Epithelial ovarian cancer: Evolution of management in the era of precision medicine.
Ovarian cancer is the second most common cause of gynecologic cancer death in women around the world. The outcomes are complicated, because the disease is often diagnosed late and composed of several subtypes with distinct biological and molecular properties (even within the same histological subtype), and there is inconsistency in availability of and access to treatment. Upfront treatment largely relies on debulking surgery to no residual disease and platinum-based chemotherapy, with the addition of antiangiogenic agents in patients who have suboptimally debulked and stage IV disease. Major improvement in maintenance therapy has been seen by incorporating inhibitors against poly (ADP-ribose) polymerase (PARP) molecules involved in the DNA damage-repair process, which have been approved in a recurrent setting and recently in a first-line setting among women with BRCA1/BRCA2 mutations. In recognizing the challenges facing the treatment of ovarian cancer, current investigations are enlaced with deep molecular and cellular profiling. To improve survival in this aggressive disease, access to appropriate evidence-based care is requisite. In concert, realizing individualized precision medicine will require prioritizing clinical trials of innovative treatments and refining predictive biomarkers that will enable selection of patients who would benefit from chemotherapy, targeted agents, or immunotherapy. Together, a coordinated and structured approach will accelerate significant clinical and academic advancements in ovarian cancer and meaningfully change the paradigm of care.
['Lheureux|Stephanie|S|', 'Braunstein|Marsela|M|0000-0002-4838-5224', 'Oza|Amit M|AM|']
D000970:Antineoplastic Agents D000077216:Carcinoma, Ovarian Epithelial D065426:Cytoreduction Surgical Procedures D005260:Female D006801:Humans D058990:Molecular Targeted Therapy D009364:Neoplasm Recurrence, Local D009367:Neoplasm Staging D010051:Ovarian Neoplasms D057285:Precision Medicine D024162:Second-Look Surgery
clinical trials gynecologic oncology medical oncology molecularly targeted therapies ovarian neoplasms