Table 4

Possible individualized investigational approaches to the treatment of metastatic or recurrent clear cell ovarian cancer.

Molecular subgroupTargetPossible agent(s)Additional comments
ARID1A mutant tumorsDDR pathwayATR inhibitors(±PARP inhibitors)
Histone deacetylaseHDAC inhibitors
Zeste homolog 2EZH2 inhibitor
PI3K/AKT/mTOR activatedPI3K/AKT/mTOR pathwayPI3K/mTOR/TORC inhibitors
MAPK pathway activatedMAPK pathwayRAS/RAF/MEK inhibitorsInhibitor choice mutation-dependent
Mismatch repair deficientPD1/PD-L1PD1/PD-L1 inhibitorsMay require to be part of basket study
Mesenchymal-type gene expression profileAngiogenic pathwaysVEGF monoclonal antibodies and VEGFR tyrosine kinase inhibitors
  • ATR, ataxia telangiectasia and Rad3-related protein; DDR, DNA damage response; EZH2, Zeste homolog 2; HDAC, histone deacetylase; MAPK, mitogen-activated protein kinase; mTOR, mammalian target of rapamycin; PARP, poly-ADP ribose polymerase; PD1, programmed cell death protein 1; PD-L1, programmed death ligand 1; TORC, mammalian target of rapamycin complex; VEGF, vascular endothelial growth factor; VEGFR, vascular endothelial growth factor receptor.