GNPS - Evolution of the earliest stages of ovarian cancer from mutant fallopian tube epithelial cells

Ovarian cancer is also known as a silent killer as women are usually diagnosed in advanced stages when the disease has already spread to vital peritoneal organs leading to poor survival. Therefore, improving outcomes for this disease would require a greater understanding of the earliest stages, where the disease can be cured with current treatments. Fallopian tubes (FTs) are a site of origin of ovarian cancer. Here, by combining gene sequencing, proteomics, organoids, mouse genetics, lineage tracing, and quantitative modeling, we showed that mutant Pax8+ FT progenitor cells gain clonal growth advantage over their wild-type neighbors and expand over time, colonizing large areas of FT epithelium, resulting in the formation of pre-cancerous lesions. The growth of these precursor lesions is modulated by ovarian hormones, where estrogen promotes and progesterone suppresses their growth. Collectively, this study provides insight into how a single mutant FT epithelial cell leads to early ovarian cancer evolution.