Ovarian cancer is unusual among intra-abdominal epithelial cancers in that it only rarely spreads through the bloodstream to different sites. More commonly, ovarian cancer spreads locally in the abdominal cavity. Recent work in Dr. Swisher’s laboratory identified tumor-specific, cell-free DNA in the plasma of patients with ovarian cancer. One third of ovarian cancer patients had circulating tumor-specific DNA. Circulating tumor DNA was correlated with worse survival rates and the development of subsequent brain metastases. She proposes that alterations in factors that cause angiogenesis, or new blood vessel growth, explain the worse prognosis and increased metastatic potential of cases with circulating tumor DNA. Angiogenesis is critical in tumor growth and metastasis, allowing tumor cells access to nascent blood vessels. Angiogenic factors have been associated with poor prognosis in ovarian cancer. In her study, she will examine the stability of the small blood vessels near and within ovarian cancers and assess expression of genes and proteins involved in ovarian cancer angiogenesis in two groups of ovarian cancers: those from patients with circulating tumor DNA and those without. She expects that tumors from women with free tumor DNA in plasma will show decreased vessel stability and alterations in angiogenic factor gene expression that correlate with worse survival. The lack of understanding of ovarian tumor biology and metastasis has hindered efforts to improve survival, as most women relapse and die of chemoresistant disease. Testing the relationship of free tumor DNA in plasma and ovarian tumor angiogenesis will provide a previously unexamined basis from which to gain unique insights into ovarian tumor biology.