Advances in mass spectrometry-based technologies to direct personalized medicine in ovarian cancer

•Traditional proteomics has not yielded markers that have passed clinical validation.•We examine alternative MS-based strategies for ovarian cancer biomarker discovery.•Complementary strategies include glycomics, metabolomics, peptidomics, etc.•MS-based initiatives to find diagnostic and chemoresistant markers are discussed.

Ovarian cancer is the most lethal gynaecological malignancy in North America and remains one of the most difficult cancers to manage. Although the 5-year survival rates are high when the disease is diagnosed early, this decreases exponentially in late-stage diagnoses and due to the current lack of screening methods, ovarian cancer is often diagnosed in its later stages when the cancer has progressed considerably. To exacerbate this, ovarian cancer patients almost always experience recurrence and resistance to chemotherapy after an initial positive response to treatment. Clearly, new modalities of clinical management are needed for this deadly disease. With the recent advent of high-throughput proteomic technologies, there have been numerous efforts to profile ovarian cancer using mass spectrometry to identify novel biomarkers for various clinical applications including diagnosis, prognosis, therapeutic targets, and monitoring therapeutic response. Identifying such novel biomarkers would allow for better tailoring of disease prevention and treatment on an individual basis in order to improve patient outcome. Unfortunately, traditional bottom-up proteomics have not yielded any markers able to pass stringent clinical validation. As a result, many alternative strategies have recently emerged where mass spectrometry is employed in a complementary fashion to traditional shotgun proteomics. In this review, we will examine such complementary mass spectrometry-based biomarker discovery efforts with a focus on early diagnostic markers and markers of chemoresistance.

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