Cancer Genetics and Epigenetics, 2025, Vol.13, No.2, 50-61 http://medscipublisher.com/index.php/cge 53 pathways such as PD-1/PD-L1 and are currently undergoing clinical trial evaluations. To overcome the immunosuppressive microenvironment of tumors, these drugs are usually used in combination with other therapies (Cortez et al., 2017; Konstantinopoulos and Matulonis, 2023). Although immune checkpoint inhibitors have enabled long-term control of the condition in some patients, the overall effective rate is not ideal. This indicates that more precise screening of applicable patients is still needed, and better combined treatment regimens need to be explored (Konstantinopoulos and Matulonis, 2023). At present, relevant research focuses on finding biomarkers that can predict therapeutic effects and optimizing the application of such drugs in personalized treatment, with the goal of enabling patients with advanced ovarian cancer to achieve stable and long-lasting therapeutic effects (Cortez et al., 2017). 3.3 Emerging therapies New therapies such as antibody-drug conjugates (ADCs) and cancer vaccines have expanded the options for individualized treatment of advanced ovarian cancer. ADC precisely delivers potent cytotoxic drugs to cancer cells through the targeted characteristics of monoclonal antibodies. This strategy achieves selective killing of drugs and reduces toxicity to normal tissues. This targeted delivery method has shown advantages in the treatment of advanced, metastatic or recurrent patients, which helps to overcome drug resistance and improve therapeutic efficacy (Wang et al., 2021). The cancer vaccine is a brand-new treatment method. Its working mode is to present tumor-related substances to the human immune system, prompting the immune system to actively recognize and eliminate ovarian cancer cells (Akter et al., 2022). At present, most cancer vaccines are still in the research and trial stage, but they play a significant role. Especially when used in combination with other immunotherapy methods and targeted drugs, they can enhance the immune system's surveillance of tumors and reduce the possibility of cancer recurrence. When these treatment methods are developed more perfectly, the current deficiencies in treatment can be addressed, and the level of personalized treatment for advanced ovarian cancer can be greatly improved (Wang et al., 2021). 4 Biomarkers and Patient Selection 4.1 The predictive effect of BRCA mutations on HRD scores Mutations in the BRCA1/2 gene are the core factor leading to abnormal homologous recombination repair function in patients with ovarian cancer. This situation is of great significance when carrying out personalized treatment. If BRCA gene mutations are detected in patients or their HRD scores are relatively high, it often means that the therapeutic effect of using platinum-based chemotherapy drugs and PARP inhibitors will be better for them. Therefore, by detecting these indicators, doctors can more accurately select patients suitable for treatment with such targeted drugs. Nowadays, whether it is for the treatment of advanced ovarian cancer or the management of recurrent ovarian cancer, checking the BRCA gene and HRD status is something that must be done when formulating the treatment plan (Chastek et al., 2021; Tonti et al., 2024). Although very useful, there is currently a lack of effective and commonly used HRDgene detection methods, and there are no clear treatment plans that rely entirely on these markers (Tonti et al., 2024). However, the use of BRCA and HRD tests has significantly increased and they have begun to be used in earlier treatment stages, which is in line with the trend of making the treatment of advanced ovarian cancer more individualized and effective (Chastek et al., 2021). 4.2 The value of immune-related markers Studies have found that immune indicators such as PD-L1 expression level and tumor mutational burden (TMB) may predict the therapeutic effect of patients with advanced ovarian cancer after using immune checkpoint inhibitors (Na et al., 2024). Especially for patients with high PD-L1 expression levels, the effect is often better after using immunotherapy. Detecting this indicator can help doctors identify which patients are more suitable for using this type of drug. By the same token, patients with high TMB levels are more likely to respond to immunotherapy. However, the specific role it plays in the treatment of ovarian cancer is still under further study.
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