Ovarian Cancer in Women Living With HIV: Epidemiology, Mechanisms, and Clinical Management

Abstract

The growing concern over the intersection of ovarian cancer [OC] and Human Immunodeficiency Virus [HIV] among women has prompted considerable scientific inquiry into the possible implications of HIV for the incidence of ovarian malignancies. This review explores the occurrence of OC in HIV-positive women, examining the multifaceted pathophysiological interactions that may contribute to ovarian tumorigenesis in this population. The primary aim of the research is to evaluate the possible association between HIV infection and OC development, with a focus on immune dysfunction, viral load, and antiretroviral therapy as potential contributors. This review synthesizes findings from epidemiological studies, clinical trials, and laboratory investigations to highlight the complex interplay of immunosuppression and cancerogenesis in the context of HIV infection. The significance of this work lies in its potential to inform targeted healthcare strategies and interventions for HIV-positive women, addressing both cancer prevention and management in this vulnerable group. Methodologically, this review assesses the results of a comprehensive analysis of cross-sectional studies, cohort data, and case-control studies to evaluate the relationship between HIV and OC risk. The findings suggest that the association between HIV and OC remains incompletely understood, as the available evidence is limited, heterogeneous, and largely observational; possible contributing factors may include chronic inflammation, immune suppression, and long-term antiretroviral drug use. These findings contribute to a deeper understanding of the intersection of viral infections and cancer risk, with important implications for future research and public health policy. The practical significance of this research lies in its potential to support clinical awareness and improve recognition of this underexplored issue in HIV-positive women.

 

Keywords

• Ovarian Cancer
• HIV-positive Women
• Cancer Risk
• Immune Dysfunction
• Antiretroviral Therapy

HIV ile Yaşayan Kadınlarda Over Kanseri: Epidemiyoloji, Mekanizmalar ve Klinik Yönetim

Abstract

Keywords

• Over kanseri
• HIV pozitif kadınlar
• kanser riski
• immün disfonksiyon

References

1. Smith AJB, Varma S, Rositch AF, Levinson K. Gynecologic cancer in HIV-positive women: a systematic review and meta-analysis. Am J Obstet Gynecol. 2019;221(3):194–207.e5.doi:10.1016/j.ajog.2019.02.022.
2. Momenimovahed Z, Tiznobaik A, Taheri S, Salehiniya H. Ovarian cancer in the world: epidemiology and risk factors. Int J Womens Health. 2019;11:287–99. doi:10.2147/IJWH.S197604.
3. Zamwar UM, Anjankar AP. Aetiology, epidemiology, histopathology, classification, detailed evaluation, and treatment of ovarian cancer. Cureus. 2022;14(10):e30561. doi:10.7759/cureus.30561.
4. Tossetta G. Metformin improves ovarian cancer sensitivity to paclitaxel and platinum-based drugs: A review of in vitro findings. Int J Mol Sci. 2022;23(21):12893. doi:10.3390/ijms232112893
5. Matulonis UA, Sood AK, Fallowfield L, Howitt BE, Sehouli J, Karlan BY. Ovarian cancer. Nat Rev Dis Primers. 2016;2:16061.doi:10.1038/nrdp.2016.61.
6. American Cancer Society. Ovarian cancer risk factors (Internet). 2021 Jan 26 (cited 2025 Mar 15). Available from: https://www.cancer.org.
7. Stronach EA, Paul J, Timms KM, Hughes E, Brown K, Neff C, et al. Biomarker assessment of HR deficiency, tumor BRCA1/2 mutations, and CCNE1 copy number in ovarian cancer: associations with clinical outcome following platinum monotherapy. Mol Cancer Res. 2018;16(7):1103–11. doi:10.1158/1541-7786.MCR-18-0034.
8. Filippova OT, Selenica P, Pareja F, Vahdatinia M, Zhu Y, Pei X, et al. Molecular characterization of high-grade serous ovarian cancers occurring in younger and older women. Gynecol Oncol. 2021;161(2):545–52. doi:10.1016/j.ygyno.2021.02.028.

9. Arildsen NS, Martin de la Fuente L, Måsbäck A, Malander S, Forslund O, Kannisto P, et al. Detecting TP53 mutations in diagnostic and archival liquid-based Pap samples from ovarian cancer patients using an ultra-sensitive ddPCR method. Sci Rep. 2019;9(1):15506. doi:10.1038/s41598-019-51697-6.
10. Casper C, Crane H, Menon M, et al. HIV/AIDS comorbidities: impact on cancer, noncommunicable diseases, and reproductive health. In: Holmes KK, Bertozzi S, Bloom BR, et al., editors. Major Infectious Diseases. 3rd ed. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 3. Chapter 3. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525185/ doi:10.1596/978-1-4648-0524-0_ch3.
11. Chay WY, McCluggage WG, Lee CH, Köbel M, Irving J, Millar J, et al. Outcomes of incidental fallopian tube high-grade serous carcinoma and serous tubal intraepithelial carcinoma in women at low risk of hereditary breast and ovarian cancer. Int J Gynecol Cancer. 2016;26(3):431–6.doi:10.1097/IGC.0000000000000639.
12. ViiV Healthcare. HIV in women (Internet). 2023 (cited 2025 Mar 19). Available from: https://www.viivhealthcare.com
13. Kaida A, Carter A, de Pokomandy A, Patterson S, Proulx-Boucher K, Nohpal A, et al. Sexual inactivity and sexual satisfaction among women living with HIV in Canada in the context of growing social, legal and public health surveillance. J Int AIDS Soc. 2015;18(Suppl 5):20284. doi:10.7448/IAS.18.6.20284.
14. Mayo Clinic. HIV/AIDS (Internet). Mayo Clinic; 2024 Feb 9 (cited 2025 Mar 19). Available from: https://www.mayoclinic.org/diseases-conditions/hiv-aids/
15. Hejran AB, Sarwari A, Hassand MH. Exploring the expensive therapeutic potential and clinical applications of viruses severe acute respiratory syndrome (SARS)-COV-2. Life Res. 2025;8(1):2.doi:10.53388/LR20250002. HIV.gov. HIV and women’s health issues. U.S. Department of Health & Human Services; 2024 Sep 16 (cited 2025 Mar 19). Available from: https://www.hiv.gov.
16. Olin JL, Klibanov O, Chan A, Spooner LM. Managing Pharmacotherapy in People Living With HIV and Concomitant Malignancy. Ann Pharmacother. 2019;53(8):812–32. doi:10.1177/1060028019833038.
17. Hejran AB, Alimyar O, Afghan R, Niazi P. Exploring the multifaceted role of viruses in sustaining biodiversity: mechanisms, implications, and contributions to ecosystems stability. Scientia Technol Sci Soc. 2024;1(2):35–49. doi:10.59324/stss.2024.1(2).04.
18. Kar SP, Berchuck A, Gayther SA, Goode EL, Moysich KB, Pearce CL, et al. Common genetic variation and susceptibility to ovarian cancer: Current insights and future directions. Cancer Epidemiol Biomarkers Prev. 2018;27(4):395–404. doi:10.1158/1055-9965.EPI-17-0315.
19. Koestler DC, Chalise P, Cicek MS, Cunningham JM, Armasu S, Larson MC, et al. Integrative genomic analysis identifies epigenetic marks that mediate genetic risk for epithelial ovarian cancer. BMC Med Genomics. 2014;7:8.doi:10.1186/1755-8794-7-8.
20. Piedimonte S, Power J, Foulkes WD, Weber E, Palma L, Schiavi A, et al. BRCA testing in women with high-grade serous ovarian cancer: gynecologic oncologist-initiated testing compared with genetics referral. Int J Gynecol Cancer. 2020;30(11):1757–61.doi:10.1136/ijgc-2020-001261.
21. Pierre ME, Manneh R, Hernández A, Rodríguez J, Fletcher AV, Ramírez HM, et al. Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer. Rev Colomb Obstet Ginecol. 2024;75(1):4094. doi:10.18597/rcog.4094.
22. Ducie J, Dao F, Considine M, Olvera N, Shaw PA, Kurman RJ, et al. Molecular analysis of high-grade serous ovarian carcinoma with and without associated serous tubal intra-epithelial carcinoma. Nat Commun. 2017;8(1):990.doi:10.1038/s41467-017-01217-9.
23. Pfisterer J, Shannon CM, Baumann K, Rau J, Harter P, Joly F, et al. Bevacizumab and platinum-based combinations for recurrent ovarian cancer: a randomised, open-label, phase 3 trial. Lancet Oncol. 2020;21(5):699–709.doi:10.1016/S1470-2045(20)30142-X.
24. Kim J, Park EY, Kim O, Schilder JM, Coffey DM, Cho CH, et al. Cell origins of high-grade serous ovarian cancer. Cancers. 2018;10(11):433.doi:10.3390/cancers10110433.
25. Dicks EM, Tyrer JP, Ezquina S, Jones M, Baierl J, Peng PC, et al. Exome sequencing identifies HELB as a novel susceptibility gene for non-mucinous, non-high-grade-serous epithelial ovarian cancer. medRxiv. 2024;2024.04.02.24304968.doi:10.1101/2024.04.02.24304968.
26. Valiaveettil C, Loutfy M, Kennedy VL, Caddy S, Yudin M, Conway T, et al. High prevalence of abnormal menstruation among women living with HIV in Canada. PLoS One. 2019;14(12):e0226992. doi:10.1371/journal.pone.0226992.
27. Feharsal Y, Andrijono A, Singoprawiro CS, Lisnawati L, Pakasi TA, Putra AD, et al. Role of CD44 and CD24 Expression on 2-years Disease Free Survival in Patients with Advanced Epithelial Ovarian Carcinoma. Asian Pac J Cancer Prev. 2024;25(2):513–9. doi:10.31557/APJCP.2024.25.2.513.
28. Dilley J, Burnell M, Gentry-Maharaj A, Ryan A, Neophytou C, Apostolidou S, et al. Ovarian cancer symptoms, routes to diagnosis and survival - population cohort study in the ‘no screen’ arm of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Gynecol Oncol. 2020;158(2):316–22. doi:10.1016/j.ygyno.2020.05.002.
29. Li C, Ding H, Tian J, Wu L, Wang Y, Xing Y, et al. Forkhead box protein C2 promotes epithelial-mesenchymal transition, migration and invasion in cisplatin-resistant human ovarian cancer cell line (SKOV3/CDDP). Cell Physiol Biochem. 2016;39(3):1098–1110.doi:10.1159/000447818.
30. Slade E, Berg L, Dworzynski K, Manchanda R, Barber V, Bowen R, et al. Ovarian cancer: identifying and managing familial and genetic risk. London: National Institute for Health and Care Excellence (NICE); 2024 Mar 21. (NICE Clinical Guidelines, No. 241.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK604286/
31. Carter A, de Pokomandy A, Loutfy M, Ding E, Sereda P, Webster K, et al. Validating a self-report measure of HIV viral suppression: an analysis of linked questionnaire and clinical data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study. BMC Res Notes. 2017;10(1):138. doi:10.1186/s13104-017-2453-8.
32. Pathak S, Wilczyński JR, Paradowska E. Factors in Oncogenesis: Viral Infections in Ovarian Cancer. Cancers. 2020;12(3):561.doi:10.3390/cancers12030561.
33. Fuller PJ, Leung D, Chu S. Genetics and genomics of ovarian sex cord-stromal tumors. Clin Genet. 2017;91(2):285–91. doi:10.1111/cge.12917.
34. Yang Y, Wu L, Shu XO, Cai Q, Shu X, Li B, et al. Genetically predicted levels of DNA methylation biomarkers and breast cancer risk: Data from 228,951 women of European descent. J Natl Cancer Inst. 2020;112(3):295–304. doi:10.1093/jnci/djz109.
35. Li G, Zhang Y, Li K, Liu X, Lu Y, Zhang Z, et al. Transformer-based AI technology improves early ovarian cancer diagnosis using cfDNA methylation markers. Cell Rep Med. 2024;5(8):101666. doi:10.1016/j.xcrm.2024.101666.
36. Bergsten TM, Burdette JE, Dean M. Fallopian tube initiation of high grade serous ovarian cancer and ovarian metastasis: Mechanisms and therapeutic implications. Cancer Lett. 2020;476:152–60. doi:10.1016/j.canlet.2020.02.017.
37. Romagnolo C, Leon AE, Fabricio ASC, Taborelli M, Polesel J, Del Pup L, et al. HE4, CA125 and risk of ovarian malignancy algorithm (ROMA) as diagnostic tools for ovarian cancer in patients with a pelvic mass: an Italian multicenter study. Gynecol Oncol. 2016;141(2):303–11. doi:10.1016/j.ygyno.2016.01.016.
38. Garg G, Yilmaz A, Kumar P, Turkoglu O, Mutch DG, Powell MA, et al. Targeted metabolomic profiling of low and high grade serous epithelial ovarian cancer tissues: a pilot study. Metabolomics. 2018;14(12):154.doi:10.1007/s11306-018-1448-3.
39. Zhang R, Yang X, Roque DM, Li C, Lin J. A novel small molecule LLL12B inhibits STAT3 signaling and sensitizes ovarian cancer cell to paclitaxel and cisplatin. PLoS One. 2021;16(4):e0240145. doi:10.1371/journal.pone.0240145.
40. Mathew C, Ghildyal R. CRM1 Inhibitors for Antiviral Therapy. Front Microbiol. 2017;8:1171. doi:10.3389/fmicb.2017.01171. Oliver NT, Chiao EY. Malignancies in women with HIV infection. Curr Opin HIV AIDS. 2017;12(1):69–76. doi:10.1097/COH.0000000000000332.
41. Saner FAM, Takahashi K, Budden T, Pandey A, Ariyaratne D, Zwimpfer TA, et al. Concurrent RB1 loss and BRCA-deficiency predicts enhanced immunological response and long-term survival in tubo-ovarian high-grade serous carcinoma. medRxiv. 2023;2023.11.09.23298321. doi:10.1101/2023.11.09.23298321.
42. Josahkian JA, Saggioro FP, Vidotto T, Ventura HT, Candido Dos Reis FJ, de Sousa CB, et al. Increased STAT1 expression in high-grade serous ovarian cancer is associated with a better outcome. Int J Gynecol Cancer. 2018;28(3):459–65. doi:10.1097/IGC.0000000000001193.
43. Fujiwara H, Suzuki M, Takeshima N, Takizawa K, Kimura E, Nakanishi T, et al. Evaluation of human epididymis protein 4 (HE4) and Risk of Ovarian Malignancy Algorithm (ROMA) as diagnostic tools of type I and type II epithelial ovarian cancer in Japanese women. Tumour Biol. 2015;36(2):1045–53.doi:10.1007/s13277-014-2738-7.
44. Wang Z, Tao X, Ying C. CPH-I and HE4 are more favorable than CA125 in differentiating borderline ovarian tumors from epithelial ovarian cancer at early stages. Dis Markers. 2019;2019:6241743.doi:10.1155/2019/6241743.
45. Song Z, Wang X, Fu J, Wang P, Chen X, Zhang D. Copenhagen index (CPH-I) is more favorable than CA125, HE4, and risk of ovarian malignancy algorithm (ROMA): Nomogram prediction models with clinical-ultrasonographic feature for diagnosing ovarian neoplasms. Front Surg. 2023;9:1068492.doi:10.3389/fsurg.2022.1068492.
46. Wadhwa K, Kapoor N, Kaur H, Abu-Seer EA, Tariq M, Siddiqui S, et al. A comprehensive review of the diversity of fungal secondary metabolites and their emerging applications in healthcare and environment. Mycobiology. 2024;1–53. doi:10.1080/12298093.2024.2416736.
47. Luo HJ, Hu ZD, Cui M, Zhang XF, Tian WY, Ma CQ, et al. Diagnostic performance of CA125, HE4, ROMA, and CPH-I in identifying primary ovarian cancer. J Obstet Gynaecol Res. 2023;49(3):998–1006. doi:10.1111/jog.15540.
48. Hejran AB, Saken K, Afghan R, Niazi P. Antigenic switch potential of influenza D virus. Asia Pac J Pharmacother Toxicol. 2024;4(1):95–111. doi:10.32948/ajpt.2024.11.25.
49. Nikolaidi A, Fountzilas E, Fostira F, Psyrri A, Gogas H, Papadimitriou C. Neoadjuvant treatment in ovarian cancer: New perspectives, new challenges. Front Oncol. 2022;12:820128. doi:10.3389/fonc.2022.820128.
50. Mueller JJ, Zhou QC, Iasonos A, O’Cearbhaill RE, Alvi FA, El Haraki A, et al. Neoadjuvant chemotherapy and primary debulking surgery utilization for advanced-stage ovarian cancer at a comprehensive cancer center. Gynecol Oncol. 2016;140(3):436–42. doi:10.1016/j.ygyno.2016.01.008.
51. Li J, Meeks H, Feng BJ, Healey S, Thorne H, Makunin I, et al. Targeted massively parallel sequencing of a panel of putative breast cancer susceptibility genes in a large cohort of multiple-case breast and ovarian cancer families. J Med Genet. 2016;53(1):34–42. doi:10.1136/jmedgenet-2015-103452.
52. Levinson KL, Riedel DJ, Ojalvo LS, Chan W, Angarita AM, Fader AN, et al. Gynecologic cancer in HIV-infected women: Treatment and outcomes in a multi-institutional cohort. AIDS. 2018;32(2):171–7. doi:10.1097/QAD.0000000000001664.
53. Monib A, Niazi P, Barai S, Sawicka B, Baseer A, Nikpay A, et al. Nitrogen Cycling Dynamics: Investigating Volatilization and its Interplay with N2 Fixation. J Res Appl Sci Biotechnol. 2024;3(1):17–31. doi:10.55544/jrasb.3.1.4.
54. American Cancer Society. Ovarian cancer (Internet). 2024 Jan 19 (cited 2025 Mar 15). Available from: https://www.cancer.org/cancer/ovarian-cancer.html
55. Broder M. A new look at non–AIDS-defining gynecologic cancers in HIV-positive women (Internet). MedPage Today; 2019 Jun 20 (cited 2025 Mar 15). Available from: https://www.medpagetoday.com
56. Webb PM, Jordan SJ. Global epidemiology of epithelial ovarian cancer. Nat Rev Clin Oncol. 2024;21(5):389–400. doi:10.1038/s41571-024-00881-3.
57. Pesce F, Devouassoux-Shisheboran M. Les tumeurs héréditaires de l’ovaire vues par le pathologiste. Ann Pathol. 2020;40(2):85–94. doi:10.1016/j.annpat.2020.02.015.
58. Chung C, Lee R. An update on current and emerging therapies for epithelial ovarian cancer: focus on poly (adenosine diphosphate-ribose) polymerase inhibition and antiangiogenesis. J Oncol Pharm Pract. 2017;23(6):454–69.doi:10.1177/1078155216657165.
59. Zang B, Helms M, Besch L, Kalmbach N, Stegen S, Blohmer JU, et al. Interdisciplinary risk counseling for hereditary breast and ovarian cancer: real-world data from a specialized center. Arch Gynecol Obstet. 2023;307(5):1585–92. doi:10.1007/s00404-022-06819-3.
60. Konstanta I, Fostira F, Apostolou P, Stratikos E, Kalfakakou D, Pampanos A, et al. Contribution of RAD51D germline mutations in breast and ovarian cancer in Greece. J Hum Genet. 2018;63(11):1149–58.doi:10.1038/s10038-018-0498-8.
61. da Costa E Silva Carvalho S, Cury NM, Brotto DB, de Araujo LF, Rosa RCA, Texeira LA, et al. Germline variants in DNA repair genes associated with hereditary breast and ovarian cancer syndrome: analysis of a 21 gene panel in the Brazilian population. BMC Med Genomics. 2020;13(1):21.doi:10.1186/s12920-019-0652-y.
62. Pavanello M, Chan IH, Ariff A, Pharoah PD, Gayther SA, Ramus SJ. Rare Germline Genetic Variants and the Risks of Epithelial Ovarian Cancer. Cancers. 2020;12(10):3046.doi:10.3390/cancers12103046.
63. Pisanic TR 2nd, Cope LM, Lin SF, Yen TT, Athamanolap P, Asaka R, et al. Methylomic analysis of ovarian cancers identifies tumor-specific alterations readily detectable in early precursor lesions. Clin Cancer Res. 2018;24(24):6536–47. doi:10.1158/1078-0432.CCR-18-1199.
64. Fanale D, Pivetti A, Cancelliere D, Spera A, Bono M, Fiorino A, et al. BRCA1/2 variants of unknown significance in hereditary breast and ovarian cancer (HBOC) syndrome: Looking for the hidden meaning. Crit Rev Oncol Hematol. 2022;172:103626. doi:10.1016/j.critrevonc.2022.103626.
65. Tuncer SB, Celik B, Erciyas SK, Erdogan OS, Gültaslar BK, Odemis DA, et al. Germline mutational variants of Turkish ovarian cancer patients suspected of hereditary breast and ovarian cancer (HBOC) by next-generation sequencing. Pathol Res Pract. 2024;254:155075. doi:10.1016/j.prp.2023.155075.
66. Fridley BL, Armasu SM, Cicek MS, Larson MC, Wang C, Winham SJ, et al. Methylation of leukocyte DNA and ovarian cancer: relationships with disease status and outcome. BMC Med Genomics. 2014;7:21.doi:10.1186/1755-8794-7-21.
67. Singh A, Gupta S, Badarukhiya JA, Sachan M. Detection of aberrant methylation of HOXA9 and HIC1 through multiplex MethyLight assay in serum DNA for the early detection of epithelial ovarian cancer. Int J Cancer. 2020;147(6):1740–52. doi:10.1002/ijc.32984.
68. Winham SJ, Armasu SM, Cicek MS, Larson MC, Cunningham JM, Kalli KR, et al. Genome-wide investigation of regional blood-based DNA methylation adjusted for complete blood counts implicates BNC2 in ovarian cancer. Genet Epidemiol. 2014;38(5):457–66. doi:10.1002/gepi.21815.
69. Johnatty SE, Tyrer JP, Kar S, Beesley J, Lu Y, Gao B, et al. Genome-wide analysis identifies novel loci associated with ovarian cancer outcomes: Findings from the Ovarian Cancer Association Consortium. Clin Cancer Res. 2015;21(23):5264–76. doi:10.1158/1078-0432.CCR-15-0632.
70. Reid BM, Permuth JB, Chen YA, Teer JK, Monteiro AN, Chen Z, et al. Integration of population-level genotype data with functional annotation reveals over-representation of long noncoding RNAs at ovarian cancer susceptibility loci. Cancer Epidemiol Biomarkers Prev. 2017;26(1):116–25. doi:10.1158/1055-9965.EPI-16-0341.
71. Loginov VI, Pronina IV, Burdennyy AM, Filippova EA, Kazubskaya TP, Kushlinsky DN, et al. Novel miRNA genes deregulated by aberrant methylation in ovarian carcinoma are involved in metastasis. Gene. 2018;662:28–36. doi:10.1016/j.gene.2018.04.005.
72. Richards EJ, Permuth-Wey J, Li Y, Chen YA, Coppola D, Reid BM, et al. A functional variant in HOXA11-AS, a novel long non-coding RNA, inhibits the oncogenic phenotype of epithelial ovarian cancer. Oncotarget. 2015;6(33):34745–57. doi:10.18632/oncotarget.5784.
73. Braga LdaC, Silva LM, Ramos AP, Piedade JB, Vidigal PV, Traiman P, et al. Single CpG island methylation is not sufficient to maintain the silenced expression of CASPASE-8 apoptosis-related gene among women with epithelial ovarian cancer. Biomed Pharmacother. 2014;68(1):87–91. doi:10.1016/j.biopha.2013.12.004.
74. Ding JJ, Wang G, Shi WX, Zhou HH, Zhao EF. Promoter hypermethylation of FANCF and susceptibility and prognosis of epithelial ovarian cancer. Reprod Sci. 2016;23(1):24–30.doi:10.1177/1933719115612136.
75. Yang J, Zhou Y, Ng SK, Huang KC, Ni X, Choi PW, et al. Characterization of MicroRNA-200 pathway in ovarian cancer and serous intraepithelial carcinoma of fallopian tube. BMC Cancer. 2017;17(1):422.doi:10.1186/s12885-017-3417-z.
76. Hauke J, Horvath J, Groß E, Gehrig A, Honisch E, Hackmann K, et al. Gene panel testing of 5589 BRCA1/2-negative index patients with breast cancer in a routine diagnostic setting: results of the German Consortium for Hereditary Breast and Ovarian Cancer. Cancer Med. 2018;7(4):1349–58. doi:10.1002/cam4.1376.
77. Saner FAM, Takahashi K, Budden T, Pandey A, Ariyaratne D, Zwimpfer TA, et al. Concurrent RB1 loss and BRCA deficiency predicts enhanced immunologic response and long-term survival in tubo-ovarian high-grade serous carcinoma. Clin Cancer Res. 2024;30(16):3481–98. doi:10.1158/1078-0432.CCR-23-3552.
78. Siamakpour-Reihani S, Cobb LP, Jiang C, Zhang D, Previs RA, Owzar K, et al. Differential expression of immune related genes in high-grade ovarian serous carcinoma. Gynecol Oncol. 2020;156(3):662–8. doi:10.1016/j.ygyno.2019.12.019.
79. Wu RC, Wang P, Lin SF, Zhang M, Song Q, Chu T, et al. Genomic landscape and evolutionary trajectories of ovarian cancer precursor lesions. J Pathol. 2019;248(1):41–50. doi:10.1002/path.5219.
80. Norris EJ, Zhang Q, Jones WD, DeStephanis D, Sutker AP, Livasy CA, et al. Increased expression of neurotensin in high grade serous ovarian carcinoma with evidence of serous tubal intraepithelial carcinoma. J Pathol. 2019;248(3):352–62. doi:10.1002/path.5264.
81. Morgan RD, McNeish IA, Cook AD, James EC, Lord R, Dark G, et al. Objective responses to first-line neoadjuvant carboplatin-paclitaxel regimens for ovarian, fallopian tube, or primary peritoneal carcinoma (ICON8). Lancet Oncol. 2021;22(2):277–88.doi:10.1016/S1470-2045(20)30591-X.
82. Tao YP, Zhu HY, Shi QY, Wang CX, Hua YX, Hu HY, et al. S1PR1 regulates ovarian cancer cell senescence through the PDK1-LATS1/2-YAP pathway. Oncogene. 2023;42(47):3491–502. doi:10.1038/s41388-023-02853-w.
83. Liu X, Yu Y, Zhang J, Lu C, Wang L, Liu P, et al. HDAC1 Silencing in Ovarian Cancer Enhances the Chemotherapy Response. Cell Physiol Biochem. 2018;48(4):1505–18.doi:10.1159/000492260. Retraction in: Cell Physiol Biochem. 2024 Apr 30;58(2):199.doi:10.33594/000000698.
84. Coleridge SL, Bryant A, Kehoe S, Morrison J. Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer. Cochrane Database Syst Rev. 2021;2(2):CD005343. doi:10.1002/14651858.CD005343.pub5.
85. Gong K, Dong Y, Wang L, Duan Y, Yu J, Sun Y, et al. Nanoparticle BAF312@CaP-NP Overcomes Sphingosine-1-Phosphate Receptor-1-Mediated Chemoresistance Through Inhibiting S1PR1/P-STAT3 Axis in Ovarian Carcinoma. Int J Nanomedicine. 2020;15:5561–71. doi:10.2147/IJN.S248667.
86. Qiu JJ, Lin YY, Ye LC, Ding JX, Feng WW, Jin HY, et al. Overexpression of long non-coding RNA HOTAIR predicts poor patient prognosis and promotes tumor metastasis in epithelial ovarian cancer. Gynecol Oncol. 2014;134(1):121–8. doi:10.1016/j.ygyno.2014.03.556.
87. Baghal-Sadriforoush S, Bagheri M, Abdi Rad I, Sotoodeh Nejadnematalahi F. PI3K Inhibition Sensitize the Cisplatin-resistant Human Ovarian Cancer Cell OVCAR3 by Induction of Oxidative Stress. Rep Biochem Mol Biol. 2022;10(4):675–85. doi:10.52547/rbmb.10.4.675.
88. Della Pepa C, Tonini G, Santini D, Losito S, Pisano C, Di Napoli M, et al. Low grade serous ovarian carcinoma: from the molecular characterization to the best therapeutic strategy. Cancer Treat Rev. 2015;41(2):136–43. doi:10.1016/j.ctrv.2014.12.003.
89. Nuzzo PV, Berchuck JE, Korthauer K, Spisak S, Nassar AH, Abou Alaiwi S, et al. Detection of renal cell carcinoma using plasma and urine cell-free DNA methylomes. Nat Med. 2020;26(7):1041–3. doi:10.1038/s41591-020-0933-1.
90. Zhang D, Xu R, Huo T, Liu Y, Hao Z, Sun Y, et al. Perioperative management of a patient with unexpectedly detected early-stage ovarian mucinous carcinoma combined with progressive bulbar paralysis: A case report and literature review. BMC Womens Health. 2024;24(1):274.doi:10.1186/s12905-024-03117-9.
91. Johansen EL, Thusgaard CF, Thomassen M, Boonen SE, Jochumsen KM. Germline pathogenic variants associated with ovarian cancer: a historical overview. Gynecol Oncol Rep. 2022;44:101105.doi:10.1016/j.gore.2022.101105.
92. Halani D, Jaiswal A. Postmenopausal woman with 24 kilograms ovarian mucinous cystadenoma: a rare case report. Pan Afr Med J. 2023;44:42. doi:10.11604/pamj.2023.44.42.36942.
93. Andrikopoulou A, Zografos E, Apostolidou K, Kyriazoglou A, Papatheodoridi AM, Kaparelou M, et al. Germline and somatic variants in ovarian carcinoma: A next-generation sequencing (NGS) analysis. Front Oncol. 2022;12:1030786.doi:10.3389/fonc.2022.1030786.
94. Dilley J, Gentry-Maharaj A, Ryan A, Burnell M, Manchanda R, Kalsi J, et al. Ovarian cancer symptoms in pre-clinical invasive epithelial ovarian cancer - an exploratory analysis nested within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Gynecol Oncol. 2023;179:123–30. doi:10.1016/j.ygyno.2023.11.005. Kohn EC, Ivy SP. Whence high-grade serous ovarian cancer. Am Soc Clin Oncol Educ Book. 2017;37:443–8.doi:10.1200/EDBK_174718.
95. Gutiérrez-Enríquez S, Bonache S, de Garibay GR, Osorio A, Santamariña M, Ramón y Cajal T, et al. About 1% of the breast and ovarian Spanish families testing negative for BRCA1 and BRCA2 are carriers of RAD51D pathogenic variants. Int J Cancer. 2014;134(9):2088–97. doi:10.1002/ijc.28540.
96. Buckley DN, Lewinger JP, Gooden G, Spillman M, Neuman M, Guo XM, et al. OvaPrint-A Cell-free DNA Methylation Liquid Biopsy for the Risk Assessment of High-grade Serous Ovarian Cancer. Clin Cancer Res. 2023;29(24):5196–206. doi:10.1158/1078-0432.CCR-23-1197.
97. Lu Y, Beeghly-Fadiel A, Wu L, Guo X, Li B, Schildkraut JM, et al. A Transcriptome-Wide Association Study Among 97,898 Women to Identify Candidate Susceptibility Genes for Epithelial Ovarian Cancer Risk. Cancer Res. 2018;78(18):5419–30. doi:10.1158/0008-5472.CAN-18-0951.
98. Kansu B, Gardner J, Price-Tate R, Murch O, Murray A. BRCA gene testing in women with high-grade serous ovarian carcinoma. J Obstet Gynaecol. 2021;41(6):962–5. doi:10.1080/01443615.2020.1820466.
99. Markauskas A, Mogensen O, dePont Christensen R, Jensen PT. Primary surgery or interval debulking for advanced epithelial ovarian cancer: does it matter?. Int J Gynecol Cancer. 2014;24(8):1420–8. doi:10.1097/IGC.0000000000000241.
100. Zhang S, Dolgalev I, Zhang T, Ran H, Levine DA, Neel BG. Both fallopian tube and ovarian surface epithelium are cells-of-origin for high-grade serous ovarian carcinoma. Nat Commun. 2019;10(1):5367.doi:10.1038/s41467-019-13116-2.
101. Hiu S, Bryant A, Gajjar K, Kunonga PT, Naik R. Ultra-radical (extensive) surgery versus standard surgery for the primary cytoreduction of advanced epithelial ovarian cancer. Cochrane Database Syst Rev. 2022;8(8):CD007697. doi:10.1002/14651858.CD007697.pub3.
102. Contreras-Galindo R, Dube D, Fujinaga K, Kaplan MH, Markovitz DM. Susceptibility of human endogenous retrovirus type K to reverse transcriptase inhibitors. J Virol. 2017;91(23):e01309-17. doi:10.1128/JVI.01309-17.
103. Adler E, Mhawech-Fauceglia P, Gayther SA, Lawrenson K. PAX8 expression in ovarian surface epithelial cells. Hum Pathol. 2015;46(7):948–56. doi:10.1016/j.humpath.2015.03.017
104. Hardy LR, Pergande MR, Esparza K, Heath KN, Önyüksel H, Cologna SM, et al. Proteomic analysis reveals a role for PAX8 in peritoneal colonization of high-grade serous ovarian cancer that can be targeted with micelle encapsulated thiostrepton. Oncogene. 2019;38(32):6003–16. doi:10.1038/s41388-019-0842-2.
105. Rodgers LH, Ó hAinmhire E, Young AN, Burdette JE. Loss of PAX8 in high-grade serous ovarian cancer reduces cell survival despite unique modes of action in the fallopian tube and ovarian surface epithelium. Oncotarget. 2016;7(22):32785–95. doi:10.18632/oncotarget.9051.
106. Soong TR, Howitt BE, Miron A, Horowitz NS, Campbell F, Feltmate CM, et al. Evidence for lineage continuity between early serous proliferations (ESPs) in the Fallopian tube and disseminated high-grade serous carcinomas. J Pathol. 2018;246(3):344–51. doi:10.1002/path.5145.
107. Mao YN, Zeng LX, Li YH, Liu YZ, Wu JY, Li L, et al. Significance and expression of PAX8, PAX2, p53 and RAS in ovary and fallopian tubes to origin of ovarian high-grade serous carcinoma. Zhonghua Fu Chan Ke Za Zhi. 2017;52(10):687–96. doi:10.3760/cma.j.issn.0529-567X.2017.10.008.
108. Zhu S, Bao H, Zhang MC, Liu H, Wang Y, Lin C, et al. KAZN as a diagnostic marker in ovarian cancer: A comprehensive analysis based on microarray, mRNA-sequencing, and methylation data. BMC Cancer. 2022;22(1):662. doi:10.1186/s12885-022-09747-2.
109. Li L, Zheng H, Huang Y, Huang C, Zhang S, Tian J, et al. DNA methylation signatures and coagulation factors in the peripheral blood leucocytes of epithelial ovarian cancer. Carcinogenesis. 2017;38(8):797–805. doi:10.1093/carcin/bgx057.
110. Yang Y, Wu L, Shu X, Lu Y, Shu XO, Cai Q, et al. Genetic data from nearly 63,000 women of European descent predicts DNA methylation biomarkers and epithelial ovarian cancer risk. Cancer Res. 2019;79(3):505–17. doi:10.1158/0008-5472.CAN-18-2726.
111. Qiu JJ, Ye LC, Ding JX, Feng WW, Jin HY, Zhang Y, et al. Expression and clinical significance of estrogen-regulated long non-coding RNAs in estrogen receptor α-positive ovarian cancer progression. Oncol Rep. 2014;31(4):1613–22. doi:10.3892/or.2014.3000.
112. Widschwendter M, Zikan M, Wahl B, Lempiäinen H, Paprotka T, Evans I, et al. The potential of circulating tumor DNA methylation analysis for the early detection and management of ovarian cancer. Genome Med. 2017;9(1):116. doi:10.1186/s13073-017-0500-7.
113. Granato T, Porpora MG, Longo F, Angeloni A, Manganaro L, Anastasi E. HE4 in the differential diagnosis of ovarian masses. Clin Chim Acta. 2015;446:147–55. doi:10.1016/j.cca.2015.03.047.
114. Chen Y, Johnson JD, Jayamohan S, He Y, Venkata PP, Jamwal D, et al. KDM1A/LSD1 inhibition enhances chemotherapy response in ovarian cancer. Mol Carcinog. 2024;63(10):2026–39. doi:10.1002/mc.23792.
115. Olasinde A, Ogunlaja O, Olasinde YT, Mobolaji-Ojibara MU, Adelaja-Ojulari N. Giant Ovarian Cyst in a Term Pregnancy Simulating a Massive Ascites: A Case Report. Cureus. 2022;14(12):e33199. doi:10.7759/cureus.33199.
116. Akhras LN, Faroog S, AlSebay L. A 27-kg Giant Ovarian Mucinous Cystadenoma in a 72-Year-Old Postmenopausal Patient: A Case Report. Am J Case Rep. 2019;20:1601–6. doi:10.12659/AJCR.917490.
117. Oliveira DVNP, Biskup E, O’Rourke CJ, Hentze JL, Andersen JB, Høgdall C, et al. Developing a DNA Methylation Signature to Differentiate High-Grade Serous Ovarian Carcinomas from Benign Ovarian Tumors. Mol Diagn Ther. 2024;28(6):821–34. doi:10.1007/s40291-024-00740-y.
118. Banet N, Kurman RJ. Two types of ovarian cortical inclusion cysts: proposed origin and possible role in ovarian serous carcinogenesis. Int J Gynecol Pathol. 2015;34(1):3–8. doi:10.1097/PGP.0000000000000120.
119. Tang W, Jiang Y, Mu X, Xu L, Cheng W, Wang X. MiR-135a functions as a tumor suppressor in epithelial ovarian cancer and regulates HOXA10 expression. Cell Signal. 2014;26(7):1420–6. doi:10.1016/j.cellsig.2014.03.002.
120. Lu H, Liu Y, Wang J, Fu S, Wang L, Huang C, et al. Detection of ovarian cancer using plasma cell-free DNA methylomes. Clin Epigenetics. 2022;14(1):74. doi:10.1186/s13148-022-01285-9.
121. Pisanic TR 2nd, Wang Y, Sun H, Considine M, Li L, Wang TH, et al. Methylomic landscapes of ovarian cancer precursor lesions. Clin Cancer Res. 2020;26(23):6310–20. doi:10.1158/1078-0432.CCR-20-0270.
122. Marinelli LM, Kisiel JB, Slettedahl SW, Mahoney DW, Lemens MA, Shridhar V, et al. Methylated DNA markers for plasma detection of ovarian cancer: Discovery, validation, and clinical feasibility. Gynecol Oncol. 2022;165(3):568–76. doi:10.1016/j.ygyno.2022.03.018.
123. Liberto JM, Chen SY, Shih IM, Wang TH, Wang TL, Pisanic TR 2nd. Current and Emerging Methods for Ovarian Cancer Screening and Diagnostics: A Comprehensive Review. Cancers (Basel). 2022;14(12):2885. doi:10.3390/cancers14122885.
124. Frąszczak K, Barczyński B. The Role of Cancer Stem Cell Markers in Ovarian Cancer. Cancers (Basel). 2023;16(1):40. doi:10.3390/cancers16010040.
125. Bryant A, Hiu S, Kunonga PT, Gajjar K, Craig D, Vale L, et al. Impact of residual disease as a prognostic factor for survival in women with advanced epithelial ovarian cancer after primary surgery. Cochrane Database Syst Rev. 2022;9(9):CD015048. doi:10.1002/14651858.CD015048.pub2.
126. Muinao T, Deka Boruah HP, Pal M. Diagnostic and Prognostic Biomarkers in ovarian cancer and the potential roles of cancer stem cells - An updated review. Exp Cell Res. 2018;362(1):1–10. doi:10.1016/j.yexcr.2017.10.018.
127. Sheng X, Li J, Yang L, Chen Z, Zhao Q, Tan L, et al. Promoter hypermethylation influences the suppressive role of maternally expressed 3, a long non-coding RNA, in the development of epithelial ovarian cancer. Oncol Rep. 2014;32(1):277–85. doi:10.3892/or.2014.3208.
128. Yaqing X, Yang G, Linlin Y, Youqing R, Henghui Y, Ping Y, et al. Identification of different subtypes of ovarian cancer and construction of prognostic models based on glutamine-metabolism associated genes. Heliyon. 2024;10(6). doi:10.1186/s13048-024-01526-w.
129. Niazi P. Isolation and Characterization of a (Surfactin-Like Molecule) Produced by Bacillus subtilis: Antagonistic Impact on Root-Knot Nematodes. Sci Res Commun. 2024;4(2). doi:10.52460/src.2024.010.
130. Horackova K, Zemankova P, Nehasil P, Vocka M, Hovhannisyan M, Matejkova K, et al. A comprehensive analysis of germline predisposition to early-onset ovarian cancer. Sci Rep. 2024;14(1):16183. doi:10.1038/s41598-024-66324-2.
131. Koczkowska M, Krawczynska N, Stukan M, Kuzniacka A, Brozek I, Sniadecki M, et al. Spectrum and prevalence of pathogenic variants in ovarian cancer susceptibility genes in a group of 333 patients. Cancers. 2018;10(11):442. doi:10.3390/cancers10110442.
132. McCuaig JM, Care M, Ferguson SE, Kim RH, Stockley TL, Metcalfe KA. Year 1: Experiences of a tertiary cancer centre following implementation of reflex BRCA1 and BRCA2 tumor testing for all high-grade serous ovarian cancers in a universal healthcare system. Gynecol Oncol. 2020;158(3):747–53. doi:10.1016/j.ygyno.2020.06.507.
133. Przybytkowski E, Davis T, Hosny A, Eismann J, Matulonis UA, Wulf GM, et al. An immune-centric exploration of BRCA1 and BRCA2 germline mutation-related breast and ovarian cancers. BMC Cancer. 2020;20(1):197. doi:10.1186/s12885-020-6605-1.
134. Eoh KJ, Kim HM, Lee JY, Kim S, Kim SW, Kim YT, et al. Mutation landscape of germline and somatic BRCA1/2 in patients with high-grade serous ovarian cancer. BMC Cancer. 2020;20(1):204. doi:10.1186/s12885-020-6693-y.
135. Maksimenko J, Irmejs A, Trofimovičs G, Bērziņa D, Skuja E, Purkalne G, et al. High frequency of pathogenic non-founder germline mutations in BRCA1 and BRCA2 in families with breast and ovarian cancer in a founder population. Hered Cancer Clin Pract. 2018;16:12. doi:10.1186/s13053-018-0094-0.
136. Graffeo R, Livraghi L, Pagani O, Goldhirsch A, Partridge AH, Garber JE. Time to incorporate germline multigene panel testing into breast and ovarian cancer patient care. Breast Cancer Res Treat. 2016;160(3):393–410. doi:10.1007/s10549-016-4003-9.
137. Pietragalla A, Arcieri M, Marchetti C, Scambia G, Fagotti A. Ovarian cancer predisposition beyond BRCA1 and BRCA2 genes. Int J Gynecol Cancer. 2020;30(11):1803–10. doi:10.1136/ijgc-2020-001556.
138. Poveda AM, Davidson R, Blakeley C, Milner A. Olaparib maintenance monotherapy in platinum-sensitive, relapsed ovarian cancer without germline BRCA mutations: OPINION Phase IIIb study design. Future Oncol. 2019;15(32):3651–63. doi:10.2217/fon-2019-0343.
139. Soukupová J, Lhotová K, Zemánková P, Vočka M, Janatová M, Stolařová L, et al. Contribution of massive parallel sequencing to diagnosis of hereditary ovarian cancer in the Czech Republic. Klin Onkol. 2019;32(Suppl 2):72–8. doi:10.14735/amko2019S72.
140. Öfverholm A, Törngren T, Rosén A, Arver B, Einbeigi Z, Haraldsson K, et al. Extended genetic analysis and tumor characteristics in over 4600 women with suspected hereditary breast and ovarian cancer. BMC Cancer. 2023;23(1):738. doi:10.1186/s12885-023-11229-y.
141. Gadducci A, Guarneri V, Peccatori FA, Ronzino G, Scandurra G, Zamagni C, et al. Current strategies for the targeted treatment of high-grade serous epithelial ovarian cancer and relevance of BRCA mutational status. J Ovarian Res. 2019;12(1):9. doi:10.1186/s13048-019-0484-6.
142. Škapa P, Dundr P. Onkopatologické aspekty inaktivace genů BRCA1 a BRCA2 v nádorech ovaria, děložní tuby a pánevního peritonea (Oncopathological aspects of BRCA1 and BRCA2 genes inactivation in tumors of ovary, fallopian tube and pelvic peritoneum). Cesk Patol. 2016;52(4):199–204.
143. Weber-Lassalle N, Hauke J, Ramser J, Richters L, Groß E, Blümcke B, et al. BRIP1 loss-of-function mutations confer high risk for familial ovarian cancer, but not familial breast cancer. Breast Cancer Res. 2018;20(1):7. doi:10.1186/s13058-018-0935-9.
144. Weber-Lassalle N, Borde J, Weber-Lassalle K, Horváth J, Niederacher D, Arnold N, et al. Germline loss-of-function variants in the BARD1 gene are associated with early-onset familial breast cancer but not ovarian cancer. Breast Cancer Res. 2019;21(1):55. doi:10.1186/s13058-019-1137-9.
145. Flaum N, van Veen EM, Smith O, Amico S, Newman WG, Crosbie EJ, et al. Dominant-negative pathogenic variant BRIP1 c.1045G>C is a high-risk allele for non-mucinous epithelial ovarian cancer: A case-control study. Clin Genet. 2022;101(1):48–54. doi:10.1111/cge.14068.
146. Nurmi A, Muranen TA, Pelttari LM, Kiiski JI, Heikkinen T, Lehto S, et al. Recurrent moderate-risk mutations in Finnish breast and ovarian cancer patients. Int J Cancer. 2019;145(10):2692–700. doi:10.1002/ijc.32309.
147. Moyer CL, Ivanovich J, Gillespie JL, Doberstein R, Radke MR, Richardson ME, et al. Rare BRIP1 Missense Alleles Confer Risk for Ovarian and Breast Cancer. Cancer Res. 2020;80(4):857–67. doi:10.1158/0008-5472.CAN-19-1991.
148. Janatova M, Soukupova J, Stribrna J, Kleiblova P, Vocka M, Boudova P, et al. Mutation analysis of the RAD51C and RAD51D genes in high-risk ovarian cancer patients and families from the Czech Republic. PLoS One. 2015;10(6):e0127711. doi:10.1371/journal.pone.0127711.
149. Lax SF. Familiäres Mamma- und Ovarialkarzinom (Hereditary breast and ovarian cancer). Pathologe. 2017;38(3):149–55. doi:10.1007/s00292-017-0298-5.
150. Foretová L, Navrátilová M, Svoboda M, Vašíčková P, Sťahlová EH, Házová J, et al. Recommendations for Preventive Care for Women with Rare Genetic Cause of Breast and Ovarian Cancer. Klin Onkol. 2019;32(Suppl2):6–13. doi:10.14735/amko2019S6.
151. Omar A, Marques N, Crawford N. Cancer and HIV: The Molecular Mechanisms of the Deadly Duo. Cancers. 2024;16(3):546. doi:10.3390/cancers16030546.
152. Isaguliants M, Bayurova E, Avdoshina D, Kondrashova A, Chiodi F, Palefsky JM. Oncogenic effects of HIV-1 proteins, mechanisms behind. Cancers. 2021;13(2):305. doi:10.3390/cancers13020305.
153. American Cancer Society. Viruses that can lead to cancer (Internet). 2025 (cited 2025 Mar 15). Available from: https://www.cancer.org
154. Shen J, Liu T, Bei Q, Xu S. Comprehensive landscape of ovarian cancer immune microenvironment based on integrated multi-omics analysis. Front Oncol. 2021;11:685065. doi:10.3389/fonc.2021.685065.
155. Basnet S, Van der Heijden M, Quixabeira DCA, Jirovec E, Grönberg-Vähä-Koskela SAM, Clubb JHA, et al. Overcoming effector T cell exhaustion in ovarian cancer ascites with a novel adenovirus encoding for a MUC1 bispecific antibody engager and IL-2 cytokine. Mol Ther. 2024;32(9):3114–27. doi:10.1016/j.ymthe.2024.06.029.
156. Lee A, Kang J, Lee H, Lee YS, Choi YJ, Lee KH, et al. BRCA1/2 somatic mutation detection in formalin-fixed paraffin-embedded tissue by next-generation sequencing in Korean ovarian cancer patients. Pathol Res Pract. 2019;215(11):152595. doi:10.1016/j.prp.2019.152595.
157. Takaya H, Nakai H, Takamatsu S, Mandai M, Matsumura N. Homologous recombination deficiency status-based classification of high-grade serous ovarian carcinoma. Sci Rep. 2020;10(1):2757. doi:10.1038/s41598-020-59671-3.
158. Guffanti F, Mengoli I, Damia G. Current HRD assays in ovarian cancer: differences, pitfalls, limitations, and novel approaches. Front Oncol. 2024;14:1405361. doi:10.3389/fonc.2024.1405361.
159. Abe A, Imoto I, Ueki A, Nomura H, Kanao H. Moderate-Risk Genes for Hereditary Ovarian Cancers Involved in the Homologous Recombination Repair Pathway. Int J Mol Sci. 2022;23(19):11790. doi:10.3390/ijms231911790.
160. Mustanski B, Ryan DT, Remble TA, D’Aquila RT, Newcomb ME, Morgan E. Discordance of Self-report and Laboratory Measures of HIV Viral Load Among Young Men Who Have Sex with Men and Transgender Women in Chicago: Implications for Epidemiology, Care, and Prevention. AIDS Behav. 2018;22(7):2360–7. doi:10.1007/s10461-018-2112-7.
161. Gandhi RT, Bedimo R, Hoy JF, Landovitz RJ, Smith DM, Eaton EF, et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2022 recommendations of the International Antiviral Society–USA panel. JAMA. 2023;329(1):63–84.
162. Niazi P, Alimyar O, Azizi A, Monib AW, Ozturk H. People-plant Interaction: Plant Impact on Humans and Environment. J Environ Agric Stud. 2023;4(2):1–7. doi:10.32996/jeas.2023.4.2.1.
163. Trivedi S, Srivastava A, Saxena D, Ali D, Alarifi S, Solanki VS, et al. Phytofabrication of silver nanoparticles by using Cucurbita maxima leaf extract and its potential anticancer activity and pesticide degradation. Mater Technol. 2025;40(1):2440907. doi:10.1080/10667857.2024.2440907
164. Rihana N, Nanjappa S, Sullivan C, Velez AP, Tienchai N, Greene JN. Malignancy trends in HIV-infected patients over the past 10 years in a single-center retrospective observational study in the United States. Cancer Control. 2018;25(1):1073274818797955. doi:10.1177/1073274818797955.
165. Mortaz E, Tabarsi P, Mansouri D, Khosravi A, Garssen J, Velayati A, et al. Cancers Related to Immunodeficiencies: Update and Perspectives. Front Immunol. 2016;7:365. doi:10.3389/fimmu.2016.00365.
166. Chao A, Chang TC, Lapke N, Jung SM, Chi P, Chen CH, et al. Prevalence and clinical significance of BRCA1/2 germline and somatic mutations in Taiwanese patients with ovarian cancer. Oncotarget. 2016;7(51):85529–41. doi:10.18632/oncotarget.13456.
167. Cheng Z, Ennis DP, Lu B, Mirza HB, Sokota C, Kaur B, et al. The genomic trajectory of ovarian high-grade serous carcinoma can be observed in STIC lesions. J Pathol. 2024;264(1):42–54. doi:10.1002/path.6322.
168. Gill SE, McGree ME, Weaver AL, Cliby WA, Langstraat CL. Optimizing the treatment of ovarian cancer: Neoadjuvant chemotherapy and interval debulking versus primary debulking surgery for epithelial ovarian cancers likely to have suboptimal resection. Gynecol Oncol. 2017;144(2):266–73. doi:10.1016/j.ygyno.2016.11.021.
169. Yadav VK, Pramanik S, Alghamdi S, Atwah B, Qusty NF, Babalghith AO, et al. Therapeutic innovations in nanomedicine: Exploring the potential of magnetotactic bacteria and bacterial magnetosomes. Int J Nanomedicine. 2025;20:403–44. doi:10.2147/IJN.S462031.
170. Kapper C, Oppelt P, Arbeithuber B, Gyunesh AA, Vilusic I, Stelzl P, et al. Targeting ferroptosis in ovarian cancer: Novel strategies to overcome chemotherapy resistance. Life Sci. 2024;349:122720. doi:10.1016/j.lfs.2024.122720.
171. Singh DN, Daripelli S, Elamin Bushara MO, Polevoy GG, Prasanna M. Genetic Testing for Successful Cancer Treatment. Cureus. 2023;15(12):e49889. doi:10.7759/cureus.49889.
172. Coleman RL, Brady MF, Herzog TJ, Sabbatini P, Armstrong DK, Walker JL, et al. Bevacizumab and paclitaxel-carboplatin chemotherapy and secondary cytoreduction in recurrent, platinum-sensitive ovarian cancer (NRG Oncology/Gynecologic Oncology Group study GOG-0213): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2017;18(6):779–91. doi:10.1016/S1470-2045(17)30279-6.
173. Bugide S, Gonugunta VK, Penugurti V, Malisetty VL, Vadlamudi RK, Manavathi B. HPIP promotes epithelial-mesenchymal transition and cisplatin resistance in ovarian cancer cells through PI3K/AKT pathway activation. Cell Oncol. 2017;40(2):133–44. doi:10.1007/s13402-016-0308-2.
174. Shi T, Zhu J, Feng Y, Tu D, Zhang Y, Zhang P, et al. Secondary cytoreduction followed by chemotherapy versus chemotherapy alone in platinum-sensitive relapsed ovarian cancer (SOC-1): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2021;22(4):439–49. doi:10.1016/S1470-2045(21)00006-1.
175. Dos Santos Guimarães I, Ladislau-Magescky T, Tessarollo NG, Dos Santos DZ, Gimba ERP, Sternberg C, et al. Chemosensitizing effects of metformin on cisplatin- and paclitaxel-resistant ovarian cancer cell lines. Pharmacol Rep. 2018;70(3):409–17. doi:10.1016/j.pharep.2017.11.007.
176. Pignata S, Lorusso D, Joly F, Gallo C, Colombo N, Sessa C, et al. Carboplatin-based doublet plus bevacizumab beyond progression versus carboplatin-based doublet alone in patients with platinum-sensitive ovarian cancer: a randomised, phase 3 trial. Lancet Oncol. 2021;22(2):267–76. doi:10.1016/S1470-2045(20)30637-9.
177. Miller RE, Leary A, Scott CL, Serra V, Lord CJ, Bowtell D, et al. ESMO recommendations on predictive biomarker testing for homologous recombination deficiency and PARP inhibitor benefit in ovarian cancer. Ann Oncol. 2020;31(12):1606–22. doi:10.1016/j.annonc.2020.08.2102.
178. Coleridge SL, Bryant A, Kehoe S, Morrison J. Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced ovarian epithelial cancer. Cochrane Database Syst Rev. 2021;7(7):CD005343. doi:10.1002/14651858.CD005343.pub6.
179. Paulo P, Cardoso M, Brandão A, Pinto P, Falconi A, Pinheiro M, et al. Genetic landscape of homologous recombination repair genes in early-onset/familial prostate cancer patients. Genes Chromosomes Cancer. 2023;62(12):710–20. doi:10.1002/gcc.23190.
180. Visvanathan K, Shaw P, May BJ, Bahadirli-Talbott A, Kaushiva A, Risch H, et al. Fallopian tube lesions in women at high risk for ovarian cancer: A multicenter study. Cancer Prev Res (Phila). 2018;11(11):697–706. doi:10.1158/1940-6207.CAPR-18-0009.
181. Tassi RA, Todeschini P, Siegel ER, Calza S, Cappella P, Ardighieri L, et al. FOXM1 expression is significantly associated with chemotherapy resistance and adverse prognosis in non-serous epithelial ovarian cancer patients. J Exp Clin Cancer Res. 2017;36(1):63. doi:10.1186/s13046-017-0536-y.
182. Oza AM, Cibula D, Benzaquen AO, Poole C, Mathijssen RH, Sonke GS, et al. Olaparib combined with chemotherapy for recurrent platinum-sensitive ovarian cancer: a randomised phase 2 trial. Lancet Oncol. 2015;16(1):87–97. doi:10.1016/S1470-2045(14)71135-0.
183. Lei SM, Liu X, Xia LP, Ke Y, Wei LW, Li L, et al. Relationships between decreased LAMC3 and poor prognosis in ovarian cancer. Zhonghua Fu Chan Ke Za Zhi. 2021;56(7):489–97. doi:10.3760/cma.j.cn112141-20210426-00230.
184. Gonzalez-Pastor R, Goedegebuure PS, Curiel DT. Understanding and addressing barriers to successful adenovirus-based virotherapy for ovarian cancer. Cancer Gene Ther. 2021;28(5):375–89. doi:10.1038/s41417-020-00227-y.
185. Sohn MH, Kim SI, Shin JY, Kim HS, Chung HH, Kim JW, et al. Classification of high-grade serous ovarian carcinoma by epithelial-to-mesenchymal transition signature and homologous recombination repair genes. Genes. 2021;12(7):1103. doi:10.3390/genes12071103.
186. Lawrenson K, Fonseca MAS, Liu AY, Segato Dezem F, Lee JM, Lin X, et al. A study of high-grade serous ovarian cancer origins implicates the SOX18 transcription factor in tumor development. Cell Rep. 2019;29(11):3726–35.e4. doi:10.1016/j.celrep.2019.10.122.
187. Zhang J, Liu L, Sun Y, Xiang J, Zhou D, Wang L, et al. MicroRNA-520g promotes epithelial ovarian cancer progression and chemoresistance via DAPK2 repression. Oncotarget. 2016;7(18):26516–34. doi:10.18632/oncotarget.8530.
188. Skorupa A, Klimek M, Ciszek M, Pakuło S, Cichoń T, Cichoń B, et al. Metabolomic analysis of histological composition variability of high-grade serous ovarian cancer using 1H HR MAS NMR spectroscopy. Int J Mol Sci. 2024;25(20):10903. doi:10.3390/ijms252010903.
189. Neesham D, Richards A, McGauran M. Advances in epithelial ovarian cancer. Aust J Gen Pract. 2020;49(10):665–9. doi:10.31128/AJGP-09-19-5098.
190. Peters PN, Whitaker RS, Lim F, Russell S, Bloom EA, Pollara J, et al. Oncolytic adenovirus MEM-288 induces an anti-tumor immune response in high grade serous ovarian cancer. Neoplasia. 2024;57:101056. doi:10.1016/j.neo.2024.101056.
191. Torres HA, Mulanovich V. Management of HIV infection in patients with cancer receiving chemotherapy. Clin Infect Dis. 2014;59(1):106–14. doi:10.1093/cid/ciu174.
192. Kuanyshkaliyeva A, Igissinov N, Turgambayeva A. Estimation of the change of ovarian cancer incidence in Kazakhstan: Component analysis of its dynamics with the consideration of ethnic features. Iran J Public Health. 2016;45(8):1012–9.
193. Viviano M, DeBeaudrap P, Tebeu PM, Fouogue JT, Vassilakos P, Petignat P. A review of screening strategies for cervical cancer in human immunodeficiency virus-positive women in sub-Saharan Africa. Int J Womens Health. 2017;9:69–79. doi:10.2147/IJWH.S103868.
194. Ghebre RG, Grover S, Xu MJ, Chuang LT, Simonds H. Cervical cancer control in HIV-infected women: Past, present and future. Gynecol Oncol Rep. 2017;21:101–8. doi:10.1016/j.gore.2017.07.009.
195. Hirasawa A, Imoto I, Naruto T, Akahane T, Yamagami W, Nomura H, et al. Prevalence of pathogenic germline variants detected by multigene sequencing in unselected Japanese patients with ovarian cancer. Oncotarget. 2017;8(68):112258–67. doi:10.18632/oncotarget.22733.
196. Dareng EO, Coetzee SG, Tyrer JP, Peng PC, Rosenow W, Chen S, et al. Integrative multi-omics analyses to identify the genetic and functional mechanisms underlying ovarian cancer risk regions. Am J Hum Genet. 2024;111(6):1061–83. doi:10.1016/j.ajhg.2024.04.011.
197. Heitz F, Marth C, Henry S, Reuss A, Cibula D, Gaba Garcia L, et al. AGO-OVAR 28/ENGOT-ov57. Niraparib alone versus niraparib in combination with bevacizumab in patients with carboplatin-taxane-based chemotherapy in advanced ovarian cancer: a multicenter randomized phase III trial. Int J Gynecol Cancer. 2023;33(12):1966–9. doi:10.1136/ijgc-2023-004944.
198. Perna A, Lucariello A, Sellitto C, Agliata I, Carleo MA, Sangiovanni V, et al. Different Cell Cycle Modulation in SKOV-3 Ovarian Cancer Cell Line by Anti-HIV Drugs. Oncol Res. 2017;25(9):1617–24. doi:10.3727/096504017X14905635363102.
199. Nakamura K, Terai Y, Tanabe A, Ono YJ, Hayashi M, Maeda K, et al. CD24 expression is a marker for predicting clinical outcome and regulates the epithelial-mesenchymal transition in ovarian cancer via both the Akt and ERK pathways. Oncol Rep. 2017;37(6):3189–200. doi:10.3892/or.2017.5583.
200. Cai D, Liu T, Fang J, Liu Y. Molecular cluster mining of high-grade serous ovarian cancer via multi-omics data analysis aids precise medicine. J Cancer Res Clin Oncol. 2023;149(11):9151–65. doi:10.1007/s00432-023-04831-x.
201. Baseer AQ, Usmani A, Mushfiq S, Hassand MH, Rahimi BA, Monib AW, et al. Assessment of hand hygiene practices among nurses at a regional hospital in Kandahar, Afghanistan: A cross-sectional study based on the World Health Organization (WHO) ‘Your 5 Moments for Hand Hygiene’ guidelines. Belitung Nurs J. 2025;11(1):83. doi:10.33546/bnj.3460.
202. Tao Y, Li H, Huang R, Mo D, Zeng T, Fang M, et al. Clinicopathological and prognostic significance of cancer stem cell markers in ovarian cancer patients: Evidence from 52 studies. Cell Physiol Biochem. 2018;46(4):1716–26. doi:10.1159/000489586.
203. Liang L, Zhang Y, Li C, Liao Y, Wang G, Xu J, et al. Plasma cfDNA methylation markers for the detection and prognosis of ovarian cancer. EBioMedicine. 2022;83:104222. doi:10.1016/j.ebiom.2022.104222.
204. Sihombing UHM, Andrijono A, Purwoto G, Gandamihardja S, Harahap AR, Rustamadji P, et al. CD44+/CD24- Expression as predictors of ovarian cancer chemoresistance: immunohistochemistry and flow cytometry study. J Egypt Natl Cancer Inst. 2022;34(1):44. doi:10.1186/s43046-022-00143-2.
205. Han SA, Jang JH, Won KY, Lim SJ, Song JY. Prognostic value of putative cancer stem cell markers (CD24, CD44, CD133, and ALDH1) in human papillary thyroid carcinoma. Pathol Res Pract. 2017;213(8):956–63. doi:10.1016/j.prp.2017.05.002.
206. Tumiati M, Hietanen S, Hynninen J, Pietilä E, Färkkilä A, Kaipio K, et al. A functional homologous recombination assay predicts primary chemotherapy response and long-term survival in ovarian cancer patients. Clin Cancer Res. 2018;24(18):4482–93. doi:10.1158/1078-0432.CCR-17-3770.
207. Zhang R, Chen X, Fu S, Xu L, Lin J. A small molecule STAT3 inhibitor, LLL12, enhances cisplatin and paclitaxel mediated inhibition of cell growth and migration in human ovarian cancer cells. Oncol Rep. 2020;44(3):1224–32. doi:10.3892/or.2020.7667.
208. Zhao RJ, Wang YY, Li Z, Wu KY, Kong LF, Zheng WX. Morphologic features of fallopian tubal epithelium in pelvic high-grade serous carcinoma. Zhonghua Bing Li Xue Za Zhi. 2017;46(8):542–7. doi:10.3760/cma.j.issn.0529-5807.2017.08.005.
209. Hosseini A, Minucci S. A comprehensive review of lysine-specific demethylase 1 and its roles in cancer. Epigenomics. 2017;9(8):1123–42. doi:10.2217/epi-2017-0022.
210. Si Y, Song N, Ji Y. Construction of a nomogram model for predicting the outcome of debulking surgery for ovarian cancer on the basis of clinical indicators. Front Oncol. 2024;14:1421247. doi:10.3389/fonc.2024.1421247.
211. Kobal B, Noventa M, Cvjeticanin B, Barbic M, Meglic L, Herzog M, et al. Primary debulking surgery versus primary neoadjuvant chemotherapy for high-grade advanced-stage ovarian cancer: Comparison of survivals. Radiol Oncol. 2018;52(3):307–19. doi:10.2478/raon-2018-0030.
212. Fagotti A, Ferrandina G, Vizzielli G, Fanfani F, Gallotta V, Chiantera V, et al. Phase III randomised clinical trial comparing primary surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer with high tumour load (SCORPION trial): Final analysis of peri-operative outcome. Eur J Cancer. 2016;59:22–33. doi:10.1016/j.ejca.2016.01.017.
213. Margul D, Yu C, AlHilli MM. Tumor Immune Microenvironment in Gynecologic Cancers. Cancers (Basel). 2023;15(15):3849. doi:10.3390/cancers15153849.
214. Puronen CE, Ford ES, Uldrick TS. Immunotherapy in people with HIV and cancer. Front Immunol. 2019;10:2060. doi:10.3389/fimmu.2019.02060.
215. Li X, Ng ASN, Mak VCY, Chan KKL, Cheung ANY, Cheung LWT. Strategic Combination Therapies for Ovarian Cancer. Curr Cancer Drug Targets. 2020;20(8):573–85. doi:10.2174/1568009620666200511084007.
216. Herzog TJ, Monk BJ. Bringing new medicines to women with epithelial ovarian cancer: what is the unmet medical need? Gynecol Oncol Res Pract. 2017;4:13. doi:10.1186/s40661-017-0050-0.
217. Clifford C, Vitkin N, Nersesian S, Reid-Schachter G, Francis JA, Koti M. Multi-omics in high-grade serous ovarian cancer: biomarkers from genome to the immunome. Am J Reprod Immunol. 2018;80(2):e12975. doi:10.1111/aji.12975.
218. Li W, Ma H, Zhang J, Zhu L, Wang C, Yang Y. Unraveling the roles of CD44/CD24 and ALDH1 as cancer stem cell markers in tumorigenesis and metastasis. Sci Rep. 2017;7(1):13856. doi:10.1038/s41598-017-14364-2.
219. Song M, Cui M, Liu K. Therapeutic strategies to overcome cisplatin resistance in ovarian cancer. Eur J Med Chem. 2022;232:114205. doi:10.1016/j.ejmech.2022.114205.
220. Chung VY, Tan TZ, Huang RL, Lai HC, Huang RY. Loss of discoidin domain receptor 1 (DDR1) via CpG methylation during EMT in epithelial ovarian cancer. Gene. 2017;635:9–15. doi:10.1016/j.gene.2017.09.001.
221. Gong S, Chen Y, Zhang Y, Li C, Jiang Q. Comparison of serum cancer antigen 125, human epididymis protein 4, ROMA, and CPH-I for diagnosis of ovarian cancer in Chinese patients with ovarian mass. J South Med Univ. 2019;39(12):1393–401. doi:10.12122/j.issn.1673-4254.2019.12.02.
222. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Clinicalinfo.HIV.gov; 2025. Available from: https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv/initiation-of-antiretroviral-therapy