Personalized approach to the ovarian cancer treatment

The aim of the review is to summarize the modern views on etiopathogenesis and treatment of ovarian cancer, as well as to search for ways for a more personalized approach to the management of patients with this oncological disease. Despite the limited number of patients participating in clinical trials of ovarian cancer, there are obvious results of gradual evolution in its diagnosis and treatment. Studies of etiopathogenesis led to a better understanding of the ovarian cancer genesis mechanisms, whereas evolution in treatment was marked by combination of secondary cytoreductive surgery with the most effective chemotherapeutic drugs and biological agents. The introduction of biomarkers, particularly CA125 (cancer antigen 125), in the diagnostic algorithm for both primary and recurrent ovarian cancer has opened up new horizons for the application of effective methods of treatment at the disease earliest stages. However, in the landmark study of G.J. Rustin et al. there was no a statistically significant difference in disease-free and overall survival among female patients with immediate treatment of recurrent ovarian cancer based only on elevated CA125 and female patients in whom chemotherapy was initiated after the clinical symptoms manifestation. Conducting clinical trials in small cohorts of patients with certain ovarian cancer histotype will help to select one or another effective combination of chemotherapy and/or biological agents administered not only intravenously, but also intraperitoneally, and thereby provide the personalized approach to the treatment of this disease.