Platinum resistant ovarian cancer - No longer a graveyard for drug development

For nearly 25 years the concept of platinum resistance has framed platinum-resistant and refractory ovarian cancer (PROC) as a high-risk, uniform subpopulation characterized as having limited therapeutic options, early disease progression and inevitable death. With the incorporation of targeted therapies in well-designed, scientifically-driven, randomized clinical trials for PROC, no longer is the disease seen as a homogeneous entity. Molecular biomarkers inform the tumor biology and clinical course of PROC. Over the past decade, five novel therapies involving anti-angiogenesis strategies, antibody-drug conjugates, immunologic checkpoint inhibition and glucocorticoid receptor blockade have been made available, several of which confer a survival benefit. As the therapeutic armamentarium for PROC expands, it will be important to clarify adverse event mitigation, and the role of biomarkers and their assays.