What we do

Ovarian neoplasms are principally classified into epithelial tumours, sex cord stromal tumours, and germ cell tumours. Each group includes benign and malignant neoplasms and there are also tumours of uncertain malignant potential and borderline tumours. These tumours are encountered at different frequencies in clinical practice, with a largely proportionate inclusion in clinical and basic science studies.

Our group is interested in the identification of diagnostic and prognostic biomarkers and potential therapeutic targets for several types of tumours and in particular ovarian tumours. We have a special interest in borderline ovarian tumours and sex cord stromal tumours. Published work from our laboratory shows that there are molecular subtypes of serous borderline ovarian tumours with benign like and malignant like signatures. Continued work in this area will hopefully lead to the identification of predictive biomarkers for the biological behaviour of individual borderline tumours, as well as the identification of potential therapeutic targets for tumours showing aggressive behaviour; both of which remain to be unmet clinical needs. Similar challenges are also encountered in the management of some sex cord stromal tumours in addition to the need for the identification of robust diagnostic biomarkers for rare entities within this group, particularly ones that present with atypical histological features.

To explore this we analyse patient samples using a range of advanced techniques as well as techniques used in diagnostic histopathology laboratories to study the translational potential of our findings.

Our laboratory is privileged by always working on the basis of close collaboration between scientists and clinicians. This is very much embodied in our work on borderline ovarian tumours where we have been working for at least 10 years now in collaboration with clinical teams in several centres in the United Kingdom through a National multicentre study led by our group, in addition to our work with our colleagues in the multidisciplinary team of the West London Gynaecological Cancer Centre based at the Hammersmith and Queen Charlotte and Chelsea Hospitals. The aim of our work is to develop protocols for optimal care for patients with borderline ovarian tumours from primary diagnosis to personalised surgical procedures and follow-up plans and management of progressive disease.

In addition to our work on clinical specimens our group works on the thorough characterisation and development of in vitro models for our tumours of interest as a discovery tool to better understand tumour pathology and mechanisms underlying tumour development, progression and response to therapy.

Why it is important

Epithelial ovarian tumours are the commonest types of ovarian tumours and they affect women of different age groups, including young patients in the reproductive age group. Early diagnosis, precise tumour typing and stratification in terms of prognosis and eligibility to generic and targeted therapy are important aspects for tumour management.

How it can benefit patients

Borderline ovarian tumours usually affect women in the reproductive age group, and carry the potential for recurrence and progression to cancers that can happen after many years. Their management ideally requires radical surgery and long term follow up, both of which have serious effects on these young women in terms of potential loss of fertility and long term and health concern related anxiety. The same challenges are also shared by some sex cord stromal tumours.

Both of these entities are relatively understudied in comparison to the commoner and more aggressive types of ovarian tumours. Our work on these entities addresses questions and gaps of knowledge that have the potential to provide findings that contribute to evidence based personalised medical managment for these patients, matching the choice of therapy with what would work best for each individual patient.

Summary of current research

  1. Development of in vitro models for low grade serous carcinoma and borderline ovarian tumours.
  2. Characterisation of in vitro models of sex cord stromal tumours.
  3. Studying the histogenesis, genomic changes and signalling pathways in uncommon ovarian tumours. 

Information

Funders and related centres

Funders
  • Imperial BRC Funding
  • Egyptian Ministry of Higher Education
  • North West London Pathology
Related centres
  • West London Gynaecological Cancer Centre
  • Institute of Cancer Research – Tumour Profiling Unit
  • Imperial College Healthcare NHS Trust Tissue Bank

Useful links for patients

Publications

Find all of Professor Mona El-Bahrawy's publications here

Clinical trials

  • Professor El-Bahrawy was the lead investigator of the multicentre study, Borderline ovarian tumours: A strategy for developing optimal care. 
  • Professor El-Bahrawy was the nominated pathologist at Imperial College London for the following trials:

A Two-Part, Phase I Open Label, Dose Escalation Study To Assess The Safety, Pharmacokinetics And Clinical Activity Of Nuc-1031, A Nucleoside Analogue, In Participants With Advanced Solid Tumours.

A Two-Part Phase 1/2a, Open-Label, Dose-Escalation Study to Evaluate the Tolerability and Preliminary Antitumour Activity of OPB-111001 in Patients with Advanced Cancers that are Poorly Responsive to Standard Anticancer Treatment.

A Phase 1b, multi-center, open-label, dose escalation study of GSK2256098 (FAK inhibitor) in combination with Trametinib (MEK inhibitor) in subjects with advanced solid tumours.

A Phase I Open-Label Dose-Escalation Study of the Focal Adhesion Kinase Inhibitor, GSK2256098, in Subjects with Solid Tumours.

SCOTROC 4: A prospective, multicentre, randomized trial of carboplatin flat dosing Vs intrapatient dose escalation in first line chemotherapy of ovarian, fallopian tube and primary peritoneal cancers.

An Open Label Study To Investigate the Pharmacokinetics and Pharmacodynamics of Repeat Escalating Doses of the Oral AKT Inhibitor GSK2141795 by 18F FDG PET Analysis in Subjects with Ovarian Cancer.

Phase I, open-label, multi-center, dose-escalation study with extension to evaluate safety, pharmacokinetics and activity of CH5132799, a PI3K inhibitor administered orally as a monotherapy in patients with advanced solid tumors.

A phase 1 open-label, dose-finding study to evaluate the safety and pharmacokinetics of ONX 0801, a novel α-folate receptor-mediated thymidylate synthase inhibitor, in patients with advanced solid tumours.

A phase 2, open-label test-retest study to assess the reproducibility of quantitative measurements of 18F uptake by solid tumours using pet imaging following intravenous administration of AH111585 (18F) injection.

[18F]fluorothymidine-positron emission tomography (FLT-PET) and DCE/DW-MRI for early response monitoring in epithelial ovarian cancer (EOC).

mEOC: A GCIG Intergroup multicentre trial of open label carboplatin and paclitaxel +/- bevacizumab compared with oxaliplatin and capecitabine +/- bevacizumab as first line chemotherapy  in patients with mucinous Epithelial Ovarian Cancer (mEOC).

Randomised Phase III Trial of Paclitxel plus Carboplatin (TC) Therapy versus Irinotecan plus Cisplatin (CPT-P) Therapy as a First Line Chemotherapy for Clear Cell Carcinoma of the Ovary.

Our researchers

Motasim Masood

Motasim Masood
Post Doctoral Research Fellow

Lamiaa Sabry

Lamiaa Sabry
PhD student

Sara Jouharji

Sara Jouharji
PhD student

Leshanth Uthayanan

Leshanth Uthayanan
Honorary Research Associate