Targeted Therapy for Ovarian Cancer

Treatment for ovarian cancer usually involves several forms of treatment to attack the cancer in different ways. Treatment can vary depending on your overall health and whether you have other health conditions. It also depends on the specific type and stage of your ovarian cancer.

Targeted therapy is one type of treatment used for ovarian cancer. It uses drugs to find and attack the parts of cancer cells that are different from normal, healthy cells, in an attempt to reduce the damage to healthy cells.¹

There are a few types of targeted therapies that each work differently. In general, they interfere with how a cancer cell grows, repairs itself, or communicates with other cells.¹

Is targeted therapy the same as chemotherapy?

While the general term “chemotherapy” means drugs to treat cancer, targeted therapy is different from standard chemotherapy.²

Standard chemotherapy is toxic to various multiplying cells. It damages both healthy and cancerous cells, which is why so many different side effects can occur. On the other hand, targeted therapy tries to minimize the damage to the healthy cells.²

Also, the goal of standard chemotherapy is to destroy existing cancer cells. But targeted therapies often aim to stop cancer cells from multiplying.²

How does targeted therapy work?

Targeted therapies work by acting on – or “targeting” – certain substances within cancer cells. Targets may include:²

• A cancer cell that has too much of a certain protein
• A cancer cell that has a specific protein that normal cells do not
• A cancer cell with a protein that is changed in some way

Once the therapy locates the substance it wants to target, it works to:²

• Block chemical signals that would tell the cancer cell to grow or multiply
• Bring toxins to cancer cells
• Change proteins in the cancer cell to cause cell death
• Trigger the immune system to destroy the cancer cells
• Block new blood vessel formation

Examples of targeted therapies

Since targeted therapies can work in different ways, there are many different kinds.

Angiogenesis inhibitors

Angiogenesis is the process of making new blood vessels. Cancers can make new blood vessels in order to grow and spread in the body. In some cancer cells, there is a protein that signals new blood vessels to form. Angiogenesis inhibitors attach to this protein so it can slow or stop the growth of blood vessels. This process can then slow or stop the growth of the cancer.¹

Examples of angiogenesis inhibitors include:^1,4-8

• Avastin^® (bevacizumab)
• Mvasi™ (bevacizumab-awwb)
• Zirabev™ (bevacizumab-bvzr)
• Vegzelma^® (bevacizumab-adcd)
• Alymsys^® (bevacizumab-maly)

Antibody-drug conjugates (ADCs)

Antibody-drug conjugates are chemotherapy drugs that are linked to an antibody that is made in a lab. This antibody attaches to the cancer cells so that it can bring the chemo directly to those cells. An ADC approved by the US Food and Drug Administration (FDA) to treat certain forms of ovarian cancer is:^1,9

• Elahere™ (mirvetuximab soravtansine-gynx)

PARP inhibitors

Some people with ovarian cancer may have inherited changes (mutations) of the BRCA genes. Poly (ADP-ribose) polymerase (PARP) inhibitor drugs are often prescribed for people who have a BRCA mutation. But they can be used for people who do not have a BRCA mutation as well.¹

PARP inhibitor drugs make it hard for tumors to repair DNA that has been damaged. This results in destroying cancer cells instead of growing more cancer cells.

Here are some examples of PARP inhibitors:^1,10-12

• Lynparza^® (olaparib)
• Rubraca^® (rucaparib)
• Zejula^® (niraparib)

NTRK inhibitors

This targeted therapy works on cancer cells with NTRK gene mutations. These mutations lead to abnormal proteins that may cause cancer cells to grow. NTRK inhibitors work to stop these proteins and prevent further growth of the cancer. Only a small number of ovarian cancers have mutations in the NTRK gene.¹

Examples of NTRK inhibitors include:^1,13,14

• Vitrakvi^® (larotrectinib)
• Rozlytrek^® (entrectinib)

What are the possible side effects?

Side effects can vary depending on the specific type of drug you are taking.

Common side effects of certain angiogenesis inhibitors include:^4-8

• Nose bleeds
• Headache
• High blood pressure
• Dry skin
• High amounts of protein in your urine

Common side effects of certain ADCs include:⁹

• Problems with your vision
• Extreme tiredness (fatigue)
• Nausea
• Abdominal pain
• Damage to your nerves

Common side effects of certain PARP inhibitors include:^10-12

• Nausea
• Fatigue
• Low amount of healthy red blood cells (anemia)
• Decreased appetite
• Vomiting

Common side effects of certain NTRK inhibitors include:^13,14

• Fatigue
• Constipation
• Cough
• Diarrhea
• Muscle and bone pain

Elahere has a boxed warning, the strictest warning from the FDA. It has this warning because it can cause severe visual symptoms such as visual damage, pain, or inflammation.⁹

These are not all the possible side effects of targeted therapy drugs. Talk to your doctor about what to expect when taking targeted therapy drugs. You also should contact your doctor if you have any changes that concern you when taking targeted therapy drugs.

Other things to know

Targeted therapies may not be right for everyone. Talk to your doctor about what treatment options are best for you and the possible side effects, risks, and benefits of these drugs.

Targeted therapy drugs for ovarian cancer can harm an unborn baby. In general, if you or your partner can become pregnant, use birth control during treatment and for some time after the last dose of targeted therapy drugs. Do not breastfeed during treatment with targeted therapy drugs and for some time after the last dose. Talk to your doctor about your options for birth control and breastfeeding as they relate to the specific targeted therapy you are prescribed.^4-14

Before beginning treatment for ovarian cancer, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.