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High-grade serous ovarian cancer: lines of therapy

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5 standard-of-care settings across 4 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comers
Screening, prevention and diagnosis1
Advanced, first line1
Maintenance1
Second line2

Screening, prevention and diagnosis

SubgroupSettingApproachProducts and trialsEvidence
All comersPrevention in carriersRisk-reducing salpingo-oophorectomy around age 35 to 45 by gene; opportunistic salpingectomy at other pelvic surgery for everyone.54

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersFirst lineComplete cytoreductive surgery, primary or after three cycles, with carboplatin-paclitaxel for six cycles; bevacizumab added in stage IV or residual disease.98

Maintenance

SubgroupSettingApproachProducts and trialsEvidence
All comersMaintenance after first lineOlaparib for BRCA-mutant tumours (SOLO-1), niraparib for all comers (PRIMA), olaparib plus bevacizumab for HRD-positive tumours (PAOLA-1).87

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersPlatinum-sensitive relapseSecondary cytoreduction in selected patients (DESKTOP III), platinum doublet, PARP inhibitor maintenance if not already used.88
All comersPlatinum-resistant relapseSingle-agent chemotherapy with or without bevacizumab; mirvetuximab soravtansine for folate receptor alpha-high tumours (MIRASOL); relacorilant with nab-paclitaxel in trials and early approvals.98

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.