New Strategies in the treatment of ovarian cancer -current clinical perspectives and future potential
Cet article passe en revue les travaux récents sur le développement de nouvelles thérapies ciblées des cancers de l'ovaire
The treatment of ovarian cancer is set to undergo rapid changes, as strategies incorporating molecular targeted therapies begin to take shape. These are based on a better appreciation of approaches targeting the tumour microenvironment as well as specific subtypes of the disease, with distinct molecular abberations. Targeting the VEGF pathway through bevacizumab is clearly effective, with positive randomised trials at all disease stages; targeting defective homologous recombination repair pathways with PARP inhibitors is also proving successful in a substantial proportion of patients with high grade serous ovarian cancer. In this article we will review progress in these two leading areas and also discuss the potential for targeting other pathways and receptors which may be activated in ovarian cancer, including the RAS/RAF/MEK and PI3K/AKT/mToR pathways; the ErbB and IGF family of receptors; mitotic check points and also the folate receptor. Here as well as single agent therapy in selected cases, the way forward should include combination treatments aimed at dealing with the key problem of cytotoxic drug resistance and rational approaches to patient selection will become an essential component of future strategies.