Abstract
Ovarian cancer remains the leading cause of gynecologic cancer-related deaths among women worldwide. The dismal survival rate is partially due to recurrence after standardized debulking surgery and first-line chemotherapy. In recent years, targeted therapies, including antiangiogenic agents or poly (ADP-ribose) polymerase inhibitors, represent breakthroughs in the treatment of ovarian cancer. As more therapeutic agents become available supplemented by a deeper understanding of ovarian cancer biology, a range of combination treatment approaches are being actively investigated to further improve the clinical outcomes of the disease. These combinations, which involve DNA-damaging agents, targeted therapies of signaling pathways and immunotherapies, simultaneously target multiple cancer pathways or hallmarks to induce additive or synergistic antitumor activities. Here we review the preclinical data and ongoing clinical trials for developing effective combination therapies in treating ovarian cancer. These emerging therapeutic modalities may reshape the treatment landscape of the disease.
Keywords: Chemotherapy, combination treatment, immunotherapy, ovarian cancer, targeted therapy, poly (ADP-ribose) polymerase inhibitors.
[http://dx.doi.org/10.1200/JCO.1996.14.11.2968] [PMID: 8918494]
[http://dx.doi.org/10.1001/jama.2011.766] [PMID: 21642681]
[http://dx.doi.org/10.1016/0090-8258(89)90636-7] [PMID: 2920954]
[http://dx.doi.org/10.1056/NEJM199601043340101] [PMID: 7494563]
[http://dx.doi.org/10.1093/jnci/djg036] [PMID: 12953086]
[http://dx.doi.org/10.1186/s12943-019-0954-x] [PMID: 30782187]
[http://dx.doi.org/10.3390/cancers11010119] [PMID: 30669514]
[http://dx.doi.org/10.1016/j.ygyno.2018.09.001] [PMID: 30217369]
[http://dx.doi.org/10.1038/nature03445] [PMID: 15829967]
[PMID: 11489790]
[http://dx.doi.org/10.1124/mol.112.080614] [PMID: 22833573]
[http://dx.doi.org/10.1158/1535-7163.MCT-11-0597] [PMID: 22778154]
[http://dx.doi.org/10.1016/S1470-2045(14)71135-0] [PMID: 25481791]
[http://dx.doi.org/10.1038/bjc.2014.345] [PMID: 25025963]
[http://dx.doi.org/10.1016/j.ygyno.2017.12.029] [PMID: 29352572]
[http://dx.doi.org/10.1038/cdd.2016.124] [PMID: 27834954]
[http://dx.doi.org/10.1158/1078-0432.CCR-16-2273] [PMID: 27993965]
[http://dx.doi.org/10.3390/cancers10050149] [PMID: 29783721]
[http://dx.doi.org/10.1200/JCO.2016.67.5942] [PMID: 27998224]
[http://dx.doi.org/10.1016/j.ccell.2019.05.001]
[http://dx.doi.org/10.1016/j.celrep.2017.11.095] [PMID: 29262321]
[http://dx.doi.org/10.3892/ijo.2017.3914] [PMID: 28350129]
[http://dx.doi.org/10.1016/j.bcp.2018.06.019] [PMID: 29953843]
[http://dx.doi.org/10.1186/s13048-016-0239-6] [PMID: 27179933]
[http://dx.doi.org/10.1200/JCO.2012.42.0505] [PMID: 22529265]
[http://dx.doi.org/10.1200/JCO.2013.51.4489] [PMID: 24637997]
[http://dx.doi.org/10.1016/j.ygyno.2017.07.137] [PMID: 28774461]
[http://dx.doi.org/10.1093/annonc/mdz018] [PMID: 30753272]
[http://dx.doi.org/10.1126/scitranslmed.aav4508] [PMID: 31092693]
[http://dx.doi.org/10.1056/NEJMoa1911361] [PMID: 31851799]
[http://dx.doi.org/10.1038/bjc.2011.62] [PMID: 21364581]
[http://dx.doi.org/10.1016/j.ygyno.2010.08.008] [PMID: 20837357]
[http://dx.doi.org/10.1016/j.ygyno.2007.11.029] [PMID: 18191993]
[http://dx.doi.org/10.1016/j.ygyno.2008.02.009] [PMID: 18423560]
[http://dx.doi.org/10.1016/j.ejca.2014.03.005] [PMID: 24709487]
[http://dx.doi.org/10.1097/IGC.0b013e31826d1438] [PMID: 23027040]
[http://dx.doi.org/10.2147/DDDT.S82035] [PMID: 26124641]
[http://dx.doi.org/10.1200/JCO.2009.22.3354] [PMID: 19901115]
[http://dx.doi.org/10.1200/JCO.2015.66.0787] [PMID: 27269942]
[http://dx.doi.org/10.1093/annonc/mds282] [PMID: 23002282]
[http://dx.doi.org/10.1200/JCO.2016.67.1891] [PMID: 27998236]
[http://dx.doi.org/10.1200/JCO.2014.55.7348] [PMID: 25225436]
[http://dx.doi.org/10.1001/jamaoncol.2017.4218] [PMID: 29242937]
[http://dx.doi.org/10.1016/j.ejca.2013.08.007] [PMID: 24011934]
[PMID: 31395751]
[http://dx.doi.org/10.1158/1078-0432.CCR-14-1814] [PMID: 25500057]
[http://dx.doi.org/10.1158/1078-0432.CCR-17-3697] [PMID: 29959144]
[http://dx.doi.org/10.1158/1535-7163.MCT-18-0413] [PMID: 30679390]
[http://dx.doi.org/10.1038/s41467-019-08574-7] [PMID: 30755611]
[http://dx.doi.org/10.1016/j.ygyno.2016.07.092] [PMID: 27426307]
[http://dx.doi.org/10.1093/annonc/mdw672] [PMID: 27993796]
[http://dx.doi.org/10.1016/S1470-2045(18)30905-7] [PMID: 30880072]
[http://dx.doi.org/10.1038/nrclinonc.2013.208] [PMID: 24247168]
[http://dx.doi.org/10.1007/s00262-008-0583-5] [PMID: 18791714]
[http://dx.doi.org/10.1136/ijgc-2018-000011] [PMID: 30640705]
[http://dx.doi.org/10.1038/nature12213] [PMID: 23770567]
[http://dx.doi.org/10.1158/0008-5472.CAN-18-1003] [PMID: 30482774]
[http://dx.doi.org/10.1038/nrclinonc.2018.9] [PMID: 29434333]
[http://dx.doi.org/10.1158/0008-5472.CAN-14-3098] [PMID: 26573793]
[http://dx.doi.org/10.1186/s12967-015-0613-y] [PMID: 26219551]
[http://dx.doi.org/10.1186/s40425-019-0654-5] [PMID: 31362778]
[http://dx.doi.org/10.1158/2326-6066.CIR-15-0044] [PMID: 26138335]
[http://dx.doi.org/10.1016/j.ygyno.2017.03.234]
[http://dx.doi.org/10.1001/jamaoncol.2019.1048] [PMID: 31194228]
[http://dx.doi.org/10.1200/JCO.2016.72.1340] [PMID: 28471727]
[http://dx.doi.org/10.1001/jamaoncol.2019.3343] [PMID: 31600397]
[http://dx.doi.org/10.1158/2326-6066.CIR-13-0126] [PMID: 24535937]
[http://dx.doi.org/10.18632/oncotarget.3597] [PMID: 25888637]
[http://dx.doi.org/10.1002/ijc.27388] [PMID: 22139992]
[http://dx.doi.org/10.1126/scitranslmed.aao5931] [PMID: 29643231]
[http://dx.doi.org/10.1038/ncomms14754] [PMID: 28345650]
[http://dx.doi.org/10.1158/1078-0432.CCR-14-0463] [PMID: 25294909]
[http://dx.doi.org/10.1038/mto.2016.34] [PMID: 28035333]
[http://dx.doi.org/10.1158/1078-0432.CCR-18-0220] [PMID: 30206160]
[http://dx.doi.org/10.1186/s13048-016-0236-9] [PMID: 27188274]
[http://dx.doi.org/10.1016/j.cell.2016.04.009] [PMID: 27133165]
[http://dx.doi.org/10.4049/jimmunol.1301119] [PMID: 23898037]
[http://dx.doi.org/10.1158/2326-6066.CIR-17-0314] [PMID: 29588319]