Deciphering mitochondrial metabolic vulnerabilities in ovarian clear cell carcinoma with mass spectrometry-based clinical proteomics.

introductionOvarian clear cell carcinoma (OCCC) is a rare gynecologic malignancy with a high mortality rate and a lack of response to standard chemotherapy. Despite the functional association between the loss of ARID1A and mitochondrial dependency, the clinical translation of mitochondria-targeted therapies in OCCC has been hindered by a substantial disconnect between biological insight and therapeutic application. There is an urgent, unmet need to identify novel, more specific and effective therapies targeting the mitochondria-related molecular vulnerabilities of ARID1A-mutant OCCC. AREAS COVERED: This critical perspective is informed by results from PubMed literature searches and recent webinars and presentations providing insight into opportunities for mass spectrometry (MS)-based proteomic approaches to enhance and accelerate the clinical translation of mitochondria-targeted therapies in OCCC. EXPERT OPINION: The MS-based proteomic analysis of clinically-relevant experimental models of OCCC will provide a unique opportunity to progress beyond simplified preclinical models and incorporate the full spectrum of patient-specific systemic and microenvironmental factors that may influence therapeutic response, including the adipocyte-related metabolic dependencies of OCCC. Targeted MS is a precise and robust approach that can be applied to verify these novel, mechanistic insights into how mitochondria-targeted therapies intersect with tumor metabolism in OCCC.