The majority of patients diagnosed with advanced epithelial ovarian carcinoma (EOC) relapse with resistant disease, and there are no biomarkers that possess clinical utility to identify or monitor these patients. This study aimed to identify secreted proteins (‘secretome’) collected from human EOC cell lines that differ in their inherent platinum sensitivity. Secreted proteins collected from conditioned medium from ovarian cancer cell lines that vary in their sensitivity to cisplatin were digested with trypsin and analysed by liquid chromatography-tandem mass spectrometry for peptide identification. Of the 1688 proteins identified, 16 possessed significant differential abundances (P<0.05) between the platinum-resistant and -sensitive cell lines. A number of these were verified by immunoblot, including COL11A1, which was also found to be associated with worse progression-free survival (PFS; N=723) and overall survival (OS; N=1183) as assessed from publicly available transcript expression data from ovarian cancer tumour specimens. Secretome proteomics of EOC cells resulted in the identification of a novel candidate biomarker, COL11A1. The expression level of COL11A1 correlates to worse PFS and OS, and is predicted to reside in peripheral circulation making this an attractive candidate for validation in sera as a biomarker of cisplatin resistance and poor outcome.

The incidence and mortality of uterine cancer are increasing, with 66 570 new cases, including endometrial cancers and sarcomas, and 12 940 deaths estimated in the United States.^1-4 Disparities between Black and White patients with uterine cancer have persisted over decades, with higher likelihoods of aggressive disease, recurrence, and death among Black patients.^5-16 The factors explaining these trends and disparities are complex and multifactorial.^{7-11,15,17-22} Structural determinants of health integrate social constructs such as race and ethnicity with biological associations of inherited ancestry, lifestyle, exposures, and other factors to influence trends and disparities in disease susceptibility, severity, and outcomes.^17,18,20-22 Even among patients with uterine cancer who have equal access to care²³ and receive similar guideline-adherent treatment, racial differences in cancer diagnosis and survival persist.^15,24,25 Differences in histologic subtype, disease stage, tumor grade, treatment, supportive services, and molecular features have been implicated in health disparities among patients with uterine cancer.^{6-16,24,26-50}

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