Grunewald Tami, Ledermann Jonathan A
University College London Hospitals, London, UK.
University College London Hospitals, London, UK; UCL Cancer Institute, London, UK.
Best Pract Res Clin Obstet Gynaecol. 2017 May;41:139-152. doi: 10.1016/j.bpobgyn.2016.12.001. Epub 2016 Dec 8.
Epithelial ovarian cancer has the highest mortality rate of all gynaecological malignancies. Most women present with advanced disease and develop a recurrence after radical surgery and chemotherapy. Improving the results of first- or subsequent-line chemotherapy has been slow, and novel approaches to systemic treatment are needed. Ovarian cancer is a heterogeneous disease with complex molecular and genetic changes. Understanding these better will provide information on the mechanisms of resistance and opportunities to target therapy more rationally, exploiting specific changes in the tumour. Here we reviewed targeted approaches to therapy, focussing on targeting angiogenesis and inhibition of DNA repair, 2 areas that show promising activity. Additionally, we reviewed studies that are underway, targeting the cell cycle, signalling pathways and immunotherapeutic strategies. Many of these innovative approaches already demonstrate promising activity in ovarian cancer and have the potential to improve the outcome in women with ovarian cancer.
上皮性卵巢癌在所有妇科恶性肿瘤中死亡率最高。大多数女性就诊时已处于疾病晚期,在根治性手术和化疗后会复发。一线或后续化疗效果的改善进展缓慢,因此需要新的全身治疗方法。卵巢癌是一种异质性疾病,具有复杂的分子和基因变化。更好地了解这些变化将为耐药机制提供信息,并为更合理地靶向治疗提供机会,利用肿瘤中的特定变化。在此,我们综述了靶向治疗方法,重点关注靶向血管生成和抑制DNA修复,这两个领域显示出有前景的活性。此外,我们还综述了正在进行的针对细胞周期、信号通路和免疫治疗策略的研究。这些创新方法中的许多已经在卵巢癌中显示出有前景的活性,并且有可能改善卵巢癌女性的治疗结果。