Nair Megha, Samidurai Arun, Das Anindita, Kakar Sham S, Kukreja Rakesh C
Department of Internal Medicine, Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
Department of Physiology, University of Louisville, Louisville, KY, USA.
J Ovarian Res. 2025 Apr 5;18(1):72. doi: 10.1186/s13048-025-01636-z.
Ovarian Cancer (OC) is recognized as the most lethal gynecologic malignancy, characterized by numerous genetic mutations that trigger uncontrolled cellular growth and replication. Emerging evidence suggests that non-coding RNAs including miRNAs and lncRNAs significantly influence OC through their multiple roles including tumor initiation, progression, metastasis, immune evasion, and chemoresistance, making them promising diagnostic markers and therapeutic targets. The primary approach to treating OC typically involves cytoreductive surgery followed by chemotherapy. However, the chemotherapeutic agents, particularly the anthracyclines such as doxorubicin (DOX), are known for their cardiotoxic effects, which can range from acute to chronic, potentially leading to heart failure and death. To enhance the overall treatment response and to minimize cardiotoxicity, alternative strategies have been explored. These include the use of liposomal doxorubicin (DOXIL) as a substitute for DOX, various radiotherapies, immunotherapies, and the co-administration of angiotensin-converting enzyme inhibitors and/or beta-blockers. Phosphodiesterase-5 inhibitors (PDE5i) have also demonstrated efficacy in reducing cardiotoxicity linked to cancer treatments and in promoting apoptosis in cancer cells across multiple cancer types. Although there is no current clinical trial directly examining the impact of PDE5i on reducing cardiotoxicity in OC, however emerging therapies such as Withaferin A, PARP inhibitors, and nanoparticle combination therapy show promise. Additional research is essential to develop treatments that are both effective against OC and less harmful to the heart.
卵巢癌（OC）被认为是最致命的妇科恶性肿瘤，其特征是存在大量基因突变，这些突变会引发细胞的失控生长和复制。新出现的证据表明，包括微小RNA（miRNA）和长链非编码RNA（lncRNA）在内的非编码RNA通过其在肿瘤起始、进展、转移、免疫逃逸和化疗耐药等多个方面的作用，对卵巢癌产生显著影响，这使得它们有望成为诊断标志物和治疗靶点。治疗卵巢癌的主要方法通常包括细胞减灭术，随后进行化疗。然而，化疗药物，特别是阿霉素（DOX）等蒽环类药物，因其心脏毒性作用而闻名，这种毒性作用可从急性到慢性，有可能导致心力衰竭和死亡。为了提高整体治疗反应并将心脏毒性降至最低，人们探索了替代策略。这些策略包括使用脂质体阿霉素（DOXIL）替代阿霉素、各种放射疗法、免疫疗法，以及联合使用血管紧张素转换酶抑制剂和/或β受体阻滞剂。磷酸二酯酶-5抑制剂（PDE5i）在降低与癌症治疗相关的心脏毒性以及促进多种癌症类型癌细胞凋亡方面也已显示出疗效。尽管目前没有直接研究PDE5i对降低卵巢癌心脏毒性影响的临床试验，但是诸如Withaferin A、聚（ADP-核糖）聚合酶（PARP）抑制剂和纳米颗粒联合疗法等新兴疗法显示出了前景。开展既有效对抗卵巢癌又对心脏危害较小的治疗方法的研究至关重要。
