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Neoadjuvant chemotherapy for epithelial ovarian cancer--role of apoptosis

Tania Dutta1, Himani Sharma, Lalit Kumar

  • 1Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Cancer Chemotherapy and Pharmacology
|May 21, 2005
PubMed
Abstract

Insights

Chemotherapy for ovarian cancer increases apoptosis by reducing Bcl-2 and survivin, independent of p53. More cycles of neoadjuvant chemotherapy may be more effective in inducing apoptosis.

Area of Science:

  • Gynecologic Oncology
  • Cancer Biology
  • Molecular Medicine

Background:

  • Epithelial ovarian cancer is a leading cause of gynecological cancer mortality, often diagnosed at advanced stages.
  • Tumor progression is driven by uncontrolled cell growth and resistance to apoptosis.
  • The impact of chemotherapy on apoptosis-related molecular markers in ovarian cancer remains unclear.

Purpose of the Study:

  • To compare the expression of proapoptotic (p53, p73) and antiapoptotic (Bcl-2, Bcl-XL, survivin) proteins in ovarian cancer patients.
  • To evaluate the effect of two different chemotherapy regimens on these apoptosis markers.

Main Methods:

  • 24 untreated epithelial ovarian cancer patients were randomized into two groups.
  • Patients received either 3 cycles chemotherapy pre/post-surgery or 6 cycles pre-surgery.
  • Apoptosis markers were analyzed using Western blotting, immunohistochemistry, and TUNEL assay.

Main Results:

  • Chemotherapy decreased antiapoptotic Bcl-2 and survivin, increasing the apoptotic index.
  • No significant change was observed in Bcl-XL expression.
  • A decrease in proapoptotic p53 was noted; p73 was not expressed. Findings were similar between groups.

Conclusions:

  • Chemotherapy induces apoptosis in ovarian cancer via a p53-independent pathway, downregulating Bcl-2 and survivin.
  • Six cycles of neoadjuvant chemotherapy appear more effective in inducing apoptosis than three cycles.
  • Larger studies are needed to confirm these findings.

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