Overcoming Chemotherapy Resistance in High Grade Serous Ovarian Cancer

High grade serous (HGS) cancer of the ovary (OC) is a lethal malignancy with advanced stage disease remaining incurable. HGS OC is sensitive to platinum based chemotherapy with complete responses being frequent, but relapses are inevitable, with resistance invariably emerging. Deeper understanding of the pathogenesis of HGS OC with new sequencing techniques shows that aberrations in the BRCA pathway may play a major role. Changes in the homologous recombination pathway and DNA repair may play a role in platinum resistance. This review article describes various approaches that have been studied in the management of chemotherapy resistance in HGS OC including Poly ADPribose polymerase (PARP) inhibition, Wee1 inhibition, epigenetic agents, immunotherapy and angiogenesis targeting agents.