The cellular response to anticancer agent treatments is determined by many factors that could be altered in tumor cells. The induction of apoptosis of cancer cells is thought to be important for the overall response of these cells. Despite the introduction of new and potent anticancer agents, the survival rate for patients with ovarian cancer remains poor. In general ovarian cancer cells present a poor propensity to undergo apoptosis, which could be one of the reasons for this relatively poor response observed in the clinic. Induction of apoptosis is the result of activation and repression of pro- and antiapoptotic genes, which are regulated by complex mechanisms. Many cancer cells activate a “survival” program to escape disruption and allow propagation. In this review we have analyzed the role of genetic alterations observed in ovarian cancer cells in determining cellular response to drug treatment.