The “Road” to Malignant Transformation from Endometriosis to Endometriosis-Associated Ovarian Cancers (EAOCs) - An mTOR-Centred Review

Sep 21, 2026

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Ovarian cancer is an umbrella disease comprising multiple subtypes, including endometrioid and clear-cell ovarian carcinomas that frequently originate from ectopic endometrium, forming endometriosis-associated ovarian cancers (EAOCs). The mechanistic target of rapamycin (mTOR) regulates cellular homeostasis and is dysregulated across endometriosis and EAOCs, potentially promoting carcinogenesis along a continuum from benign, cancer-like states to overt malignancy. This review highlights mTOR dysregulation, links to cancer driver mutations, and transformation shaped by environmental, hormonal, and epigenetic influences. It also addresses postmenopausal disease and summarizes mTOR-targeted therapies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages28

Reading Time1 h 11 min

AccessFree to download

Introduction

Ovarian cancer heterogeneity and classification

Endometriosis and its link to EAOCs

mTOR signaling overview

Review scope and aims

mTOR dysregulation in endometriosis and EAOCs

Cancer driver mutations and mTOR pathway interactions

Transformation mechanisms

Postmenopausal endometriosis and malignant propensity

mTOR-targeted therapeutics

cancers Review The “Road” to Malignant Transformation from Endometriosis to Endometriosis-Associated Ovarian Cancers (EAOCs): An mTOR-Centred Review Radwa Hablase 1,2, Ioannis Kyrou 3,4,5,6,7,8,9, Harpal Randeva 3,4,5,6, Emmanouil Karteris 1 and Jayanta Chatterjee 1,2, * Citation: Hablase, R.; Kyrou, I.; Randeva, H.; Karteris, E.; Chatterjee, J. The “Road” to Malignant Transformation from Endometriosis to Endometriosis-Associated Ovarian Cancers (EAOCs): An mTOR-Centred Review. Cancers 2024, 16, 2160 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers16112160 Academic Editor: Alfonso Baldi Received: 19 April 2024 Revised: 29 May 2024 Accepted: 1 June 2024 Published: 6 June 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB83PH, UK; [radwa.hablase2@nhs.net](radwa.hablase2@nhs.net) (R.H.); [emmanouil.karteris@brunel.ac.uk](emmanouil.karteris@brunel.ac.uk) (E.K.) 2 Academic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust Hospital, Guildford GU2 7XX, UK 3 Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK; [harpal.randeva@uhcw.nhs.uk](harpal.randeva@uhcw.nhs.uk) (H.R.) 4 Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK 5 Institute for Cardiometabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK 6 Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK 7 Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK 8 College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK 9 Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece * [Correspondence: jayanta.chatterjee1@nhs.net](Correspondence: jayanta.chatterjee1@nhs.net) Simple Summary: Ovarian cancer is the eighth most common cancer among women globally and 207,000 women die every year, whereas endometriosis affects around 10% of women of reproductive age. Endometriosis-associated ovarian cancers (EAOCs) frequently arise from ectopic endometrium (i.e., the presence of endometrial/stromal cells outside the uterine cavity) in the ovary. Over the past decades, there has been an increasing volume of evidence to suggest that signalling centred around the mechanistic target of rapamycin (mTOR) plays an important role in cellular functions such as proliferation, survival, and autophagy. This review summarizes the current landscape of mTOR signalling in these gynaecological malignancies and the emerging therapeutic options. Abstract: Ovarian cancer is an umbrella term covering a number of distinct subtypes. Endometrioid and clear-cell ovarian carcinoma are endometriosis-associated ovarian cancers (EAOCs) frequently arising from ectopic endometrium in the ovary. The mechanistic target of rapamycin (mTOR) is a crucial regulator of cellular homeostasis and is dysregulated in both endometriosis and endometriosisassociated ovarian cancer, potentially favouring carcinogenesis across a spectrum from benign disease with cancer-like characteristics, through an atypical phase, to frank malignancy. In this review, we focus on mTOR dysregulation in endometriosis and EAOCs, investigating cancer driver gene mutations and their potential interaction with t

FAQs

Which factors are considered in the pathogenesis of transformation to cancer?

The review considers environmental, hormonal, and epigenetic factors that contribute to the complex transformation process from endometriosis to malignancy.

Sep 21, 2026

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