Immune-Checkpoint Inhibitors in Platinum-Resistant Ovarian Cancer

SIMPLE SUMMARY: Patients with platinum-resistant ovarian cancer experience poor prognosis. No mature evidence supports the routine adoption of immunotherapy alone in this setting. However, the combination of immunotherapy with target therapies seems to be a promising option in patients with ovarian cancer. Ongoing trials are testing the combination between immune therapy and other target therapies, including PARP inhibitors, TKI, and anti-angiogenetic therapies. Further evidence is needed to assess the real impact and cost-effectiveness of immmunotherapic agents in platinum-resistant ovarian cancer. ABSTRACT: Platinum-resistant ovarian cancer (OC) has limited treatment options and is associated with a poor prognosis. There appears to be an overlap between molecular mechanisms responsible for platinum resistance and immunogenicity in OC. Immunotherapy with single agent checkpoint inhibitors has been evaluated in a few clinical trials with disappointing results. This has prompted exploration of immunotherapy combination strategies with chemotherapy, anti-angiogenics, poly (ADP-ribose) polymerase (PARP) inhibitors and other targeted agents. The role of immunotherapy in the treatment of platinum-resistant OC remains undefined. The aim of this review is to describe the immunobiology of OC and likely benefit from immunotherapy, discuss clinical trial data and biomarkers that warrant further exploration, as well as provide an overview of future drug development strategies.