Targeted therapy for ovarian cancer

Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells and limit harm to normal cells. Targeted therapy may also be called molecular targeted therapy.

Targeted therapy is sometimes used to treat ovarian cancer. It may also be used to treat fallopian tube or primary peritoneal cancer, which are very similar to ovarian cancer. These cancers start in the same type of tissue as most ovarian cancers and are staged and treated the same way. If you have targeted therapy, your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

You may have targeted therapy to:

• treat advanced cancer
• treat cancer that doesn’t respond to other treatments or comes back (recurs) after treatment

Different types of targeted therapy are used for ovarian, fallopian tube and primary peritoneal cancer.

Angiogenesis is the growth of new blood vessels. A tumour has to make new blood vessels in order to grow, so anti-angiogenesis drugs try to cut off a tumour’s blood supply by stopping it from developing new blood vessels.

Bevacizumab (Avastin) is an angiogenesis inhibitor for advanced or recurrent cancer. If you have advanced ovarian, fallopian tube or primary peritoneal cancer, bevacizumab may be offered after the cancer has responded to chemotherapy with a platinum drug such as carboplatin or cisplatin. If you have recurrent cancer that did not respond to chemotherapy, bevacizumab may be combined with chemotherapy drugs to help them work better. Bevacizumab is given intravenously (by IV) every 2 to 3 weeks.

Poly ADP-ribose polymerase (PARP) is an enzyme that helps repair damage to DNA. PARP inhibitors block PARP so cancer cells can’t repair their DNA, which causes them to die.

PARP inhibitors may be used for advanced or recurrent ovarian, fallopian tube or primary peritoneal cancer. They may be offered after the cancer has responded to chemotherapy with a platinum drug, such as carboplatin or cisplatin. PARP inhibitors are used as maintenance therapy to prevent the cancer from coming back. The PARP inhibitors given may include the following:

• Olaparib (Lynparza) will only be offered if you have a BRCA1 or BRCA2 gene mutation or a positive homologous recombination deficiency (HRD) test, which means the cancer cells have difficulty repairing DNA damage and the tumour will be more sensitive to PARP inhibitors. Olaparib is usually taken by mouth twice a day.
• Niraparib (Zejula) may also be offered. You don't need to have a BRCA gene mutation or be HRD positive to take this drug. Niraparib is usually taken by mouth once a day.

Side effects of targeted therapy will depend mainly on the type of drug or combination of drugs, the dose, how it's given and your overall health. Tell your healthcare team if you have side effects that you think are from targeted therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Talk to your doctor or pharmacist about what side effects to expect.

Find out more about targeted therapy. To make the decisions that are right for you, ask your healthcare team questions about targeted therapy.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.