Current status on biologic therapies in the treatment of epithelial ovarian cancer

Treatment of epithelial ovarian cancer generally involves surgical staging followed by chemotherapy with a combination of a platinum and a taxane-containing agent. However, a majority of patients recur and ultimately succumb to their cancer. Novel therapies that target specific pathways involved in ovarian tumorigenesis are rapidly emerging. In ovarian cancer, targeted therapies have focused on both the vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) pathways. Single-agent bevacizumab, a VEGF inhibitor, demonstrated significant clinical activity in multiple phase II studies. Various combinations of cytotoxic and biologic agents with bevacizumab as well as newer anti-angiogenesis agents are being tested. In contrast, EGFR inhibitors have not shared the same clinical activity in epithelial ovarian cancers as compared to the VEGF inhibitors. Translational studies are needed to help design rational combinations of targeted agents and to help predict response to therapy.