Recent advances in the role of long non-coding RNAs in ovarian cancer chemoresistance.

Ovarian cancer (OC) remains a leading cause of cancer-related mortality among women, with a persistently low five-year survival rate. Currently, the primary treatment modalities for OC include surgery and systemic chemotherapy. However, despite initial therapeutic efficacy, the majority of patients eventually experience relapse and drug resistance, severely limiting clinical outcomes. Consequently, there is an urgent need to elucidate the molecular mechanisms underlying OC and develop innovative strategies to overcome chemoresistance. Long non-coding RNAs (lncRNAs), emerging as novel transcriptional regulators, exhibit aberrant expression and mutations closely associated with tumorigenesis, metastasis, and drug resistance. As promising biomarkers and therapeutic targets, lncRNAs hold significant potential for advancing cancer treatment. Growing evidence indicates that lncRNAs contribute to chemoresistance in OC through various mechanisms, including functioning as competing endogenous RNAs (ceRNAs) to sequester miRNAs, participating in epigenetic regulation, influencing metabolism, impairing DNA damage repair, and modulating key signaling pathways, thereby affecting the efficacy of cisplatin, carboplatin, and paclitaxel. This review summarizes the mechanistic roles and recent advances in lncRNA research related to OC chemoresistance, aiming to provide novel perspectives and pathways to address this clinical challenge.