The lack of an identifiable precursor lesion for ovarian carcinoma hinders attempts to design rational surveillance and chemoprevention for this deadly disease. Indeed, it is uncertain which are the specific cells in the female genital tract that transform into ovarian and primary peritoneal malignancies. A better understanding of the early steps in ovarian tumorigenesis would facillitate the development of new screening and prevention stratgies. Inherited mutations in the BRCA1 gene results in an approximate 40% lifetime risk of ovarian, tubal or peritoneal carcinoma. Current clinical recommendations for women with BRCA1 mutations include risk- reducing salpingo-oophorectomy (RRSO) by age 40 after completion of child-bearing. Our group and others have identified a high rate of high grade serous neoplasia in the fallopian tubes of BRCA1 mutation carriers undergoing RRSO. The frequency of occult tubal neoplasia exceeds that of ovarian neoplasia when using a detailed surgical and pathological protocol. We hypothesize that most ovarian and peritoneal carcinomas arising in BRCA1 mutation carriers are seeded from neoplastic cells arising in the fallopian tubes. This phenomenon could have important implications for the development of sporadic as well as hereditary ovarian carcinoma. The overall goal of the current proposal is to define a premalignant tubal phenotype in women with inherited BRCA1 mutations.
The specific aims of this proposal are: 1. Characterize tubal epithelium in unaffected women with BRCA1 mutations and in women with BRCA1- associated or sporadic ovarian and peritoneal carcinomas. 2. Identify and characterize a gene expression signature associated with premalignant alterations in pathologically normal tubal epithelium from women with BRCA1 mutations. 3. Evaluate priority genes from Specific Aim 2 in inherited and sporadic ovarian and peritoneal carcinomas.

Public Health Relevance

An improved understanding of the early steps in ovarian carcinoma development is needed to facilitate rational and novel strategies for screening and prevention. Identification of a pre-cursor lesion for ovarian and peritoneal carcinoma and proof of its potential for malignant progression would facilitate chemoprevention trials in high-risk women and provide new targets for early detection.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Molecular Oncogenesis Study Section (MONC)
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Patriotis, Christos F
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University of Washington
Obstetrics & Gynecology
Schools of Medicine
United States
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Bernards, Sarah S; Norquist, Barbara M; Harrell, Maria I et al. (2016) Genetic characterization of early onset ovarian carcinoma. Gynecol Oncol 140:221-5
Norquist, Barbara M; Harrell, Maria I; Brady, Mark F et al. (2016) Inherited Mutations in Women With Ovarian Carcinoma. JAMA Oncol 2:482-90
Sherman, Mark E; Drapkin, Ronny I; Horowitz, Neil S et al. (2016) Rationale for Developing a Specimen Bank to Study the Pathogenesis of High-Grade Serous Carcinoma: A Review of the Evidence. Cancer Prev Res (Phila) 9:713-20
Tolcher, Mary C; Swisher, Elizabeth M; Medeiros, Fabiola et al. (2015) Characterization of precursor lesions in the endometrium and fallopian tube epithelium of early-stage uterine serous carcinoma. Int J Gynecol Pathol 34:57-64
Pennington, Kathryn P; Walsh, Tom; Harrell, Maria I et al. (2014) Germline and somatic mutations in homologous recombination genes predict platinum response and survival in ovarian, fallopian tube, and peritoneal carcinomas. Clin Cancer Res 20:764-75
Powell, C B; Swisher, E M; Cass, I et al. (2013) Long term follow up of BRCA1 and BRCA2 mutation carriers with unsuspected neoplasia identified at risk reducing salpingo-oophorectomy. Gynecol Oncol 129:364-71
Pennington, Kathryn P; Walsh, Tom; Lee, Ming et al. (2013) BRCA1, TP53, and CHEK2 germline mutations in uterine serous carcinoma. Cancer 119:332-8
Norquist, Barbara M; Pennington, Kathryn P; Agnew, Kathy J et al. (2013) Characteristics of women with ovarian carcinoma who have BRCA1 and BRCA2 mutations not identified by clinical testing. Gynecol Oncol 128:483-7
Pennington, Kathryn P; Wickramanayake, Anneka; Norquist, Barbara M et al. (2013) 53BP1 expression in sporadic and inherited ovarian carcinoma: Relationship to genetic status and clinical outcomes. Gynecol Oncol 128:493-9
Smith, Na Lu; Welcsh, Piri; Press, Joshua Z et al. (2012) E2F3b over-expression in ovarian carcinomas and in BRCA1 haploinsufficient fallopian tube epithelium. Genes Chromosomes Cancer 51:1054-62

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