Cancer Genetics and Epigenetics, 2025, Vol.13, No.2, 50-61 http://medscipublisher.com/index.php/cge 54 When selecting patients suitable for immunotherapy, referring to these immune indicators is expected to make the treatment more precise and effective (Na et al., 2024). Now, researchers are striving to optimize these indicators and also plan to combine them with other molecular characteristics and clinical symptoms, so that patients can be classified more accurately and the most appropriate treatment plans can be found. 4.3 Treatment monitoring is conducted using liquid biopsy Liquid biopsy, especially the analysis of circulating tumor DNA (ctDNA), provides a non-surgical method for monitoring the treatment response and disease progression of ovarian cancer (Singh et al., 2019). By examining the genetic and epigenetic changes in ctDNA, doctors can track the tumor condition in real time, possibly discover the causes of drug resistance and guide timely adjustment of treatment. This method can take samples multiple times. Compared with the traditional tissue examination, it can provide more comprehensive and updated tumor molecular information. Although the clinical application of ctDNa-based markers is still under development, technological advancements have made rapid and bedside diagnosis increasingly feasible. The use of liquid biopsy is expected to detect the recurrence of advanced ovarian cancer earlier, monitor minimal residual lesions, and formulate individualized treatment plans for continuous treatment (Singh et al., 2019). 5 Clinical Progress of Personalized Combined Treatment Regimens 5.1 PARP inhibitor trials PARP inhibitors have greatly improved the treatment of advanced ovarian cancer, especially for those patients carrying BRCA gene mutations or having defects in homologous recombination repair. Important clinical trials like SOLO and PRIMA have shown that compared with the use of placebos, continuous treatment with PARP inhibitors such as olaparib and niraparib can significantly prolong the time during which patients do not experience disease deterioration, whether they are newly diagnosed patients or those with disease recurrence (Secord et al., 2021; Konstantinopoulos and Matulonis, 2023). These studies have made PARP inhibitors key drugs for personalized treatment, and they are most effective in patients screened out through genetic testing. Recently, there have been studies attempting to use PARP inhibitors in combination with anti-angiogenic drugs (such as bevacizumab), hoping to achieve better therapeutic effects. From the perspective of the actual treatment effective rate and the time for patients' condition to stabilize, this combined treatment plan has achieved good results, especially in those newly diagnosed female patients with advanced ovarian cancer who have detected defects in homologous recombination repair (An et al., 2021; Secord et al., 2021). These research results indicate that selecting appropriate patients based on biomarkers and adopting combined treatment methods are very helpful for improving the treatment effect of patients. 5.2 Key immunotherapy research Immunotherapy, especially immune checkpoint inhibitors targeting PD-1/PD-L1, has been evaluated in the treatment of advanced ovarian cancer through important studies such as the KEYNOTE and CheckMate series. Although the treatment effective rate of using PD-1/PD-L1 inhibitors alone is generally average (only 8%~22.2%) in the unscreened population of ovarian cancer patients, the therapeutic effect will be better if these drugs are combined with other therapies (such as chemotherapy, anti-angiogenic therapy or PARP inhibitors) (Figure 2) (Palaia et al., 2020; An et al., 2021; Zhang et al., 2022). The ongoing and recently completed clinical trials mainly aim to break the suppression of the immune system by tumors and transform those "cold" tumors that respond poorly to immunotherapy into "hot" tumors that are vulnerable to attack by the immune system (Palaia et al., 2020; Zhang et al., 2022). Researchers are actively exploring various combined treatment regimens, aiming to enhance the activity of immune cells and improve the clinical therapeutic effect. Early research results show that some specific patient groups can obtain significant therapeutic benefits after adopting these combined treatment methods (An et al., 2021; Zhang et al., 2022). 5.3 Real-world evidence and meta-analysis results Through the summary and analysis of multiple studies and the research based on the actual clinical treatment
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