An overview of early investigational therapies for chemoresistant ovarian cancer

Abstract

Introduction: Epithelial ovarian cancer (EOC) is the fourth commonest cause of female cancer death in the developed world. Although progress in treatment has improved survival, ∼ 80% of patients with advanced EOC will experience a recurrence and eventually will become resistant to chemotherapy. The aim of treatment for chemoresistant EOC has traditionally been limited to palliation of symptoms but the recent introduction of new therapies targeting molecular pathways is beginning to demonstrate improvements in disease control.

Areas covered: This review provides an overview of early investigational drugs for the treatment of ‘platinum-resistant’ EOC. The article is based on English peer-reviewed articles located on MEDLINE and related abstracts presented at major international meetings.

Expert opinion: Drugs targeting several pathways are increasingly used to treat ‘platinum-resistant’ EOC. Currently, drugs targeting the angiogenesis pathway have been shown to significantly improve patient outcome. Studies are also being undertaken with inhibitors of poly(ADP-ribose) polymerase (PARP), targeting the DNA repair pathway as it is possible that the benefits seen with these agents in ‘platinum-sensitive’ disease will apply to those with ‘platinum-resistant’ disease. The discovery of predictive biomarkers that identify patients which benefit from these targeted therapies is paramount to the success of these treatments in the future.

Keywords:

• angiogenesis
• chemotherapy
• immune checkpoint inhibitors
• ovarian cancer
• recurrence
• resistant
• targeted therapy

Declaration of interests

P Benedetti Panici has attended advisory boards for AstraZeneca, Pharmamar and Roche in the last 5 years. JA Ledermann has acted as the Principal Investigator for the AstraZeneca sponsored study 19 olaparib trial. In the last 5 years, he has also attended advisory boards for AstraZeneca, Clovis, Boehringer Ingelheim, Merck & Co., and Roche. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

This box summarizes key points contained in the article.