New Hypothesis on Pathogenesis of Ovarian Cancer Lead to Future Tailored Approaches

Table 1

The correlation of the five types of Prat theory and clinical implications.

	HGSH	LGSH	MC	EC	CCC
Prat theory
Precursor lesions	STIC	Serous borderline tumor	Cystoadenoma/borderline; tumor	Atypical endometriosis	Atypical endometriosis
Pattern of spread	Very early transcoelomic spread	Transcoelomic spread	Usually limited to ovary	Usually limited to pelvis	Usually limited to pelvis
Molecular; abnormalities	BRCA; P53	BRAF; KRAS	KRAS; HER2	PTEN; ARID1A	HNF1; ARID1A
Chemosensitivity	High	Intermediate	Low	High	Low
Prognosis	Poor	Intermediate	Favorable	Favorable	Intermediate
Clinical implications
Potential; target therapies	PARP inhibitors	BRAF; KRAS inhibitors	Monoclonal antibodies Anti-HER2; KRAS inhibitors	Not Available	Not available
Potential role of; screening	Research of novel early biomarkers	Research of novel early biomarkers	Transvaginal ultrasound + CA125	Transvaginal ultrasound + CA125	Transvaginal ultrasound + CA125

HGSC: high-grade serous carcinoma; LGSC: low-grade serous carcinoma; EC: endometrioid carcinoma; CCC: clear cell carcinoma; MC: mucinous carcinoma; STIC: serous tubal intraepithelial carcinoma.