Cancer Genetics and Epigenetics, 2025, Vol.13, No.2, 50-61 http://medscipublisher.com/index.php/cge 52 Gourley, 2016; Hollis, 2023). There are mainly five types of tissues, namely high-grade serous, endometrioid, clear cell, mucous and low-grade serous. Now the medical community has confirmed that, from the clinical and molecular levels, they all belong to different diseases (Hollis and Gourley, 2016; Hollis, 2023). Through the study of molecular characteristics, different subgroups can be further subdivided among these tissue types, and the differences in genetic changes, treatment responses and survival conditions can be discovered (Rojas et al., 2016; Hollis and Gourley, 2016; Hollis, 2023). This molecular difference is important for the treatment of patients because for cases like clear cell carcinoma and mucinous ovarian cancer, conventional chemotherapy is not very effective and other treatment methods need to be adopted (Hollis, 2023; Tong et al., 2023). Nowadays, more and more patients are classified based on their molecular characteristics to select appropriate targeted treatment regimens and assess recovery conditions. However, there are still many difficulties in applying these research results to daily clinical treatment (Hollis and Gourley, 2016; Bukłaho et al., 2023). 2.3 Mechanisms of key signaling pathways In advanced ovarian cancer, several core signaling pathways often experience dysfunction. These abnormalities drive tumor progression and induce therapeutic resistance. DNA damage repair pathways, especially the parts involving BRCA1/2 genes and homologous recombination repair, have become the research focus due to regulating the sensitivity of tumors to targeted drugs such as PARP inhibitors (Lheureux et al., 2019; Colombo et al., 2024). Furthermore, alterations in the TP53 pathway trigger uncontrolled cell proliferation, resulting in genomic instability. This phenomenon is particularly common in high-grade serous carcinoma (Hollis and Gourley, 2016; Hollis, 2023; Lheureux et al., 2019). Other pathways, such as signal networks that regulate angiogenesis, cell survival and the tumor microenvironment, also play key roles in disease progression and drug resistance formation (Mok et al., 2009; Rojas et al., 2016; Schoutrop et al., 2022). For example, the high expression of the angiogenic factor MAGP2 often indicates a poor prognosis for patients and an increase in tumor vascular density. Clarifying the molecular mechanisms of these pathways is crucial for discovering new therapeutic targets and formulating efficient individualized regimens (Rojas et al., 2016; Schoutrop et al., 2022). 3 Strategies for Personalized Treatment 3.1 Principles for targeted drug selection based on genomic testing Genetic testing is becoming increasingly crucial for selecting targeted drugs for advanced ovarian cancer. With the help of this test, doctors can determine which patients are more suitable for specific treatment methods based on the molecular characteristics of the tumor. Just like the gene expression analysis model, it can accurately determine whether patients are resistant to platinum-based chemotherapy drugs and help doctors quickly identify those patients who need to switch or add other targeted drugs (Dressman et al., 2007; Zhou, 2024). Moreover, this kind of detection can also identify oncogenic pathways such as Src and Rb/E2F that are in an active state. Treating with drugs targeting these pathways can improve the therapeutic efficacy of platinum-resistant patients (Dressman et al., 2007). Applying the results of genomic testing to clinical treatment decisions makes treatment plans more tailored to the individual conditions of patients, changing the past "one-size-fits-all" treatment model. Doctors select targeted therapies such as PARP inhibitors or anti-angiogenic drugs based on the unique genetic changes of each patient's tumor, which can not only improve the therapeutic effect but also reduce unnecessary side effects (Cortez et al., 2017; Nakai and Matsumura, 2022). This precise treatment approach is changing the treatment pattern of advanced ovarian cancer, bringing better treatment outcomes and longer survival periods to patients (Dressman et al., 2007). 3.2 Application and characteristics of immune checkpoint inhibitors Immune checkpoint inhibitors provide a new treatment approach for advanced ovarian cancer. This type of drug can enhance the body's ability to recognize and clear cancer cells. They specifically act on immune signaling
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