Normal cells must overcome multiple protective mechanisms to develop into cancer cells. Their new capabilities
include self-sufficiency in growth signals and insensitivity to antigrowth signals, evasion of apoptosis, a limitless replicative
potential, sustained angiogenesis, and tissue invasion and metastasis; these are also termed the six hallmarks of cancer. A
deep understanding of the genetic and protein alterations involved in these processes has enabled the development of targeted therapy strategies and clinical trial design in the search for ovarian cancer treatments. Clinically, significantly longer progression-free survival has been observed in the single use of PARP, MEK, VEGF and Chk1/Chk2 inhibitors. However, the
clinical efficacy of the targeted agents are still restricted to specific molecular subtypes and no trials illustrate a benefit in
overall survival. Exploring novel drug targets or combining current feasible biological agents hold great promise to further
improve outcomes in ovarian cancer. In this review, we intend to provide a comprehensive description of the molecular alterations involved in ovarian cancer carcinogenesis and of emerging biological agents and combined strategies that target
aberrant pathways, which might shed light in future ovarian cancer treatment.