High grade serous (HGS) cancer of the ovary (OC) is a lethal malignancy with
advanced stage disease remaining incurable. HGS OC is sensitive to platinum based chemotherapy
with complete responses being frequent, but relapses are inevitable, with resistance
invariably emerging. Deeper understanding of the pathogenesis of HGS OC with
new sequencing techniques shows that aberrations in the BRCA pathway may play a major
role. Changes in the homologous recombination pathway and DNA repair may play a role
in platinum resistance. This review article describes various approaches that have been
studied in the management of chemotherapy resistance in HGS OC including Poly ADPribose
polymerase (PARP) inhibition, Wee1 inhibition, epigenetic agents, immunotherapy
and angiogenesis targeting agents.
Keywords: Chemotherapy, high grade serous, ovarian, resistance.
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