Where do antiangiogenic agents belong in the treatment algorithm for ovarian cancer?

Prediction of therapy response in ovarian cancer: Where are we now?

Therapy resistance is a major challenge in the management of ovarian cancer (OC). Advances in detection and new technology validation have led to the emergence of biomarkers that can predict responses to available therapies. It is important to identify predictive biomarkers to select resistant and sensitive patients in order to reduce important toxicities, to reduce costs and to increase survival. The discovery of predictive and prognostic biomarkers for monitoring therapy is a developing field and provides promising perspectives in the era of personalized medicine. This review article will discuss the biology of OC with a focus on targetable pathways; current therapies; mechanisms of resistance; predictive biomarkers for chemotherapy, antiangiogenic and DNA-targeted therapies, and optimal cytoreductive surgery; and the emergence of liquid biopsy using recent studies from the Medline database and ClinicalTrials.gov.

Anti-angiogenic agents in ovarian cancer: dawn of a new era?

Epithelial ovarian cancer is a leading cause of cancer-related death for women both in the United States and worldwide, and the effectiveness of cytotoxic chemotherapy has plateaued. Angiogenesis plays an important role in ovarian cancer biology, and exploration of anti-angiogenic agents in this disease has demonstrated anti-tumor activity both as monotherapy and in combination with cytotoxic chemotherapy. However, key questions remain regarding the use of these drugs in ovarian cancer, such as where in treatment should they be used, should these drugs be used as single agents or combined with chemotherapy, can and which biomarkers predict efficacy, are there efficacy and toxicity differences amongst the various agents, what are the cost-benefit ratios of these therapies, and are the patient outcome improvements observed in completed studies significant enough to warrant widespread use of these drugs? Here, we review recent progress and discuss ongoing controversies regarding the use of anti-angiogenic therapies in ovarian cancer.