ABCA transporter gene expression and poor outcome in epithelial ovarian cancer

Ellen L. Hedditch, Bo Gao, Amanda J. Russell, Yi Lu, Catherine Emmanuel, Jonathan Beesley, Sharon E. Johnatty, Xiaoqing Chen, Paul Harnett, Joshy George, Rebekka T. Williams, Claudia Flemming, Diether Lambrechts, Evelyn Despierre, Sandrina Lambrechts, Ignace Vergote, Beth Karlan, Jenny Lester, Sandra Orsulic, Christine WalshPeter Fasching, Matthias W. Beckmann, Arif B. Ekici, Alexander Hein, Keitaro Matsuo, Satoyo Hosono, Toru Nakanishi, Yasushi Yatabe, Tanja Pejovic, Yukie Bean, Florian Heitz, Philipp Harter, Andreas Du Bois, Ira Schwaab, Estrid Hogdall, Susan K. Kjaer, Allan Jensen, Claus Hogdall, Lene Lundvall, Svend Aage Engelholm, Bob Brown, James Flanagan, Michelle D. Metcalf, Nadeem Siddiqui, Thomas Sellers, Brooke Fridley, Julie Cunningham, Joellen Schildkraut, Ed Iversen, Rachel P. Weber, Andrew Berchuck, Ellen Goode, David D. Bowtell, Georgia Chenevix-Trench, Anna Defazio, Murray D. Norris, Stuart Macgregor, Michelle Haber, Michelle J. Henderson

Research output: Contribution to journalArticlepeer-review

99 Scopus citations


Background ATP-binding cassette (ABC) transporters play various roles in cancer biology and drug resistance, but their association with outcomes in serous epithelial ovarian cancer (EOC) is unknown. Methods The relationship between clinical outcomes and ABC transporter gene expression in two independent cohorts of high-grade serous EOC tumors was assessed with real-time quantitative polymerase chain reaction, analysis of expression microarray data, and immunohistochemistry. Associations between clinical outcomes and ABCA transporter gene single nucleotide polymorphisms were tested in a genome-wide association study. Impact of short interfering RNA-mediated gene suppression was determined by colony forming and migration assays. Association with survival was assessed with Kaplan-Meier analysis and log-rank tests. All statistical tests were two-sided. Results Associations with outcome were observed with ABC transporters of the A subfamily, but not with multidrug transporters. High-level expression of ABCA1, ABCA6, ABCA8, and ABCA9 in primary tumors was statistically significantly associated with reduced survival in serous ovarian cancer patients. Low levels of ABCA5 and the C-allele of rs536009 were associated with shorter overall survival (hazard ratio for death = 1.50; 95% confidence interval [CI] =1.26 to 1.79; P = 6.5e-6). The combined expression pattern of ABCA1, ABCA5, and either ABCA8 or ABCA9 was associated with particularly poor outcome (mean overall survival in group with adverse ABCA1, ABCA5 and ABCA9 gene expression = 33.2 months, 95% CI = 26.4 to 40.1; vs 55.3 months in the group with favorable ABCA gene expression, 95% CI = 49.8 to 60.8; P =. 001), independently of tumor stage or surgical debulking status. Suppression of cholesterol transporter ABCA1 inhibited ovarian cancer cell growth and migration in vitro, and statin treatment reduced ovarian cancer cell migration. Conclusions Expression of ABCA transporters was associated with poor outcome in serous ovarian cancer, implicating lipid trafficking as a potentially important process in EOC.

Original languageEnglish (US)
Article numberdju149
JournalJournal of the National Cancer Institute
Issue number7
StatePublished - Jul 9 2014

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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