Molecular mechanisms of mherapy resistance in ovarian cancer

Abstract

Ovarian cancer remains one of the most frequently diagnosed and lethal gynaecological malignancies. Standard treatment involves surgical cytoreduction followed by chemotherapy based on platinum compounds and taxanes. Despite initial therapeutic efficacy, many patients experience disease recurrence and develop drug resistance, posing a significant clinical challenge. This review summarises the main molecular mechanisms underlying resistance to commonly used drugs, including paclitaxel, cisplatin, and PARP inhibitors. The role of multidrug resistance (MDR), associated with the overexpression of ABC transporters and alterations in drug metabolism, is discussed. Particular attention is given to cellular mechanisms, including changes in microtubule structure, regulation of apoptosis, and activation of signalling pathways such as PI3K/AKT/mTOR. Mechanisms related to drug transport, detoxification, and DNA repair are also addressed, together with the influence of the tumour microenvironment and epigenetic modifications. Understanding these mechanisms may contribute to the development of novel therapeutic strategies.