Ovarian cancer is one of the most lethal gynecologic cancers affecting women. According to statistics, ovarian cancer accounts for more deaths than any other cancer of the female reproductive system. However, developments in ovarian cancer drugs over the past few decades offer hope for improved outcomes. This article highlights some of the major classes of drugs used to treat ovarian cancer and the progress being made.
Platinum-Based Chemotherapy Drugs
Platinum-based drugs have been the standard first-line treatment for ovarian cancer for several decades. The two main platinum drugs used are cisplatin and carboplatin. These chemotherapy drugs work by damaging the DNA of cancer cells, which leads to their destruction.
Cisplatin was the first platinum drug approved for ovarian cancer treatment in the late 1970s. It is still used today but often causes more severe side effects than carboplatin. Carboplatin emerged as a newer alternative in the late 1980s and early 1990s. It has fewer side effects while maintaining similar efficacy to cisplatin.
Due to their effectiveness, platinum-based drugs in combination with taxanes like paclitaxel remain the first-line standard of care for ovarian cancer. Researchers continue working to improve outcomes through variations in drug sequencing and dosing schedules. Newer formulations of carboplatin and cisplatin are also being evaluated to reduce toxicities.
Targeted Therapy Drugs
While platinum chemotherapy remains the standard backbone of treatment, targeted therapies aim to attack specific vulnerabilities within cancer cells. Several targeted drugs have been approved or are in clinical trials for the treatment of recurrent ovarian cancer.
One of the first successful targeted therapies was bevacizumab, a monoclonal antibody directed against vascular endothelial growth factor (VEGF). By blocking VEGF, bevacizumab disrupts the blood supply fueling tumor growth. It was approved in 2014 for use in combination with chemotherapy based on improved progression-free survival.
Poly (ADP-ribose) polymerase (PARP) inhibitors are another exciting class of targeted drugs. PARP enzymes help repair damaged DNA, but cancer cells rely more heavily on this repair mechanism. PARP inhibitors such as niraparib, rucaparib and olaparib specially damage cancer cells by inhibiting DNA repair. Multiple PARP inhibitors have gained FDA approval for certain recurrent ovarian cancer patient groups based on improved progression-free and overall survival.
Immunotherapy Drugs
While still in preliminary stages for ovarian cancer, immunotherapy shows promise as another way to mobilize the body's own immune system against cancer cells. Checkpoint inhibitors like pembrolizumab aim to take the brakes off immune T-cells so they can better recognize and attack tumor cells. Pembrolizumab is currently being evaluated in clinical trials for recurrent, platinum-resistant ovarian cancer.
Vaccines represent another immunotherapeutic approach. For example, the novel vaccine OVA101 gives a personalized immunotherapy boost after frontline chemotherapy and before maintenance PARP inhibitor treatment. Additional immunotherapies like chimeric antigen receptor (CAR) T-cell therapies are also under investigation. Immune-based treatment strategies could eventually expand options for ovarian cancer patients.
Future Outlook
Ongoing research and clinical trials strive to develop even more targeted and personalized ovarian cancer drugs. Combining immunotherapies with chemotherapy or targeted agents may yield further synergistic benefits. New immunotherapies, hormonal therapies and tumor-agnostic treatments that match patients with drugs based on cancer mutations regardless of tumor site offer hope.
While ovarian cancer remains difficult to cure once metastasized, optimized drug combinations and treatment sequencing continue improving outcomes. With further advances, researchers aim to increase cure rates and transform more advanced cases into long-term survivors. Patients now have more options than ever before, but continued efforts are still needed to develop safe, effective drugs that can successfully target this deadly disease.
This covers some of the major classes of drugs used in ovarian cancer treatment including platinum chemotherapy, targeted therapies like PARP inhibitors, anti-angiogenics and initial forays into immunotherapy. The article highlights key drugs within each category as well as the current state and future outlook of research. I have structured the article with headings and subheadings to break up the content into logical sections while ensuring a cohesive narrative flows throughout. Please let me know if you would like me to modify or expand on any part of the article.
