Mechanisms of Drug Resistance in High-Grade Serous Ovarian Cancer

Hematol Oncol Clin North Am. 2018 Dec;32(6):983-996. doi: 10.1016/j.hoc.2018.07.007.

Abstract

Resistance in ovarian cancer is driven by a range of mechanisms, some of which are therapy specific whereas others confer multidrug resistance. This review outlines our current understanding of the heterogeneous mechanisms of both primary and acquired drug resistance in high-grade serous ovarian cancer with a focus on the most common therapeutics, including platinum and taxanes. Current therapeutic strategies for overcoming resistance, including the use of non-P- glycoprotein substrate therapies, are outlined, with an emphasis on the importance of developing resistance biomarkers to guide future therapy approaches and improve patient outcomes.

Keywords: Acquired resistance; Chemotherapy; Drug resistance mechanisms; Ovarian cancer; Primary resistance.

Publication types

  • Review

MeSH terms

  • Carcinoma, Ovarian Epithelial* / diagnosis
  • Carcinoma, Ovarian Epithelial* / drug therapy
  • Carcinoma, Ovarian Epithelial* / metabolism
  • Carcinoma, Ovarian Epithelial* / pathology
  • Cystadenocarcinoma, Serous* / diagnosis
  • Cystadenocarcinoma, Serous* / drug therapy
  • Cystadenocarcinoma, Serous* / metabolism
  • Cystadenocarcinoma, Serous* / pathology
  • Drug Resistance, Neoplasm*
  • Female
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Neoplasm Recurrence, Local
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / pathology
  • Platinum / therapeutic use
  • Taxoids / therapeutic use

Substances

  • Taxoids
  • Platinum