Title:A Comprehensive Review on Current Treatments and Challenges
Involved in the Treatment of Ovarian Cancer
Volume: 24
Issue: 2
Author(s): Saika Saman, Nimisha Srivastava*, Mohd Yasir and Iti Chauhan
Affiliation:
- Department of Pharmaceutics, Faculty of Pharmacy, Amity Institute of Pharmacy, Lucknow, Amity University Uttar
Pradesh, Sector 125, Noida, 201313, India
Keywords:
Ovaries, ovarian cancer, multidrug resistance, chemotherapy, nanocarriers, nano-systems.
Abstract:
Ovarian cancer (OC) is the second most common gynaecological malignancy. It typically
affects females over the age of 50, and since 75% of cases are only discovered at stage III or IV,
this is a sign of a poor diagnosis. Despite intraperitoneal chemotherapy's chemosensitivity, most patients
relapse and face death. Early detection is difficult, but treatment is also difficult due to the
route of administration, resistance to therapy with recurrence, and the need for precise cancer targeting
to minimize cytotoxicity and adverse effects.
On the other hand, undergoing debulking surgery becomes challenging, and therapy with many chemotherapeutic
medications has manifested resistance, a condition known as multidrug resistance
(MDR). Although there are other therapeutic options for ovarian cancer, this article solely focuses
on co-delivery techniques, which work via diverse pathways to overcome cancer cell resistance.
Different pathways contribute to MDR development in ovarian cancer; however, usually, pump
and non-pump mechanisms are involved. Striking cancerous cells from several angles is important
to defeat MDR. Nanocarriers are known to bypass the drug efflux pump found on cellular membranes
to hit the pump mechanism.
Nanocarriers aid in the treatment of ovarian cancer by enhancing the delivery of chemotherapeutic
drugs to the tumour sites through passive or active targeting, thereby reducing unfavorable side effects
on the healthy tissues. Additionally, the enhanced permeability and retention (EPR) mechanism
boosts the bioavailability of the tumour site. To address the shortcomings of conventional delivery,
the current review attempts to explain the current conventional treatment with special reference
to passively and actively targeted drug delivery systems (DDSs) towards specific receptors developed
to treat ovarian cancer. In conclusion, tailored nanocarriers would optimize medication delivery
into the intracellular compartment before optimizing intra-tumour distribution. Other novel
treatment possibilities for ovarian cancer include tumour vaccines, gene therapy, targeting epigenetic
alteration, and biologically targeted compounds. These characteristics might enhance the therapeutic
efficacy.