Epithelial invasive ovarian cancer (EOC) is the second

Epithelial invasive ovarian cancer (EOC) is the second most common gynaecological
malignancy 1 and one of the ten types of cancers with the highest incidence and mortality
rates 2. It is considered to be a challenge of 21st-century medicine because approximately
77-78% of the cases are still diagnosed in advanced stages III or IV 3. In 2011, the results
of PLCO (Prostate, Lung, Colorectal, Ovarian Cancer Screening) trial had concluded that all
screening tests have no contribution in a decrease of mortality due to ovarian cancer. In 2017
the results of a collaborative re-analysis from Ovarian Cancer Cohort Consortium suggested
that IGF-1 concentration is inversely correlated with EOC risk independent of histological
phenotype 4-5.
The role of IGF system components in carcinogenesis of ovarian cancer was based on
investigative epidemiological results, experiments in vivo and in vitro and on attempts of
application of drugs affecting the IGF axis 6. Investigative hypotheses in original papers
were based on physiological functions manifested by the entire family of IGF (ligands,
receptors, binding proteins, adaptor molecules) 6. In the context of carcinogenesis, the
essential functions of IGF family involve intensification of proliferation, inhibition of cell
apoptosis as well influence on cell transformation through the synthesis of several regulatory
proteins 7. Components of IGF axis control survival and influence metastases of cells.
Interactions of IGF axis components may be of a direct or indirect nature. The immediate
effects are linked to activation of PI3K/Akt signaling pathway, in which the initiating role is
played by, first of all, IGF-1 and IGF-1R. The activity of this signaling pathway leads to an
increased mutagenesis, cell cycle progression, and protection against different apoptotic
stresses. Indirect effects of IGF axis depend on interactions between IGFs and other molecules
essential for cancer aetiology (e.g. sex hormones, products if suppressor genes, viruses, other
growth factors) and the style of life (nutrition, physical activity). 

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