Abstract IA005: The biology of stress and resilience in ovarian cancer

Abstract Epidemiological studies have shown that adversity factors such as stress, depression, and trauma are associated with greater mortality in a variety of cancers. In contrast, resilience factors such as social support and hope have been related to slower progression and longer survival among cancer patients including women with ovarian cancer. This presentation will highlight some of the biological underpinnings of such findings. Effects of stress, social isolation, and depression on stress response systems will be discussed; these psychosocial factors have been linked with increased activity of the sympathetic nervous system and its products such as norepinephrine and dysregulation of the diurnal cycle of the neuroendocrine stress hormone cortisol. These factors in turn have downstream effects in blunting the cellular immune response and enhancing pro-metastatic processes including angiogenesis, invasion, and anoikis. Effects of these stress mediators, particularly beta-adrenergic signaling, on pro-metastatic processes have been shown experimentally in pre-clinical studies both in vitro and in vivo. Stress and social isolation have been linked with expression of pro-metastatic molecular signatures in both tumor and exosomes in clinical populations of ovarian cancer patients. In contrast, positive psychosocial factors are associated with higher levels of the “anti-stress hormone” oxytocin in the tumor microenvironment as well as with more normalized diurnal profiles of cortisol and lower levels of proinflammatory cytokines. A variety of biobehavioral interventions have been successfully tested in cancer populations to maximize patient resilience and reduce stress. Clinical implications of these findings for the design of pharmacological trials as well as implications for patient management will be discussed. Citation Format: Susan K. Lutgendorf. The biology of stress and resilience in ovarian cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Ovarian Cancer Research; 2025 Sep 19-21; Denver, CO. Philadelphia (PA): AACR; Cancer Res 2025;85(18_Suppl):Abstract nr IA005.