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Quantitative and qualitative metrics of tumor stroma in predicting ovarian cancer outcomes and expansion of its study with AI-based tools
Univ Minnesota, MA 55455 USA.
Emory Univ, GA 30322 USA; Georgia Inst Technol, GA 30322 USA.
Emory Univ, GA 30322 USA; Georgia Inst Technol, GA 30322 USA; Atlanta Vet Adm Med Ctr, GA 30033 USA.
Univ Minnesota, MA 55455 USA.
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2025 (English)In: Molecular Therapy Oncology, E-ISSN 2950-3299, Vol. 33, no 2, article id 201001Article, review/survey (Refereed) Published
Abstract [en]

Epithelial ovarian cancer remains one of the deadliest gynecologic malignancies, with late-stage diagnosis, high recurrence rates, and resistance to platinum-based chemotherapy contributing to poor survival outcomes. Central to the effective management of ovarian cancer is the thorough evaluation of diagnostic and prognostic indicators. Critical determinants encompass the extent of the tumor; its stage and grade; and level of the circulating biomarker, CA-125. Additional tumor cell-centric factors such as BRCA1/2 mutation status, homologous recombination deficiency, and folate receptor-alpha (FR alpha) protein levels inform initial treatment and maintenance strategies. Unfortunately, these markers alone cannot fully predict outcomes or significantly improve survival rates. This review emphasizes the body of data suggesting that both quantitative and qualitative metrics of tumor stroma play a crucial role in the prognosis and outcomes of epithelial ovarian cancer. We examine quantitative and qualitative metrics such as stromal proportion, tumor density, stiffness, and texture. We explore how artificial intelligence (AI) tools advance the measurement of these parameters, offering unprecedented opportunities to integrate stromal biomarkers into clinical decision-making. By synthesizing emerging evidence, we propose a framework for leveraging stromal properties-individually and in combination-as novel prognostic indicators to improve outcomes for patients with ovarian cancer.

Place, publisher, year, edition, pages
CELL PRESS , 2025. Vol. 33, no 2, article id 201001
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-214889DOI: 10.1016/j.omton.2025.201001ISI: 001506368400001PubMedID: 40524858Scopus ID: 2-s2.0-105007154517OAI: oai:DiVA.org:liu-214889DiVA, id: diva2:1971418
Note

Funding Agencies|VA Research and Development Office through the Lung Precision Oncology Program [IK6BX006185]; Office of the Assistant Secretary of Defense for Health Affairs through the Prostate Cancer Research Program [LPOP-L0021]; AstraZeneca [W81XWH-15-1-0558, W81XWH-20-1-0851, W81XWH-21-1-0160]; Prevent Cancer Foundation; Scott Mackenzie Foundation; U.S. Department of Veterans Affairs

Available from: 2025-06-17 Created: 2025-06-17 Last updated: 2026-01-20

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