From cytoreduction to precision oncology: evolution of ovarian cancer therapy

Ovarian cancer remains the most lethal gynecologic malignancy due to its asymptomatic progression, limited screening modalities, and late-stage diagnosis. Although initial responses to platinum-based chemotherapy are common, recurrence and multidrug resistance are nearly universal, necessitating a shift toward biomarker-guided, precision-based interventions. This review synthesizes current evidence on the evolving landscape of ovarian cancer treatment, with emphasis on molecular pathogenesis, histotype-specific vulnerabilities, and advances in therapeutic strategies. Focus is placed on the clinical integration of poly (ADP-ribose) polymerase (PARP) inhibitors, vascular endothelial growth factor (VEGF)-targeting agents, immune checkpoint inhibitors, and antibody–drug conjugates, alongside emerging platforms such as liquid biopsy, artificial intelligence–enhanced diagnostics, and histotype-driven targeted therapies. Translational insights from other malignancies were utilized to highlight future directions for ovarian cancer, including dual pathway targeting, immune and epigenetic modulation, and receptor-guided cytotoxic delivery. Collectively, these advances demonstrate how precision oncology is advancing ovarian cancer treatment, with the potential to improve survival outcomes while preserving quality of life.