Ovarian Cancer: Treatment and Resistance to Pharmacotherapy

Abstract

Despite advances in surgical techniques and chemotherapy, ovarian cancer is still a leading cause of death among gynecological cancers. In addition to the late detection of the disease, the main reason for poor prognosis is resistance to pharmacotherapy, mostly platinum compounds. About a third of patients do not respond to primary platinum-based chemotherapy treatment, and over time, eventually, 80% of other patients develop chemoresistance, which makes the recurrence of disease incurable. In this review, we describe a difficult clinical hurdle faced in ovarian cancer therapy as a result of platinum resistance, as well as resistance to newer targeted therapy with PARP inhibitors and bevacizumab. We, furthermore, give attention also to the role of the tumor microenvironment as it is less well understood than the tumor cell-intrinsic mechanism. Because a central goal in ovarian cancer research is the development of novel strategies to overcome chemoresistance, treatment for cancer is moving toward personalized therapy.

Periostin in ovarian carcinoma: from heterogeneity to prognostic value

“…Ovarian cancer (OC), characterized by pathogenic and morphologic heterogeneity, is one of the most fatal gynecological malignancies due to its late diagnosis in the advanced stage, frequent relapse, and resistance to therapy [1][2][3]. The histopathologic spectrum of ovarian tumors comprises epithelial, germ cells, and sex cord-stromal tumors [4].…”

Deciphering resistance mechanisms and novel strategies to overcome drug resistance in ovarian cancer: a comprehensive review

“…One of the primary reasons for the poor prognosis of OC is drug resistance (DR), particularly to platinum-based compounds. Around one-third of patients do not respond to initial platinum-based chemotherapy, and over time, 80% of other patients develop chemotherapy resistance, rendering disease recurrence practically incurable [ 6 ].…”

Comparative study on the mutation spectrum of L‐MYC and C‐MYC genes of blood cfDNA in patients with ovarian cancer and healthy females

“…1 Due to its asymptomatic nature, unclear sign and symptoms, majority of patients are diagnosed at an advanced stage. 2,3 Increasing evidences report that the family history of OC is associated with increased risk of this disease. 4 According to a global research published by the International Federation of Gynecology and Obstetrics (FIGO), the prevalence of OC is increasing in younger women, although various investigations have outlined that these young women are interested in preserving their fertility in addition to treating this cancer but it is difficult to sustain the reproductive function because the ovary is site of the primary cancer.…”

“…Ovarian cancer (OC), the eighth most common cancer worldwide is the most mystifying gynecological malignancy among the females 1 . Due to its asymptomatic nature, unclear sign and symptoms, majority of patients are diagnosed at an advanced stage 2,3 . Increasing evidences report that the family history of OC is associated with increased risk of this disease 4 .…”