Considerations for Chemotherapy Treatment in Platinum Resistant High-Grade Serous Ovarian Cancer

Abstract

Ovarian cancer is considered to be the most fatal type of any gynecological cancer. Prognosis for the disease is poor, with a median survival of only thirty-two months following diagnosis and a five-year survival rate of only 39%. Many of the most lethal ovarian cancer cases are classified as part of the high-grade serous ovarian cancer (HGSOC) subtype, which is the most aggressive form of the disease. The primary concern with regards to treatment is that nearly 30% of patients will develop a resistance to forms of platinum chemotherapy, which is the main method of treatment. This suggests that a one-size fits all approach cannot be taken to treat ovarian cancer, and that further research must be done to understand how to treat the patients who present with platinum resistance. This literature review examines the mutations within two susceptible loci, specifically, the p53 and BRCA1/2 genes, in order to understand how platinum resistance develops and why it is present in some patients. The objectives of this review are  to characterize the underlying genetic mechanisms affecting platinum resistance, specify the biomarkers associated with those mechanisms, and describe alternative methods for approaching the treatment of ovarian cancer on an individual scale.