Rare ovarian tumours. Other treatments for ovarian cancer

Abstract

Aim The description of rare malignant ovarian tumours and the most suitable treatments. Alternative therapies different from intravenous chemotherapy are also explained. Methods Literature review and ongoing trial information have been used to elaborate this guide. Results Each ovarian cancer type must be identified and treated properly from diagnostic to surgery, adjuvant treatment and metastatic disease. Hormonotherapy can be useful as an alternative treatment, especially in low-grade ovarian cancer and endometrioid subtype. Tumour characterisation is appropriated for treatment selection when targeted therapy is indicated. MEK inhibitors, tyrosine-kinase inhibitors, EGFR inhibitors, therapies against integrins, antibody–drug conjugates and other strategies are described. Antiangiogenics, PARP inhibitors and immunotherapy are discussed in other parts of this publication. Conclusion Different ovarian cancer types must receive the appropriated treatment. Alternative therapies may be evaluated beyond the standard therapy, frequently in a clinical trial, and an individualised molecular study may help to find the best treatment.

Endometriosis-Associated Ovarian Cancer: From Molecular Pathologies to Clinical Relevance

“…However, the individual treatment plan depends on various factors such as the stage of cancer, the extent of spread, the patient's overall health, and their fertility desires. Therefore, the therapy of patients with EAOC and other ovarian cancers differs from their histological subtype [154], namely, the high-grade serous ovarian carcinoma (HGSOC), low-grade serous carcinoma of the ovary (LGSOC), clear-cell ovarian carcinoma (CCOC), endometrioid ovarian carcinoma, mucinous carcinoma, and borderline ovarian tumors, as well as germ cell tumors and stromal tumors [155]. Nevertheless, primary ovarian cancer and EAOC with the same pathological type share a similar origin [12,156], and thus may result in comparable treatment strategies.…”

“…Hormonotherapy is another adjuvant systemic treatment option in endometrioid ovarian cancer exhibiting hormonal receptor positivity [155,163]. Thus, the hormone-receptor status has an impact on the treatment [170], as is known for other gynecological tumors.…”

“…However, further research and clinical trials in patients with EAOC are necessary to confirm the benefit of PARP inhibitors and bevacizumab in this clinical subgroup. In addition, targeted therapies using tyrosine-kinase inhibitors, MEK inhibitors, and PI3K/mTOR/Akt inhibitors are currently being tested in several ovarian cancer subtypes [155]. For example, the efficiency of the mTOR/AKT inhibitor temsirolimus in decreasing endometriotic cell proliferation was confirmed in a mouse model of deep-infiltrating endometriosis [196].…”

The potential value of cancer‐testis antigens in ovarian cancer: Prognostic markers and targets for immunotherapy

“…Thus, early diagnosis and maintenance therapy after surgical resection are particularly important in ovarian cancer, and novel treatment methods are urgently needed to improve the prognoses of patients with advanced ovarian cancer. 5 Hence, current research has focused on the therapeutic targets and related molecular mechanisms of ovarian cancer. Owing to the development of whole genome sequencing technology, the genome map of ovarian cancer has been established, which facilitates the identification of the driving genes of ovarian cancer occurrence and development and provides a strategy for the targeted treatment of ovarian cancer.…”

Immunotherapy in rare ovarian cancer

“…Up to recently, all subtypes of EOC are included in the same clinical trials, leading to a uniform treatment. Yet we are well aware they behave biologically differently and thus warrant a different approach [4]. Non-HGSOC generally have good prognosis in early disease, but treating advanced and recurrent disease is challenging, mostly given their resistance to cytotoxic treatments.…”