Ovarian cancer is often referred to as the "silent killer" due to its difficulty in detection at an early stage. While ovarian cancer accounts for only about 3% of all cancers in women, it causes more deaths than any other cancer of the female reproductive system. Fortunately, major advances have been made in ovarian cancer drugs that are helping more women survive this disease. This article provides an overview of some key drugs used to treat ovarian cancer.

Platinum-Based Chemotherapy Drugs

Platinum-based chemotherapy drugs, such as carboplatin and cisplatin, have been the standard treatments for ovarian cancer for decades. These drugs work by cross-linking DNA strands in cancer cells, preventing them from replicating. Though extremely toxic, platinum drugs are effective at destroying fast-growing cancer cells. In the first-line treatment of ovarian cancer, carboplatin is usually administered along with paclitaxel or another chemotherapy drug to increase effectiveness. While platinum drugs are not curative on their own, they significantly improve survival rates when used as part of initial treatment.

angiogenesis inhibitors disrupt the formation of new blood vessels that tumors need to grow. One such drug used to treat ovarian cancer is bevacizumab (Avastin). As an angiogenesis inhibitor, bevacizumab starves tumors of nutrients and oxygen by blocking vascular endothelial growth factor (VEGF). Studies have found bevacizumab improves progression-free survival when combined with chemotherapy as a first-line or maintenance treatment for ovarian cancer. The drug is also being examined as a potential treatment for recurrent disease. Side effects can include high blood pressure, bleeding, problems wound healing and gastrointestinal perforations. Careful monitoring is required with bevacizumab treatment.

PARP Inhibitors: A New Target

Poly (ADP-ribose) polymerase, or PARP, inhibitors are an exciting new class of drugs for ovarian cancer. PARP is an enzyme involved in DNA repair. PARP inhibitors work by blocking cancer cells already deficient in homologous recombination repair, like those with BRCA gene mutations, from repairing DNA damage. This leaves the cancer vulnerable to cell death. In 2017, the FDA approved the PARP inhibitor olaparib (Lynparza) for the maintenance treatment of recurrent ovarian cancer patients with a BRCA mutation who have responded to platinum-based chemotherapy. More recently, it was approved for germline BRCA-mutated advanced ovarian cancer after three or more lines of chemotherapy. Rubraca (rucaparib) and Zejula (niraparib) are two other PARP inhibitors approved to treat ovarian cancer. Ongoing research continues to explore the potential of PARP inhibitors in different treatment settings and biomarker populations. Side effects can include fatigue, nausea, vomiting, diarrhea and low blood cell counts.

Immunotherapies

While not yet standard treatments for ovarian cancer, immunotherapies are an area of active investigation. Immunotherapy aims to help the body's own immune system better recognize and destroy cancer cells. Pembrolizumab and avelumab are two immune checkpoint inhibitor drugs being studied for their ability to treat ovarian cancer by releasing the brakes on T-cell responses. Early studies show promise, though more research is still needed on patient selection biomarkers and combination treatment strategies. Vaccines designed to trigger anti-tumor immune responses are another immunotherapy approach in clinical trials. By training the immune system to target unique ovarian cancer antigens, some hope immunotherapies could eventually offer new treatment options or help prevent recurrence. However, more evidence is still needed from ongoing and future clinical trials.

Long-Term Survivorship and Quality of Life

For the small percentage of women who achieve remission from advanced stage ovarian cancer, long-term survivorship becomes a priority. Recurrence is still common even years later, requiring careful monitoring. This prolonged uncertainty poses ongoing psychological challenges. Supportive care approaches aim to optimize quality of life through healthy lifestyle changes, symptom management, palliative care when needed, and mental health support. Open communication with healthcare providers, patient advocate groups, and familial/social networks play an integral role in maintaining hope and coping abilities for long-term ovarian cancer survivors. More research into improving physical and emotional well-being throughout survivorship journeys remains important.

Conclusion

While ovarian cancer remains a serious disease, major strides have been made in recent years to improve treatment outcomes. Advancements in platinum-based chemotherapy, targeted agents like PARP inhibitors and angiogenesis inhibitors, and newer immunotherapies are helping more women survive what was once a deadly diagnosis. Continued research seeks to build upon these gains through developing innovative new treatment strategies, earlier detection methods, preventative interventions and improving quality of life for long-term survivors. There is still work to be done, but with ongoing medical progress and support, more women impacted by ovarian cancer have reason for increased hope.