Anterior gradient 2 protein belongs to a family of chaperone‐like proteins, namely protein disulfide isomerase. Generally, AGR2 is highly expressed in mucus‐secreting cells and endocrine organs, and in this study, we aimed to evaluate AGR2 and cell cycle molecules in epithelial ovarian cancer and its implications on prognosis. One hundred seventy‐five patient's samples that were diagnosed with primary epithelial ovarian carcinoma were selected. All the patients were treated with platinum‐taxane standard chemotherapy after surgery and CA125 serum levels were routinely determined. Four‐micrometer‐thick sections were processed by immunohistochemistry using an automated immunostainer, Ventana BenchMark AutoStainer with AGR2, cyclin D1, p21WAF1, and p53. Forty‐nine of 167 cases (29.3%) showed strong to moderate cytoplasmic marking of AGR2, and 118 (70.7%) had weak to negative expression. The absence of the AGR2 protein was observed in high‐grade serous carcinoma (P < .001) and significantly associated with disease‐free survival (DFS; P = .034). The expression of G1‐S phase‐regulatory proteins showed loss of p21 in high‐grade serous carcinoma (P < .001) and was related with poor DFS (P = .003). Strong and diffuse immunoexpression of p53 plus complete absence of p53 staining was interpreted as likely indicating a TP53 gene mutation. This result showed worse DFS alone (P = .012) and combined with low levels of AGR2 (P = .005). The expression profile of AGR2 and cell cycle proteins here presented was showed as good prognosis marker in epithelial ovarian cancer. This finding suggests AGR2 and as putative biomarker of disease progression in chemotherapy‐treated high‐grade serous carcinoma patients.

The most common subtype of renal cell carcinoma is the clear cell type (ccRCC), accounting for 75 % of cases. Inactivation of VHL gene is thought to be an early event in ccRCC carcinogenesis. Our intention was to assess whether VHL mutational status might provide useful predictive or prognostic information in patients with ccRCC. VHL messenger RNA (mRNA) expression was analyzed by in situ hybridization and its protein by immunohistochemistry on a tissue microarray containing samples from 148 cases. This was validated by qRT-PCR on 62 cases, for which RNA was available. The mutation status was assessed in 91 cases by Sanger sequencing. VHL was found mutated in 57 % of cases, with missense mutations in 26 %, nonsense in 5 %, splice site in 13 %, deletions in 39 %, indels in 8 %, duplications in 8 %, and insertions in 2 % of the cases. The prevalence of mutations by exon was the following: exon 1, 47 %; exon 2, 27 %; and exon 3, 13 %. VHL protein was expressed in a high number of cases (80 %), but significant correlations were not found between protein expression, clinical data, and survival. Importantly, of the 91 samples evaluated by sequencing, 45 were mutated, and 87 % of those were strongly positive. We found 32 novel mutations in the VHL gene in ccRCC. The presence of mutations was not concordant with mRNA or protein expression. Nonsense mutations of the VHL gene appear to be related with poorer prognosis and survival.

Versican expression promotes tumor growth by destabilizing focal cell contacts, thus impeding cell adhesion and facilitating cell migration. It not only presents or recruits molecules to the cell surface, but also modulates gene expression levels and coordinates complex signal pathways. Previously, we suggested that the interaction between versican and human epidermal growth factor receptors may be directly associated with tumor aggressiveness. Thus, the expression of EGFR and HER-2 in these neoplasms may contribute to a better understanding of the progression mechanisms in malignant mammary tumors. The purpose of this study was to correlate the gene and protein expressions of EGFR and HER2 by RNA In Situ Hybridization (ISH) and immunohistochemistry (IHC), respectively, and their relationship with the versican expression in carcinomas in mixed tumors and carcinosarcomas of the canine mammary gland. The results revealed that EGFR mRNA expression showed a significant difference between in situ and invasive carcinomatous areas in low and high versican expression groups. Identical results were observed in HER-2 mRNA expression. In immunohistochemistry analysis, neoplasms with low versican expression showed greater EGFR immunostaining in the in situ areas than in invasive areas, even as the group presenting high versican expression displayed greater EGFR and HER-2 staining in in situ areas. Significant EGFR and HER-2 mRNA and protein expressions in in situ carcinomatous sites relative to invasive areas suggest that these molecules play a role during the early stages of tumor progression.

To identify biomarkers that could predict response or lack of response to conventional chemotherapy at the time of diagnosis of high-grade serous ovarian carcinoma (HGSOC), the present study compared large-scale gene expression from patients with short or long disease-free survival times, according to the last cycle of chemotherapy, and validated these findings using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and conventional immunohistochemical (IHC) analysis. Samples were selected for microarray evaluation, at the time of diagnosis, using the following criteria: Identical debulking primary surgery, International Federation of Gynaecology and Obstetrics staging, histological subtype and grade. These were divided into 2 groups, regarding the outcome after 2 years of followup. Prostaglandin D2 synthase 21 kDa (brain) (PTGDS) was found to be expressed at a significantly higher level in the tumours of patients with a short disease-free survival time, and this was validated by RT-qPCR in all samples. Furthermore, the study evaluated PGD2, the protein product of the PTGDS gene, in a large cohort of 114 HGSOC patients using the Ventana Benchmark automated platform, and IHC positivity was correlated with clinicopathological data and outcome. The global gene expression analysis identified 1,149 genes that were differentially expressed in microarray data, according to the patient outcome. Further analysis RT-qPCR validated PTGDS gene expression in the same samples (r=0.945; P<0.001). IHC analysis showed an inverse profile, with positivity for PGD2 strongly associated with an increase in disease-free survival (P=0.009), the absence of relapse (P=0.039) and sensitivity to platinum-based therapy (P=0.016). Multiple Cox regression showed that IHC evaluation of PGD2 was also a prognostic marker associated with relapse (hazard ratio, 0.37; P=0.002). Overall, the results showed that IHC evaluation of PGD2 is an independent marker of good prognosis in HGSOC. This finding contributes to our understanding of the mechanism of tumour regulation and to investigations into biomarkers that predict response to chemotherapy.

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Introduction: Bevacizumab is an antiangiogenic agent approved to treat ovarian cancer in combination to chemotherapy. The relative benefit of bevacizumab in ovarian cancer patients seems to be greater the more the disease becomes platinum resistant. Cyclin E1 overexpression is a marker of platinum resistance. In this study we aimed to evaluate the benefit of bevacizumab in platinum sensitive recurrent ovarian cancer and to test if the benefit changes according to platinum-free interval (PFI) and cyclin E1 expression. Methods: We retrospectively evaluated data from patients with platinum sensitive recurrent ovarian cancer treated with CT plus bevacizumab (Bev group) and CT alone (CT group) at a tertiary cancer center in Brazil from 2005 to 2017. The two groups were paired according to histology, platinum free interval and number of previous treatment lines. Cyclin E1 expression was evaluated by immunohistochemistry in tissue microarray. Progression-free survival (PFS) was compared between the groups with log rank test and cox regression. Results: 124 patients were included, 62 in each group. Bev group and CT group were well balanced regarding histology (high grade serous carcinoma 94% in Bev group, 93% in CT group), PFI (PFI &gt; 12 months in 36.2% in Bev group, 39.3% in CT group) and number of previous treatment lines (one previous chemotherapy in 55.7% in Bev group, 60.0% in CT group). Median age and median PFI were 56.2 years old and 59.2 years old, and 9.7 months and 10.5 months, in the Bev and CT groups, respectively. All patients were treated with platinum doublets with paclitaxel, gemcitabine or liposomal doxorubicin except for one patient treated with cisplatin plus bevacizumab and one patient treated with liposomal doxorubicin. Median PFS (mPFS) was 19.5 months for the Bev group vs. 16.0 months in the CT group (p = 0.150). Patients with a PFI &gt; 12 months showed a mPFS of 20.0 months vs. 15.5 for patients with a PFI &lt; 12 months (p=0.029). Patients with cyclin E1 overexpression showed a mPFS of 15.8 months vs. 19.7 months for those without cyclin E1 overexpression (p=0.05). Benefit of bevacizumab was present only in the subgroup of patients with PFI &lt; 12 months (mPFS 18.6 versus 10.4 months, p=0.002) and in the subgroup of patients with cyclin E1 overexpression (mPFS 16.3 versus 7.0 months, p=0.010). Conclusions:Markers of resistance to chemotherapy such as cyclin E1 overexpression and PFI identify patients with the greatest benefit of bevacizumab. This data could help to discern between maintenance treatment options in the era of PARP inhibitors and anti-angiogenics. Citation Format: Adriana Regina G. Ribeiro, Marcella M. Salvadori, Louise de Brot, Graziele Bovolim, Henrique Mantoan, Felipe Ilelis, Mariana R. Alves, Nayra Soares Amaral, Solange M. Sanches, Joyce Lisboa, Elizabeth S. dos Santos, Ronaldo Pereira, Fabricio S. Castro, Joao Paulo S. Lima, Andrea P. Guimaraes, Glauco Baiocchi, Alexandre Andre B. Da Costa. Cyclin E1 overexpression identifies patients with greater benefit from bevacizumab in platinum sensitive recurrent ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3157.