Ovarian cancer (OC) has a high rate of mortality and is the fifth most common cause of death in females all over the world. The etiology is still unclear. Numerous factors such as smoking, obesity, and unhealthy diet may affect the risk of OC. Having a family history of breast and OC is one of the main risks for developing OC. Mutations of BRCA1/2 are associated with OC risk as well. The histopathological classification of OC reveals the four most common types: serous, clear cell, endometrioid, and mucinous; these are epithelial OC types, and other types are rare. Furthermore, OC can be subdivided into types I and II. Type I tumors are most probably caused by atypical proliferative tumors. Type II tumors include high-grade carcinoma of the serous type, carcinosarcoma, and carcinoma, which are not differentiated and generally originate from tubal intraepithelial carcinoma of the serous type. Typically, type I tumors are present in early stages, usually with good prognosis. Type II tumors are classified as high-grade tumors and are most often diagnosed at advanced FIGO stages with poor prognosis. High-grade serous OC accounts for 90% of serous OC. Tumor heterogeneity aggravates OC treatment. The standard care for primary epithelial ovarian cancer (EOC) is cytoreductive surgery followed by platinum-based chemotherapy. Neoadjuvant chemotherapy can be used in certain cases followed by cytoreductive surgery. The main prognostic factor is complete tumor resection. However, about 70% of patients relapse. Resistance to chemotherapeutic agents remains a major challenge in EOC treatment, in which many different factors are involved. In recent years, the examination of molecular parameters and their prognostic impact has become increasingly relevant in EOC, and furthermore, the use of immunotherapy has expanded the therapeutic range. As the clinical need is greatest for relapsed patients, this systematic review will focus on recent advances in molecular biology with prognostic and predictive markers and treatment options for recurrent/refractory OC. Inclusion criteria for the review: potential prospective or predictive biomarkers in preclinical or clinical use in relapsed and refractory OC, prognostic impact, clinical and preclinical trials, and immunotherapy. Exclusion criteria for the review: primary OC, no full text or abstract available, not the topic mentioned above, and text not available in English. Risk of bias: the included studies were evaluated descriptively for the topics mentioned above, and data were not compared with each other. The objective is to highlight the molecular mechanisms of the most promising targeted agents under clinical investigation to demonstrate their potential relevance in recurrent/refractory OC.
卵巢癌（OC）死亡率高，是全球女性第五大常见死因。其病因尚不明确。吸烟、肥胖和不健康饮食等多种因素可能影响卵巢癌的发病风险。乳腺癌和卵巢癌家族史是罹患卵巢癌的主要风险因素之一。BRCA1/2基因突变也与卵巢癌风险相关。卵巢癌的组织病理学分类显示四种最常见类型：浆液性、透明细胞、子宫内膜样和粘液性；这些属于上皮性卵巢癌类型，其他类型较为罕见。此外，卵巢癌可进一步分为I型和II型。I型肿瘤很可能由非典型增生性肿瘤发展而来。II型肿瘤包括高级别浆液性癌、癌肉瘤和未分化癌，通常起源于浆液性输卵管上皮内癌。I型肿瘤通常发现于早期阶段，预后较好。II型肿瘤属于高级别肿瘤，多在FIGO晚期确诊，预后较差。高级别浆液性卵巢癌占浆液性卵巢癌的90%。肿瘤异质性增加了卵巢癌的治疗难度。原发性上皮性卵巢癌（EOC）的标准治疗方案是肿瘤细胞减灭术联合铂类化疗。在某些情况下可采用新辅助化疗后再行肿瘤细胞减灭术。完全切除肿瘤是主要预后因素。然而约70%的患者会出现复发。化疗药物耐药性仍是EOC治疗面临的主要挑战，涉及多种不同因素。近年来，分子参数检测及其预后影响在EOC中日益重要，免疫疗法的应用也拓展了治疗范围。鉴于复发患者的临床需求最为迫切，本系统综述将重点关注分子生物学领域的最新进展，包括预后和预测标志物以及复发/难治性卵巢癌的治疗方案。综述纳入标准：临床前或临床研究中用于复发难治性卵巢癌的潜在前瞻性或预测性生物标志物、预后影响、临床及临床前试验、免疫疗法。排除标准：原发性卵巢癌、无全文或摘要、非相关主题、非英文文献。偏倚风险：对纳入研究就上述主题进行描述性评估，数据未进行相互比较。旨在重点阐述临床研究中最具前景的靶向药物的分子机制，以证明其在复发/难治性卵巢癌中的潜在应用价值。
肿瘤(癌症)患者之家