suppressor 1. The CCNE1 gene encodes for the cyclin E1 protein which accumulates at the G1-S phase transition point of the cell cycle. Detecting the cancerous tumor progression can be difficult for pathologists. While some tumors will appear in the ovary, others spread over the outer lining of the ovary and to other organs such as the uterus, fallopian tube, and lymph glands. Clinical relevance Clear-cell tumors are frequently found at an early stage and therefore can be cured with surgery. Through clinical examination or preoperative imaging techniques, tumors have been reported to range from 3-20 cm. Most ovarian tumors are benign and rarely spread past the ovary. Therefore, surgical removal of the ovary or partial removal of the ovary is sufficient for treatment for malignant tumors. When diagnosed beyond FIGO (International Federation of Gynecology and Obstetrics) stage 1 patients usually have a poor prognosis. If the malignant tumors metastasize and spread throughout the body then they could potentially be fatal. Clear-cell tumors have been found to be resistant to conventional chemotherapy using platinum and taxane. Although the cause of this chemoresistance is unknown, there is research that provides partial explanation of this occurrence. For example, studies show that clear-cell tumor cells proliferate at lower rates than serous adenocarcinomas which then could aid in a lower response from clear-cell tumors to chemotherapies. Given that treatment options are limited for ovarian clear-cell cancer patients, researchers are studying biomarkers or specific pathways that could aid in developing future treatment. These patients are good candidates for targeted therapies since the standard does not adequately help their care. Some suggested therapeutic targets include the PI3K/AKT/mTOR, VEGF, Il-6/STAT3, MET, and HNF-1beta pathways. Better insight into genomic heterogeneity would also provide a personalized approach to identifying treatment targets for clear-cell tumor patients that share similar phenotypes. Developing stronger options is also beneficial because ovarian cancer is the fifth leading cause of cancer deaths for women and is one of the most lethal gynecological cancers. References Ovarian cancer