Autophagy regulation in ovarian cancer chemoresistance: Molecular mechanisms and emerging frontiers

Chemotherapy resistance is currently the primary cause of death in patients with ovarian cancer. An increasing amount of data indicates a close relationship between autophagy and chemotherapy resistance in this malignancy. Autophagy, an intracellular degradation process essential for maintaining cellular homeostasis, can promote chemotherapy resistance when dysregulated. This review synthesizes current knowledge on how autophagy-related drugs, proteins, RNAs, and pathway interventions influence chemoresistance in ovarian cancer, along with their underlying molecular mechanisms. It also outlines the broader relationship between autophagy and tumor, with a specific focus on ovarian cancer. Additionally, we evaluate the potential of combination therapies involving autophagy-modulating agents and conventional chemotherapeutic drugs, based on their synergistic effects. Although the majority of studies indicate that autophagy activation promotes cisplatin resistance in ovarian cancer, a minority of reports suggest opposing roles. This review aims to provide new perspectives for overcoming chemotherapy resistance in ovarian cancer. Resistance is currently the primary cause of death in patients with ovarian cancer. An increasing amount of data indicates a close relationship between autophagy and chemotherapy resistance in ovarian cancer. Autophagy is an intracellular degradation process that maintains cellular homeostasis. Imbalances in autophagy can lead to chemotherapy resistance in ovarian cancer.