC is less

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nih

https://pubmed.ncbi.nlm.nih.gov/27354448/

[287] Specifying the ovarian cancer risk threshold of 'premenopausal risk ... Premenopausal RRSO appears to be extremely cost-effective at ≥4% lifetime OC risk, with ≥42.7 days gain in life expectancy if compliance with hormone replacement therapy is high. ... Specifying the ovarian cancer risk threshold of 'premenopausal risk-reducing salpingo-oophorectomy' for ovarian cancer prevention: a cost-effectiveness

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC10023359/

[293] Lifestyle Intervention in ovarian cancer Enhanced Survival (LIVES ... These findings were corroborated by epidemiological analyses from Australia wherein higher diet quality after ovarian cancer was associated with a 39% higher survival as well as in a recent study by Sasmoto among 1003 ovarian cancer survivors where a pro-inflammatory diet score was associated with higher ovarian cancer specific mortality .

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nih

https://www.nih.gov/news-events/news-releases/daily-physical-activity-even-light-intensities-linked-lower-cancer-risk

[294] Daily physical activity, even at light intensities, linked to lower ... The researchers also explored the impact of replacing daily sedentary time with light- and moderate-to-vigorous-intensity physical activity and found that this shift was associated with a reduced risk of cancer. The associations between physical activity and cancer risk remained even after researchers adjusted for demographic factors, lifestyle

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC10974142/

[295] Healthy Lifestyle and Cancer Risk: Modifiable Risk Factors to Prevent ... Healthy lifestyle for the prevention of cancer. In 2018, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) released a report supporting updated cancer prevention recommendations ().The report, "Diet, Nutrition, Physical Activity and Cancer: A Global Perspective", sets out a series of lifestyle recommendations, including following a healthy diet

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jhu

https://pathology.jhu.edu/ovarian-cancer/patient-stories

[311] Patient Stories - Ovarian Cancer | Johns Hopkins Pathology Patient Stories Members of our patient community share their personal ovarian cancer stories to help those struggling with an ovarian cancer diagnosis. Stories and art have helped people come to terms with their experiences since the beginning of time. By reading and looking at the work of others, we see and feel that we are not alone.

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mageewomens

https://mageewomens.org/patient-stories/never-losing-hope

[312] Never Losing Hope: Ovarian cancer survivor shares her story One thing that Jan and Dr. Courtney-Brooks feel strongly about is that despite what you hear about ovarian cancer, there is a lot of hope. "It's a challenging disease but we have patients who are 5 and 10 year survivors. We're learning new treatment options all the time so we are really proactive about treating our patients."

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thepatientstory

https://thepatientstory.com/patient-stories/ovarian-cancer/epithelial/jodi-s/

[313] Jodi's Stage 4 Epithelial Metastatic Ovarian Cancer Story Jodi shares her stage 4 ovarian cancer story, from first symptoms to undergoing chemo and a hysterectomy, and also highlights how she navigated life with cancer. In particular, Jodi describes losing her hair, including eyebrows and eyelashes, how important it was to have caregivers and support , and how she managed a cancer diagnosis and

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thepatientstory

https://thepatientstory.com/patient-stories/ovarian-cancer/clear-cell/sara-i/

[314] Sara's Stage 3A High-Grade Serous & Clear Cell Carcinoma Ovarian Cancer ... The nature of ovarian cancer and recurrences. With ovarian cancer, it's like a 70% chance of recurrence. It doesn't matter what kind of ovarian cancer you have. It's more of being stage 3. It's a very high recurrence rate. It's a very aggressive cancer, especially being high grade.

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ourwayforward

https://www.ourwayforward.com/ovarian-cancer-support-and-resources/oc-organizations

[321] Ovarian Cancer Support Organizations - Our Way Forward Ovarian Cancer Support Organizations | Our Way Forward And OCRA is the voice for the ovarian cancer community: fighting for more resources and policies on Capitol Hill, helping future health professionals recognize the disease through our Survivors Teaching Students® program, providing hope and insight by pairing newly diagnosed patients with our Woman to Woman program, and connecting survivors at our Ovarian Cancer National Conference. www.cancer.org This organization’s mission is to connect these women with the unique support of survivors and peers, creating a community where no one has to face breast, ovarian, uterine or metastatic breast cancer alone. It also hosts an online community with information and support for women with ovarian cancer.

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medanta

https://www.medanta.org/patient-education-blog/the-emotional-toll-of-ovary-cancer-coping-with-fear-anxiety-and-depression

[323] The Emotional Toll of Ovary Cancer: Coping with Fear, Anxiety, and ... By understanding the emotional toll of ovarian cancer and implementing coping strategies, individuals can navigate the journey with more resilience and improved quality of life. Building a strong support network, expressing emotions, prioritising self-care, and seeking professional help are all essential steps in managing fear, anxiety, and

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ovariancancerresources

https://www.ovariancancerresources.com/patient-resources/mental-health-strategies-for-well-being/

[325] Ovarian Cancer and Mental Health: Strategies for Well-being Ovarian Cancer and Mental Health: Strategies for Well-being. Patient Resources; ... those who sought more emotional and social support experienced a higher quality of life and lower levels of depression. Help is available, and while it may not change your ovarian cancer diagnosis, it can certainly ease the emotional burden along the way

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medanta

https://www.medanta.org/patient-education-blog/the-emotional-toll-of-ovary-cancer-coping-with-fear-anxiety-and-depression

[327] The Emotional Toll of Ovary Cancer: Coping with Fear, Anxiety, and ... However, these emotions are normal and valid responses to the challenges faced. By understanding the emotional toll of ovarian cancer and implementing coping strategies, individuals can navigate the journey with more resilience and improved quality of life.

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myovariancancerteam

https://www.myovariancancerteam.com/resources/coping-with-the-anxiety-and-stress-of-advanced-ovarian-cancer

[328] Coping With the Anxiety and Stress of Advanced Ovarian Cancer A diagnosis of advanced ovarian cancer can lead to feelings of being stressed, anxious, and overwhelmed. Recognizing anxiety and chronic stress and learning better coping strategies can support your mental health. Staying on track with treatment, talking to a counselor, relaxation techniques, medication to support your mood, and getting support from friends, clergy, or family can all help

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uthscsa

https://cancer.uthscsa.edu/news-and-stories/coping-emotional-challenges-cancer

[329] Coping with the Emotional Challenges of Cancer Cancer Care Our Cancer Programs Cancer Treatments Cancer Surgery Cancer Prevention and Screenings Skin Cancer Screenings Patient and Family Services During Cancer Care Mays Cancer Center Shared Resources Cancer Care Our Cancer Programs Cancer Treatments Cancer Surgery Cancer Prevention and Screenings Skin Cancer Screenings Patient and Family Services During Cancer Care Mays Cancer Center Shared Resources Keep a positive outlook: A positive outlook can help cancer patients cope with the emotional challenges of treatment. The Mays Cancer Center, home to UT Health San Antonio MD Anderson, offers a range of support services for cancer patients and their families. Make An Appointment Find a Doctor or Location Search Cancer Treatments Clinical Trials and Research Access MyChart Cancer Treatments

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dana-farber

https://www.dana-farber.org/newsroom/features/prioritizing-mental-health

[330] Mind and Body: Prioritizing Mental Health - Dana-Farber Cancer Institute Support Tailored to Cancer's Unique Challenges. To that end, mental health care for cancer patients is specialized. In addition to mortality fears, many patients experience shame or self-doubt for having mental health concerns in the first place, worrying that they're not fighting hard enough. ... This was true for ovarian cancer patient

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mayoclinic

https://cancerblog.mayoclinic.org/2024/05/01/ovarian-cancer-new-treatments-and-research/

[353] Ovarian cancer: New treatments and research Ovarian cancer: New treatments and research - Mayo Clinic Comprehensive Cancer Center Blog Ovarian cancer: New treatments and research Ovarian cancer: New treatments and research Ovarian Cancer Ovarian Cancer Diagnosis and Treatment, Ovarian Cancer, Research and Clinical Trials, Survivorship Ovarian cancer: New treatments and research Dr. Weroha says new treatments are helping more people survive ovarian cancer of all types, and researchers are studying new treatments and screening methods in clinical trials. Matthew Block, M.D., Ph.D., a Mayo Clinic medical oncologist, and Keith Knutson, Ph.D., a Mayo Clinic researcher, are developing a vaccine to prevent ovarian cancer tumors from returning in people with advanced ovarian cancer whose tumors have recurred after surgery and chemotherapy. Learn more about ovarian cancer and find a clinical trial at Mayo Clinic.

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wiley

https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.35135

[354] Top advances of the year: Ovarian cancer - Lumish - 2024 - Cancer ... Over the past decade, ADCs have gained increasing traction for the treatment of solid tumors because of their ability to selectively deliver cytotoxic drugs to tumor cells, resulting in enhanced efficacy and tolerability relative to cytotoxic chemotherapy, and 2022 brought the first FDA approval for an ADC to treat ovarian cancer. 6, 7 Although

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nih

https://pubmed.ncbi.nlm.nih.gov/39762846/

[355] Promising new drugs and therapeutic approaches for treatment of ovarian ... Promising new drugs and therapeutic approaches for treatment of ovarian cancer-targeting the hallmarks of cancer - PubMed Promising new drugs and therapeutic approaches for treatment of ovarian cancer-targeting the hallmarks of cancer For this purpose, we analyzed approvals and current clinical phase III studies (registered at ClinicalTrials.gov (National Library of Medicine, National Institutes of Health; U.S. Department of Health and Human Services, 2024)) for new drugs on the basis of their mechanisms of action and identified new target approaches. A broad spectrum of new promising drugs is currently under investigation in clinical phase III studies targeting mainly the hallmarks "self-sufficiency in growth signals," "genomic instability," and "angiogenesis." The benefit of immune checkpoint inhibitors in ovarian cancer has been demonstrated for the first time.

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mdpi

https://www.mdpi.com/1718-7729/31/12/592

[358] Challenges in Implementing Comprehensive Precision Medicine Screening ... This reiterates the intricate biological and molecular heterogeneity of ovarian cancer, highlighting the challenges of translating precision medicine approaches into meaningful clinical outcomes for this disease.

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frontiersin

https://www.frontiersin.org/journals/drug-delivery/articles/10.3389/fddev.2024.1339936/full

[359] Future theranostic strategies: emerging ovarian cancer biomarkers to ... Folate receptor alpha (FOLR1), which is a glycosylphosphatidylinositol-anchored glycoprotein has emerged as a promising biomarker for the detection of ovarian cancer, exhibiting notable potential and versatility in clinical applications (Leung et al., 2013; Bax et al., 2023).Serum analysis has revealed elevated levels of FOLR1 in patients with ovarian cancer compared to those with benign

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healthmanagement

https://healthmanagement.org/c/artificial-intelligence/News/transforming-ovarian-cancer-diagnosis-with-advanced-biomarkers-and-ai

[360] Transforming Ovarian Cancer Diagnosis with Advanced Biomarkers and AI Groundbreaking advancements in biomarkers, algorithms, and artificial intelligence (AI) are driving a new era in OC diagnosis. Researchers are increasingly turning to advanced biomarkers and algorithm-based techniques to improve the early and accurate detection of OC. The integration of biomarkers, innovative algorithms and advanced non-invasive techniques is revolutionising OC diagnosis, offering new avenues for early and accurate detection that could save countless lives. Photoacoustic imaging, biomarkers, liquid biopsy, artificial intelligence in healthcare, Early cancer detection, ovarian cancer diagnosis, MAGIC algorithm, AI in oncology, OC diagnostic innovations ovarian cancer diagnosis, biomarkers, artificial intelligence in healthcare, MAGIC algorithm, liquid biopsy, photoacoustic imaging, early cancer detection, AI in oncology, OC diagnostic innovations Discover groundbreaking advancements in ovarian cancer diagnosis, leveraging biomarkers, AI, and innovative algorithms to improve early detection and outcomes.

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springer

https://link.springer.com/article/10.1007/s13402-016-0309-1

[361] Emerging diagnostic, prognostic and therapeutic biomarkers for ovarian ... Background In spite of various treatment options currently available, ovarian cancer (OC) still remains a leading cause of death in women world-wide. Diagnosis at an early stage is one of the most important factors that determines survival. Current clinical diagnostic tools have, however, a limited efficacy in early OC detection. Therefore, there is a critical need for new (early) diagnostic

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sgo

https://www.sgo.org/wp-content/uploads/2014/11/Herzog-et-al-Clinical-trial-endpoints.pdf

[362] PDF clinical trial design with the express purpose of encouraging novel drug development in ovarian cancer. Points of emphasis include: ovarian cancer heterogeneity (histologic subtypes and molecular genetic alterations), clinical trial design elements, surrogate as well as composite endpoints, and the four principles of clinical drug

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thelancet

https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(22

[364] Clinical research in ovarian cancer: consensus ... - The Lancet The Gynecologic Cancer InterGroup (GCIG) sixth Ovarian Cancer Conference on Clinical Research was held virtually in October, 2021, following published consensus guidelines. The goal of the consensus meeting was to achieve harmonisation on the design elements of upcoming trials in ovarian cancer, to select important questions for future study, and to identify unmet needs. All 33 GCIG member

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nashbio

https://nashbio.com/blog/clinical-trials/understanding-patient-selection-in-clinical-trials-considerations-and-implications/

[366] Understanding Patient Selection in Clinical Trials: Considerations and ... Understanding Patient Selection in Clinical Trials: Considerations and Implications Appropriate patient selection is fundamental in clinical research, shaping the  safety of the trial and relevance of its results. Patient selection refers to the process of setting eligibility criteria for participant enrollment in clinical studies. Below are several ways that effective patient selection criteria play a vital role in enhancing the integrity and outcomes of clinical research: Challenges of Patient Selection Methodological challenges in patient selection can affect the applicability of research findings. Ethical Considerations in Patient Selection Ethics plays a crucial role in designing patient selection criteria. Appropriate patient selection is a critical component of clinical research that impacts the accuracy, safety, and applicability of study results.

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nih

https://pmc.ncbi.nlm.nih.gov/articles/PMC11558429/

[368] Next-generation sequencing uncovers crucial mutated genes and potential ... The low survival rate of ovarian cancer patients indicates that, beyond BRCA1/2 mutations, additional gene mutations may play a role in ovarian cancer development. Moreover, recent studies in genomic research have substantiated evidence of the participation of numerous other genes in the onset and progression of ovarian cancer .