Targeted Therapy for Ovarian Cancer
Targeted therapy is a newer type of cancer treatment that uses drugs or other substances to identify and attack cancer cells while doing little damage to normal cells. These therapies attack the cancer cells' inner workings − the programming that makes them different from normal, healthy cells. Each type of targeted therapy works differently, but all alter the way a cancer cell grows, divides, repairs itself, or interacts with other cells.
Bevacizumab (Avastin®) belongs to a class of drugs known as angiogenesis inhibitors. In order for cancers to grow and spread, they need new blood vessels to form to nourish the tumors (called angiogenesis). This drug binds to a substance called VEGF that signals new blood vessels to form. This can slow or stop the growth of cancers.
In studies, bevacizumab has been shown to shrink or slow the growth of advanced epithelial ovarian cancers. Trials to see if bevacizumab works even better when given along with chemotherapy have shown good results in terms of shrinking (or stopping the growth of) tumors. But it doesn’t seem to help women live longer.
This drug is given as an infusion into the vein (IV) every 2 to 3 weeks.
Common side effects include high blood pressure, tiredness, bleeding, low white blood cell counts, headaches, mouth sores, loss of appetite, and diarrhea. Rare but possibly serious side effects include blood clots, severe bleeding, slow wound healing, holes forming in the colon (called perforations), and the formation of abnormal connections between the bowel and the skin or bladder (fistulas). If a perforation or fistula occurs it can lead to severe infection and may require surgery to correct.
Olaparib (Lynparza™) is a type of drug known as a PARP (poly(ADP)-ribose polymerase) inhibitor. PARP enzymes are normally involved in one pathway to help repair damaged DNA inside cells. The BRCA genes (BRCA1 and BRCA2) are also normally involved in a different pathway of DNA repair, and mutations in those genes can block that pathway. By blocking the PARP pathway, olaparib makes it very hard for tumor cells with a BRCA gene that doesn’t work to repair damaged DNA, which often leads to the death of these cells.
This drug is used to treat advanced epithelial ovarian cancer. Because it relies on a blocked BRCA pathway to work, at this time it is only used in patients who have mutations in the BRCA genes. Only a small portion of women with ovarian cancer have mutated BRCA genes. If you are not known to have a BRCA mutation, your doctor will test your blood to be sure you have one before starting treatment with this drug.
In studies, this drug helped some advanced ovarian cancers in women who had BRCA mutations stop growing or shrink for a time. So far though, it hasn’t been shown to help the women live longer.
This drug is taken by mouth, twice a day.
Side effects tend to be mild and include nausea, vomiting, diarrhea, fatigue, loss of appetite, and muscle and joint pain. Rarely, some patients treated with olaparib have developed a blood cancer, such as myelodysplastic syndrome and acute myeloid leukemia.
Other targeted therapy drugs are being studied.
Our document Targeted Therapy has more information about these kinds of drugs.
Last Medical Review: August 5, 2014 Last Revised: February 4, 2016
- Surgery for Ovarian Cancer
- Chemotherapy for Ovarian Cancer
- Targeted Therapy for Ovarian Cancer
- Hormone Therapy for Ovarian Cancer
- Radiation Therapy for Ovarian Cancer
- Treatment of Invasive Epithelial Ovarian Cancers, by Stage
- Treatment for Epithelial Tumors of Low Malignant Potential
- Treatment for Germ Cell Tumors of the Ovary
- Treatment for Stromal Tumors of the Ovary, by Stage