Precision in Progress: How Biomarkers and Targeted Therapies are Reshaping Ovarian Cancer Care

Each year on May 8, World Ovarian Cancer Day offers an opportunity to reflect on the global burden of ovarian cancer while spotlighting both cumulative and recent progress toward improving outcomes for patients. Although ovarian cancer continues to carry the highest mortality rate among gynecologic malignancies, the field is advancing rapidly, particularly in the areas of biomarker discovery and targeted therapies. As we observe World Ovarian Cancer Day in 2025, health care professionals are encouraged to recognize how precision oncology is reshaping treatment paradigms and presenting new opportunities to personalize care and improve survival outcomes.

Biomarkers Driving Precision Medicine 

One of the most transformative shifts in ovarian cancer care has been the integration of biomarkers into routine management. Germline and somatic BRCA1/2 mutations have long been recognized, but the broader concept of homologous recombination deficiency (HRD) has now entered clinical practice. HRD testing helps identify patients who are likely to benefit from poly (ADP-ribose) polymerase (PARP) inhibitors, thereby expanding precision treatment beyond BRCA mutation carriers.

Additionally, a new generation of biomarkers has emerged, allowing clinicians to further refine prognostic and predictive models and guide treatment decision-making. Tumor mutational burden (TMB), deficiencies in mismatch repair (MMR), and microsatellite instability (MSI) are emerging not only as prognostic indicators but also as actionable markers to guide immunotherapy selection. The use of circulating tumor DNA (ctDNA) to monitor minimal residual disease is another promising advance, offering the potential for real-time adaptation of treatment strategies and more timely detection of recurrence. As these technologies mature, they can empower clinicians to intervene proactively and with greater precision, streamlining ovarian cancer management into a more personalized and dynamic model of care.

Evolving Approaches in Targeted Therapeutics

Personalized therapy is now at the core of ovarian cancer treatment algorithms. PARP inhibitors such as olaparib, niraparib, and rucaparib have become key maintenance therapies for patients with ovarian cancer, particularly those with BRCA mutations or HRD-positive tumors. Anti-angiogenic agents like bevacizumab (a VEGF inhibitor) have also become established components of first-line and recurrent treatment strategies.

Treatment resistance remains a formidable challenge in ovarian cancer management. Ongoing research is focused on combination approaches, such as pairing PARP inhibitors with anti-angiogenic agents or immune checkpoint inhibitors. For example, the combination of olaparib and bevacizumab has demonstrated improved efficacy in HRD-positive patients, underscoring the potential of dual-target strategies.

Furthermore, the FDA’s recent approval of the antibody-drug conjugate (ADC) mirvetuximab soravtansine-gynx, which targets folate receptor alpha (FRα), has opened a new therapeutic avenue. This agent has demonstrated encouraging activity in platinum-resistant disease, emerging as a promising option for heavily pretreated patients with recurrent ovarian cancer. Other ADCs targeting novel antigens are currently in development, raising hopes of further expanding the targeted therapy arsenal and offering additional lines of therapy for patients with limited options.

Future Directions: Biomarkers as a Strategic Element of Care

The promise of biomarker-driven therapy extends far beyond treatment selection. The integration of artificial intelligence (AI) and machine learning is poised to accelerate biomarker discovery and application, leading the way for more nuanced, individualized treatment planning. AI-driven radiology tools and digital pathology platforms are under investigation for their potential to predict treatment response and guide real-time clinical decision-making.

Looking ahead, integrated molecular biomarker profiling—including genomic, transcriptomic, and proteomic analyses—will likely shape the next frontier in ovarian cancer care. These multimodal approaches promise to empower clinicians to match patients with the most effective therapies at every stage of the disease. The convergence of these technologies may also pave the way for adaptive clinical trial designs that better reflect the heterogeneity of ovarian cancer and accelerate the pace of therapeutic innovation.

As we commemorate World Ovarian Cancer Day, the trajectory of ovarian cancer care is increasingly characterized by biomarker-driven, targeted approaches. Ongoing collaboration among researchers, clinicians, and multidisciplinary cancer care professionals will be essential to translate these scientific advances into meaningful outcomes for patients.