Ovarian cancer encompasses many molecularly and etiologically distinct diseases, but patients have not yet benefitted from our evolving understanding through the development and translation of subtype-specific molecularly targeted therapies. We hypothesize that, for a small molecularly-defined subset of ovarian cancer patients, the secreted protein protease inhibitor SPINK1 may represent a key oncogenic driver of tumor proliferation, invasion, and chemoresistance, and that SPINK1 may offer a novel therapeutic target for this group of women. We further hypothesize that these activities of SPINK1 are mediated not through protease inhibition, but through a newly discovered activity of SPINK1 as a growth factor capable of activating the epidermal growth factor receptor (EGFR). Here, we propose three specific aims designed to test these hypotheses. (1) We will define how SPINK1 affects ovarian cancer cell growth, invasion, and drug resistance, using cell culture models of ovarian cancer in combination with SPINK1 gene silencing and recombinant SPINK1 treatment. We will also test the ability of SPINK1 neutralizing antibodies to inhibit the growth an invasion of SPINK1-positive ovarian cancer cells, and to sensitize cells to chemotherapy. (2) We will define the molecular interaction between SPINK1 and EGFR, using quantitative binding measurements and X-ray crystallography. We will also determine the role of EGFR signaling in the cancer-promoting activities of SPINK1 in ovarian cancer cells. (3) We will evaluate expression of SPINK1 in a large set of invasive epithelial ovarian cancer biospecimens, testing the association with EGFR signaling pathway activation and with survival. In aggregate, this work has the potential to define SPINK1 signaling as a key driver of malignancy for a previously unrecognized subset of ovarian cancer patients, and as a molecular target for novel drug development.

Public Health Relevance

Ovarian cancer is the deadliest of cancers unique to women, and it has been more than 30 years since a novel discovery has resulted in significant improvements to ovarian cancer survival. We hypothesize that a small subgroup of the deadliest ovarian cancers produce a protein called SPINK1 that feeds their growth. By learning more about how SPINK1 makes ovarian tumors grow, and by identifying which patients have this subtype of tumor, we hope to ultimately develop new drugs to block SPINK1 that will dramatically improve outcome in these patients.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Exploratory/Developmental Grants (R21)
Project #
Application #
Study Section
Special Emphasis Panel (ZCA1)
Program Officer
Sathyamoorthy, Neeraja
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Mayo Clinic Jacksonville
United States
Zip Code
Mehner, Christine; Oberg, Ann L; Kalli, Kimberly R et al. (2015) Serine protease inhibitor Kazal type 1 (SPINK1) drives proliferation and anoikis resistance in a subset of ovarian cancers. Oncotarget 6:35737-54