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Targeted agents in epithelial ovarian cancer: review on emerging therapies and future developments
Rajitha Lokadasan1, Francis V James2, Geetha Narayanan1
1Department of Medical Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India.
Abstract:
Epithelial ovarian cancer (EOC) remains a clinical challenge and there is a need to optimise the currently available treatment and to urgently develop new therapeutic strategies. Recently, there has been improved understanding of the molecular characteristics and tumour microenvironment of ovarian cancers. This has facilitated the development of various targeted agents used concurrently with chemotherapy or as maintenance. Most of the studies have explored the tumour angiogenesis pathways. In phase-III trials, bevacizumab showed a statistically significant improvement in progression-free survival, although there was no improvement in overall survival in selected high-risk cases. Although several multi-targeted tyrosine kinase inhibitors were found to be useful, the toxicity and survival benefit has to be weighed. Poly ADP ribose polymerase (PARP) inhibitors have been another marvellous molecule found to be effective in breast cancer 1, early onset (BRCA)-positive ovarian cancers. Several newer molecules targeting Her 2, Wee tyrsine kinases, PIP3/AKT/mTR-signalling pathways, folate receptors are under development and may provide additional opportunities in the future. This article focuses on the targeted agents that have successfully paved the way in the management of epithelial ovarian cancer and the newer molecules that may offer therapeutic opportunities in the future.
Insights
Epithelial ovarian cancer treatments are evolving with targeted agents. While bevacizumab improves progression-free survival, new therapies targeting specific pathways offer future promise for better outcomes.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Epithelial ovarian cancer (EOC) presents significant clinical challenges, necessitating optimized treatments and novel therapeutic strategies.
- Advances in understanding EOC molecular characteristics and tumor microenvironment have spurred the development of targeted agents.
- Current research focuses on targeted therapies, including angiogenesis inhibitors and poly (ADP-ribose) polymerase (PARP) inhibitors.
Purpose of the Study:
- To review targeted agents that have advanced epithelial ovarian cancer management.
- To explore emerging molecular targets and novel therapeutic opportunities for EOC.
- To discuss the role of targeted therapies in conjunction with chemotherapy or as maintenance treatment.
Main Methods:
- Review of phase-III clinical trials data for targeted agents in epithelial ovarian cancer.
- Analysis of molecular pathways and their relevance to EOC targeted therapy development.
- Examination of the efficacy, toxicity, and survival benefits of various targeted agents.
Main Results:
- Bevacizumab demonstrated significant improvement in progression-free survival in phase-III trials for EOC.
- Poly (ADP-ribose) polymerase (PARP) inhibitors show efficacy, particularly in BRCA-mutated ovarian cancers.
- Several multi-targeted tyrosine kinase inhibitors offer potential benefits, but require careful consideration of toxicity and survival impact.
Conclusions:
- Targeted agents have become integral to epithelial ovarian cancer management, improving progression-free survival.
- Ongoing research into novel molecules targeting pathways like Her 2 and PIP3/AKT/mTOR signaling holds promise for future EOC therapies.
- Personalized therapeutic strategies based on molecular profiling are crucial for optimizing EOC treatment outcomes.
