Clinical implications of marker expression of Carcinoma-Associated Fibroblasts (CAFs) in patients with epithelial ovarian carcinoma after treatment with neoadjuvant chemotherapy

Paulette Mhawech-Fauceglia, Dan Wang, Damanzoopinder Samrao, Grace Kim, Kate Lawrenson, Teodulo Meneses, Song Liu, Annie Yessaian, Tanja Pejovic

Research output: Contribution to journalArticle

11 Scopus citations


Cancer-associated fibroblasts (CAFs) play an important role in tumor initiation and progression. The aim of this study is to explore the role of 2 CAF markers, fibroblast activated protein (FAP) and α-smooth muscle actin (αSMA), in patients with epithelial ovarian cancer (EOC) post-neoadjuvant chemotherapy. Sixty-six patients with the diagnosis of EOC treated with debulking surgery after neoadjuvant therapy were retrieved from the archives. Immunohistochemistry for FAP and αSMA antibodies were performed on paraffin-embedded tissue. Fisher's exact test was performed to test the association between FAP and αSMA expression and disease status. Kaplan-Meier method with log-rank test was used to check the survival difference between different FAP tumor/stroma expressions. FAP stroma pos . expression was strongly associated with higher recurrences rate [OR: 15.95; 95 % CI: 1.521-835.206; p∈=∈0.0072]. Cases with combined FAP stroma pos and FAP tumor neg had higher death rate [OR: 4.845; 95 % CI: 1.53-16.61; p∈=∈0.0046] and higher recurrence rate [OR: 5.12; 95 % CI: 0.91-54.42; p∈=∈0.0487] compared to all the others. Cases with combined FAP stroma neg and FAP tumor neg were more likely to have lower recurrence rates [OR: 0.086; 95 % CI: 0.001-0.997; p∈=∈0.0248]. αSMA was expressed by tumor-associated stroma in 95 % of cases and by tumor cells in 9 % of cases. No statistical power was found for αSMA and disease status. Our data indicate that FAP plays an important role in predicting tumor aggressiveness in patients with EOC post-neoadjuvant therapy, and its frequent expression in this malignancy implicates that FAP targeted therapy could be a very attractive strategy.

Original languageEnglish (US)
Pages (from-to)33-39
Number of pages7
JournalCancer Microenvironment
Issue number1-2
StatePublished - Aug 2014



  • Cancer-associated fibroblasts (CAF)
  • Disease outcome
  • Epithelial ovarian cancer (EOC)
  • Neoadjuvant therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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