Targeted therapy and immunotherapy: Diamonds in the rough in the treatment of epithelial ovarian cancer

Abstract

Currently, for ovarian cancer, which has the highest mortality rate among all gynecological cancers, the standard treatment protocol is initial tumor cytoreductive surgery followed by platinum-based combination chemotherapy. Although the survival rate after standard treatment has improved, the therapeutic effect of traditional chemotherapy is very limited due to problems such as resistance to platinum-based drugs and recurrence. With the advent of the precision medicine era, molecular targeted therapy has gradually entered clinicians’ view, and individualized precision therapy has been realized, surpassing the limitations of traditional therapy. The detection of genetic mutations affecting treatment, especially breast cancer susceptibility gene (BRCA) mutations and mutations of other homologous recombination repair defect (HRD) genes, can guide the targeted drug treatment of patients, effectively improve the treatment effect and achieve a better patient prognosis. This article reviews different sites and pathways of targeted therapy, including angiogenesis, cell cycle and DNA repair, and immune and metabolic pathways, and the latest research progress from preclinical and clinical trials related to ovarian cancer therapy.

Analysis of olaparib-induced hyperglycemia during three-month therapy with consideration of BMI of ovarian cancer patients

“…Although ovarian cancer is a malignancy with a poor prognosis, currently available treatments allow to extend both the time to progression, as well as the overall survival period. According to numerous studies, PARP inhibitors represent a group of drugs which may potentially prolong these parameters [1,4,18]. However, as with any drug, they may imply the risk of complications.…”

“…The primary clinical trials investigating the efficacy of olaparib (SOLO-1, SOLO-2, STUDY-19, Olympia, PAOLA-1, Profound) did not report the occurrence of hyperglycemia as an adverse effect in the groups receiving the active substance [1,2,3,5,8,9,10,18,20,21,22]. The exception is the POLO trial, which was conducted to evaluate the efficacy of olaparib in metastatic pancreatic adenocarcinoma with inherited mutations in the BRCA genes.…”

“…Most cases of ovarian cancer are diagnosed at late stages and show poor 5-year survival rate, predominantly due to the lack of early detection methods and the absence of specific signs of cancer development [1]. Treatment of ovarian cancer most frequently begins with surgery, involving cytoreductive procedure.…”

Identifying Explainable Machine Learning Models and a Novel SFRP2+ Fibroblast Signature as Predictors for Precision Medicine in Ovarian Cancer

“…Ovarian cancer (OC), cervical cancer, and endometrial cancer are commonly diagnosed diseases that affect the female reproductive organs [1][2][3]. Advanced-stage OC is estimated to have the highest mortality rate among gynecological cancers [4][5][6]. Approximately 90-95% of OC takes the form of primary tumors originating from epithelial cells, while the remaining 5-10% comprises primary cancers from other cell subtypes [3,6,7].…”

In Vitro and In Vivo Efficacy of a Stroma-Targeted, Tumor Microenvironment Responsive Oncolytic Adenovirus in Different Preclinical Models of Cancer

“…Bevacizumab, combined with platinum-based chemotherapy, has been recommended by the National Comprehensive Cancer Network (NCCN) guidelines as a first-line treatment for EOC [ 9 ]. This recommendation is based on its demonstrated advantage of a prolonging progression-free survival (PFS) that does not last more than 3.5 months in average [ 13 ]. Interestingly, the combination of the anti-PD1 and anti-CTLA4 check point inhibitors showed promising results in platinum-resistant ovarian cancer at the six month-interim analyses with an overall response rate (ORR) of 34% (doubling the results of nivolumab monotherapy) [ 14 , 15 ].…”