Platinum-sensitive ovarian cancer: lines of therapy
5 standard-of-care settings across 2 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Maintenance
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| BRCA / HRD | First-line maintenance, BRCA-mutant | Olaparib for two years (SOLO-1), or olaparib with bevacizumab (PAOLA-1); niraparib as an alternative. | 92 | ||
| BRCA / HRD | First-line maintenance, HRD-positive BRCA-wild-type | Olaparib plus bevacizumab (PAOLA-1) or niraparib (PRIMA) after HRD testing. | 98 | ||
| BRCA / HRD | First-line maintenance, HRD-negative | Niraparib (PRIMA, smaller benefit) or bevacizumab; observation is reasonable after discussion. | 98 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | First platinum-sensitive relapse | Secondary cytoreduction in AGO-score-positive patients (DESKTOP III), then carboplatin doublet with pegylated liposomal doxorubicin, gemcitabine or paclitaxel, bevacizumab if not previously given, and PARP inhibitor maintenance if PARP-naive. | 98 | ||
| All comers | Relapse after PARP inhibitor | Platinum doublet; PARP rechallenge has limited benefit; trials of ATR, WEE1 and next-generation PARP1-selective inhibitors. | 82 |
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.