Ovarian Cancer-Insights into Platinum Resistance and Overcoming It.
Andrei HavasiSimona Sorana CainapAna Teodora HavasiCalin Ioan CăinapPublished in: Medicina (Kaunas, Lithuania) (2023)
Ovarian cancer is the most lethal gynecologic malignancy. Platinum-based chemotherapy is the backbone of treatment for ovarian cancer, and although the majority of patients initially have a platinum-sensitive disease, through multiple recurrences, they will acquire resistance. Platinum-resistant recurrent ovarian cancer has a poor prognosis and few treatment options with limited efficacy. Resistance to platinum compounds is a complex process involving multiple mechanisms pertaining not only to the tumoral cell but also to the tumoral microenvironment. In this review, we discuss the molecular mechanism involved in ovarian cancer cells' resistance to platinum-based chemotherapy, focusing on the alteration of drug influx and efflux pathways, DNA repair, the dysregulation of epigenetic modulation, and the involvement of the tumoral microenvironment in the acquisition of the platinum-resistant phenotype. Furthermore, we review promising alternative treatment approaches that may improve these patients' poor prognosis, discussing current strategies, novel combinations, and therapeutic agents.
Keyphrases
- poor prognosis
- end stage renal disease
- long non coding rna
- dna repair
- newly diagnosed
- chronic kidney disease
- stem cells
- gene expression
- ejection fraction
- prognostic factors
- dna damage
- single cell
- peritoneal dialysis
- emergency department
- dna methylation
- patient reported outcomes
- radiation therapy
- locally advanced
- endometrial cancer
- combination therapy
- cell therapy
- drug induced