上皮性卵巢癌（OC）是全球最致命的妇科恶性肿瘤。用针对血管内皮生长因子（VEGF）的抗体贝伐珠单抗阻断血管生成在不同OC治疗线路中展现出有效性。该研究通过回顾性分析三个独立队列，调查了肿瘤血管生成相关基因的临床影响及其与OC患者贝伐珠单抗治疗反应的关联。在一个始发OC队列（n = 195）中量化了七种血管生成基因（VEGF，VEGFR2，PDGFA，PDGFB，PDGFRA，PDGFRB，KIT）的mRNA表达，建立了一个0到3的转录瘤血管生成评分，并与无进展生存期（PFS）和总生存期（OS）相关联。在独立的公开队列来自癌症基因组图谱（TCGA，n = 582）中确认了该评分，并在来自ICON7试验的基因表达寡库（GEO）数据集GSE140082（n = 380）中分析了瘤血管生成评分对贝伐珠单抗治疗的预测效能。在始发队列中，瘤血管生成评分预测了OC患者的PFS和OS（p < 0.001，分别）。肿瘤PDGFA表达（PFS：HR 2.46，p = 0.005；OS：HR 2.26，p = 0.011）和高肿瘤转录血管生成评分（PFS：HR 1.41，p = 0.018）被确定为独立的临床预测因子。转录血管生成评分在TCGA队列中对PFS具有显著但较小的影响效应。然而，在ICON7试验中，瘤血管生成评分与贝伐珠单抗治疗的益处没有关联。我们的研究表明，肿瘤血管生成因子的表达对OC不利。建立的评分可以用于确定对靶向血管生成治疗有反应的患者，这一概念值得进行前瞻性受控性临床试验。 Copyright©2023，Elsevier Inc.发行。

Epithelial ovarian cancer (OC) is the deadliest gynecological malignancy worldwide. Blocking angiogenesis with bevacizumab, an antibody targeting vascular endothelial growth factor (VEGF), shows efficacy in different lines of OC therapy. This study investigates the clinical impact of tumoral expression of angiogenesis-related genes and their association with bevacizumab response in OC in retrospective analysis of three independent cohorts.mRNA expression of seven angiogenic genes (VEGF, VEGFR2, PDGFA, PDGFB, PDGFRA, PDGFRB, KIT) was quantified in an inception OC cohort (n = 195) and a transcriptional tumor angiogenesis score from 0 to 3 was established and linked to progression-free survival (PFS) and overall survival (OS). This score was corroborated in an independent publicly available cohort from The Cancer Genome Atlas (TCGA, n = 582) and prediction of therapeutic efficacy of bevacizumab by the angiogenesis score was analyzed in the Gene Expression Omnibus (GEO) dataset GSE140082 (n = 380) from the ICON7-trial.The tumor angiogenesis score prognosticated PFS and OS in patients with OC from the inception cohort (p < 0.001, respectively). Tumoral PDGFA expression (PFS: HR 2.46, p = 0.005; OS: HR 2.26, p = 0.011) and a high tumoral transcriptional angiogenesis score (PFS: HR 1.41, p = 0.018) were identified as independent predictors of clinical outcome. The transcriptional angiogenesis score exhibited a significant though smaller effect size on PFS in the TCGA cohort. However, in the ICON7-trial, the angiogenesis score was not associated with benefit of bevacizumab treatment.Our study indicates that tumoral expression of angiogenic genes is unfavorable in OC. The established score could be used to identify patients who respond to targeted angiogenic therapies, a concept that warrants prospective controlled clinical trials.Copyright © 2023. Published by Elsevier Inc.