'Triple negative' epithelial ovarian cancer and pathologic markers for prognosis

To summarize the recent evidence for 'triple negative' epithelial ovarian cancer (TNEOC), characterized by lack of expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor type 2 (HER2), and to discuss its potential pathologic markers for prognosis and targeted therapy.

'Triple negative' phenotype is traditionally referred to as a specific subtype of breast cancer negative for estrogen receptor, progesterone receptor and HER2 expression. Recent studies have shown that such 'triple negative' phenotype also exists in ovarian and endometrial cancer. TNEOC accounts for about 15% of epithelial ovarian carcinoma. This specific subtype tends to exhibit more aggressive characteristics and a worse prognosis. The molecular features of TNEOC are similar to those of 'triple negative' breast cancer (TNBC), a widely studied histological subtype. Recently, a panel of specific pathologic biomarkers has been identified in TNBC. Currently, phase I and phase II trials to examine the safety and efficacy of a poly (ADP-ribose) polymerase inhibitor (olaparib) and angiogenesis inhibitors (sunitinib and bevacizumab) in TNBC are ongoing. These TNBC-associated pathologic markers could be used to screen for novel prognostic factors and therapeutic targets in TNEOC.

'Triple negative' phenotype has important implications for clinical management of patients with ovarian cancer.