Molecular mechanisms of drug resistance in ovarian cancer

J Cell Physiol. 2018 Jun;233(6):4546-4562. doi: 10.1002/jcp.26289. Epub 2018 Jan 4.


Ovarian cancer is the most lethal malignancy among the gynecological cancers, with a 5-year survival rate, mainly due to being diagnosed at advanced stages, recurrence and resistance to the current chemotherapeutic agents. Drug resistance is a complex phenomenon and the number of known involved genes and cross-talks between signaling pathways in this process is growing rapidly. Thus, discovering and understanding the underlying molecular mechanisms involved in chemo-resistance are crucial for management of treatment and identifying novel and effective drug targets as well as drug discovery to improve therapeutic outcomes. In this review, the major and recently identified molecular mechanisms of drug resistance in ovarian cancer from relevant literature have been investigated. In the final section of the paper, new approaches for studying detailed mechanisms of chemo-resistance have been briefly discussed.

Keywords: chemotherapeutic agents; drug resistance; molecular mechanisms; ovarian cancer.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • DNA Damage
  • DNA Repair
  • Drug Resistance, Neoplasm / genetics*
  • Energy Metabolism / drug effects
  • Energy Metabolism / genetics
  • Enzymes / genetics
  • Enzymes / metabolism
  • Epithelial-Mesenchymal Transition / drug effects
  • Epithelial-Mesenchymal Transition / genetics
  • Female
  • Humans
  • Membrane Transport Proteins / genetics
  • Membrane Transport Proteins / metabolism
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / genetics*
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / pathology
  • Oxidative Stress / drug effects
  • Oxidative Stress / genetics
  • RNA, Untranslated / genetics
  • RNA, Untranslated / metabolism
  • Signal Transduction / drug effects
  • Signal Transduction / genetics


  • Antineoplastic Agents
  • Enzymes
  • Membrane Transport Proteins
  • RNA, Untranslated