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Main Authors: Kathleen I Pishas, Karla J Cowley, Evanny Marinovic, Martin Köbel, Marta Llaurado‐Fernandez, Hannah Kim, Shaine Chenxin Bao, Dalia Mizikovsky, Nathan J Palpant, Raunak Shrestha, Robert Vary, Jennii Luu, Liliane Meunier, Timothy Semple, Pilar Blancafort, Emily Golden, Paul A Cohen, Mark S Carey, Ian G Campbell, Kaylene J Simpson, Dane Cheasley
Format: Artículo Open Access
Published: Wiley 2026
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Online Access:https://pathsocjournals.onlinelibrary.wiley.com/doi/10.1002/path.70075
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author Kathleen I Pishas
Karla J Cowley
Evanny Marinovic
Martin Köbel
Marta Llaurado‐Fernandez
Hannah Kim
Shaine Chenxin Bao
Dalia Mizikovsky
Nathan J Palpant
Raunak Shrestha
Robert Vary
Jennii Luu
Liliane Meunier
Timothy Semple
Pilar Blancafort
Emily Golden
Paul A Cohen
Mark S Carey
Ian G Campbell
Kaylene J Simpson
Dane Cheasley
author_facet Kathleen I Pishas
Karla J Cowley
Evanny Marinovic
Martin Köbel
Marta Llaurado‐Fernandez
Hannah Kim
Shaine Chenxin Bao
Dalia Mizikovsky
Nathan J Palpant
Raunak Shrestha
Robert Vary
Jennii Luu
Liliane Meunier
Timothy Semple
Pilar Blancafort
Emily Golden
Paul A Cohen
Mark S Carey
Ian G Campbell
Kaylene J Simpson
Dane Cheasley
Kathleen I Pishas
Karla J Cowley
Evanny Marinovic
Martin Köbel
Marta Llaurado‐Fernandez
Hannah Kim
Shaine Chenxin Bao
Dalia Mizikovsky
Nathan J Palpant
Raunak Shrestha
Robert Vary
Jennii Luu
Liliane Meunier
Timothy Semple
Pilar Blancafort
Emily Golden
Paul A Cohen
Mark S Carey
Ian G Campbell
Kaylene J Simpson
Dane Cheasley
collection Wiley Open Access
contents Identifying therapeutic targets in low‐grade serous ovarian carcinomas with no specific molecular profile Kathleen I Pishas Karla J Cowley Evanny Marinovic Martin Köbel Marta Llaurado‐Fernandez Hannah Kim Shaine Chenxin Bao Dalia Mizikovsky Nathan J Palpant Raunak Shrestha Robert Vary Jennii Luu Liliane Meunier Timothy Semple Pilar Blancafort Emily Golden Paul A Cohen Mark S Carey Ian G Campbell Kaylene J Simpson Dane Cheasley The Journal of Pathology Abstract Low‐grade serous ovarian carcinoma (LGSOC) is a rare, indolent ovarian cancer subtype with limited effective therapies. Approximately 40% of cases lack canonical MAPK/ERK or PI3K/AKT/mTOR pathway alterations and are classified as having no specific molecular profile (NSMP). These patients have poor responses to chemotherapy, MEK inhibitors, and hormonal therapies, highlighting the need for alternative strategies. This study aimed to identify novel therapeutic targets in NSMP LGSOC. A high‐throughput drug screen of 3,436 compounds (including FDA‐approved, clinically tested, and investigational agents) was conducted across 12 LGSOC and one control ovarian epithelial cell line. EGFR inhibitors emerged as selective hits in NSMP cell lines and were further tested in two NSMP and two MAPK‐mutant lines in combination with standard‐of‐care chemotherapy agents, carboplatin and paclitaxel. EGFR expression was assessed using RNA sequencing, DNA methylation profiling, and immunohistochemistry in primary tumors, followed by survival analysis based on expression levels. Unsupervised clustering of drug response data revealed subtype‐specific vulnerabilities, with EGFR inhibitors showing marked cytotoxicity in all five NSMP lines (robust Z ‐score ≤ −2), and minimal activity in MAPK‐ and USP9X ‐mutant lines. EGFR inhibitors (avitinib, AV‐412) showed selective, low‐dose synergy with standard‐of‐care chemotherapy in NSMP models, with minimal and inconsistent effects in MAPK‐mutant lines. NSMP tumors showed elevated EGFR mRNA and EGFR protein expression, associated with poor survival, advanced disease stage, and peritoneal involvement, and inversely correlated with MAPK mutations. These findings position EGFR overexpression as a defining and targetable feature of NSMP LGSOC and support further preclinical validation of EGFR inhibitors as a treatment strategy for this understudied cancer subtype. © 2026 The Pathological Society of Great Britain and Ireland. 10.1002/path.70075 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1002/path.70075
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spellingShingle Identifying therapeutic targets in low‐grade serous ovarian carcinomas with no specific molecular profile
Kathleen I Pishas
Karla J Cowley
Evanny Marinovic
Martin Köbel
Marta Llaurado‐Fernandez
Hannah Kim
Shaine Chenxin Bao
Dalia Mizikovsky
Nathan J Palpant
Raunak Shrestha
Robert Vary
Jennii Luu
Liliane Meunier
Timothy Semple
Pilar Blancafort
Emily Golden
Paul A Cohen
Mark S Carey
Ian G Campbell
Kaylene J Simpson
Dane Cheasley
The Journal of Pathology
Identifying therapeutic targets in low‐grade serous ovarian carcinomas with no specific molecular profile Kathleen I Pishas Karla J Cowley Evanny Marinovic Martin Köbel Marta Llaurado‐Fernandez Hannah Kim Shaine Chenxin Bao Dalia Mizikovsky Nathan J Palpant Raunak Shrestha Robert Vary Jennii Luu Liliane Meunier Timothy Semple Pilar Blancafort Emily Golden Paul A Cohen Mark S Carey Ian G Campbell Kaylene J Simpson Dane Cheasley The Journal of Pathology Abstract Low‐grade serous ovarian carcinoma (LGSOC) is a rare, indolent ovarian cancer subtype with limited effective therapies. Approximately 40% of cases lack canonical MAPK/ERK or PI3K/AKT/mTOR pathway alterations and are classified as having no specific molecular profile (NSMP). These patients have poor responses to chemotherapy, MEK inhibitors, and hormonal therapies, highlighting the need for alternative strategies. This study aimed to identify novel therapeutic targets in NSMP LGSOC. A high‐throughput drug screen of 3,436 compounds (including FDA‐approved, clinically tested, and investigational agents) was conducted across 12 LGSOC and one control ovarian epithelial cell line. EGFR inhibitors emerged as selective hits in NSMP cell lines and were further tested in two NSMP and two MAPK‐mutant lines in combination with standard‐of‐care chemotherapy agents, carboplatin and paclitaxel. EGFR expression was assessed using RNA sequencing, DNA methylation profiling, and immunohistochemistry in primary tumors, followed by survival analysis based on expression levels. Unsupervised clustering of drug response data revealed subtype‐specific vulnerabilities, with EGFR inhibitors showing marked cytotoxicity in all five NSMP lines (robust Z ‐score ≤ −2), and minimal activity in MAPK‐ and USP9X ‐mutant lines. EGFR inhibitors (avitinib, AV‐412) showed selective, low‐dose synergy with standard‐of‐care chemotherapy in NSMP models, with minimal and inconsistent effects in MAPK‐mutant lines. NSMP tumors showed elevated EGFR mRNA and EGFR protein expression, associated with poor survival, advanced disease stage, and peritoneal involvement, and inversely correlated with MAPK mutations. These findings position EGFR overexpression as a defining and targetable feature of NSMP LGSOC and support further preclinical validation of EGFR inhibitors as a treatment strategy for this understudied cancer subtype. © 2026 The Pathological Society of Great Britain and Ireland. 10.1002/path.70075 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Identifying therapeutic targets in low‐grade serous ovarian carcinomas with no specific molecular profile
topic The Journal of Pathology
url https://pathsocjournals.onlinelibrary.wiley.com/doi/10.1002/path.70075