Chemotherapy uses anti-cancer drugs to destroy cancer cells. It's one of the main treatments for ovarian cancer. Some of the commonly used chemotherapy drugs for ovarian cancer include:
- Carboplatin: Carboplatin is often used in combination with another chemotherapy drug called paclitaxel. Together, these two drugs are the standard initial treatment for ovarian cancer. Carboplatin works by binding to DNA in cancer cells and blocking their ability to multiply. This eventually causes the cancer cells to die.
- Paclitaxel: Paclitaxel stops cancer cells from dividing and multiplying by disrupting the cellular microtubule function during cell division. When used together with carboplatin, paclitaxel can significantly improve survival rates in women with ovarian cancer. Paclitaxel is administered by intravenous infusion.
- Cisplatin: Cisplatin is another platinum-based chemotherapy drug used for ovarian cancer. Like carboplatin, cisplatin also binds to DNA to block cancer cell division. However, carboplatin has fewer side effects than cisplatin and is often preferred. Cisplatin is still used for ovarian cancer patients who cannot tolerate carboplatin.
- Pegylated liposomal doxorubicin: This chemotherapy drug encapsulates doxorubicin inside pegylated liposomes to reduce its toxic effects. It works by interfering with DNA and RNA synthesis in cancer cells. Pegylated liposomal doxorubicin is used for recurrent ovarian cancer and reduces the risk of heart damage associated with regular doxorubicin use.
Targeted Therapy Drugs
Targeted therapy drugs work by interfering with specific molecules involved in cancer growth and progression. Some targeted therapy drugs approved for ovarian cancer drugs include:
- Bevacizumab: Bevacizumab is a monoclonal antibody that works by inhibiting vascular endothelial growth factor (VEGF). VEGF promotes formation of new blood vessels to help tumors grow. By blocking VEGF, bevacizumab starves tumors of nutrients and oxygen, slowing their growth. It has to be given with chemotherapy.
- Olaparib: Olaparib is a PARP inhibitor that exploits genetically inherited or acquired defects in the BRCA genes commonly found in ovarian cancers. It prevents cancer cells from repairing damaged DNA, pushing them towards cell death. Olaparib is approved as a maintenance monotherapy for patients with BRCA-mutated ovarian cancer.
- Niraparib: Like olaparib, niraparib is also a PARP inhibitor approved as a maintenance monotherapy for patients with recurrent ovarian cancer who responded to platinum-based chemotherapy irrespective of their BRCA status.
- Rucaparib: Rucaparib is another PARP inhibitor used as monotherapy for relapsed ovarian cancer associated with BRCA mutations, including germline and somatic BRCA mutations.
Immunotherapy Drugs
In addition to chemotherapy and targeted therapies, immunotherapies are showing promising results in ovarian cancer drugs. Some immunotherapy drugs approved or being studied for ovarian cancer include:
- Bevacizumab: By inhibiting VEGF, bevacizumab indirectly enhances anti-tumor immunity. It has been shown to improve survival when given with chemotherapy as the initial treatment for ovarian cancer.
- Pembrolizumab: Pembrolizumab is a monoclonal antibody that blocks PD-1 receptors on T-cells, reactivating anti-tumor immunity. A phase II study showed pembrolizumab resulted in durable responses in patients with PD-L1-positive recurrent ovarian cancer.
- Durvalumab: Durvalumab blocks PD-L1 interaction with PD-1/PD-L1 receptors to spur anti-tumor immune response. A Phase I/II study reported durvalumab combined with olaparib shrank tumors in 26% of evaluable ovarian cancer patients.
- Vaccines: Therapeutic vaccines designed to generate immune response against CA125 antigen expressed on majority of ovarian tumor cells are also under investigation. Studies show they may improve survival when given with chemotherapy.
New Drugs on Horizon
Researchers continue exploring new targets and developing novel drugs against them to improve ovarian cancer drugs outcomes. Some drugs under clinical evaluation include:
- Telaglenastat: A first-in-class glutaminase inhibitor that blocks glutamine metabolism crucial for cancer growth. Early studies show it may help overcome platinum resistance.
- Mirvetuximab soravtansine: An antibody-drug conjugate targeting folate receptor-α frequently expressed on ovaries tumors. It delivers chemotherapy directly to cancer cells.
- Tisotumab vedotin: Another ADC targeting tissue factor, an initiator of blood coagulation overexpressed in ovarian cancer. Preliminary results demonstrate promising anti-tumor activity.
- TI-011: An oncolytic virus engineered to replicate inside and destroy cancer cells while leaving normal cells unharmed. Phase I data show TI-011 may work against platinum-resistant ovarian tumors.
- Serine protease inhibitors: Targeting tumor microenvironment factor uPA/UPAR involved in tumor growth and metastasis. Phase I/II studies ongoing to evaluate their potential.
With continuous advancements, the future looks hopeful in improving treatment outcomes for women suffering from this life-threatening cancer through newer and better drugs. Combination regimens incorporating both established and experimental agents also hold promise.
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