World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website


Volume 12, Number 4, August 2021, pages 85-92

Personalized Medicine in Ovarian Cancer: A Perspective From Mexico


Figure 1.
Figure 1. Key features of OC. (a) Associated factors. (b) Treatment options. (c) OC FIGO staging. OC: ovarian cancer.


Table 1. OC in Numbers in Mexico and the World According to Globocan 2018


Table 2. Milestones in PM of OC
ADAMTS: A disintegrin and metalloproteinase with thrombospondin motifs; AHT: adjuvant hormone therapy; AKT: protein kinase B; ARID1A: AT-rich interaction domain 1A; CA-125: cancer antigen-125; DNA: deoxyribonucleic acid; EZH2: enhancer of Zeste homolog 2; GWAS: genome-wide association study; HE4: human epididymis protein 4; HGSC: high-grade serous ovarian cancer; miRNA: microribonucleic acid; MOC: mucinous ovarian carcinoma; mTOR: mammalian target of rapamycin; OC: ovarian cancer; OCSI: Ovarian Cancer Symptom Index; OS: overall survival; PARP: poly (ADP-ribose) polymerase; PIK3CA: p110α subunit of phosphatidylinositol 3-kinase; PM: personalized medicine; ROCA: risk of ovarian cancer algorithm; VEGF: vascular endothelial growth factor.
2007VEGF-targeted therapy showed to be effective in the treatment of OC.[9]
2007OC screening calculated the OC risk of an individual by analyzing serial CA-125 values via ROCA and made it possible to choose the right dose of medication.[10]
2007The OCSI was created, anticipating being useful for early diagnosis and in this way improving personalized treatments.[11]
2008Biomarkers for OC, like HE4, were shown to be over-expressed in epithelial OC. Examining values of 11 markers showed that the combination of HE4 and CA-125 had the highest predictive value of this study.[12]
2008Screening OC patients for BRCA mutations allowed a new personalized treatment with a PARP inhibitor (AZD2281 blocks the pathway used by BRCA mutated cells to repair DNA damage).[13]
2010Use of bevacizumab as the leading molecular targeted agent for OC. Identification of biomarkers to select patients for bevacizumab treatment became an advance because it was well tolerated.[14]
2011DICER1 mutations were found in non-epithelial ovarian tumors. Aberrant miRNA processing resulted from DICER1 could be a specific feature in the development of certain types of non-epithelial OC.[15]
2010PIK3CA mutations could predict response to PI3K/AKT/mTOR inhibitors. PIK3CA mutations are known to be common in 12% of OC.[16]
2010Introduction of neoadjuvant chemotherapy in OC: right therapy to the right person.[17]
2015The first genetic map of how HGSC evolves in response to chemotherapy was created. At least four molecular events were associated with acquired resistance.[18]
2015ADAMTS mutations were found as a possible predictor of chemosensitivity in OC without BRCA1 or BRCA2 mutations.[19]
2015A GWAS for MOC identified three risk associations at 2q13, 2q31.1 and 19q13.2.[20]
2015The relation between EZH2 and ARID1A is a potentially effective treatment target for ovarian clear cell carcinoma, where < 50% of ARID1A is mutated and shows a low response to platinum-based chemotherapy.[21]
2015BRCAs mutations were detected in 28% of samples of OC cases.[22]
2016AHT after surgery becomes a personalized medicine approach for helping extend the OS of the patients with OC.[23]
2016Development of a cancer therapy program using integrative genomic data. Therapeutic recommendations were made after considering the genetic and genomic alterations profiles.[24]
2016Four commercial tools were compared to identify therapeutic recommendations for a given genetic mutation in cancers.[25]
2018A total of 180 BRCAs genetic variants in sporadic OC tumors were found from Mexican patients.[26]


Table 3. Current Clinical Studies for OC in Mexico [30]
Title of the studyRecruitment countriesResearch sites in MexicoDurationSubjects (worldwide/national)
OC: ovarian cancer.
Phase III, open-label, randomized, controlled, multi-center study to assess the efficacy and safety of Olaparib monotherapy versus physician’s choice single-agent chemotherapy in the treatment of platinum-sensitive relapsed ovarian cancer in patients carrying germline BRCA 1/2 mutations.Argentina, Belgium, Brazil, Canada, Czechia, Hungary, Israel, Italy, Republic of Korea, Mexico, Poland, Spain, and the United States of AmericaOaxaca Site Management Organization, S.C., Oaxaca, Oaxaca6 years411/64
Hyperthermic intraperitoneal chemotherapy in ovarian carcinoma clinical-stage IIIC and IV during interval laparotomy. Phase II study.MexicoNational Institute of Cancerology of Mexico3 years100/100
Validation of HISPANEL in Mexican patients with a high risk of hereditary breast and ovarian cancer syndrome.MexicoNational Institute of Cancerology and Tec-Salud-Tecnologico de Monterrey4 years1,290/700
Phase 3 randomized placebo-controlled double-blind study of Romiplostim for the treatment of Chemotherapy-induced Thrombocytopenia in patients receiving chemotherapy for treatment of non-small cell lung cancer (NSCLC), ovarian cancer, or breast cancer.United States of America, Argentina, Austria, Brazil, Bulgaria, Chile, Colombia, Greece, Hungary, Mexico, Peru, Poland, Portugal, Romania, Russian Federation, Spain, Turkey, and UkraineOaxaca Site Management Organization, S.C., Oaxaca, Oaxaca and not specified research sites in San Luis Potosi, San Luis Potosi and La Paz, Baja California Sur1 year162/10


Table 4. FDA-Approved Drugs for the Treatment of OC [38]
FDA: Food and Drug Administration; OC: ovarian cancer.
Tepadina (thiotepa)Adienne SAInjection15 mg/vial1959No
Platinol (cisplatin)Hq Spclt PharmaInjection75 mg/m21978Yes
Doxil (doxorubicin hydrochloride liposome)Baxter healthcare Corp.Injection2 mg/mL1995Yes
Gemzar (gemcitabine hydrochloride)LillyInjection200 mg base/vial1996Yes
Taxol (paclitaxel)Bristol-Myers SquibbInjection175 mg/m21998Yes
Hycamtin (topotecan hydrochloride)SmithKline Beecham PharmaceuticalsInjection1.5 mg/m21998Yes
Alkeran (melphalan)Glaxo Wellcome, Inc.Tablets0.2 mg/kg2001Yes
Paraplatin (carboplatin aqueous solution)Bristol-Myers SquibbInjectionDetermined by doctor2003Yes
Doxorubicin hydrochlorideSun PharmInjection50 mg/m22013Yes
Lynparza (Olaparib)AstraZenecaCapsules, tablets300 mg2014, 2017Yes
Rubraca (Rucaparib)Clovis Oncology, Inc.Tablets600 mg2016No
Zejula (Niraparib)Tesaro, Inc.Capsules300 mg2017No
Avastin (bevacizumab)Genetech, Inc.Injection25 mg/mL2018Yes