The last five years has seen a major expansion in the number of clinical trials with molecular targeted agents in ovarian cancer. Most of the studies are with anti-angiogenic agents. This review discusses the rationale for molecular targeted therapy in ovarian cancer and the current randomized trials. It focuses on anti-angiogenic agents, particularly bevacizumab and small molecule VEGFR tyrosine kinase inhibitors, and EGFR, α-folate receptor, PARP, src kinase and IGFR inhibitors. The results of first-line trials and studies in recurrent disease with bevacizumab will soon be available. Results of many other trials with molecular targeted therapy will follow over the next 2-3 years. We highlight some of the complex issues about sequencing, duration of therapy and selection of agents to aid the debate about the best use of molecular targeted agents in the treatment of ovarian cancer.

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