Ovarian cancer and resistance to therapies: Clinical and laboratory perspectives

The cancer that originates in ovary is one of the most deadly gynecological malignancies. Despite advances in surgical and therapeutic options, patient survival remains poor in ovarian cancer. Debulking surgery is the primary option to manage patients with this malignancy. Radiation has been used in adjuvant therapy for ovarian cancer patients but has largely been replaced with platinum-based chemotherapy. Response of chemotherapy is impulsive in some patients, and long-term analyses showed recurrence of disease in approximately half of the patients. Several combinations or regimen were tested for achieving optimal response and increasing ovarian cancer patient survival. Morbidity associated with intensive therapy and resistance to widely used chemotherapy are the major concerns in treating ovarian cancer patients. Therefore, it is important for developing effective strategies to sensitize malignant cells to standard therapy. Such strategies have the potential in achieving improved response with minimal side effects. Platinum-based drugs are abundantly used for treating initial malignancy and recurrent disease, especially, improving the response of platinum-based chemotherapy and addressing drug resistance is highly beneficial to treat relapsed patients or the patients with advanced-stage disease. This chapter summarizes research findings in this area with the support of current peer-reviewed literature and elaborates future directions for improving the therapeutic response in ovarian cancer.