Ovarian Cancer

Biological or targeted therapies

Biological or targeted therapies are some of the latest developments in ovarian cancer treatment. Biological therapies are developed from or are created to target substances that occur naturally in the body. These drugs have been designed or modified in the laboratory to change the way that cells work and talk to (signal to) each other, which causes these cells to target and destroy or control the growth of cancer (Cancer Research UK, 2022).

These therapies can be used on their own or in combination with other treatments such as chemotherapy, and may be used as a maintenance treatment, which 'aims to stop the cancer from coming back or growing for as long as possible' (Cancer Research UK, 2022). They are often used for high-grade cancers (cancer with cells that look abnormal under a microscpre, are more agressive, and spread faster than low-grade cancer cells).

There are many different types of biological therapies, including:

Cancer growth blockers: cancer growth inhibitors/blockers interfere with the way cancer cells use 'chemical messengers' to help the cell to develop and divide.

PARP inhibitors: PARP inhibitors are a type of cancer growth blocker that block the Poly (ADP-ribose) polymerase (PARP) protein, which is involved in helping damaged cells repair themselves. Cells that have faults in BCRA genes are particularly sensitive to PARP inhibitors.

Olaparib (Lynparza) is a PARP inhibitor used as a maintenance treatment for advanced high-grade ovarian cancer that has responded to platinum-based chemotherapy and has a mutation or change in the BRCA gene.
Niraparib (Zejula) and rucaparib (Rubraca) are types of PARP inhibitors that are used as a maintenance treatment for high-grade ovarian cancer that has come back (relapsed) and is platinum sensitive (responds to platinum chemotherapy).

Blood supply blockers or anti-angiogenic drugs: cancer cannot grow without its own blood supply. Anti-angiogenic drugs stop tumours (cancers) from developing their own blood vessels, so the cancer cells can't get the oxygen and food that they need in order to grow.

Bevacizumab (Avastin) is a anti-angiogenic drug that is used either with chemotherapy or on its own as a maintenance treatment. Bevacizumab targets and blocks a cancer cell protein called vascular endothelial growth factor (VEGF), which has the effect of stopping the cancer from growing the blood vessels that it needs to be able to survive and grow (Cancer Research UK 2022).

Monoclonal antibodies: monoclonal antibodies are drugs that can 'recognise' and find specific cells in the body. Monoclonal antibodies can be designed to find a particular type of cancer cell, attach itself to them and destroy them. They can also be designed to disrupt blood supply to a tumour or carry a radioactive molecule, which then delivers radiation directly to the cancer cells.

Vaccines: vaccines aim to help the immune system recognise and attack cancer cells.

OvarianVax is a vaccine for ovarian cancer that is in early stages of development and testing at the University of Oxford. As this vaccine is still in the early stages, a timeline for clinical trials for and availability of this vaccine has not yet been determined. OvarianVax is being developed as a preventative measure for ovarian cancer (Ovarian Cancer Action, 2024). ***

Olaparib with bevacizumab: the combination of olaparib with bevacizumab may be used as a maintenance treatment for high-grade, advanced epithlial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer that has responded to first-line platinum-based chemotherapy in combination with bevacizumab and that has a BRCA gene change and/or an increased tendency for gene mutations (NICE, 2024). *

The type of targeted therapy that is recommended depends on the type and stage of cancer, treatment history (the results of other treatments that have been tried), and whether the cancer has changes or mutations in what is called the BRCA gene.

Targeted cancer drugs can be given as tablets or through a tube (cannula) or central line (a long tube or 'line' placed in the chest or through a vein in the arm that stays in place for the duration of the treatment) into the bloodstream (intravenously).

Side effects vary by treatment type, but some general side effects noted with biological/targeted therapies include:

tiredness or fatigue
loss of appetite
sore mouth
low blood cell levels (anaemia)
nausea or feeling sick **

We have not yet been able to interview anyone who has had biological therapies for ovarian cancer. If you have had this type of treatment and you would like us to include your story on this website, please email hexi@phc.ox.ac.uk for more information.

*The National Institute for Health and Care Excellence (NICE), 'Olaparib with bevacizumab for maintenance treatment of advanced high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer', technology appraisal guidance TA946, 'Recommendations'. Published 17 January 2024. Accessed December 2024.

**Cancer Research UK, 'Targeted cancer drugs for ovarian cancer'. Last reviewed 16 March 2022. Accessed December 2024.

***Ovarian Cancer Action, 'Ovarianvax and what you need to know about the ovarian cancer vaccine'. Published 10 October 2024. Accessed December 2024.

Last reviewed December 2024.
Last updated December 2024.