The first 60 days: Platinum-resistant ovarian cancer
Platinum-resistant ovarian cancer grows back within six months of platinum chemotherapy, or during it, and used to be treated with single chemotherapy drugs that shrink a tumour one time in ten. The antibody-drug conjugate mirvetuximab soravtansine, the cortisol-blocking drug relacorilant and pembrolizumab in PD-L1-positive tumours have each extended survival in phase 3 trials since 2023. Below, week by week, is what OnCo's record of Platinum-resistant ovarian cancer says about the first two months: the order is typical, the timing is yours to ask about. Sections appear only where the record has something to say. Orientation, not medical advice.
What happens now
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
- PathologistNamed in the standard of care for: Supportive care.
- Medical oncologistNamed in the standard of care for: Folate receptor alpha-high, PD-L1 CPS 1 or more, Any expression status, Later lines.
- Palliative and supportive care teamNamed in the standard of care for: Supportive care.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Mirvetuximab soravtansine with ophthalmic monitoring (MIRASOL).
Pembrolizumab with weekly paclitaxel, with bevacizumab where not previously given (KEYNOTE-B96).
Relacorilant with nab-paclitaxel (ROSELLA); or single-agent weekly paclitaxel, pegylated liposomal doxorubicin, topotecan or gemcitabine with bevacizumab if bevacizumab-naive (AURELIA).
Clinical trials of antibody-drug conjugates against CDH6, folate receptor alpha, B7-H4 and TROP2; hormonal therapy in receptor-positive low-grade disease.
Early palliative care, drainage of ascites, management of bowel obstruction and nutritional support alongside anticancer treatment.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Newly diagnosed
- What is my exact diagnosis, stage, and grade, and which tests established them?Everything else follows from an accurate stage and subtype.
- Which biomarkers have been tested on my tumour (for example Platinum-free interval under six months, Folate receptor alpha immunohistochemistry, PD-L1 combined positive score, Prior bevacizumab and PARP inhibitor exposure, CDH6, B7-H4 and TROP2 expression), and what were the results?These results decide eligibility for targeted therapy, immunotherapy, and trials.
- Which subtype is my cancer, and does that change the recommended treatment?Recognised subtypes for this cancer include Platinum-refractory, Platinum-resistant relapse within six months, Folate receptor alpha-high.
- Is germline (inherited) genetic testing recommended for me or my family?Inherited variants can change treatment and matter for relatives.
Folate receptor alpha-high
- For my situation (folate receptor alpha-high), which of the standard options do you recommend and why?Guideline options include: Mirvetuximab soravtansine with ophthalmic monitoring (MIRASOL).
- Am I a candidate for Mirvetuximab soravtansine, and what side effects should I expect?Knowing the expected toxicities helps you plan work, family, and supportive care.
- How do the results of MIRASOL / GOG-3045 apply to someone like me?Trial populations differ from individual patients; ask how closely you match.
PD-L1 CPS 1 or more
- For my situation (pd-l1 cps 1 or more), which of the standard options do you recommend and why?Guideline options include: Pembrolizumab with weekly paclitaxel, with bevacizumab where not previously given (KEYNOTE-B96).
- Am I a candidate for Pembrolizumab, Paclitaxel / nab-paclitaxel, Bevacizumab, and what side effects should I expect?Knowing the expected toxicities helps you plan work, family, and supportive care.
- How do the results of KEYNOTE-B96 / ENGOT-ov65 apply to someone like me?Trial populations differ from individual patients; ask how closely you match.
Any expression status
- For my situation (any expression status), which of the standard options do you recommend and why?Guideline options include: Relacorilant with nab-paclitaxel (ROSELLA); or single-agent weekly paclitaxel, pegylated liposomal doxorubicin, topotecan or gemcitabine with bevacizumab if bevacizumab-naive (AURELIA).
- Am I a candidate for Relacorilant, Paclitaxel / nab-paclitaxel, Pegylated liposomal doxorubicin or related drugs, and what side effects should I expect?Knowing the expected toxicities helps you plan work, family, and supportive care.
- How do the results of ROSELLA / GOG-3073 apply to someone like me?Trial populations differ from individual patients; ask how closely you match.
Later lines
- For my situation (later lines), which of the standard options do you recommend and why?Guideline options include: Clinical trials of antibody-drug conjugates against CDH6, folate receptor alpha, B7-H4 and TROP2; hormonal therapy in receptor-positive low-grade disease.
- Am I a candidate for Raludotatug deruxtecan, Rinatabart sesutecan, Luveltamab tazevibulin or related drugs, and what side effects should I expect?Knowing the expected toxicities helps you plan work, family, and supportive care.
- How do the results of REJOICE-Ovarian01 and RAINFOL-01 (Rina-S) apply to someone like me?Trial populations differ from individual patients; ask how closely you match.
Supportive care
- For my situation (supportive care), which of the standard options do you recommend and why?Guideline options include: Early palliative care, drainage of ascites, management of bowel obstruction and nutritional support alongside anticancer treatment.
Any stage
- Are there clinical trials I could join, for example of Raludotatug deruxtecan, REJOICE-Ovarian01, Rinatabart sesutecan, RAINFOL-01 (Rina-S)?Trials are how the next standard of care is set; asking early keeps options open.
- Would a second opinion at a high-volume centre change anything, and can you help arrange it?Rare or high-stakes decisions benefit from a centre that treats many similar patients.
- What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?Supportive care improves quality of life and helps patients complete treatment.
- I read that “Sequencing antibody-drug conjugates that share topoisomerase or tubulin payloads”. How does that affect my plan?Open problems are where trials and second opinions matter most.
- I read that “Whether platinum resistance can be reversed rather than bypassed”. How does that affect my plan?Open problems are where trials and second opinions matter most.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
- REJOICE-Ovarian01Phase 2/3 · recruiting · NCT06161025Platinum-resistant ovarian cancer, 1-3 prior lines: raludotatug deruxtecan (CDH6 ADC) vs physician's-choice chemotherapy
- RAINFOL-01 (Rina-S)Phase 1/2 · active · NCT05579366Advanced ovarian and endometrial cancer, heavily pretreated: rinatabart sesutecan (FRα ADC, exatecan payload) across FRα expression levels
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
- Platinum-resistant ovarian cancer: the full pagePlatinum-resistant ovarian cancer grows back within six months of platinum chemotherapy, or during it, and used to be treated with single chemotherapy drugs that shrink a tumour one time in ten. The antibody-drug conjugate mirvetuximab soravtansine, the cortisol-blocking drug relacorilant and pembrolizumab in PD-L1-positive tumours have each extended survival in phase 3 trials since 2023.
- One-page appointment sheetYour questions, the words you may hear, what to bring, and space for the answers. Print it.
- Treatment sequencingWhich treatment tends to follow which, line by line.
- NavigatorStandard of care for your stage, what you have tried, and trials near you.