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Vaginal microbiota composition linked to ovarian cancer risk
Key clinical point: A case-control study suggests the cervicovaginal microbiome is associated with ovarian cancer risk.
Major finding: In a case-control analysis, females younger than 50 years with ovarian cancer were more likely to have a community type O microbiota relative to age-matched controls (adjusted odds ratio, 2.80; P = .020).
Study details: A case-control study of 176 females with epithelial ovarian cancer and 109 females with BRCA1 mutations without a diagnosis of ovarian cancer.
Disclosures: The study was funded by the EU’s Horizon 2020 Research and Innovation Programme, the EU’s Horizon 2020 European Research Council Programme, and The Eve Appeal. The authors reported financial affiliations with Eurofins, AstraZeneca, Biocad, Clovis, Pharmamar, Roche, Takeda, and Tesaro.
Nené NR et al. Lancet Oncol. 2019 Jul 9. doi: 10.1016/S1470-2045(19)30340-7.
One question that remains from the current study is whether the human microbiota is an important factor in the pathogenesis and development of ovarian cancer.
Currently, there has been no evidence directly linking the composition of the human microbiota to ovarian cancer. As a result, causation has yet to be established by means of randomized studies, since the majority of completed studies have been cross-sectional in nature. As a highly heterogeneous condition, several factors may be involved, including a variety of host reproductive, genetic, microbiota, and lifestyle considerations.
While various mechanisms have been proposed, other less familiar causes could also be implicated. For example, Dr. Nené and colleagues found an association between BRCA1 mutation carriers younger than 50 years of age and the presence of community type O microbiota, while only 10%-15% of females with incident ovarian cancers exhibit this mutation. These findings accentuate the complexities of ovarian cancer pathophysiology.
Despite the suggested benefits of probiotic therapy, there remains a call for systems biology strategies in ovarian cancer research. In a similar manner, the human microbiota needs to be considered in future research.
Hans Verstraelen, MD, MPH, PhD, is affiliated with Ghent University and the Ghent University Hospital in Belgium. Dr. Verstraelen reported no competing interests. These comments are adapted from his editorial (Lancet Oncol. 2019 Jul 9. doi: 10.1016/ S1470-2045[19]30340-7 ).