New hopes and promises in the treatment of ovarian cancer focusing on targeted treatment—A narrative review Original paper

What was studied?

This narrative review examines the advancements in targeted therapies for ovarian cancer. It focuses on recent developments in the treatment landscape, particularly on therapies such as angiogenesis inhibitors, PARP inhibitors, immune checkpoint inhibitors, and folate receptor alpha inhibitors. The review highlights the potential of these therapies in extending progression-free survival (PFS) and overall survival (OS) in ovarian cancer patients. It also emphasizes the importance of identifying biomarkers that could guide treatment decisions and help in personalizing therapies for patients, as well as the challenges that still need to be addressed for these therapies to be fully effective in clinical practice.

Who was studied?

The studies reviewed in this article involve ovarian cancer patients, including those with platinum-sensitive and platinum-resistant ovarian cancer. These patients often have varying genetic backgrounds, with a focus on those carrying BRCA1/BRCA2 mutations and those expressing folate receptor alpha (FRα). Clinical trials from multiple phases and different study designs were included to assess the effectiveness of therapies like bevacizumab, olaparib, and mirvetuximab soravtansine. Both early and advanced-stage patients were studied, and the review draws on findings from various regions and healthcare settings.

Most important findings

The review highlights the positive effects of targeted therapies such as bevacizumab, which is an anti-VEGF therapy. It has demonstrated an improvement in progression-free survival when combined with chemotherapy for advanced ovarian cancer, although its impact on overall survival remains limited. The PARP inhibitor olaparib has been particularly effective for patients with BRCA mutations, improving both overall and progression-free survival, especially in recurrent platinum-sensitive ovarian cancer. Mirvetuximab soravtansine, which targets folate receptor alpha, has shown promising results in platinum-resistant ovarian cancer patients who have high FRα expression. Despite the promise of immune checkpoint inhibitors, they have not yet demonstrated significant efficacy in ovarian cancer, with ongoing research needed to assess their potential. The review suggests that combining different targeted therapies might yield better results, although side effects and toxicity remain a challenge.

Key implications

The review suggests that while targeted therapies have provided new hope in ovarian cancer treatment, they are not curative and often only delay the recurrence of the disease. The key to improving treatment outcomes lies in better patient selection through genetic and molecular profiling, ensuring that patients receive the therapies most likely to be effective for their specific cancer subtype. Further clinical trials are needed, particularly for those with platinum-resistant ovarian cancer, as current treatment options are limited. Moreover, ongoing research into combining targeted therapies and identifying novel biomarkers will be essential to advancing treatment strategies and improving survival rates for ovarian cancer patients.