Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Dec 15;125 Suppl 24(Suppl 24):4623-4629.
doi: 10.1002/cncr.32544.

New strategies in ovarian cancer treatment

Jung-Min Lee  1 , Lori Minasian  2 , Elise C Kohn  3
Affiliations
Review

New strategies in ovarian cancer treatment

Jung-Min Lee et al. Cancer. .

Abstract

Insights from basic science dissecting carcinogenesis in the fallopian tube and ovary have led to a deeper understanding of the origin, molecular characteristics, and types of ovarian cancers. This logically then has led to the development of novel approaches to treat ovarian cancer. Increasingly, novel agents are being developed to target the different growth pathways. The identification of molecular markers associated with different histopathologies has resulted in newer clinical trial designs to capture both clinical and translational endpoints. Unique molecular characteristics in DNA damage and repair pathways and unique cell surface markers have driven new drug development, yielding promise for both patients with platinum-sensitive and platinum-resistant ovarian cancers. Specific examples described include the histology-selective mutations, such as ARID1A in clear cell and endometrioid ovarian cancers; the rationale for using cell cycle checkpoint inhibitors when there already is a p53-mediated loss of cell cycle checkpoint regulation or combinations of agents that will both induce neoantigen formation and unleash immune modulators; and techniques to enhance the therapeutic delivery of known agents. A systematic and thoughtful approach to combining agents in clinical trials is needed so that irrespective of the trial outcomes, the results inform both clinical and translational endpoints.

Keywords: chemotherapy; combination therapy; microenvironment; new agents; ovarian cancer; targeted therapy.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES

The authors made no disclosures.

Figures

Figure 1.
Figure 1.
The Nordic Society of Gynaecological Oncology (NSGO)-OV-UMB1 umbrella study. A different Gynecologic Cancer InterGroup clinical trials group is leading each arm and NSGO is the sponsor. Part 1 involves safety and initial activity assessment of the doublet. If the doublet passes the predetermined statistical target, it moves into a randomized phase 2 study against standard of care, using a 2:1 randomization (NSGO-OV-UM1/ENGOT-OV30). ATRi indicates ATR inhibitor; ENGOT, European Network for Gynaecological Oncological Trial.
See this image and copyright information in PMC

References

    1. Duska LR, Kohn EC. The new classifications of ovarian, fallopian tube, and primary peritoneal cancer and their clinical implications. Ann Oncol. 2017;28(suppl 8):viii8–viii12. - PMC - PubMed
    1. Conic I, Stanojevic Z, Jankovic Velickovic L, et al. Epithelial ovarian cancer with CD117 phenotype is highly aggressive and resistant to chemotherapy. J Obstet Gynaecol Res. 2015;41:1630–1637. - PubMed
    1. Farley J, Brady WE, Vathipadiekal V, et al. Selumetinib in women with recurrent low-grade serous carcinoma of the ovary or peritoneum: an open-label, single-arm, phase 2 study. Lancet Oncol. 2013;14:134–140. - PMC - PubMed
    1. Wiegand KC, Shah SP, Al-Agha OM, et al. ARID1A mutations in endometriosis-associated ovarian carcinomas. N Engl J Med. 2010;363:1532–1543. - PMC - PubMed
    1. Guan B, Mao TL, Panuganti PK, et al. Mutation and loss of expression of ARID1A in uterine low-grade endometrioid carcinoma. Am J Surg Pathol. 2011;35:625–632. - PMC - PubMed

Publication types