Narrative review of novel chemotherapeutic agents in management of ovarian cancer

Abstract

: For over 30 years cytotoxic chemotherapy has been used to treat epithelial ovarian cancer. Type of platinum agents, scheduling of chemotherapy and the use of neoadjuvant have been extensively studied. However, in the past decade understanding of the biology of epithelial ovarian cancer and advances in molecular diagnostics have helped to identify new molecular pathways and design small molecules and antibodies which can transform treatment of this deadly disease. Such advances have enabled us to pursue new strategies in order to enhance the efficacy of chemotherapeutic agents, delay recurrence, overcome resistance to platinum or treat platinum resistant disease. In this section we review recent advances leading to approval of new agents, and the current efforts in developing new chemotherapeutic drugs. We discuss the role of antiangiogenic agents including vascular endothelial growth factor (VEGF) antibodies, VEGF receptor (VEGFR) tyrosine kinase inhibitors and Tie-Ang inhibitors. We also review new developments that have led to the approval of poly(ADP-ribose) polymerase (PARP) inhibitors as maintenance therapy in frontline and recurrent epithelial ovarian cancer and discuss new DNA repair targeting agents such as ataxia telangiectasia-mutated and Rad3-related (ATR) and cell cycle checkpoint inhibitors. Finally, we review the study data related to the most recent therapeutic strategies such as antibody drug conjugates. The role of immunotherapy in ovarian cancer has already been discussed in the previous article “The role of immunotherapy in ovarian cancer” in this special series. 12 tubulin-targeting DM4 through a cleavable linker. Following binding to the FR α , antigen mediated endocytosis results in an DM4 acts as anti-tubulin The tolerability preliminary of mirvetuximab This study platinum-resistant or platinum-refractory disease. Investigators reported partial response in 8/24 patients (33% of patients).