Evolution of concepts of platinum resistance in ovarian cancer and current therapeutic opportunities
- Authors: Nikandrova A.A.1, Musaeva K.M.2, Denisova A.V.3, Manzurov A.K.4, Popova A.A.4, Pezuev S.R.5, Khorumov M.A.5, Mazhidova E.D.6, Khubaeva S.S.6, Molchanova Y.A.4, Kulakova A.Y.7, Timush M.I.7, Fomenko A.E.7, Bezlepkina A.A.8, Mustafina A.I.3
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Affiliations:
- Russian University of Medicine
- North-Ossetian State Medical Academy
- Bashkir State Medical University
- N.I. Pirogov Russian National Research Medical University
- North Caucasian State Academy
- Kadyrov Chechen State University
- Kuban State Medical University
- Rostov State Medical University
- Issue: Vol 12, No 4 (2025)
- Pages: 395-411
- Section: Reviews
- URL: https://ogarev-online.ru/2313-8726/article/view/376619
- DOI: https://doi.org/10.17816/aog690082
- EDN: https://elibrary.ru/AHPBLA
- ID: 376619
Cite item
Abstract
Ovarian cancer remains one of the leading causes of mortality among gynecological cancers. The major challenge in its treatment is the development of resistance to platinum-based agents. Traditionally, platinum sensitivity of the tumor was assessed based on the treatment-free interval. However, with the introduction of targeted and maintenance therapies, such as PARP inhibitors and antiangiogenic drugs, these criteria require reevaluation. Current evidence indicates that platinum resistance arises from complex biological processes involving homologous recombination deficiency, activation of DNA repair pathways, alterations in the tumor microenvironment, increased expression of drug transporters, evasion of apoptosis, as well as the involvement of cancer stem cells and clonal evolution. The elucidation of these mechanisms has provided the basis for new therapeutic strategies. A key focus is on ATR and WEE1 inhibitors, epigenetic agents, antibody–drug conjugates, immunotherapy, and combination approaches that act simultaneously on multiple pathogenic pathways. A promising direction involves integrating molecular profiling and biomarker assessment to select patients most sensitive to specific therapeutic modalities. Thus, the evolving concept of platinum resistance in ovarian cancer reflects a shift from time-based clinical criteria toward molecular and biological stratification. This transition opens new opportunities for personalized treatment, which can enhance not only treatment efficacy but also long-term outcomes for patients with an unfavorable prognosis.
About the authors
Arina A. Nikandrova
Russian University of Medicine
Email: chirach726@gmail.com
ORCID iD: 0009-0007-7645-2248
Russian Federation, Moscow
Kheda M.E. Musaeva
North-Ossetian State Medical Academy
Email: musaevamm_00@mail.ru
ORCID iD: 0009-0004-6885-2370
Russian Federation, Vladikavkaz
Anna V. Denisova
Bashkir State Medical University
Email: tur.anutka@mail.ru
ORCID iD: 0009-0008-0569-2751
Russian Federation, Ufa
Artem K. Manzurov
N.I. Pirogov Russian National Research Medical University
Email: artemmanzurov@yandex.ru
ORCID iD: 0009-0008-4480-9684
Russian Federation, Moscow
Anna A. Popova
N.I. Pirogov Russian National Research Medical University
Email: anna.magic.24.07@gmail.com
ORCID iD: 0009-0008-6079-0151
Russian Federation, Moscow
Shakhban R. Pezuev
North Caucasian State Academy
Email: pezuev05@gmail.com
ORCID iD: 0009-0001-0038-4978
student
Russian Federation, CherkesskMuslim A. Khorumov
North Caucasian State Academy
Email: horumov.muslim@ya.ru
ORCID iD: 0009-0009-1199-7284
Russian Federation, Cherkessk
Eliza D. Mazhidova
Kadyrov Chechen State University
Email: mazidovaeliza@gmail.com
ORCID iD: 0009-0007-8635-7682
Russian Federation, Grozny
Saida S. Khubaeva
Kadyrov Chechen State University
Email: khubaevasaida@mail.ru
ORCID iD: 0009-0008-1023-478X
Russian Federation, Grozny
Yulia A. Molchanova
N.I. Pirogov Russian National Research Medical University
Email: Juliamolcanova03@gmail.com
ORCID iD: 0009-0005-1421-0978
Russian Federation, Moscow
Arina Yu. Kulakova
Kuban State Medical University
Email: a.y.kulakova@mail.ru
ORCID iD: 0009-0000-9976-9247
Russian Federation, Krasnodar
Maхim I. Timush
Kuban State Medical University
Email: bestcelesteru@gmail.com
ORCID iD: 0009-0000-7939-7255
Russian Federation, Krasnodar
Aleхandra E. Fomenko
Kuban State Medical University
Email: fomenko.al.2017@gmail.com
ORCID iD: 0009-0003-8618-7805
Russian Federation, Krasnodar
Anastasiia A. Bezlepkina
Rostov State Medical University
Email: anastasiiabezl@gmail.com
ORCID iD: 0009-0002-7093-1401
Russian Federation, Rostov-on-Don
Angelina I. Mustafina
Bashkir State Medical University
Author for correspondence.
Email: angelina30.03.2001@icloud.com
ORCID iD: 0009-0009-3139-0519
Russian Federation, Ufa
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