title: New strategy for overcoming resistance to chemotherapy of ovarian cancer.
abstract: BACKGROUND
  Ovarian cancer is one of the most sensitive solid tumors, with objective responses ranging from 60 to 80% even in patients with advanced stage. However, most patients ultimately recur and develop resistance to chemotherapy. As a result, the survival rate for patients with ovarian cancer has not improved over the past 20 years. Resistance to chemotherapy presents a major obstacle to attempt to improve the prognosis of patients with ovarian cancer. A new strategy is necessary to improve the prognosis of patients with ovarian cancer.
  
  
  METHODS
  The mechanism of chemoresistance was reviewed to get over the resistance. Additionally, the biological characteristics of ovarian cancer and molecular-targeted agents including signal-transduction inhibitors and anti-angiogenesis were discussed.
  
  
  RESULTS
  Genetic diagnosis for chemosensitivity with drug-resistance genes may be a useful predictor. Unfortunately, molecular-targeted therapy alone has been insufficient to improve the prognosis for patients with advanced ovarian cancer. Molecular molecular-targeted therapy should be carried out together with conventional cytotoxic agents. On the occasion of the use of the molecular targeted-agents, care of the appearance of the unexpected adverse effect should be important.
  
  
  CONCLUSIONS
  The future research in this field will enable to develop an effective strategy for conquest of chemoresistance in ovarian cancer.
authors.affiliation: Tottori University Hospital Cancer Center, Yonago 683-8504, Japan.
authors.forename: Junzo
authors.initials: J
authors.lastname: Kigawa
keywords: chemotherapy;; molecular targeted agent; ovarian cancer; resistance
references.citation: J Clin Oncol. 2009 Mar 20;27(9):1419-25
references.pmid: 19224846
references.citation: Nature. 1993 Apr 29;362(6423):841-4
references.pmid: 7683111
references.citation: Cancer Res. 2004 Feb 15;64(4):1403-10
references.pmid: 14973057
references.citation: Cell. 2002 Jan 25;108(2):153-64
references.pmid: 11832206
references.citation: Int J Cancer. 1999 Oct 22;84(5):521-4
references.pmid: 10502731
references.citation: J Clin Oncol. 1992 Aug;10(8):1225-9
references.pmid: 1321891
references.citation: Science. 2005 Jan 7;307(5706):58-62
references.pmid: 15637262
references.citation: Clin Cancer Res. 2006 May 15;12(10):2964-6
references.pmid: 16707590
references.citation: Int J Cancer. 1992 Feb 20;50(4):604-10
references.pmid: 1537625
references.citation: Int J Oncol. 2005 Nov;27(5):1441-8
references.pmid: 16211241
references.citation: N Engl J Med. 2011 Dec 29;365(26):2484-96
references.pmid: 22204725
references.citation: Biochemistry. 1988 Apr 5;27(7):2253-9
references.pmid: 2838070
references.citation: Int J Gynecol Cancer. 2008 May-Jun;18(3):499-505
references.pmid: 18476949
references.citation: Int J Gynecol Cancer. 2007 Jan-Feb;17(1):76-82
references.pmid: 17291235
references.citation: Jpn J Cancer Res. 1997 Dec;88(12):1218-23
references.pmid: 9473741
references.citation: Nature. 2006 Jan 19;439(7074):274-5
references.pmid: 16421553
references.citation: Clin Cancer Res. 1998 Jul;4(7):1737-41
references.pmid: 9676849
references.citation: Ann Oncol. 1997 Oct;8(10):963-8
references.pmid: 9402168
references.citation: Ann Oncol. 1993;4 Suppl 4:35-40
references.pmid: 8312199
references.citation: CA Cancer J Clin. 2009 Mar-Apr;59(2):111-37
references.pmid: 19278961
references.citation: Cancer Chemother Pharmacol. 1988;21(1):71-4
references.pmid: 3342468
references.citation: Cancer Res. 1987 Nov 15;47(22):5944-7
references.pmid: 3664496
references.citation: Clin Cancer Res. 2003 Oct 15;9(13):4682-8
references.pmid: 14581337
references.citation: JAMA. 2011 Jun 8;305(22):2292; author reply 2292-3
references.pmid: 21642679
references.citation: Cancer Res. 1988 Jan 1;48(1):68-73
references.pmid: 3335000
references.citation: Int J Gynecol Cancer. 2012 Jul;22(6):922-9
references.pmid: 22672985
references.citation: Int J Gynecol Cancer. 2007 Jul-Aug;17(4):771-6
references.pmid: 17343605
references.citation: J Biol Chem. 2002 Sep 6;277(36):33490-500
references.pmid: 12087097
references.citation: Cancer. 1993 Feb 15;71(4 Suppl):1559-64
references.pmid: 8094320
references.citation: Jpn J Cancer Res. 1999 Dec;90(12):1373-9
references.pmid: 10665656
references.citation: N Engl J Med. 2011 Dec 29;365(26):2473-83
references.pmid: 22204724
references.citation: Cancer Res. 1995 May 15;55(10):2097-103
references.pmid: 7743509
references.citation: Int J Clin Oncol. 2012 Oct;17(5):423
references.pmid: 22926639
references.citation: Gynecol Oncol. 2002 Aug;86(2):171-6
references.pmid: 12144824
references.citation: Cancer Res. 1996 Feb 15;56(4):789-93
references.pmid: 8631015
references.citation: J Clin Oncol. 1991 Mar;9(3):389-93
references.pmid: 1999708
references.citation: J Clin Oncol. 1994 Sep;12(9):1748-53
references.pmid: 7916038
references.citation: Adv Exp Med Biol. 2000;465:207-14
references.pmid: 10810628
references.citation: J Clin Oncol. 2012 Jun 10;30(17):2039-45
references.pmid: 22529265
references.citation: Oncogene. 2003 Apr 10;22(14):2192-205
references.pmid: 12687021
references.citation: World J Biol Chem. 2010 Jul 26;1(7):209-20
references.pmid: 21537476
references.citation: J Biol Chem. 2004 Mar 19;279(12):10962-72
references.pmid: 14701865
references.citation: Cancer Sci. 2007 Dec;98(12):2002-8
references.pmid: 17900261
references.citation: Biochem Pharmacol. 1996 Oct 11;52(7):967-77
references.pmid: 8831715
references.citation: Clin Cancer Res. 2001 Aug;7(8):2182-94
references.pmid: 11489791
references.citation: Biochemistry. 1989 May 30;28(11):4629-38
references.pmid: 2548584
references.citation: Clin Cancer Res. 1997 Aug;3(8):1245-52
references.pmid: 9815806
references.citation: Cancer Res. 2006 Jan 1;66(1):212-20
references.pmid: 16397234
references.citation: Int J Gynaecol Obstet. 2006 Nov;95 Suppl 1:S161-92
references.pmid: 17161157