Targeted therapy and immunotherapy in ovarian cancer.
10.5124/jkma.2016.59.3.180
- Author:
Jae Weon KIM
1
Author Information
1. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea. kjwksh@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Targeted therapy;
Immunotherapy;
Ovarian neoplasms
- MeSH:
Bevacizumab;
Cytotoxins;
Disease-Free Survival;
Humans;
Immunotherapy*;
Ovarian Neoplasms*
- From:Journal of the Korean Medical Association
2016;59(3):180-188
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Epithelial ovarian cancer is one of the last treatment areas to be influenced by the 'personalized medicine' bandwagon. Some anti-angiogenic agents, poly (ADP-ribose) polymerase (PARP), and immune checkpoint inhibitors have shown efficacy in early stages of development for the treatment of epithelial ovarian cancer. As a result of vigorous clinical trials, bevacizumab, cediranib, pazopanib, olaparib, and rucaparib, either used alone or in adjunct to conventional cytotoxic agents, have all been shown to improve progression-free survival in first-line/maintenance, platinum-resistant or sensitive recurrent settings. A biomarker for bevacizumab is currently elusive. Olaparib is the first drug approved for the treatment of high-grade serous tumors and requires routine testing for BRCA mutation. Trial results of PARP inhibitors in the homologous recombination-deficient (non BRCA mutation) population are awaited and the introduction of these agents into the clinic will require robust methods of detecting homologous recombination-deficiency. Second-generation studies combining anti-angiogenic agents with PARP inhibitors are in progress and early results in the recurrent setting are encouraging. Trials with immune checkpoint inhibitors such as nivolumab produced prolonged responses in a small set of ovarian cancer cases and need further exploration, for example in combination with anti-angiogenic agents. The application of targeted agents and immunologics, alone or in combination, to induce a survival advantage in patients with epithelial ovarian cancer should be continued.
