Email this article 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.A.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 Caucasus State Academy
- A.A. Kadyrov Chechen State University
- Kuban State Medical University
- Rostov State Medical University
- Section: Reviews
- Submitted: 04.09.2025
- Accepted: 23.10.2025
- Published: 27.11.2025
- URL: https://archivog.com/2313-8726/article/view/690082
- DOI: https://doi.org/10.17816/aog690082
- ID: 690082
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Abstract
Ovarian cancer remains one of the leading causes of mortality among gynecologic malignancies, with platinum resistance representing the main challenge in its management. Traditionally, the assessment of tumor sensitivity to platinum has been based on the platinum-free interval; however, with the introduction of targeted and maintenance therapies, including PARP inhibitors and antiangiogenic agents, these criteria require reassessment. Current evidence indicates that platinum resistance results from complex biological processes, including homologous recombination deficiency (HRD), activation of DNA repair pathways, alterations in the tumor microenvironment (TME), increased expression of drug transporters, evasion of apoptosis, as well as the contribution of cancer stem cells (CSC) and clonal evolution. Understanding these mechanisms has led to the development of novel therapeutic strategies. Among them, special attention is given to ATR and WEE1 inhibitors, epigenetic agents, antibody–drug conjugates (ADC), immunotherapy, and combined approaches aimed at simultaneously targeting multiple pathogenic pathways. A promising direction involves the integration of molecular profiling and biomarkers to identify patients most likely to benefit from specific treatment modalities. Thus, the evolving concept of platinum resistance in ovarian cancer reflects the transition from time-based clinical criteria to molecular and biological stratification. This paradigm shift opens new opportunities for personalized treatment, offering the potential to improve therapeutic efficacy and long-term outcomes in patients with an otherwise unfavorable prognosis.
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About the authors
Arina A. Nikandrova
Russian University of Medicine
Email: chirach726@gmail.com
ORCID iD: 0009-0007-7645-2248
student
Russian FederationKheda M.E. Musaeva
North Ossetian State Medical Academy
Email: musaevamm_00@mail.ru
ORCID iD: 0009-0004-6885-2370
student
Russian FederationAnna V. Denisova
Bashkir state medical university
Email: tur.anutka@mail.ru
ORCID iD: 0009-0008-0569-2751
student
Russian FederationArtem K. Manzurov
N.I. Pirogov Russian National Research Medical University
Email: artemmanzurov@yandex.ru
ORCID iD: 0009-0008-4480-9684
student
Russian FederationAnna A. Popova
N.I. Pirogov Russian National Research Medical University
Email: anna.magic.24.07@gmail.com
ORCID iD: 0009-0008-6079-0151
student
Shakhban R. Pezuev
North Caucasus State Academy
Email: pezuev05@gmail.com
ORCID iD: 0009-0001-0038-4978
student
Muslim A. Khorumov
North Caucasus State Academy
Email: horumov.muslim@ya.ru
ORCID iD: 0009-0009-1199-7284
student
Russian FederationEliza D. Mazhidova
A.A. Kadyrov Chechen State University
Email: mazidovaeliza@gmail.com
ORCID iD: 0009-0007-8635-7682
student
Russian FederationSaida S. Khubaeva
A.A. Kadyrov Chechen State University
Email: khubaevasaida@mail.ru
ORCID iD: 0009-0008-1023-478X
student
Russian FederationYulia A. Molchanova
N.I. Pirogov Russian National Research Medical University
Email: Juliamolcanova03@gmail.com
ORCID iD: 0009-0005-1421-0978
student
Russian FederationArina Yu. Kulakova
Kuban State Medical University
Email: a.y.kulakova@mail.ru
ORCID iD: 0009-0000-9976-9247
student
Russian FederationMaksim I. Timush
Kuban State Medical University
Email: bestcelesteru@gmail.com
ORCID iD: 0009-0000-7939-7255
student
Russian FederationAleksandra A. Fomenko
Kuban State Medical University
Email: fomenko.al.2017@gmail.com
ORCID iD: 0009-0003-8618-7805
student
Russian FederationAnastasia A. Bezlepkina
Rostov State Medical University
Email: anastasiiabezl@gmail.com
ORCID iD: 0009-0002-7093-1401
student
Russian FederationAngelina I. Mustafina
Bashkir state medical university
Author for correspondence.
Email: angelina30.03.2001@icloud.com
ORCID iD: 0009-0009-3139-0519
student
Russian Federation, Russia, 450008, Ufa, 3 Lenina StreetReferences
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