Background: Ovarian cancer is the second most common gynecologic malignancy, accounting
for approximately 220,000 deaths annually worldwide. Despite radical surgery and initial
high response rates to platinum- and taxane-based chemotherapy, most patients experience a relapse,
with a median progression-free survival of only 18 months. Overall survival is approximately 30%
at 5 years from the diagnosis. In comparison, patients out from breast cancer are more than 80 %
after ten years from the disease discovery. In spite of a large number of published fundamental and
applied research, and clinical trials, novel therapies are urgently needed to improve outcomes of the
ovarian cancer. The success of new drugs development in ovarian cancer will strongly depend on
both fully genomic disease characterization and, then, availability of biomarkers able to identify
women likely to benefit from a given new therapy.
Methods: In this review, the focus is given to describe how complex is the diseases under the simple
name of ovarian cancer, in terms of cell tumor types, histotypes, subtypes, and specific gene mutation
or differently expressed in the tumor with respect the healthy ovary. The first- and second-line
pharmacological treatment clinically used over the last fifty years are also described. Noteworthy
achievements in vitro and in vivo tested new drugs are also summarized. Recent literature related to
up to date ovarian cancer knowledge, its detection by biomarkers and chemotherapy was searched
from several articles on Pubmed, Google Scholar, MEDLINE and various Governmental Agencies
till April 2019.
Results: The papers referenced by this review allow a deep analysis of status of the art in the classification
of the several types of ovarian cancer, the present knowledge of diagnosis based on biomarkers
and imaging techniques, and the therapies developed over the past five decades.
Conclusion: This review aims at stimulating more multi-disciplinary efforts to identify a panel of
novel and more specific biomarkers to be used to screen patients for a very early diagnosis, to have
prognosis and therapy efficacy indications. The desired final goal would be to have available tools
allowing to reduce the recurrence rate, increase both the disease progression free interval and of
course the overall survival at five years from the diagnosis that today is still very low.