Editorial: Ovarian Cancer Targeted Medication: PARP Inhibitors, Anti-Angiogenic Drugs, Immunotherapy, and More -Volume II

Zhi-Bin Wang ¹ Hua De Liao ¹ GUANG LEI ² Zhaoqian Liu ^3* Nayiyuan Wu ^1* Jing Wang ^1*

• ¹ Hunan Cancer Hospital, Xiangya School of Medicine, Central South University, Changsha, China
• ² University of Texas MD Anderson Cancer Center, Houston, Texas, United States
• ³ Xiangya Hospital, Central South University, Changsha, Hunan Province, China

Ovarian cancer (OC), the deadliest gynecological malignancy, primarily relies on tumor debulking and post-surgical platinum-based chemotherapy. However, platinum resistance often emerges after multiple recurrences. Given OC's heterogeneity and complex molecular landscape, pinpointing specific molecular targets is crucial for understanding its mechanisms and progression. The therapeutic paradigm for OC is evolving from traditional chemotherapy to targeted therapies, with PARP inhibitors and anti-angiogenic agents becoming key maintenance treatments. Despite their promise, these therapies face challenges such as inefficacy, adverse effects, and cost. Nextgeneration sequencing (NGS) offers a broader spectrum of targeted agents, potentially enhancing personalized treatment strategies. Additionally, immunotherapy and ferroptosis modulation present innovative avenues for OC treatment. Enhancing the efficacy and reducing the side effects of current OC drugs, as well as exploring new targets, are pressing needs. We seek to identify novel therapeutic targets and biomarkers for OC, encouraging both computational and experimental pharmacological studies. This Research Topic encompasses pharmacological topics, including immunetargeted therapy, prognostic biomarkers, and single-cell sequencing analysis of the immune microenvironment in ovarian cancer (Figure 1 3. Sun et al.'s meta-analysis on the efficacy and safety of PARP inhibitor maintenance therapy for ovarian cancer indicates that PARP inhibitors markedly enhance progression-free survival (PFS) and overall survival (OS) compared to placebo, while concurrently elevating the risk of treatment-related adverse events. This finding accentuates the necessity for vigilant patient monitoring in clinical settings when employing PARP inhibitor maintenance therapy.However, not all patient populations benefit from existing treatment regimens. The proposition and translational research of novel therapeutic modalities are imperative.4. The expert synthesis of the safety profile of combining bevacizumab with olaparib as maintenance therapy for patients with newly diagnosed advanced ovarian cancer, based on the PAOLA-1 trial data, indicates that while the combination is deemed safe, there is a notable rate of treatment discontinuations due to adverse events. quality of life and maximize treatment efficacy.5. The review and meta-analysis, comparing the efficacy and safety of PARP inhibitors in combination with antiangiogenic agents in ovarian cancer treatment, reveals that combined therapy significantly improves PFS but also increases the incidence of adverse events. Wei et al. note that while combined therapy offers a clear advantage in PFS, its impact on OS remains uncertain.6. The meta-analysis assesses the efficacy and safety of anti-angiogenic drug monotherapy and combination therapy in ovarian cancer, indicating that combination therapy markedly improves PFS and objective response rate (ORR), while monotherapy does not yield significant survival benefits. Xie et al. highlight the critical importance of adverse event monitoring in clinical practice. 12. Massariol's study encapsulates recent advancements in immunotherapy for ovarian cancer, with a focus on strategies such as cancer vaccines, CAR-T cell therapy, and immune checkpoint inhibitors. The researchers emphasize that despite the challenges, the potential of immunotherapy in treating ovarian cancer is substantial.They noted, "By activating anti-tumor immune responses, immunotherapy can effectively eliminate tumor cells and prevent recurrence."13. The narrative review discusses advancements in targeted treatments for ovarian cancer, including anti-angiogenic agents, PARP inhibitors, and immune checkpoint inhibitors. The article underscores that while existing therapies delay recurrence, there is an urgent need for new strategies to enhance outcomes. The authors highlight that "the potential of targeted therapies lies in their ability to personalize treatment plans based on molecular characteristics, thereby enhancing patient survival rates."Regarding the early prediction of the efficacy of targeted therapy for ovarian cancer, several studies have provided commendable attempts and strategies. However, progress will eventually be made, even though the journey may be long.Overall, this Research Topic has painted a comprehensive picture of the current state and future perspectives of targeted therapies for ovarian cancer. It has not only highlighted the significant advancements in understanding the complex molecular mechanisms of OC but also underscored the tangible progress in treatment strategies.The evidence accumulated from these studies helps us refine treatment approaches, emphasizing the need for personalized medicine and the potential of combination therapies to improve patient outcomes.