title: Current and emerging treatment options in the management of advanced ovarian cancer.
abstract: BACKGROUND
  Epithelial ovarian cancer is the most lethal gynecologic malignancy. Recent advances in understanding the biology and its molecular and histological diversity have led to mechanism based therapeutic strategies such as poly-ADP-ribose polymerase inhibitors (PARP) targeting homologous recombination deficient tumor cells and anti-angiogenic therapies. Clinical trial designs in ovarian cancer have to evolve to incorporate assessment of the genomic complexity and identify predictive biomarkers to improve precision of treatment and outcome.
  
  
  METHODS
  This review summarizes present-day strategies used in the management of ovarian cancer and novel promising therapeutic approaches in development. The article is based on English peer-reviewed articles located on MEDLINE and related abstracts presented at major international meetings.
  
  
  CONCLUSIONS
  Two types of molecular targeted therapies, anti-angiogenics and PARP inhibitors, have been shown to be active in randomized clinical trials and approved by regulatory agencies. Management of ovarian cancer is poised to change with the continued advancement of precision medicine that is founded upon improved understanding of disease biology; separation into histologically and molecularly defined subgroups; and the incorporation of this new knowledge into early phase drug development and novel clinical trial design.
authors.affiliation: a Division of Medical Oncology and Hematology, Princess Margaret Hospital , University of Toronto , Toronto , Ontario , Canada.
authors.forename: Victor
authors.initials: V
authors.lastname: Rodriguez-Freixinos
authors.affiliation: b Division of Medical Oncology and Hematology , Sunnybrook Odette Cancer Centre , Toronto , Ontario , Canada.
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Mackay
authors.affiliation: a Division of Medical Oncology and Hematology, Princess Margaret Hospital , University of Toronto , Toronto , Ontario , Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Karakasis
authors.affiliation: a Division of Medical Oncology and Hematology, Princess Margaret Hospital , University of Toronto , Toronto , Ontario , Canada.
authors.forename: Amit M
authors.initials: AM
authors.lastname: Oza
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy; D010051:Ovarian Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Angiogenesis; PARP inhibitors; epithelial ovarian cancer; immunotherapy; targeted therapies