Chemotherapy resistance in epithelial ovarian cancer: Mechanisms and emerging treatments
Abstract
Ovarian cancer (OC) remains a fatal malignancy because most patients experience recurrent disease, which is resistant to chemotherapy. The outcomes for patients with platinum-resistant OC are poor, response rates to further chemotherapy are low and median survival is lower than 12 months. The complexity of platinum-resistant OC, which comprises a heterogeneous spectrum of diseases, is indeed far from being completely understood. Therefore, comprehending tumors' biological behaviour to identify reliable biomarkers, which may predict responses to therapies, is a demanding challenge to improve OC management. In the age of precision medicine, efforts to overcome platinum resistance in OC represent a dynamic and vast field in which innovative drugs and clinical trials rapidly develop. This review will present the exceptional biochemical environment implicated in OC and highlights mechanisms of chemoresistance. Furthermore, innovative molecules and new therapeutic opportunities are presented, along with currently available therapies and ongoing clinical trials.
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Chemoresistance in HGSOC stems from complex, and not fully understood, mechanisms linked to pre-existing gene expression intrinsic within the chemotherapy-naive tumor cells or the immediate microenvironment.
“These findings are in line with recent evidences indicating that chemoresistance in HGSOC stems from complex, and not fully understood, mechanisms linked to pre-existing gene expression intrinsic within the chemotherapy-naive tumor cells or the immediate microenvironment (revised in 6, [39]).”
From Identification of a novel gene signature predicting response to first-line chemotherapy in BRCA wild-type high-grade serous ovarian cancer patients (2022) · cites this paper as [6]
In platinum-resistant ovarian cancer, the choice of therapy is challenging and its failure is eventually responsible for almost all deaths from this cancer.
“In platinum-resistant OC, the choice of therapy is challenging and its failure is eventually responsible for almost all deaths from this cancer [6].”
From Identification of a novel gene signature predicting response to first-line chemotherapy in BRCA wild-type high-grade serous ovarian cancer patients (2022) · cites this paper as [6]
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Homologous Recombination Deficiency: Exploiting the Fundamental Vulnerability of Ovarian Cancer
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Buttarelli, M., Ciucci, A., Palluzzi, F., Raspaglio, G., Marchetti, C., Perrone, E., Minucci, A., Giacò, L., Fagotti, A., Scambia, G., et al. (2022) · Journal of Experimental & Clinical Cancer Research · doi:10.1186/s13046-022-02265-w · Cited by 32 · see citing works
“of platinum resistance was used, identifying as “resistant” (PFI < 6 months) patients who relapsed less than 6 months after chemotherapy was stopped, or that progressed during therapy, and as “sensitive”, patients relapsing 6 months or more after chemotherapy [6].”
BackgroundMethodSelf-citation
- Authors
- Marchetti, C., De Felice, F., Romito, A., Iacobelli, V., Sassu, C. M., Corrado, G., Ricci, C., Scambia, G., & Fagotti, A.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- Policlinico Umberto I (IT)
- Agostino Gemelli University Polyclinic (IT)
- ORCID
- Venue
- Seminars in Cancer Biology
- Publisher
- Elsevier BV
- Published
- 2021-12
- Volume
- 77
- Pages
- 144-166
- ISSN
- 1044-579X (ISSN-L)
- OpenAlex
- W3197661093
- Cited by
- 139
- References
- 6
- Citations by year
- 2026: 17 · 2025: 27 · 2024: 46 · 2023: 31 · 2022: 16 · 2021: 1
- FWCI
- 4.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Seminars in Cancer Biology (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Oncology › PARP inhibition in cancer therapy
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Keywords
- epithelial ovarian cancer, platinum resistance, chemoresistance, chemoresistance mechanisms, biomarkers, precision medicine, novel therapeutic agents, recurrent ovarian cancer, clinical trials
- MeSH terms
- Carcinoma, Ovarian Epithelial, Animals, Female, Humans, Biomarkers, Tumor, Drug Resistance, Neoplasm
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