Theoretical model of treatment strategies for clear cell carcinoma of the ovary: focus on perspectives.
OBJECTIVE
Among epithelial ovarian cancer (EOC), clear cell carcinomas (CCC) differ from the other histologic types with respect to their clinical characteristics, carcinogenesis and prognosis. The aim of this review is to summarize the current knowledge and future perspective on the new therapeutic targets and treatment strategies for CCC.


METHODS
The present article reviews the English language literature for preclinical and clinical trials and promising molecular targets on CCC of the ovary, based on the gene expression profiling studies.


RESULTS
Here, we show that (1) the expression of the genes involved in transcription, signaling, cell cycle, adhesion, matrix, proteinase, and detoxification was greatly increased in the CCC carcinogenesis; (2) upregulation of hepatocyte nuclear factor-1beta (HNF-1beta) and Polo-like kinase (PLK)-Early mitotic inhibitor-1 (Emi1) as well as their downstream targets are specifically found in most CCC. The promising molecular targeting approach will emerge in the context of HNF-1beta and PLK-Emi1 biology; and 3) several significant common pathways observed in CCC of the ovary overlap the datasets identified in CCC of the kidney. To improve the outcome in CCC therapy, we must learn various adaptive treatment strategies for renal CCC, although it is not supported by any preliminary clinical data.


CONCLUSIONS
The inhibitors that target HNF-1beta and PLK-Emi1 and their downstream signaling molecules would be evaluated. In addition, the therapy currently used in renal CCC should be considered as an alternative for the present treatments or an attractive therapeutic option for ovarian CCC. The challenges accompanying the recent advance are described in this review article.
Yoshida
Shozo
S
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
Furukawa
Naoto
N
Haruta
Shoji
S
Tanase
Yasuhito
Y
Kanayama
Seiji
S
Noguchi
Taketoshi
T
Sakata
Mariko
M
Yamada
Yoshihiko
Y
Oi
Hidekazu
H
Kobayashi
Hiroshi
H
D018262:Adenocarcinoma, Clear Cell / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D010051:Ovarian Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy*