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Schwarzenbach et al. Cancer Drug Resist 2019;2:271-96 Cancer
DOI: 10.20517/cdr.2019.010 Drug Resistance

Review Open Access

Resistance to cis- and carboplatin initiated by
epigenetic changes in ovarian cancer patients

Heidi Schwarzenbach , Peter B. Gahan 2
1
1 Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany.
2 Fondazione “Enrico Puccinelli” Onlus, Perugia 06126, Italy.
Correspondence to: Ass. Prof. Heidi Schwarzenbach, Department of Tumor Biology, University Medical Center Hamburg-
Eppendorf, Martinistraße 52, Hamburg 20246, Germany. E-mail: hschwarzenbach@uke.de

How to cite this article: Schwarzenbach H, Gahan PB. Resistance to cis- and carboplatin initiated by epigenetic changes in ovarian
cancer patients. Cancer Drug Resist 2019;2:271-96. http://dx.doi.org/10.20517/cdr.2019.010

Received: 27 Feb 2019 First Decision: 16 Apr 2019 Revised: 22 Apr 2019 Accepted: 24 Apr 2019 Published: 19 Jun 2019

Science Editor: Aamir Ahmad Copy Editor: Cai-Hong Wang Production Editor: Huang-Liang Wu

Abstract

Initially, most ovarian tumors respond to the treatment with platinum components, but frequently recurrence occurs
within the following two years in advanced ovarian cancer patients. In this regard, previous studies have shown
changes in the epigenetic patterns in ovarian cancer that are linked with resistance to cis- and carboplatin therapy.
Thus, epigenetic changes mediated by a treatment with cis- or carboplatin could identify such patients who do or do
not respond to this therapy. Therefore, an understanding of the impact of platinum on epigenetics in ovarian cancer
is important in overcoming platinum resistance. In this review, we delineate epigenetic abnormalities in cis- and
carboplatin-resistant ovarian tumors, such as changes in DNA methylation, histone modifications and deregulation
of microRNAs, and discuss the potential of epigenetic therapies in combination with platinum.

Keywords: Ovarian cancer, carboplatin, cisplatin, resistance, DNA methylation, histone modifications, microRNAs

INTRODUCTION
Although ovarian cancer is a leading cause of gynaecological cancer deaths, the primary cause of the
disease remains unclear. The lack of early markers of ovarian cancer and the development of drug resistance
following chemotherapy with, e.g., platinum-based compounds retards attempts to better identify and treat
this cancer.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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