上皮性卵巢癌 (EOC) 是一种复杂的疾病，具有多种组织学亚型，根据侵袭性和疾病进展过程，最近大致分为 I ​​型（低级别浆液性癌、子宫内膜样癌、透明细胞癌和粘液性癌）和II 型（高级别浆液性癌、高级别子宫内膜样癌和未分化癌）类别。尽管在发病机制、遗传学、预后和治疗反应方面存在显着差异，但不同亚型的 EOC 的临床诊断和治疗仍然相似。减瘤手术联合以铂类紫杉醇为基础的化疗是高级别浆液性卵巢癌（HGSOC）（最常见的一种）和其他亚型的初始治疗，但大多数患者表现出内在或获得性耐药，并在短期内复发。靶向治疗，例如抗血管生成药物（例如贝伐珠单抗）和 PARP 抑制剂（针对 BRCA 突变癌症）取得了一些成功，但通过各种机制产生的治疗耐药性提出了重大挑战。这一综合性的章节深入探讨了应对这些挑战的新兴策略，重点介绍了异常 miRNA、代谢、凋亡逃避、癌症干细胞和自噬等因素，这些因素在介导 EOC 耐药和疾病复发中发挥着关键作用。除了标准治疗之外，本研究的重点还扩展到替代靶向药物，包括检查点抑制剂、CAR T 细胞和疫苗等免疫疗法，以及针对 EOC 关键致癌途径的抑制剂。此外，本章还介绍了疾病分类、诊断、耐药途径、标准治疗和各种新兴方法的临床数据，并倡导针对个体亚型和耐药机制采取细致入微的个性化方法，旨在提高 EOC 范围内的治疗效果亚型。© 2024。Springer Nature Switzerland AG。

Epithelial ovarian cancer (EOC) is a complex disease with diverse histological subtypes, which, based on the aggressiveness and course of disease progression, have recently been broadly grouped into type I (low-grade serous, endometrioid, clear cell, and mucinous) and type II (high-grade serous, high-grade endometrioid, and undifferentiated carcinomas) categories. Despite substantial differences in pathogenesis, genetics, prognosis, and treatment response, clinical diagnosis and management of EOC remain similar across the subtypes. Debulking surgery combined with platinum-taxol-based chemotherapy serves as the initial treatment for High Grade Serous Ovarian Carcinoma (HGSOC), the most prevalent one, and for other subtypes, but most patients exhibit intrinsic or acquired resistance and recur in short duration. Targeted therapies, such as anti-angiogenics (e.g., bevacizumab) and PARP inhibitors (for BRCA-mutated cancers), offer some success, but therapy resistance, through various mechanisms, poses a significant challenge. This comprehensive chapter delves into emerging strategies to address these challenges, highlighting factors like aberrant miRNAs, metabolism, apoptosis evasion, cancer stem cells, and autophagy, which play pivotal roles in mediating resistance and disease relapse in EOC. Beyond standard treatments, the focus of this study extends to alternate targeted agents, including immunotherapies like checkpoint inhibitors, CAR T cells, and vaccines, as well as inhibitors targeting key oncogenic pathways in EOC. Additionally, this chapter covers disease classification, diagnosis, resistance pathways, standard treatments, and clinical data on various emerging approaches, and advocates for a nuanced and personalized approach tailored to individual subtypes and resistance mechanisms, aiming to enhance therapeutic outcomes across the spectrum of EOC subtypes.© 2024. Springer Nature Switzerland AG.