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Prediction of resistance to chemotherapy in ovarian cancer: a systematic review
Open accessAbstract
BACKGROUND: Patient response to chemotherapy for ovarian cancer is extremely heterogeneous and there are currently no tools to aid the prediction of sensitivity or resistance to chemotherapy and allow treatment stratification. Such a tool could greatly improve patient survival by identifying the most appropriate treatment on a patient-specific basis. METHODS: PubMed was searched for studies predicting response or resistance to chemotherapy using gene expression measurements of human tissue in ovarian cancer. RESULTS: 42 studies were identified and both the data collection and modelling methods were compared. The majority of studies utilised fresh-frozen or formalin-fixed paraffin-embedded tissue. Modelling techniques varied, the most popular being Cox proportional hazards regression and hierarchical clustering which were used by 17 and 11 studies respectively. The gene signatures identified by the various studies were not consistent, with very few genes being identified by more than two studies. Patient cohorts were often noted to be heterogeneous with respect to chemotherapy treatment undergone by patients. CONCLUSIONS: A clinically applicable gene signature capable of predicting patient response to chemotherapy has not yet been identified. Research into a predictive, as opposed to prognostic, model could be highly beneficial and aid the identification of the most suitable treatment for patients.
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The use of only one dataset for discovery does not account for biological heterogeneity, technical biases across different datasets, the large number of genes in a signature or impractical linear scoring modeling methods.
“Unfortunately, none of these existing gene signatures have been widely adopted in clinical practice, which may be due, in part, to the use of only one dataset for discovery that does not account for biological heterogeneity, technical biases across different datasets, the large number of genes in a signature or impractical linear scoring modeling methods17,18.”
From Large-scale integrated analysis of ovarian cancer tumors and cell lines identifies an individualized gene expression signature for predicting response to platinum-based chemotherapy (2019) · cites this paper as [18]
The Discussion (page unavailable) says heterogeneous patient cohorts may yield different gene signatures and reduce predictive ability. Results > Model predictive ability (page unavailable) says application to independent datasets was uncommon. The paper does not establish that using only one discovery dataset caused the lack of clinical adoption, or identify large signatures and impractical linear scoring methods as reasons for it. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe gene signatures identified by previous studies are very dissimilar, and the vast majority of genes were identified using only one study.
“A recent review revealed that the gene signatures identified by previous studies are very dissimilar, and the vast majority of genes were identified using only one study18.”
Existing gene signatures have not been widely adopted in clinical practice.
“Unfortunately, none of these existing gene signatures have been widely adopted in clinical practice, which may be due, in part, to the use of only one dataset for discovery that does not account for biological heterogeneity, technical biases across different datasets, the large number of genes in a signature or impractical linear scoring modeling methods17,18.”
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Cites
QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies
Whiting, P. F., Rutjes, A. W. S., Westwood, M. E., Mallett, S., Deeks, J. J., Reitsma, J. B., Leeflang, M. M. G., Sterne, J. A. C., Bossuyt, P. M. M., & the QUADAS-2 Group* (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-155-8-201110180-00009 · Cited by 14,199
MAP kinase signalling pathways in cancer
Dhillon, A. S., Hagan, S., Rath, O., & Kolch, W. (2007) · Oncogene · doi:10.1038/sj.onc.1210421 · Cited by 2,995
Gillet, J.-P., Calcagno, A. M., Varma, S., Marino, M., Green, L. J., Vora, M. I., Patel, C., Orina, J. N., Eliseeva, T. A., Singal, V., et al. (2011) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1111840108 · Cited by 477
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Cited by
Sorted by citations
Sun, J., Bao, S., Xu, D., Zhang, Y., Su, J., Liu, J., Hao, D., & Zhou, M. (2019) · Cell Death & Disease · doi:10.1038/s41419-019-1874-9 · Cited by 23
Metadata
- Authors
- Lloyd, K. L., Cree, I. A., & Savage, R. S.
- Affiliations
- University of Warwick (GB)
- Corresponding author
- Lloyd, Katherine L
- Venue
- BMC Cancer
- Published
- 2015-03-11
- Volume
- 15
- Issue
- 1
- Pages
- 117-117
- ISSN
- 1471-2407 (ISSN-L)
- PMC
- PMC4371880
- OpenAlex
- W2016226316
- Cited by
- 87
- References
- 3
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 4 · 2023: 9 · 2022: 8 · 2021: 14 · 2020: 8 · 2019: 12 · 2018: 9 · 2017: 8 · 2016: 7 · 2015: 1
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Cancer (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- Funders
- Medical Research Council
- Engineering and Physical Sciences Research Council (EP/F500378, EP/F500378/1, 1229056)
- Topics
- Health Sciences › Medicine › Oncology › Ovarian cancer diagnosis and treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gene expression and cancer classification
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Keywords
- ovarian cancer, chemoresistance, chemotherapy response prediction, gene expression signatures, predictive biomarkers, treatment stratification, Cox proportional hazards model, hierarchical clustering, patient heterogeneity
- MeSH terms
- Animals, Antineoplastic Agents, Female, Humans, Ovarian Neoplasms, Predictive Value of Tests, Drug Resistance, Neoplasm
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