Modern recommendations for the medical treatment of epithelial ovarian tumors

Nowadays, ovarian cancer remains the leading cause of death from cancer in women worldwide. In most cases, this disease is diagnosed at a late stage, it is difficult to treat, and it often recurs and progresses rapidly with a poor prognosis for overall survival. The success of ovarian cancer treatment depends on the radicality of surgical intervention and drug treatment, but the last one is characterized by high toxicity. The standard component of drug therapy is platinum-based chemotherapy. If a positive result is achieved after 4–6 courses of chemotherapy, it is justified to prescribe special therapy in a maintenance regimen depending on the presence/absence of BRCA1/BRCA2 mutations and HRD status of the tumor. However, despite of modern achievements in medicine over the past decades, the overall survival rate has not increased significantly.Ovarian cancer is a disease which is characterized by frequent recurrence and progressions. And the prognosis of the disease is better the later the progression occurs. The issue of selecting drug therapy in case of recurrence/progression of the disease remains quite difficult, since there are no clear recommendations for the use of chemotherapy regimens. Also, the reliable predictors of sensitivity to chemotherapy drugs are absent, there is only a 6-month interval for treatment with platinum drugs, which is also inaccurate. Clinical studies have confirmed the sensitivity of ovarian tumors to platinum and PARP inhibitors in the presence of mutations in the BRCA1/BRCA2 genes and other homologous recombination genes. In BRCA1/BRCA2 negative tumors, sensitivity to chemotherapeutic drugs, including platinum-containing drugs, remains insufficiently studied. Therefore, an important task is to find new predictors of sensitivity to platinum drugs that will help to choose the most personalized treatment and avoid unnecessary toxicity.