OnCo
cancersCancer

Ovarian cancer

Usually found late. PARP inhibitors transformed maintenance therapy, and ADCs against folate receptor and CDH6 are arriving for platinum-resistant disease.

Ovarian cancer is a group of diseases (~320,000 new cases a year) dominated by high-grade serous carcinoma, which arises in the fallopian tube, is almost always TP53-mutant, and is diagnosed at stage III-IV in three-quarters of women because there is no symptom or screening test that catches it early. Roughly half of high-grade serous tumours have homologous recombination deficiency, including ~20% with germline or somatic BRCA1/2 mutations. Low-grade serous, endometrioid, clear-cell, and mucinous carcinomas are biologically distinct and respond differently to treatment.

The standard of care is maximal cytoreductive surgery (primary or interval, after neoadjuvant carboplatin-paclitaxel), sometimes with HIPEC, followed by maintenance therapy chosen by biomarker: olaparib for BRCA-mutated disease (SOLO-1, 7-year OS 67% vs 47%), olaparib plus bevacizumab for HRD-positive disease (PAOLA-1), niraparib for the rest with declining enthusiasm after PRIMA showed no survival gain. Platinum-sensitive relapse is treated with platinum doublets and secondary surgery in selected patients (DESKTOP III); PARP inhibitors are re-used less since later-line safety signals. Platinum-resistant disease, historically dismal, now has three new options with survival benefit: mirvetuximab soravtansine for FRα-high tumours (MIRASOL), relacorilant plus nab-paclitaxel (ROSELLA, approved 2026), and pembrolizumab plus weekly paclitaxel for PD-L1-positive tumours (KEYNOTE-B96, approved February 2026, the first immunotherapy in ovarian cancer). Low-grade serous carcinoma gained its first dedicated therapy in avutometinib plus defactinib (2025).

What comes next: folate-receptor ADCs that work regardless of expression level (rinatabart sesutecan, luveltamab tazevibulin), a CDH6 ADC (raludotatug deruxtecan) in phase 3, ATR and WEE1 inhibitors for PARP-resistant disease, and prevention by opportunistic salpingectomy now that the tubal origin is accepted. Screening remains unsolved after UKCTOCS; multi-cancer blood tests are the only live hope.

State of the art today

  • First ADC (mirvetuximab) with OS benefit.
  • First treatment designed for low-grade serous carcinoma (avutometinib + defactinib, May 2025).
  • Prevention by opportunistic salpingectomy is now routine policy in several countries because the tubal origin of high-grade serous cancer is accepted.
  • Germline and HRD testing at diagnosis is standard and changes treatment for roughly half of patients.
Show survival figures (4)

Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • PARP maintenance with 7-year OS benefit in BRCA (SOLO-1).
  • Biomarker-directed maintenance after first-line chemotherapy: olaparib for BRCA (7-year OS 67% vs 47%), olaparib + bevacizumab for HRD-positive disease.
  • Three new options with overall survival benefit in platinum-resistant disease within three years: mirvetuximab (FRα-high), relacorilant + nab-paclitaxel, and pembrolizumab + paclitaxel (PD-L1-positive, first immunotherapy approval in ovarian cancer, February 2026).
  • Surgery is evidence-based at both ends: HIPEC at interval debulking adds ~12 months of survival; selected secondary cytoreduction at relapse adds ~8 months.
Who it affects
Show survival figures (2)

Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • Ovarian cancer accounts for ~320,000 cases and ~200,000 deaths per year worldwide.
  • It is the deadliest gynaecologic cancer, with 5-year survival ~50% overall and under 30% for stage IV.

Where the cases are

Cases by country · GLOBOCAN 2022
All countries →

Site: Ovary. World: 324,603 new cases, 206,956 deaths.

#CountryNew casesDeaths
1China61,06032,646
2India47,33332,978
3United States of America21,17913,273
4Indonesia15,1309,673
5Russian Federation14,6069,333
6Japan10,6935,301
7Brazil7,7105,235
8Germany7,5475,366
9Philippines6,4534,073
10United Kingdom6,3904,159

Standard of care

15top
Newly diagnosed

Surgery + platinum-taxane ± bevacizumab ± HIPEC; PARP maintenance by HRD status.

NCCN Guidelines: Ovarian Cancer
CarboplatinPaclitaxel / nab-paclitaxelHIPEC / PIPAC (intraperitoneal chemotherapy)OlaparibNiraparib
Platinum-sensitive relapse

Platinum doublet + PARP maintenance; secondary cytoreduction in selected cases.

NCCN Guidelines: Ovarian Cancer
Platinum-resistant

Mirvetuximab (FRα-high), relacorilant + nab-paclitaxel, pembrolizumab (PD-L1+), single-agent chemotherapy.

ESMO-MCBS · 2 (SORAYA mirvetuximab, single-arm)
Mirvetuximab soravtansineRelacorilantPembrolizumab
Prevention and risk

Germline testing for all patients; risk-reducing salpingo-oophorectomy for BRCA carriers (age 35-45); opportunistic salpingectomy at pelvic surgery for average-risk women; oral contraceptives reduce risk. No population screening (UKCTOCS negative).

NCCN · Genetic/Familial High-Risk Assessment v2.20…
Germline (hereditary) testingRisk-reducing and opportunistic salpingectomyChemoprevention & risk-reducing surgeryUKCTOCS
Newly diagnosed stage I-II

Complete surgical staging; adjuvant carboplatin-paclitaxel for high-grade or stage IC-II disease; observation for low-risk stage IA-IB grade 1-2.

NCCN · 1
CarboplatinPaclitaxel / nab-paclitaxelRobotic & minimally invasive surgery
Newly diagnosed stage III-IV: surgery and chemotherapy

Primary debulking if complete resection is feasible, else 3 cycles neoadjuvant carboplatin-paclitaxel then interval debulking (with HIPEC in stage III, OVHIPEC-1) and 3 more cycles; add bevacizumab for high-risk or residual disease.

NCCN · 1 (chemotherapy); 2A (HIPEC)
CarboplatinPaclitaxel / nab-paclitaxelHIPEC / PIPAC (intraperitoneal chemotherapy)OVHIPEC-1BevacizumabGOG-0218 & ICON7 (bevacizumab)
First-line maintenance, BRCA-mutated

Olaparib 2 years (SOLO-1) or olaparib + bevacizumab (PAOLA-1) or niraparib 3 years (PRIMA).

NCCN · 1ESMO-MCBS · A
OlaparibSOLO-1PAOLA-1 / ENGOT-ov25NiraparibPRIMA / ENGOT-OV26
First-line maintenance, HRD-positive BRCA-wild-type

Olaparib + bevacizumab (PAOLA-1, OS benefit) or niraparib (PRIMA, PFS only).

NCCN · 1
OlaparibBevacizumabPAOLA-1 / ENGOT-ov25NiraparibHRD & BRCA testingPARP inhibitor + bevacizumab maintenance (HRD-positive)
First-line maintenance, HRD-negative

Bevacizumab continuation if started; niraparib is an option with small PFS benefit and no OS benefit (PRIMA); observation is reasonable.

NCCN · 2A
BevacizumabNiraparibPRIMA / ENGOT-OV26
Platinum-sensitive relapse (interval >6 months)

Secondary cytoreduction if AGO-score positive (DESKTOP III); platinum doublet (carboplatin with PLD, paclitaxel, or gemcitabine) ± bevacizumab; PARP maintenance if PARP-naive and BRCA/HRD-positive.

NCCN · 1 (surgery in selected); 2A
DESKTOP III / ENGOT-ov20CarboplatinPegylated liposomal doxorubicinBevacizumabOlaparibNiraparibRucaparib
Platinum-resistant relapse, FRα-high

Mirvetuximab soravtansine (MIRASOL, OS benefit) with ophthalmic prophylaxis.

NCCN · 1ESMO-MCBS · 4
Mirvetuximab soravtansineMIRASOL / GOG-3045Folate receptor alpha
Platinum-resistant relapse, PD-L1 CPS ≥1

Pembrolizumab + weekly paclitaxel ± bevacizumab (KEYNOTE-B96, approved Feb 2026).

NCCN · 1 (2026 update)
PembrolizumabPaclitaxel / nab-paclitaxelBevacizumabKEYNOTE-B96 / ENGOT-ov65
Platinum-resistant relapse, other

Relacorilant + nab-paclitaxel (ROSELLA, approved 2026); single-agent weekly paclitaxel, PLD, or topotecan ± bevacizumab (AURELIA); clinical trials of FRα and CDH6 ADCs.

NCCN · 2A
RelacorilantROSELLA / GOG-3073Pegylated liposomal doxorubicinBevacizumabRinatabart sesutecanRaludotatug deruxtecan
Low-grade serous carcinoma

Surgery; endocrine maintenance (letrozole) after chemotherapy or instead of it; at recurrence, avutometinib + defactinib if KRAS-mutated (2025), trametinib, or endocrine therapy.

NCCN · 2A
Letrozole (and other aromatase inhibitors)Avutometinib + defactinibRAMP 201Low-grade serous ovarian cancer (LGSOC)
Rare histologies

Clear-cell: platinum-based therapy, trials of immunotherapy and ARID1A-directed agents; mucinous: consider GI regimens and HER2 testing; germ-cell: BEP chemotherapy with >90% cure.

Platinum agentsImmune checkpoint inhibitors

Subtypes & biomarkers

top
Subtypes
Biomarkers clinicians test

Target prevalence in this cancer

Target / alterationPrevalenceSource
TP53
95%
cBioPortal (TCGA)
MUC16 (CA-125)
80%
doi.org
CDH6
High-grade serous
65-85%
Wikipedia
Mesothelin
Serous
60-70%
Wikipedia
Claudin 6
varies by antibody and cutoff
50-60%
PARP
~20% germline/somatic BRCA
50%
Wikipedia
Folate receptor alpha
MIRASOL eligibility; ~80% any expression
35-40%
Wikipedia
BRCA1 / BRCA2 (HRD)
15-20%
Wikipedia
WEE1
TP53 mutation ~95%
15-20%
cBioPortal (TCGA)
KRAS
10-15%
cBioPortal (TCGA)
ATR
n/a
Wikipedia

How common each drug target or alteration is in this cancer. Population-level and approximate; see the target page for detail. Full matrix.

History

18top
  1. 1976Cisplatin transforms ovarian cancer chemotherapy

    First platinum responses in refractory disease; carboplatin follows in the 1980s.

  2. 1994BRCA1 cloned; hereditary ovarian cancer explained

    BRCA2 in 1995; germline testing enters clinical practice over the next decade.

    BRCA1 / BRCA2 (HRD)
  3. 1996Paclitaxel-cisplatin standard
  4. 1996Paclitaxel-cisplatin becomes standard (GOG-111)
    Paclitaxel / nab-paclitaxelPlatinum agents
  5. 2005Synthetic lethality of PARP inhibition in BRCA-deficient cells

    Farmer and Bryant papers in Nature set up the PARP inhibitor era.

    PARPSynthetic lethality
  6. 2007Fallopian tube identified as origin of high-grade serous cancer

    Serous tubal intraepithelial carcinoma described in BRCA carriers' prophylactic specimens; leads to salpingectomy-based prevention.

    High-grade serous ovarian carcinoma (HGSOC)Risk-reducing and opportunistic salpingectomy
  7. 2011Bevacizumab improves PFS (GOG-0218, ICON7)
    GOG-0218 & ICON7 (bevacizumab)Bevacizumab
  8. 2014Olaparib: first PARP inhibitor
    Olaparib
  9. 2014Olaparib: first PARP inhibitor approved

    For germline BRCA-mutated ovarian cancer after three lines.

    Olaparib
  10. 2018SOLO-1 and OVHIPEC-1

    Two years of first-line olaparib maintenance (PFS HR 0.30) and HIPEC at interval surgery (OS +12 months) both reported.

    SOLO-1OVHIPEC-1
  11. 2019PARP maintenance extends beyond BRCA

    PRIMA (niraparib, all comers) and PAOLA-1 (olaparib + bevacizumab, HRD-positive).

    PRIMA / ENGOT-OV26PAOLA-1 / ENGOT-ov25
  12. 2021UKCTOCS: screening does not save lives; DESKTOP III: selected surgery at relapse does
    UKCTOCSDESKTOP III / ENGOT-ov20
  13. 2022Mirvetuximab: first ovarian ADC
    Mirvetuximab soravtansine
  14. 2022Mirvetuximab soravtansine: first ovarian ADC

    Accelerated approval; full approval after MIRASOL OS benefit in 2024.

    Mirvetuximab soravtansineMIRASOL / GOG-3045
  15. 2023SOLO-1 7-year OS benefit; PARP later-line labels narrowed

    First-line maintenance benefit confirmed while later-line PARP use retreats after OS imbalances (ARIEL4, SOLO3).

    SOLO-1Rucaparib
  16. 2025First LGSOC therapy (avutometinib + defactinib); ROSELLA and KEYNOTE-B96 positive
    Avutometinib + defactinibRAMP 201ROSELLA / GOG-3073KEYNOTE-B96 / ENGOT-ov65
  17. 2026Relacorilant and pembrolizumab approved in platinum-resistant disease
    Relacorilant
  18. 2026Relacorilant and pembrolizumab approved in platinum-resistant disease

    First immunotherapy approval in ovarian cancer (February 2026).

    RelacorilantPembrolizumabKEYNOTE-B96 / ENGOT-ov65

Pipeline

14top
Phase 3ADC
Raludotatug deruxtecan
Phase 2ADC
Puxitatug samrotecan
Phase 3Multi-cancer early detection blood test
Galleri
Phase 3ADC
Rinatabart sesutecan
Phase 3ADC
Luveltamab tazevibulin
ApprovedSmall-molecule RAF/MEK clamp + FAK inhibitor
Avutometinib + defactinib · Avmapki Fakzynja Co-Pack
PARP PETRAINFOL-01 (Rina-S)REJOICE-Ovarian01WEE1ATRRisk-reducing and opportunistic salpingectomySequence folate-receptor ADCs by payload classctDNA-guided duration of PARP maintenance

Open problems

  • No effective screening.
  • PARP resistance via BRCA reversion.
  • Platinum-resistant disease remains lethal.
  • No screening test reduces mortality (UKCTOCS); three-quarters of patients are still diagnosed at stage III-IV.
  • Platinum resistance is eventually near-universal in high-grade serous disease, and each new drug adds months, not years.
  • PARP inhibitor resistance (BRCA reversion, restored fork protection) has no approved counter; later-line PARP use has been curtailed by OS signals.
  • Immunotherapy fails in first-line disease; benefit is confined to PD-L1-positive platinum-resistant tumours.
  • Clear-cell, mucinous, and carcinosarcoma have no subtype-specific approved therapy.
  • FRα-low patients are excluded from mirvetuximab; next-generation ADCs are not yet approved.
  • Access to HRD testing, PARP inhibitors, and ADCs is limited outside high-income countries.
  • Optimal duration of maintenance and ctDNA-guided de-escalation are untested.

Trials

top

Recruiting now (live from ClinicalTrials.gov)

Recruiting trials near you · live from ClinicalTrials.gov
Ovarian cancer
condition: Ovarian cancer
Open on ClinicalTrials.gov →

Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.

Landmark trials in OnCo

ATHENA-MONO / GOG-3020DESKTOP III / ENGOT-ov20DUO-O / ENGOT-ov46GOG-0218 & ICON7 (bevacizumab)KEYNOTE-B96 / ENGOT-ov65MIRASOL / GOG-3045OVHIPEC-1PAOLA-1 / ENGOT-ov25PRIMA / ENGOT-OV26RAINFOL-01 (Rina-S)RAMP 201REJOICE-Ovarian01ROSELLA / GOG-3073SOLO-1UKCTOCS

Expert centres

top
Where the expertise is

Centres linked to this cancer in OnCo

Seeking a second opinion: ask your oncologist for a referral to a high-volume centre; most accept records and pathology by mail or telehealth. In the US, use the NCI's Find a Cancer Center tool or the nonprofit Cancer Commons, which navigates options for advanced cancers at no cost.

Questions to ask

top
Bring to your appointment

Questions to ask your oncologist about Ovarian cancer

Generated from this cancer's standard of care, biomarkers, and pipeline · 46 questions

Newly diagnosed

  1. What is my exact diagnosis, stage, and grade, and which tests established them?
    Why: Everything else follows from an accurate stage and subtype.
  2. Which biomarkers have been tested on my tumour (for example BRCA1/2, HRD, FRα IHC, CDH6, CA-125), and what were the results?
    Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
  3. Which subtype is my cancer, and does that change the recommended treatment?
    Why: Recognised subtypes for this cancer include High-grade serous carcinoma, Low-grade serous carcinoma, Endometrioid carcinoma.
  4. Is germline (inherited) genetic testing recommended for me or my family?
    Why: Inherited variants can change treatment and matter for relatives.
  5. For my situation (newly diagnosed), which of the standard options do you recommend and why?
    Why: Guideline options include: Surgery + platinum-taxane ± bevacizumab ± HIPEC; PARP maintenance by HRD status.
  6. Am I a candidate for Carboplatin, Paclitaxel / nab-paclitaxel, Olaparib or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Platinum-sensitive relapse

  1. For my situation (platinum-sensitive relapse), which of the standard options do you recommend and why?
    Why: Guideline options include: Platinum doublet + PARP maintenance; secondary cytoreduction in selected cases.

Platinum-resistant

  1. For my situation (platinum-resistant), which of the standard options do you recommend and why?
    Why: Guideline options include: Mirvetuximab (FRα-high), relacorilant + nab-paclitaxel, pembrolizumab (PD-L1+), single-agent chemotherapy.
  2. Am I a candidate for Mirvetuximab soravtansine, Relacorilant, Pembrolizumab, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Prevention and risk

  1. For my situation (prevention and risk), which of the standard options do you recommend and why?
    Why: Guideline options include: Germline testing for all patients; risk-reducing salpingo-oophorectomy for BRCA carriers (age 35-45); opportunistic salpingectomy at pelvic surgery for average-risk women; oral contraceptives reduce risk. No population screening (UKCTOCS negative).
  2. How do the results of UKCTOCS apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Newly diagnosed stage I-II

  1. For my situation (newly diagnosed stage i-ii), which of the standard options do you recommend and why?
    Why: Guideline options include: Complete surgical staging; adjuvant carboplatin-paclitaxel for high-grade or stage IC-II disease; observation for low-risk stage IA-IB grade 1-2.
  2. Am I a candidate for Carboplatin, Paclitaxel / nab-paclitaxel, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Newly diagnosed stage III-IV: surgery and chemotherapy

  1. For my situation (newly diagnosed stage iii-iv: surgery and chemotherapy), which of the standard options do you recommend and why?
    Why: Guideline options include: Primary debulking if complete resection is feasible, else 3 cycles neoadjuvant carboplatin-paclitaxel then interval debulking (with HIPEC in stage III, OVHIPEC-1) and 3 more cycles; add bevacizumab for high-risk or residual disease.
  2. Am I a candidate for Carboplatin, Paclitaxel / nab-paclitaxel, Bevacizumab, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of OVHIPEC-1 and GOG-0218 & ICON7 (bevacizumab) apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

First-line maintenance, BRCA-mutated

  1. For my situation (first-line maintenance, brca-mutated), which of the standard options do you recommend and why?
    Why: Guideline options include: Olaparib 2 years (SOLO-1) or olaparib + bevacizumab (PAOLA-1) or niraparib 3 years (PRIMA).
  2. Am I a candidate for Olaparib, Niraparib, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of SOLO-1 and PAOLA-1 / ENGOT-ov25 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

First-line maintenance, HRD-positive BRCA-wild-type

  1. For my situation (first-line maintenance, hrd-positive brca-wild-type), which of the standard options do you recommend and why?
    Why: Guideline options include: Olaparib + bevacizumab (PAOLA-1, OS benefit) or niraparib (PRIMA, PFS only).
  2. Am I a candidate for Olaparib, Bevacizumab, Niraparib, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of PAOLA-1 / ENGOT-ov25 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

First-line maintenance, HRD-negative

  1. For my situation (first-line maintenance, hrd-negative), which of the standard options do you recommend and why?
    Why: Guideline options include: Bevacizumab continuation if started; niraparib is an option with small PFS benefit and no OS benefit (PRIMA); observation is reasonable.
  2. Am I a candidate for Bevacizumab, Niraparib, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of PRIMA / ENGOT-OV26 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Platinum-sensitive relapse (interval >6 months)

  1. For my situation (platinum-sensitive relapse (interval >6 months)), which of the standard options do you recommend and why?
    Why: Guideline options include: Secondary cytoreduction if AGO-score positive (DESKTOP III); platinum doublet (carboplatin with PLD, paclitaxel, or gemcitabine) ± bevacizumab; PARP maintenance if PARP-naive and BRCA/HRD-positive.
  2. Am I a candidate for Carboplatin, Pegylated liposomal doxorubicin, Bevacizumab or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of DESKTOP III / ENGOT-ov20 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Platinum-resistant relapse, FRα-high

  1. For my situation (platinum-resistant relapse, frα-high), which of the standard options do you recommend and why?
    Why: Guideline options include: Mirvetuximab soravtansine (MIRASOL, OS benefit) with ophthalmic prophylaxis.
  2. Am I a candidate for Mirvetuximab soravtansine, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of MIRASOL / GOG-3045 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Platinum-resistant relapse, PD-L1 CPS ≥1

  1. For my situation (platinum-resistant relapse, pd-l1 cps ≥1), which of the standard options do you recommend and why?
    Why: Guideline options include: Pembrolizumab + weekly paclitaxel ± bevacizumab (KEYNOTE-B96, approved Feb 2026).
  2. Am I a candidate for Pembrolizumab, Paclitaxel / nab-paclitaxel, Bevacizumab, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of KEYNOTE-B96 / ENGOT-ov65 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Platinum-resistant relapse, other

  1. For my situation (platinum-resistant relapse, other), which of the standard options do you recommend and why?
    Why: Guideline options include: Relacorilant + nab-paclitaxel (ROSELLA, approved 2026); single-agent weekly paclitaxel, PLD, or topotecan ± bevacizumab (AURELIA); clinical trials of FRα and CDH6 ADCs.
  2. Am I a candidate for Relacorilant, Pegylated liposomal doxorubicin, Bevacizumab or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of ROSELLA / GOG-3073 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Low-grade serous carcinoma

  1. For my situation (low-grade serous carcinoma), which of the standard options do you recommend and why?
    Why: Guideline options include: Surgery; endocrine maintenance (letrozole) after chemotherapy or instead of it; at recurrence, avutometinib + defactinib if KRAS-mutated (2025), trametinib, or endocrine therapy.
  2. Am I a candidate for Letrozole (and other aromatase inhibitors), Avutometinib + defactinib, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of RAMP 201 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Rare histologies

  1. For my situation (rare histologies), which of the standard options do you recommend and why?
    Why: Guideline options include: Clear-cell: platinum-based therapy, trials of immunotherapy and ARID1A-directed agents; mucinous: consider GI regimens and HER2 testing; germ-cell: BEP chemotherapy with >90% cure.

Any stage

  1. Are there clinical trials I could join, for example of Raludotatug deruxtecan, Puxitatug samrotecan, PARP PET, Galleri?
    Why: Trials are how the next standard of care is set; asking early keeps options open.
  2. Would a second opinion at a high-volume centre change anything, and can you help arrange it?
    Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
  3. What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
    Why: Supportive care improves quality of life and helps patients complete treatment.
  4. I read that “No effective screening”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.
  5. I read that “PARP resistance via BRCA reversion”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.

Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.

Everything relevant

216top

Direct links plus the targets, companies, and technologies of this cancer's products.

technologies

32
Anti-angiogenic therapyAntibody-drug conjugate (ADC)Autologous stem cell transplant (high-dose therapy)Cancer neuroscience: cutting the nerve supplyChemoprevention & risk-reducing surgeryCytotoxic chemotherapyDNA methylation profilingEndocrine therapy (SERMs, AIs, SERDs)Enteral and parenteral nutrition supportFluorescence-guided surgeryGermline (hereditary) testingHIPEC / PIPAC (intraperitoneal chemotherapy)HRD & BRCA testingImmune checkpoint inhibitorsIntravesical therapy (BCG, chemotherapy, devices, gene and viral therapy)Isolated limb perfusion and infusionLiquid biopsy (ctDNA)Monoclonal antibodiesMulti-cancer early detection (MCED)Optical & fluorescence imagingPARP inhibitorsPARP PETPercutaneous hepatic perfusion (chemosaturation)Platinum agentsRisk-reducing and opportunistic salpingectomyRobotic & minimally invasive surgerySite-specific conjugation & linker chemistrySmall-molecule kinase inhibitorsSynthetic lethality approachesT-cell engagers (bispecific)Topoisomerase-I inhibitors (and ADC payloads)Ultrasound

targets

18
ATRBRCA1 / BRCA2 (HRD)CD3CDH6Claudin 6EpCAMEstrogen receptor (ERα)Folate receptor alphaKRASMesothelinMUC16 (CA-125)PARPPD-1PD-L1PRAMETP53VEGF / VEGFRWEE1

drugs

24
ApprovedSmall-molecule RAF/MEK clamp + FAK inhibitor
Avutometinib + defactinib · Avmapki Fakzynja Co-Pack
ApprovedMonoclonal antibody (anti-VEGF)
Bevacizumab · Avastin (and biosimilars)
Phase 3ImmTAC (PRAME TCR × CD3 bispecific)
Brenetafusp
ApprovedCytotoxic chemotherapy (platinum)
Carboplatin
ApprovedCytotoxic chemotherapy (platinum)
Cisplatin · Platinol (generic)
Phase 3Multi-cancer early detection blood test
Galleri
Not mapped hereNucleoside analogue (deoxycytidine)
Gemcitabine · Gemzar / Infugem
ApprovedSmall-molecule aromatase inhibitor
Letrozole (and other aromatase inhibitors) · Femara; anastrozole (Arimidex); exemestane (Aromasin)
Phase 3ADC
Luveltamab tazevibulin
Not mapped hereAlkylating agent (nitrogen mustard)
Melphalan (including hepatic delivery system) · Alkeran / Evomela / Hepzato Kit
ApprovedADC
Mirvetuximab soravtansine · Elahere
ApprovedSmall-molecule PARP inhibitor
Niraparib · Zejula
ApprovedSmall-molecule PARP inhibitor
Olaparib · Lynparza
ApprovedCytotoxic chemotherapy (taxane)
Paclitaxel / nab-paclitaxel · Taxol / Abraxane
Not mapped hereFolate receptor-targeted near-infrared fluorescent imaging agent
Pafolacianine · Cytalux
ApprovedCytotoxic (liposomal anthracycline)
Pegylated liposomal doxorubicin · Doxil / Caelyx
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
Phase 2ADC
Puxitatug samrotecan
Phase 3ADC
Raludotatug deruxtecan
ApprovedSmall-molecule glucocorticoid receptor antagonist
Relacorilant · Lifyorli
Phase 3ADC
Rinatabart sesutecan
ApprovedSmall-molecule PARP inhibitor
Rucaparib · Rubraca
ApprovedCytotoxic (topoisomerase-I inhibitor)
Topotecan · Hycamtin
ApprovedCytotoxic (DNA minor-groove binder)
Trabectedin · Yondelis

companies

22
AbbVie (incl. ImmunoGen, Capstan)Arsenal BiosciencesAstraZenecaCorcept TherapeuticsDaiichi SankyoDebiopharmEli Lilly (incl. Loxo)Generate:BiomedicinesGenmabGRAILGSKImmunocoreJohnson & JohnsonKymera TherapeuticsMerck & Co. (MSD)Mersana TherapeuticsMonte Rosa TherapeuticsRoche / GenentechSutro BiopharmaTubulis (Gilead)Verastem OncologyXencor

institutions

28
ARCAGY-GINECOBC CancerCancer Research UK Cambridge Centre / CRUK Cambridge InstituteCentre hospitalier de l'Université de Montréal (CHUM)Centre Oscar LambretChris O'Brien LifehouseEdinburgh Cancer Centre / CRUK Scotland CentreEuropean Society of Gynaecological OncologyGOG FoundationInstitut BergoniéInstituto Português de Oncologia do Porto Francisco GentilIRCCS Regina Elena National Cancer InstituteLausanne University Hospital (CHUV) / Ludwig Institute LausanneNewcastle Cancer Centre / Northern Centre for Cancer CareNorthwell Health Cancer InstituteO'Neal Comprehensive Cancer Center at UABOntario Institute for Cancer ResearchOxford Cancer – Oxford University Hospitals and University of OxfordPeking Union Medical College HospitalPoliclinico Universitario A. GemelliQIMR Berghofer Medical Research InstituteShaare Zedek Medical CenterSociety of Gynecologic OncologyStephenson Cancer Center, OU HealthThe Wistar InstituteTongji Hospital, Huazhong University of Science and TechnologyUniversity Hospital Basel / Tumour CentreUZ Leuven / Leuven Cancer Institute

pathways

10
Base excision repair, PARP & alkylation damageDNA damage response & homologous recombinationDouble-strand break repair: HR versus end joiningLipid synthesis, uptake & cholesterolOrgan tropism: seed and soilp53 / RB / cell-cycle checkpointSWI/SNF chromatin remodellingThe angiogenic switch & tumour vesselsThe cell-cycle engine (cyclins & CDKs)The p53 network (guardian of the genome)

terms

19
CA-125Combined positive score (CPS)Debulking (cytoreductive surgery)Germline BRCA mutation (gBRCA)High-grade serous ovarian carcinoma (HGSOC)HIPEC (hyperthermic intraperitoneal chemotherapy)Intraperitoneal (IP) chemotherapyLow-grade serous ovarian cancer (LGSOC)Maintenance therapyMaintenance therapyMalignant pleural effusion and ascitesObesity-related cancers (IARC list of 13)Peritoneal metastasisPeritoneum and peritoneal metastasesPlatinum-sensitive / platinum-resistantSalpingo-oophorectomySynthetic lethalityTP53-mutated (p53-abnormal)Tumour marker

trials

15
ATHENA-MONO / GOG-3020DESKTOP III / ENGOT-ov20DUO-O / ENGOT-ov46GOG-0218 & ICON7 (bevacizumab)KEYNOTE-B96 / ENGOT-ov65MIRASOL / GOG-3045OVHIPEC-1PAOLA-1 / ENGOT-ov25PRIMA / ENGOT-OV26RAINFOL-01 (Rina-S)RAMP 201REJOICE-Ovarian01ROSELLA / GOG-3073SOLO-1UKCTOCS

pairings

4
Caution: checkpoint inhibitors in first-line ovarian cancerHIPEC at interval cytoreductive surgeryPARP inhibitor + bevacizumab maintenance (HRD-positive)Platinum chemotherapy in HRD tumours

roadmaps

1
ADC roadmap: from Mylotarg to bispecific and dual-payload ADCs

ideas

19
A functional test for homologous recombination deficiency validated across laboratoriesA multi-cancer platform trial of adaptive (dose-holiday) therapyA perpetual platform trial in every major cancer, funded as infrastructureAutomatic germline testing for every cancer type where it changes carectDNA-guided duration of PARP maintenanceEvolution-guided 'adaptive therapy' dosing tested in randomised phase 2 trialsFAPI PET as the workup for MCED positivesGo back to families of women who died of ovarian cancer and offer BRCA testingGroup trials by broken mechanism, not by organ or single mutationIs aneuploidy itself a druggable vulnerability?Make every cold tumour hot: a coordinated programme to reprogramme immune-excluded tumoursOncology teams order germline tests; tele-genetic counsellors handle the resultsOne-two punch: clear senescent cells after chemotherapyPopulation germline screening for hereditary cancer genes with cascade testingRemove the fallopian tubes during any pelvic surgery once childbearing is finishedSequence folate-receptor ADCs by payload classTreat the body cavity, not the bloodstream, for surface spreadTurn chromosomal chaos into a weakness with KIF18A inhibitorsWhich patients' blood clones will become leukaemia after treatment?

collections

1
Ovarian Cancer Research Alliance (OCRA)

people

15
Alan AshworthAmit M. OzaAngelina JolieAnna FagottiAnthony GonçalvesEvanthia GalanisEvelyn LauderGilda RadnerGiovanni ScambiaJudy E. GarberKan YonemoriMary-Claire KingSudeep GuptaSusan M. DomchekUrsula A. Matulonis

bottlenecks

4
Biomarkers are not validated or standardisedCold tumours and the immunosuppressive microenvironmentInherited risk is mostly unidentifiedMost lethal cancers are found late

key papers

4
IARC verdict: excess body fat causes 13 cancersPAOLA-1: olaparib added to bevacizumab maintenance in newly diagnosed ovarian cancer, with benefit confined to HRD-positive tumoursPROSE consortium: preventive surgery lowers cancer and death in BRCA1 and BRCA2 carriersSOLO-1: two years of olaparib maintenance after first-line chemotherapy for BRCA-mutated ovarian cancer

Key papers

4top
rctNew England Journal of Medicine 2019changed practice
PAOLA-1: olaparib added to bevacizumab maintenance in newly diagnosed ovarian cancer, with benefit confined to HRD-positive tumours

Women with newly diagnosed advanced ovarian cancer should have their tumour tested for BRCA mutations and homologous recombination deficiency, because those who are HRD-positive gain years of additional disease control and better survival from adding olaparib to bevacizumab maintenance. Those who are HRD-negative gain nothing from olaparib in this combination and should not be exposed to its toxicity and cost. HRD testing has become a routine part of ovarian cancer care as a result.

rctNew England Journal of Medicine 2018changed practice
SOLO-1: two years of olaparib maintenance after first-line chemotherapy for BRCA-mutated ovarian cancer

Every woman diagnosed with advanced high-grade ovarian cancer should be tested for BRCA mutations at diagnosis, because those who carry one should receive two years of olaparib after chemotherapy, which greatly extends the time in remission and improves long-term survival. The plateau in the survival curves suggests some patients are cured by this approach. Toxicity is mostly anaemia, fatigue and nausea, and the two-year limit appears sufficient.

reviewNew England Journal of Medicine 2016changed practice
IARC verdict: excess body fat causes 13 cancers

Maintaining a healthy weight is now established cancer prevention for over a dozen cancer types. For clinicians and policymakers, obesity belongs alongside tobacco and alcohol in prevention strategy. Whether intentional weight loss in adulthood reverses risk is still being studied, including in trials of GLP-1 drugs.

observationalJAMA 2010changed practice
PROSE consortium: preventive surgery lowers cancer and death in BRCA1 and BRCA2 carriers

For women who carry a BRCA mutation, preventive removal of the ovaries and tubes saves lives, and preventive mastectomy almost eliminates breast cancer. These are the strongest prevention effects in oncology, which is why finding carriers before they develop cancer matters so much.

Latest papers

top
Literature trend3,983 papers in the last 12 months-1% vs prior 12How this is computed
Latest papers · live from Europe PMC
Open in Europe PMC

Query for this cancer: (TITLE:"Ovarian cancer" OR ABSTRACT:"Ovarian cancer") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Ovarian cancer, not a curated reading list.

Connected

194top

Pages like this

not linked directly; found by shared links

technologies

16
Antibody-drug conjugate (ADC)Cancer neuroscience: cutting the nerve supplyChemoprevention & risk-reducing surgeryEnteral and parenteral nutrition supportGermline (hereditary) testingHIPEC / PIPAC (intraperitoneal chemotherapy)HRD & BRCA testingImmune checkpoint inhibitorsMulti-cancer early detection (MCED)PARP inhibitorsPARP PETPlatinum agentsRisk-reducing and opportunistic salpingectomyRobotic & minimally invasive surgerySynthetic lethality approachesUltrasound

targets

16
ATRBRCA1 / BRCA2 (HRD)CDH6Claudin 6EpCAMFolate receptor alphaKRASMesothelinMUC16 (CA-125)PARPPD-1PD-L1PRAMETP53VEGF / VEGFRWEE1

drugs

24
ApprovedSmall-molecule RAF/MEK clamp + FAK inhibitor
Avutometinib + defactinib · Avmapki Fakzynja Co-Pack
ApprovedMonoclonal antibody (anti-VEGF)
Bevacizumab · Avastin (and biosimilars)
Phase 3ImmTAC (PRAME TCR × CD3 bispecific)
Brenetafusp
ApprovedCytotoxic chemotherapy (platinum)
Carboplatin
ApprovedCytotoxic chemotherapy (platinum)
Cisplatin · Platinol (generic)
Phase 3Multi-cancer early detection blood test
Galleri
Not mapped hereNucleoside analogue (deoxycytidine)
Gemcitabine · Gemzar / Infugem
ApprovedSmall-molecule aromatase inhibitor
Letrozole (and other aromatase inhibitors) · Femara; anastrozole (Arimidex); exemestane (Aromasin)
Phase 3ADC
Luveltamab tazevibulin
Not mapped hereAlkylating agent (nitrogen mustard)
Melphalan (including hepatic delivery system) · Alkeran / Evomela / Hepzato Kit
ApprovedADC
Mirvetuximab soravtansine · Elahere
ApprovedSmall-molecule PARP inhibitor
Niraparib · Zejula
ApprovedSmall-molecule PARP inhibitor
Olaparib · Lynparza
ApprovedCytotoxic chemotherapy (taxane)
Paclitaxel / nab-paclitaxel · Taxol / Abraxane
Not mapped hereFolate receptor-targeted near-infrared fluorescent imaging agent
Pafolacianine · Cytalux
ApprovedCytotoxic (liposomal anthracycline)
Pegylated liposomal doxorubicin · Doxil / Caelyx
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
Phase 2ADC
Puxitatug samrotecan
Phase 3ADC
Raludotatug deruxtecan
ApprovedSmall-molecule glucocorticoid receptor antagonist
Relacorilant · Lifyorli
Phase 3ADC
Rinatabart sesutecan
ApprovedSmall-molecule PARP inhibitor
Rucaparib · Rubraca
ApprovedCytotoxic (topoisomerase-I inhibitor)
Topotecan · Hycamtin
ApprovedCytotoxic (DNA minor-groove binder)
Trabectedin · Yondelis

companies

18
AbbVie (incl. ImmunoGen, Capstan)Arsenal BiosciencesAstraZenecaCorcept TherapeuticsDaiichi SankyoDebiopharmGenerate:BiomedicinesGenmabGSKKymera TherapeuticsMerck & Co. (MSD)Mersana TherapeuticsMonte Rosa TherapeuticsRoche / GenentechSutro BiopharmaTubulis (Gilead)Verastem OncologyXencor

institutions

28
ARCAGY-GINECOBC CancerCancer Research UK Cambridge Centre / CRUK Cambridge InstituteCentre hospitalier de l'Université de Montréal (CHUM)Centre Oscar LambretChris O'Brien LifehouseEdinburgh Cancer Centre / CRUK Scotland CentreEuropean Society of Gynaecological OncologyGOG FoundationInstitut BergoniéInstituto Português de Oncologia do Porto Francisco GentilIRCCS Regina Elena National Cancer InstituteLausanne University Hospital (CHUV) / Ludwig Institute LausanneNewcastle Cancer Centre / Northern Centre for Cancer CareNorthwell Health Cancer InstituteO'Neal Comprehensive Cancer Center at UABOntario Institute for Cancer ResearchOxford Cancer – Oxford University Hospitals and University of OxfordPeking Union Medical College HospitalPoliclinico Universitario A. GemelliQIMR Berghofer Medical Research InstituteShaare Zedek Medical CenterSociety of Gynecologic OncologyStephenson Cancer Center, OU HealthThe Wistar InstituteTongji Hospital, Huazhong University of Science and TechnologyUniversity Hospital Basel / Tumour CentreUZ Leuven / Leuven Cancer Institute

pathways

10
Base excision repair, PARP & alkylation damageDNA damage response & homologous recombinationDouble-strand break repair: HR versus end joiningLipid synthesis, uptake & cholesterolOrgan tropism: seed and soilp53 / RB / cell-cycle checkpointSWI/SNF chromatin remodellingThe angiogenic switch & tumour vesselsThe cell-cycle engine (cyclins & CDKs)The p53 network (guardian of the genome)

terms

19
CA-125Combined positive score (CPS)Debulking (cytoreductive surgery)Germline BRCA mutation (gBRCA)High-grade serous ovarian carcinoma (HGSOC)HIPEC (hyperthermic intraperitoneal chemotherapy)Intraperitoneal (IP) chemotherapyLow-grade serous ovarian cancer (LGSOC)Maintenance therapyMaintenance therapyMalignant pleural effusion and ascitesObesity-related cancers (IARC list of 13)Peritoneal metastasisPeritoneum and peritoneal metastasesPlatinum-sensitive / platinum-resistantSalpingo-oophorectomySynthetic lethalityTP53-mutated (p53-abnormal)Tumour marker

trials

15
ATHENA-MONO / GOG-3020DESKTOP III / ENGOT-ov20DUO-O / ENGOT-ov46GOG-0218 & ICON7 (bevacizumab)KEYNOTE-B96 / ENGOT-ov65MIRASOL / GOG-3045OVHIPEC-1PAOLA-1 / ENGOT-ov25PRIMA / ENGOT-OV26RAINFOL-01 (Rina-S)RAMP 201REJOICE-Ovarian01ROSELLA / GOG-3073SOLO-1UKCTOCS

pairings

4
Caution: checkpoint inhibitors in first-line ovarian cancerHIPEC at interval cytoreductive surgeryPARP inhibitor + bevacizumab maintenance (HRD-positive)Platinum chemotherapy in HRD tumours

roadmaps

1
ADC roadmap: from Mylotarg to bispecific and dual-payload ADCs

ideas

19
A functional test for homologous recombination deficiency validated across laboratoriesA multi-cancer platform trial of adaptive (dose-holiday) therapyA perpetual platform trial in every major cancer, funded as infrastructureAutomatic germline testing for every cancer type where it changes carectDNA-guided duration of PARP maintenanceEvolution-guided 'adaptive therapy' dosing tested in randomised phase 2 trialsFAPI PET as the workup for MCED positivesGo back to families of women who died of ovarian cancer and offer BRCA testingGroup trials by broken mechanism, not by organ or single mutationIs aneuploidy itself a druggable vulnerability?Make every cold tumour hot: a coordinated programme to reprogramme immune-excluded tumoursOncology teams order germline tests; tele-genetic counsellors handle the resultsOne-two punch: clear senescent cells after chemotherapyPopulation germline screening for hereditary cancer genes with cascade testingRemove the fallopian tubes during any pelvic surgery once childbearing is finishedSequence folate-receptor ADCs by payload classTreat the body cavity, not the bloodstream, for surface spreadTurn chromosomal chaos into a weakness with KIF18A inhibitorsWhich patients' blood clones will become leukaemia after treatment?

collections

1
Ovarian Cancer Research Alliance (OCRA)

people

15
Alan AshworthAmit M. OzaAngelina JolieAnna FagottiAnthony GonçalvesEvanthia GalanisEvelyn LauderGilda RadnerGiovanni ScambiaJudy E. GarberKan YonemoriMary-Claire KingSudeep GuptaSusan M. DomchekUrsula A. Matulonis

bottlenecks

4
Biomarkers are not validated or standardisedCold tumours and the immunosuppressive microenvironmentInherited risk is mostly unidentifiedMost lethal cancers are found late

key papers

4
IARC verdict: excess body fat causes 13 cancersPAOLA-1: olaparib added to bevacizumab maintenance in newly diagnosed ovarian cancer, with benefit confined to HRD-positive tumoursPROSE consortium: preventive surgery lowers cancer and death in BRCA1 and BRCA2 carriersSOLO-1: two years of olaparib maintenance after first-line chemotherapy for BRCA-mutated ovarian cancer