Integrated Management of Targeted Therapies and Metabolic Interventions to Improve Treatment Outcomes and Quality of Life in Ovarian Cancer: A Scoping Review

Abstract

Context: Ovarian cancer remains one of the most lethal gynecologic malignancies, and remission outcomes are shaped by a complex interplay of clinical, genetic, therapeutic, metabolic, and psychosocial factors. Despite advances in targeted therapies and molecular diagnostics, variability in patient responses underscores the need for a comprehensive synthesis of determinants that influence remission. Evidence Acquisition: A scoping review was conducted in accordance with PRISMA guidelines. Comprehensive searches of PubMed, Scopus, Web of Science, Embase, and the Cochrane Library identified 1,450 records published between 2000 and 2024. After duplicate removal and title and abstract screening, 150 full-text articles were assessed for eligibility. Ultimately, 18 studies met the inclusion criteria and were synthesized. Data extraction focused on five domains: clinical predictors, genetic and molecular determinants, therapeutic strategies, metabolic indicators, and psychosocial influences. Tables and figures were developed to summarize the evidence, and the findings were organized into structured subsections to enhance clarity and reproducibility. Results: Clinical factors, including age, performance status, comorbidities, and biomarkers such as CA-125 kinetics, the Prognostic Nutritional Index, and systemic inflammation scores, were consistently associated with remission outcomes. Genetic and molecular analyses showed that BRCA1/2 mutations and homologous recombination defects significantly increased sensitivity to platinum-based chemotherapy and poly(ADP-ribose) polymerase inhibitors, whereas Cancer Genome Atlas profiling highlighted distinct molecular subtypes with variable remission trajectories. Therapeutic advances, including bevacizumab, dose-dense chemotherapy, and hyperthermic intraperitoneal chemotherapy, improved remission rates, particularly in high-risk and resistant disease settings. Metabolic determinants, such as malnutrition and systemic inflammation, reduced treatment tolerance, whereas psychosocial support and resilience improved adherence, immune function, and quality of life. Conclusions: Remission in ovarian cancer is influenced by multidimensional factors that extend beyond therapeutic interventions. Personalized strategies integrating molecular diagnostics, targeted therapies, nutritional optimization, and psychosocial support are essential for maximizing remission and survival outcomes. Future research should focus on refining predictive models that combine these domains, thereby advancing precision medicine and comprehensive patient care.