Targeted cancer drugs for ovarian cancer
Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. You might have them as part of your treatment for ovarian cancer.
You might have a targeted cancer drug:
- with chemotherapy
- on its own after chemotherapy
What are targeted cancer drugs?
Cancer cells have changes in their genes (DNA) that make them different from normal cells. These changes mean that they behave differently. Cancer cells can grow faster than normal cells and sometimes spread. Targeted cancer drugs work by ‘targeting’ those differences that a cancer cell has.
Targeted drugs work in different ways. For example, they can:
- stop cancer cells from dividing and growing
- encourage the immune system to attack cancer cells
- stop cancers from growing blood vessels
You might hear some targeted drugs called biological therapies.
When you might have targeted drug treatments
You might have a type of targeted cancer drug as a treatment for ovarian cancer.
Whether you have targeted therapy depends on:
- the type and grade of ovarian cancer you have
- how far the cancer has grown (the stage)
- any treatments you've already had
- whether your cancer has changes (mutations) in a gene called BRCA
- whether your cancer has changes (mutations) in a group of genes called HR genes
Tests on your cancer cells
If you have a high grade cancer, your doctor will test your cancer cells for genetic changes. This can show whether certain targeted drug treatments might work for your cancer.
To test your cancer cells, your specialist uses a sample of your cancer. This might be from a biopsy when you were first diagnosed. Or they might be able to test some tissue from an operation you have already had.
Homologous recombination deficiency (HRD) testing
Our 
constantly breaks and repairs itself. Homologous recombinant genes are responsible for repairing these breaks. Some people have faults in these genes. This is called homologous recombination deficiency (HRD).
Having HRD means that your DNA can’t repair itself. The build up of damaged DNA is called genomic instability
The most common homologous recombinant genes linked to ovarian cancer are BRCA1 and BRCA2. But there are others. For HRD testing, the will test your cancer cells for:
- a change in the
BRCA1 or BRCA 2 genes - genomic instability
If you have one or both of these, your cancer is HRD positive. And you are more likely to respond to a type of targeted drug called a PARP inhibitor.
PARP inhibitors (including olaparib, niraparib and rucaparib)
PARP is a protein found in our cells, it stands for poly-ADP ribose polymerase. It helps damaged cells to repair themselves.
As a cancer treatment, PARP inhibitors stop the PARP from doing its repair work in cancer cells and the cell dies.
There are different types of PARP inhibitor used to treat ovarian cancer. These are:
- olaparib (Lynparza)
- niraparib (Zejula)
- rucaparib (Rubraca)
You might have a PARP inhibitor if the following apply:
- you have stage 3 or 4, high grade epithelial cancer
- you are newly diagnosed or your cancer has come back (relapsed) after treatment
- your cancer has responded well to a type of chemotherapy called
platinum chemotherapy
Olaparib is only for women who have a change in a gene called BRCA1 or BRCA2. Whether you can have niraparib or rucaparib may depend on whether you don’t have a change in the BRCA1 or BRCA2 genes.
Bevacizumab (Avastin)
Bevacizumab is a type of targeted drug called an anti angiogenic drug. These drugs stop cancers from growing their own blood vessels.
Vascular endothelial growth factor (VEGF) is a protein that helps cancers to grow blood vessels. Bevacizumab blocks this protein and stops the blood vessels from growing. This means the cancer is starved and can't grow.
You might have bevacizumab with chemotherapy if you have stage 3 or 4, high grade epithelial cancer in one of the following situations:
- as your first treatment
- if your cancer has come back (relapsed) and you have had no more than 2 courses of platinum chemotherapy and no previous treatment with bevacizumab or a similar drug
Olaparib with bevacizumab
You might be able to have Olaparib and bevacizumab together as a type of .
Your doctor might suggest this if the following apply:
- you have stage 3 or 4, high grade epithelial cancer
- this has responded well to your first course of treatment with chemotherapy and bevacizumab
- you have HRD positive cancer
Trametinib (Mekinist)
Trametinib is a type of targeted drug called a cancer growth blocker.
Mitogen activated protein kinase (MEK) is a protein that makes cancer cells divide and grow in an uncontrolled way. Trametinib blocks this protein and slows down the growth of cancer cells.
You might have this drug if the following apply:
- you have low grade serous cancer
- your cancer has grown or come back after treatment with platinum chemotherapy
- you are generally fit
Are these drugs available in the UK?
New cancer drugs are licensed for use in a particular way. For example, a drug might have a license to treat a particular stage or type of ovarian cancer.
Once a drug has a license, several independent organisations approve the new cancer drugs before doctors can prescribe them on the NHS.
In England the National Institute for Health and Care Excellence (NICE) decides which drugs and treatments are available on the NHS.
In Wales, the All Wales Medicines Strategy Group (AWMSG) advises NHS Wales. They generally follow NICE decisions but can also issue their own guidance,
The Scottish Medicines Consortium (SMC) advises NHS Scotland. Its decisions are separate from decisions made by NICE.
The Department of Health advises about health and social care in Northern Ireland. They usually follow NICE decisions.
Not all targeted and immunotherapy drugs are available throughout the UK. It might depend on where you live whether you can have a certain drug. Even if a drug isn’t available through one of these organisations, there might be other ways your doctor can access a drug if it’s suitable for you.
Your doctor can tell you which drugs are suitable for you.
How you have targeted cancer drugs
You have bevacizumab through a tube into your bloodstream.
PARP inhibitors and trametinib come as tablets or capsules that you swallow.
Tablets or capsules
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
Into the bloodstream
You have this treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You may need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
Side effects
The side effects of targeted cancer drugs are different depending on the drug you’re having. Not everyone gets all side effects.
The side effects you have depend on:
- which drug you have
- whether you have it alone or with other drugs
- the amount of drug you have (the dose)
- your general health
A side effect may get better or worse during your course of treatment. Or more side effects may develop as the treatment goes on.
For more information about the side effects of your treatment, go to the individual drug pages.
When you go home
Treatment for ovarian cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects you have. Your nurse will give you numbers to call if you have any problems at home.
Research into targeted drugs
Researchers are looking at many types of targeted drugs for ovarian cancer. Some of these drugs are already used to treat other cancers, and some are new.
Researchers are looking at giving these drugs on their own or with chemotherapy.
