**Abstract**

Ovarian cancer is the most common type of cancer worldwide among women, and it is usually diagnosed at an advanced stage. The initial treatment for ovarian cancer is surgical debulking, but this is only effective in the treatment of early stage disease. Surgery alone is insufficient for treatment of advanced disease and systemic therapies, in particular chemotherapies, are indicated. The main aim of this book chapter is to review the role of nano-therapy in treatment of advance ovarian cancer, in comparison to the use of traditional chemotherapies. Nano-therapies are thought to have advantages in terms of improving drug stability in the human body, chemotherapy toxicity profile, and drug delivery to the target cells thus enhancing drug penetration into the cancer cells. This book chapter also covers the development of nano-therapy and also the type of potential cargos. In summary, the types of nanocarrier, and their roles ovarian cancer diagnosis and treatment will be discussed.

**Keywords:** ovarian cancer, nanocarrier, Doxil, TPGS, PEG

## **1. Introduction**

Although ovarian cancer represents only 5% of all cancer cases among women, it is ranked fifth for cancer deaths among women [1]. It is the most common among gynecological cancers and ranks third after uterine and cervical cancer, as it represents the highest, worst warning, and highest mortality rates [2]. Ovarian cancer, in particularly high grade serous subtype, is often regarded as systemic disease. I think you need to re-do this statement as up to 75% of OC is diagnosed at an advanced stage – stage III and IV. It is expected that in the next twenty years, the death rate of this type of cancer will increase significantly, the reason for the high death rate is that the disease grows secretly and without symptoms, the appearance of symptoms is delayed, and the lack of appropriate examination that detects the disease at certain stages, and this is why it is called the silent killer [3, 4].

Until recently, methods of prevention and early detection of ovarian cancer did not achieve satisfactory results, partly due to its heterogeneous nature [5]. In the past, ovarian cancer prevention methods were characterized by modifying risk factors and creating protective factors. Unfortunately, these modifications did not significantly reduce the incidence of the disease [6]. The initial treatment of ovarian- either with upfront cytoreductive surgery or chemotherapy (neoadjuvant) followed by interval debulking surgery, Almost the main reason behind recurring

ovarian cancer Is due to the aggressive nature of the disease and unfortunately all metastatic ovarian cancer will develop resistance to conventional systemic therapies, and it is known that cancer cells develop resistance especially through certain mechanisms such as reduced absorption, increasing elimination, inactivation/ detoxification of drugs, and accelerating DNA repair [7, 8].

Currently, many new approaches have been developed to improve delivery of drug to the target cancer cells, including the use of nanotechnology, and may be one of the solution to overcome the obstacles in treating advance ovarian cancer, nanotechnology was found to have extensively investigated for molecular imaging, drug delivery, treatment and tumor targeting [9, 10]. In addition, this type of nano-based drug can overcome the systemic toxicity towards normal cells as well as the toxicological effects of conventional chemotherapy, In addition, it is possible through this technique to control the systemic toxicity of normal cells and reduce the toxicity of chemotherapy agents. Thus the new method can be followed by using multiple chemotherapeutic drugs with a suitable nanocarrier as a solution for the future of cancer treatment. Of course, this can be done by passive targeting and active targeting where both methods are used to ensure a certain and specific targeting of cancer cells [11, 12].
