New developments in molecular targeted therapy of ovarian cancer

Abstract

Ovarian cancer remains the most mortal gynecological cancer in the world. The standard treatment for ovarian cancer remains cytoreductive surgery followed by platinum-based chemotherapy. Although most patients are platinum-sensitive initially, the majority of them will develop platinum resistance after multiple relapses, and platinum-resistant patients have a low response to the second-line chemotherapy. Besides, ovarian cancer is considered to be a highly heterogeneous disease at the molecular level. Molecular targeted therapy is expected to be a more effective and less toxic therapeutic strategy for ovarian cancer. PARP (poly-ADP-ribose polymerase) inhibitors and anti-VEGF monoclonal antibodies are two types of approved and most effective targeted drugs for ovarian cancer at present. Other potential therapeutic targets include folate receptor α, RAS/RAF/MER pathway, PI3K/AKT pathway, and immune checkpoints. Herein, we review the related clinical trials assessing the efficacy and safety of promising targets in ovarian cancer, discuss the main challenges facing targeted therapy, and propose possible solutions to optimize the treatment effects. With the advance of next-generation sequencing technology and molecular biology techniques, we are able to recognize more targetable molecular alterations in a larger group of ovarian cancer patients. Targeting these molecular abnormalities will bring us closer to the goal of personalized therapy and improve prognosis for patients with ovarian cancer.