Platinum-resistant ovarian cancer: From mechanisms to treatment strategies

Over the last few decades, platinum-based chemotherapy has served as the standard chemotherapy in treating ovarian cancer (OC). While most patients initially respond well to platinum-based chemotherapy, approximately 70% of patients eventually relapse and confer resistance to platinum. Recent preclinical evidence on platinum-resistant ovarian cancer (PROC) is encouraging. Various potential mechanisms, such as genomic and epigenetic alterations, pharmacological alterations, DNA damage repair, metabolic reprogramming, the tumor microenvironment (TME) and programmed cell death, have been implicated in platinum resistance. In addition, clinical trials regarding the treatment of PROC have shown considerable success, and a multitude of promising therapies are in progress. In this review, we comprehensively summarized the underlying mechanisms of platinum resistance in OC and proposed the most promising novel therapeutics and strategies employed in the treatment of PROC.