Table 1.

Summary of drug classes and the pathways they target, with examples and potential implications for ovarian function.

Class of drug	Examples	Targeted pathway	Relevant ovarian function(s)
EGFR/HER inhibitors	Erlotinib, gefitinib, osimertinib, lapatinib, afatinib, neratinib trastuzumab, pertuzumab, cetuximab	Receptor tyrosine kinases signalling through Ras/Raf/MEK/ERK, PI3K/Akt/mTOR, and JAK/STAT pathways; also direct nuclear translocation	Oocyte maturation, cumulus expansion, and ovulation
BRAF/MEK inhibitors	BRAF: vemurafenib, dabrafenib, encorafenib; MEK: trametinib, binimetinib, cobimetinib	Serine/threonine kinase signalling through RAS/RAF/MEK/ERK	Follicle growth, cumulus cell-oocyte complex expansion, oocyte maturation and luteinisation
PI3K/Akt/mTOR inhibitors	Sirolimus (rapamycin), temsirolimus, everolimus	PI3K/Akt/mTOR pathways regulate cell growth, motility, survival, metabolism, and apoptosis	Primordial follicle dormancy/growth activation, granulosa cell proliferation, follicle survival, possible chemoprotection
JAK/STAT inhibitors	Ruxolitinib, fedratinib, tofacitinib, baricitinib	Cytokine signal transduction through STAT phosphorylation; crosstalk with PI3K pathway	Primordial follicle growth activation, follicle survival
BCR-Abl	Imatinib, asciminib	MAPK, PI3K/Akt/mTOR, and JAK/STAT signalling	Primordial follicle survival/apoptosis, possible chemoprotection
CDK inhibitors	Palbociclib, ribociclib, abemaciclib	Cell cycle: transition from G1 to the S phase of the cell cycle	Ovulation, corpus luteum formation
PARP inhibitors	Olaparib, rucaparib, niraparib, and talazoparib	DNA repair including single-strand breaks, nucleotide excision repair, non-homologous end joining, homologous repair, and DNA mismatch repair	Direct damage and death of primordial follicle oocytes, granulosa cell dysfunction/follicle growth
Anti-angiogenesis	Bevacizumab ramucirumab, nintedanib, pazopanib, sorafenib	VEGF, FGF, PDGF receptor tyrosine kinase signalling	Possibly primordial follicle activation, antral follicle growth, corpus luteum function