HERC2 as a Potential Biomarker for Prognosis and Response to Bevacizumab in Ovarian Cancer: A Bioinformatics Approach.

It is thought that decreased HERC2 expression increases the sensitivity to ferroptosis in ovarian cancer cells and may increase the VEGF pathway in porcine endothelium by inhibiting LKB1. Based on these data, we aimed to determine whether HERC2 expression may have a positive prognostic significance in patients receiving anti-VEGF based therapy in ovarian cancer patients. The study used public databases and has a retrospective design. Following web tools or datasets were used: TCGA TARGET GTEX study (n = 427 cancer vs. 88 normal ovarian tissue) at UCSC Xena and CPTAC at UALCAN for expression, Kaplan-Meier plotter for overall survival (OS) (n = 1207 for serous histology and n = 37 for endometrioid histology in gene chip), progression-free survival (PFS) (n = 1104 for serous histology in gene chip), TIMER2.0 for correlation of PDCD1, CTLA4, CD274 (PDL1), GEPIA2 for immune gene signatures, OncoLnc, DoSurvive and OncomiR for miRNA and OS associations, CancerSEA for functional status analyses. HERC2 expression levels were lower in ovarian serous cystadenocarcinoma (OV). Lower HERC2 expression was also seen in CPTAC ovarian cancer cohort. In the overall ovarian cancer cohort, decreased HERC2 expression was associated with longer OS. In the serous histology cohort, decreased HERC2 expression was associated with shorter PFS in those receiving bevacizumab-containing chemotherapy. PDL1 and HERC2 expressions were positively correlated. hsa-miR-500a-3p was negatively correlated with HERC2 in OV, and increased expression of this miRNA was associated with better OS. There was a positive association between HERC2 expression and angiogenesis and EMT, and a negative association with invasion. Decreased HERC2 expression is associated with a favorable prognosis in overall ovarian cancer cohort, but is associated with a worse PFS in patients receiving bevacizumab with serous ovarian cancer.