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Ovarian Cancer

A plain-English summary of the published research on Ovarian Cancer, reviewed and approved by our editors — not a hand-curated clinical overview.

Research summary · reviewed
Educational only: This page is not medical advice. Coordinate decisions with your oncology team.

Reviewed Jun 2026 · OncoForge editorial · How we review →

AI extractedhuman reviewedsources checkedretractions suppressed· last updated Jun 2026

Evidence at a glanceHuman trial / meta-analysisMixed results⚠ Studies disagree
165 published studies that name Ovarian Cancer50 human studies approved & graded (trial, observational, or meta-analysis)299 human clinical studies in the Ovarian Cancer corpus2133 source documents in the Ovarian Cancer corpus

last checked June 19, 2026

Why this grade?

Human trial / meta-analysis — Includes human trial or meta-analysis evidence.

Computed deterministically from the studies’ types and reported outcomes — not written by AI, and not a claim that anything works.

What the guidelines say

NCI PDQESMONCCNASCO

We link the authoritative guidelines rather than reproduce them. Below, the treatments on this page are split into standard care, guideline or regulatory options, supportive care, and studied but not standard so established care is not mixed with experimental or supportive items.

Guideline / FDA options - context-specific
  • cisplatin
  • gemcitabine
  • bevacizumab
  • olaparib
  • rucaparib
  • carboplatin
  • relacorilant
  • mirvetuximab soravtansine
Studied, not standard - investigational
  • carboplatin-gemcitabine-bevacizumab
  • carboplatin + pegylated liposomal doxorubicin
  • carboplatin + paclitaxel
  • paclitaxel + carboplatin
  • intraperitoneal chemotherapy
  • chemotherapy
  • paclitaxel
  • pegylated liposomal doxorubicin
  • platinum-based chemotherapy
  • platinum-based combination chemotherapy
  • topotecan
  • trabectedin + pegylated liposomal doxorubicin
  • cytoreductive surgery
  • hyperthermic intraperitoneal chemotherapy
  • IDS + intraoperative HIPEC
  • Interval cytoreductive surgery (IDS)
  • modulated electro-hyperthermia (mEHT)
  • Primary debulking surgery (PDS)
  • risk-reducing bilateral salpingo-oophorectomy
  • secondary cytoreductive surgery
  • radiotherapy
  • metformin
  • niraparib
  • PARP inhibitors
  • talazoparib
  • veliparib
  • maintenance therapy
  • lymphadenectomy
  • fertility-preserving surgery
  • tumour NGS
  • risk-reducing bilateral salpingo-oophorectomy / hysterectomy / mastectomy
  • olaparib + bevacizumab
  • statins
  • Minimally invasive surgery
  • Abdominal (open) surgery
  • nivolumab
  • anastrozole
  • docetaxel
  • Fuzuloparib
  • Genistein
  • irinotecan
  • tamoxifen

Read the guidelines

Cancer-specific deep links aren’t curated yet — these search the authoritative sources for Ovarian Cancer.

Treatment map: Ovarian Cancer

Open as a full page →

Standard care plus every compound studied in the literature (each cited) and graded by evidence, organized by clinical readiness. A category, not a verdict that anything works — confirm anything here with your oncology team.

68
Interventions
0
Standard of care
22
Tested in people
11
Lab / animal
19
Named in lit.
9
Classes
Standard of care (0) Guideline option (16) Tested in people (22) Lab / animal only (11) Named in the literature (19)

Tested in people, by trial phase: Phase III ×2 · phase not reported ×20

Clinical evidence
Preclinical evidence
Standard of care
Guideline option
Tested in people
Lab / animal only
Named in the literature
Surgery & procedures
—
—
11
—
7
Radiotherapy
—
—
—
—
1
Chemotherapy
—
5
3
4
9
Targeted therapy
—
11
4
4
1
Immunotherapy
—
—
1
—
—
Hormonal therapy
—
—
—
2
—
Repurposed drugs
—
—
2
—
—
Supplements & natural agents
—
—
—
1
—
Other
—
—
1
—
1

Columns group into clinical evidence (used in, or tested on, people) and preclinical evidence (lab/animal, or only named in the literature). Cell = number of interventions; a dashed cell means none recorded there.

Established care — detail (16)
Chemotherapy
cisplatinFirst-line (advanced disease)
FDA-approved for this cancer.
—Guideline option
gemcitabine
FDA-approved for this cancer.
—Guideline option
carboplatinAdjuvant (after surgery)
FDA-approved for this cancer.
—Guideline option
cisplatin
FDA-approved for this cancer.
—Guideline option
carboplatin
FDA-approved for this cancer.
—Guideline option
Targeted therapy
bevacizumabMaintenance
FDA-approved for this cancer.
—Guideline option
bevacizumabAdjuvant (after surgery)
FDA-approved for this cancer.
—Guideline option
olaparibFirst-line (advanced disease) · BRCA-mut
FDA-approved for this cancer.
—Guideline option
rucaparibRecurrent or later-line · sBRCA/HRm
FDA-approved for this cancer.
—Guideline option
olaparibbiomarker-selected
FDA-approved for this cancer.
—Guideline option
rucaparibRecurrent or later-line
FDA-approved for this cancer.
—Guideline option
bevacizumab
FDA-approved for this cancer.
—Guideline option
rucaparib
FDA-approved for this cancer.
—Guideline option
olaparib
FDA-approved for this cancer.
—Guideline option
relacorilant
FDA-approved for this cancer.
—Guideline option
mirvetuximab soravtansine
FDA-approved for this cancer.
—Guideline option
Investigational & adjunct compounds — detail (52)
Phase III trial (2)
nivolumabpaclitaxeloff-label
Meta-analysis (20)
Abdominal (open) surgerycarboplatin + paclitaxel· Neoadjuvant (before surgery)chemotherapy· Neoadjuvant (before surgery)hyperthermic intraperitoneal chemotherapy· First-line (advanced disease)hyperthermic intraperitoneal chemotherapyIDS + intraoperative HIPEC· First-line (advanced disease)Interval cytoreductive surgery (IDS)· Neoadjuvant (before surgery)maintenance therapy· MaintenancemetforminMinimally invasive surgeryMinimally invasive surgery· Neoadjuvant (before surgery)Minimally invasive surgery· First-line (advanced disease)Minimally invasive surgery· Adjuvant (after surgery)modulated electro-hyperthermia (mEHT)olaparib + bevacizumab· MaintenancePARP inhibitors· biomarker-selectedPrimary debulking surgery (PDS)· First-line (advanced disease)statinstalazoparib· biomarker-selectedveliparib
Named in the literature
carboplatin-gemcitabine-bevacizumab· Recurrent or later-line · platinum-sensitivecarboplatin + pegylated liposomal doxorubicinpaclitaxel + carboplatinintraperitoneal chemotherapycarboplatin + paclitaxel· First-line (advanced disease)pegylated liposomal doxorubicinplatinum-based chemotherapy· First-line (advanced disease)platinum-based combination chemotherapytrabectedin + pegylated liposomal doxorubicin· Recurrent or later-linecytoreductive surgery· First-line (advanced disease)hyperthermic intraperitoneal chemotherapy· Neoadjuvant (before surgery)risk-reducing bilateral salpingo-oophorectomysecondary cytoreductive surgeryradiotherapy· Recurrent or later-linelymphadenectomyfertility-preserving surgerytumour NGSPARP inhibitors· Maintenancerisk-reducing bilateral salpingo-oophorectomy / hysterectomy / mastectomy

"Tested in people" rows show the highest trial phase found in that compound's cited human studies (Phase I–IV; "phase not reported" = a human study with no phase tag). "Studied" = named in the cited literature for this cancer. "FDA ✓" = FDA-approved for this cancer; "off-label" = an FDA-approved drug used outside its approved indications (per openFDA). Not a claim that anything works.

Reported figures

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Snapshot

The essentials in ~60 seconds — every line is drawn from the cited sources below.

What it is
Epithelial ovarian cancer is the most lethal gynecologic cancer and is usually found at an advanced stage; about 75% are diagnosed at FIGO IIIC–IV, 85%–90% are epithelial in origin, and roughly 70% of epithelial cases are high‑grade serous. [1][2][3][4]
Survival
Overall, less than half of patients live more than five years from diagnosis; five‑year survival for advanced‑stage disease is reported below 29%. [1][2]
Standard treatment
Management centers on cytoreductive surgery by specialized gynecologic oncologists aiming for complete cytoreduction, followed by platinum‑taxane chemotherapy (paclitaxel 175 mg/m2 + carboplatin AUC 5–7.5 every 3 weeks for six cycles); select patients may receive intraperitoneal chemotherapy and maintenance options such as PARP inhibitors or bevacizumab. [5][6][7][1][8][9]
Key test
BRCA (germline and somatic) and homologous recombination deficiency (HRD) testing are key at diagnosis because they guide systemic therapy selection and identify hereditary risk for family management. [10][11][12]
Biggest challenge
Most patients present with late, advanced disease and relapse is common—approximately 70–80% relapse after first‑line platinum‑taxane chemotherapy—while therapeutic options at recurrence remain limited. [2][7][13]

Ask about Ovarian Cancer

Answers come only from the cited sources on this page — with the supporting evidence shown. If the sources here don't cover your question, it will say so. Educational information, not medical advice.

Key numbers & factors

Survival by stage

StageSurvivalNotes
Stage IIIC or IV29 months PDS vs 30 months NACOverall survival reported in the EORTC‑55971 trial comparing primary debulking surgery (PDS) and neoadjuvant chemotherapy (NAC). [7]
advanced-stagebelow 29%Five-year survival reported for advanced-stage disease. [2]

Risk factors

  • ▼ lowers riskPregnancy / parity — Parous women have a 30–60% reduced risk. [14]
  • ▲ increases riskGestational diabetes mellitus (GDM) [14]
  • ▼ lowers riskRegular physical activity (Asian populations) — Associated with a 24% lower ovarian cancer risk. [15]
  • ▲ increases riskSedentary behaviour (Asian populations) — Associated with a 55% higher ovarian cancer risk. [15]
  • ▲ increases riskGermline BRCA1/BRCA2 mutations — Absolute lifetime risk reported for BRCA1 carriers 39–58% and BRCA2 carriers 13–29%. [3]
  • ▲ increases riskAdult BMI — Meta-analysis suggests 8% higher odds per SD. [16]
  • ▲ increases riskSerum estradiol — OR per SD 3.18 (95% CI 1.47–6.87). [16]
  • ▼ lowers riskVitamin D (25‑hydroxyvitamin D) — OR per SD 0.88 (95% CI 0.82–0.95). [16]
  • ▼ lowers riskGenetically indexed HMG‑CoA reductase inhibition (statin proxy) — Associated with a 34% lower odds of ovarian cancer (OR 0.66, 95% CI 0.53–0.82). [16]
  • ◆ mixedSystemic lupus erythematosus (SLE) — No significant association reported (SIR 0.96, 95% CI 0.72–1.28). [17]

Biomarkers

  • BRCA1/BRCA2ActionableIdentifies patients for targeted therapy options and familial cancer‑risk management (germline and somatic testing). [10][12][4]
  • Homologous recombination deficiency (HRD)ActionablePredicts sensitivity and likely magnitude of benefit from PARP inhibitor therapy. [11][18][4]
  • CA‑125 · Routinely used for clinical assessment and monitoring after primary treatment. [19]
  • HE4 and ROMA index · Provide additional diagnostic or surgical‑outcome insight and HE4 has higher specificity than CA‑125. [20][5]
  • C‑reactive protein (CRP) · Prognostic indicator; higher CRP associated with worse overall survival. [21]

10 sections — tap any heading to expand its cited detail. Key points are above.

Overview15 points

Key figures

Survival & outcomes
OutcomeValue95% CI
percent diagnosed at advanced stages70%—
five-year survival rate29%—
Source quotes
  • “Over 70% of patients are diagnosed at advanced stages upon their first diagnosis (2).”
  • “the prognosis of OC has remained unsatisfactory, with the five-year survival rate below 29% in advanced-stage patients (3).”
  • Sources state that most patients have advanced disease at initial diagnosis. [1][2]
  • The cited ACOG document states that, for simplicity in that bulletin, “ovarian cancer” also refers to fallopian tube and primary peritoneal cancers, reflecting contemporary understanding of origins and management. [9][22]
  • About 85%–90% of ovarian cancers are epithelial in origin, and high-grade serous histology is the most common subtype; approximately 70% of all epithelial ovarian cancers are high-grade serous (HGS) adenocarcinoma. [3][4]
  • Hereditary cancer-susceptibility syndromes that increase ovarian cancer risk include Lynch syndrome and hereditary breast and ovarian cancer syndrome; primary genetic mutations associated with hereditary breast and ovarian cancer syndrome include BRCA1 and BRCA2. [23][22]
  • The NCCN Guidelines provide multidisciplinary diagnostic workup, staging, and treatment recommendations for ovarian, fallopian tube, and primary peritoneal cancer and discuss cancers originating in the ovary, fallopian tube, or peritoneum as being managed in a similar manner. [24][25]
  • Ovarian cancer is low in prevalence but has the highest mortality of all gynecologic malignancies; epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States and is the country's fifth most common cause of cancer mortality in women. [26][25]
  • Prognosis for ovarian cancer has remained unsatisfactory, with the five-year survival rate described as below 29% in advanced-stage patients. [2]
  • Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States, with less than half of patients living >5 years from diagnosis. [1]
  • Hereditary breast and ovarian cancer syndrome is an inherited cancer-susceptibility syndrome characterized by multiple family members with breast cancer, ovarian cancer, or both. [12]
  • Ovarian cancer is described as a significant global health challenge and among the most fatal gynecological malignancies. [11]
  • Ovarian cancer exhibits significant ethnic and geographic disparities, with rising incidence in Asia contrasted with global declines. [15]
  • Approximately 75% of ovarian cancers are diagnosed at advanced stages (FIGO IIIC–IV). [3]
  • Conventional diagnosis principally depends on imaging techniques, serum biomarkers, and histological biopsy; the sensitivity and specificity of imaging techniques and biomarkers are reported to be limited, histopathological testing is inherently invasive, and there is an urgent need for more accurate, noninvasive, and reliable diagnostic methods. [27]
  • Clinical genetic testing for gene mutations allows more precise identification of women who are at increased risk of inherited breast cancer and ovarian cancer, and if a gynecologic care provider lacks necessary knowledge or expertise in cancer genetics, referral to a genetic counselor, gynecologic or medical oncologist, or other genetics specialist should be considered. [22]
  • A 2024 meta-analysis concluded that minimally invasive surgery (MIS) did not negatively impact the survival and perioperative complications of patients with epithelial ovarian cancer compared to abdominal surgery. [28]
Epidemiology20 points

Key figures

Survival & outcomes
OutcomeValue95% CI
annual deaths200000—
Source quotes
  • “EOC is the second most deadly gynaecological cancer worldwide and the first in developed countries, responsible for some 200,000 deaths annually.”
  • Epithelial ovarian cancer is the second most deadly gynaecological cancer worldwide and is responsible for about 200,000 deaths annually. [13]
  • More than 95% of ovarian cancer deaths occur among women 45 years and older. [29]
  • Randomized controlled trials have not demonstrated a mortality benefit for ovarian cancer screening and there is insufficient evidence to recommend ovarian cancer screening in the average-risk postmenopausal population studied. [30]
  • Hereditary breast and ovarian cancer syndrome is an inherited cancer-susceptibility syndrome. [31]
  • Approximately 70% of ovarian cancer cases are diagnosed at an advanced stage (FIGO stage III or IV). [11]
  • The five-year survival rate for patients with advanced-stage ovarian cancer is reported to remain below 30%. [11]
  • Pregnancy is associated with a lower risk of ovarian cancer, with parous women having a 30–60% reduced risk. [14]
  • In Asian populations, regular physical activity was associated with a 24% lower ovarian cancer risk, while sedentary behaviour was associated with a 55% higher ovarian cancer risk. [15]
  • Epithelial ovarian cancer (EOC) accounts for over 90% of all cases. [16]
  • Ovarian cancer (OC) is the third most common and the deadliest gynaecological cancer. [16]
  • In 2020, it was estimated there would be 21,750 new cases of ovarian cancers diagnosed in the United States and an estimated 13,940 women would die of the disease. [4]
  • The Colombian consensus gives the absolute annual number of cases as 1,445 per year in the country. [3]
  • Ovarian cancer accounts for approximately 4.4% of female cancer diagnoses. [32]
  • A woman’s risk of getting ovarian cancer during her lifetime is approximately 1 in 78 and her lifetime chance of dying of ovarian cancer is about 1 in 108. [4]
  • Many ovarian cancers are high-grade aggressive malignancies for which favorable survival is encountered only in early-stage disease. [26]
  • Epithelial ovarian cancer is described by the NCCN as the leading cause of death from gynecologic cancer in the United States and the fifth most common cause of cancer mortality in women. [25]
  • Ovarian cancer accounts for 1.6% of newly diagnosed cancer cases and 2.1% of cancer-associated mortality worldwide annually; approximately 313,959 new cases of ovarian cancer and 207,252 ovarian cancer-related deaths were reported globally in 2020. Reported 5-year survival and recurrence rates for ovarian cancer remain around 39% and 70%, respectively. [21]
  • Gestational diabetes mellitus (GDM) has been linked to an increased risk of ovarian cancer in observational syntheses. [14]
  • A meta-analysis reported no significant association between systemic lupus erythematosus (SLE) and ovarian cancer (standardized incidence ratio 0.96, 95% CI 0.72–1.28). [17]
  • The same meta-analysis reported that subgroup analyses indicated regional variations in cancer risk and that patients from developed countries had lower ovarian cancer risk than those from developing countries (SIR = 0.82, 95% CI 0.59–1.60). [17]
Key biomarkers25 points

Key figures

Survival & outcomes
OutcomeValue95% CI
proportion with BRCA1/2 PV detected in tumour samples15%—
proportion with somatic-only BRCA1/2 variant7%—
Prognostic factors
FactorEffectHR (95% CI)p
HR for progression-free survival▲ worse1.55 (1.3–1.84)< 0.001
HR for overall survival▲ worse1.23 (1.11–1.37)< 0.001
Source quotes
  • “Analysis of ovarian tumour samples allows the detection of a BRCA1/2 PV in approximately 15% of patients, including ~7% with a somatic-only variant [41].”
  • “Combined data demonstrated that high CRP levels exhibited an obvious relationship with poor PFS in those with OC (HR 1.55 [95% CI 1.30–1.84]; p < 0.001) (Table 3, Fig. 3).”
  • “Higher CRP levels demonstrated remarkable utility in predicting poor OS among patients with OC (HR 1.23 [95% CI 1.11–1.37]; p < 0.001) (Fig. 2, Table 2).”
  • Clinical guidelines and society statements recommend or mandate BRCA/genetic testing in ovarian cancer patients to identify those with a higher probability of benefit from specific anticancer treatments and to identify pathogenic-variant carriers for familial cancer-risk management. [10][6][31]3 sources
  • The NCCN Genetic/Familial High-Risk Assessment guidelines are intended to help identify individuals who may benefit from cancer risk assessment and genetic counseling and testing and provide recommendations for genetic testing, counseling, and risk management for hereditary cancer syndromes. [33][34]
  • High-grade serous epithelial ovarian cancer (HGSOC) comprises more than 70% of all ovarian cancer. [32]
  • Threshold CRP values used across studies varied, reported as 3.5–70 mg/L (median, 10 mg/L) in the included literature. [21]
  • The Practice Bulletin focuses on the primary genetic mutations associated with hereditary breast and ovarian cancer syndrome, BRCA1 and BRCA2. [12]
  • Both BRCA mutations and homologous recombination deficiency (HRD) status are described as pivotal predictive biomarkers in ovarian cancer. [11]
  • PARP inhibitors are described as available for the treatment of ovarian cancer patients independently of the presence of a BRCA pathogenic variant. [10]
  • Germline alterations in breast cancer 1 (gBRCA1) and breast cancer 2 (gBRCA2) genes have been identified in up to 17% of women diagnosed with epithelial ovarian cancer (EOC), and somatic mutations are found in an additional 7%. [4]
  • High-grade serous ovarian cancer is associated with BRCA germline mutation in about 20% of cases. [7]
  • Following primary treatment for ovarian cancer, clinical assessment and CA-125 are routinely used to monitor patients. [19]
  • Biomarkers such as human epididymis protein 4 (HE4) and composite models including the Ovarian Malignancy Risk Algorithm (ROMA) index and Suidan score have been reported to provide insights into surgical outcomes and predictive capabilities. [20]
  • The Colombian consensus states that germline BRCA1 mutation carriers have an absolute lifetime risk of epithelial ovarian cancer of 39–58% and BRCA2 carriers 13–29%. [3]
  • Approximately 41%–50% of epithelial ovarian cancers (EOCs) are estimated to exhibit homologous recombination deficiency (HRD). [4]
  • Homologous recombination repair deficiency (HRD) is a frequent feature of high-grade serous ovarian, fallopian tube and peritoneal carcinoma (HGSC) and is associated with sensitivity to PARP inhibitor (PARPi) therapy; clinical-trial evidence supports BRCA mutation testing and use of commercially available assays that incorporate genomic instability to identify HGSC subgroups with different magnitudes of benefit from PARPi therapy. [18]
  • The SEOM guideline states that CA 125 and HE4 are included in the Risk of Ovarian Malignancy Algorithm (ROMA) and that HE4 has higher specificity than CA 125. [5]
  • The source notes growing application of AI methods to discover and evaluate noninvasive blood biomarkers for ovarian cancer diagnosis. [27]
  • Serum estradiol was positively associated with overall ovarian cancer (OR per SD 3.18, 95% CI 1.47–6.87). [16]
  • Vitamin D concentrations (indexed by 25-hydroxyvitamin D) were negatively associated with overall ovarian cancer (OR per SD 0.88, 95% CI 0.82–0.95). [16]
  • Genetically indexed HMG-CoA reductase inhibition (a genetic proxy for statin use) was associated with a 34% lower odds of ovarian cancer per SD increase (OR 0.66, 95% CI 0.53–0.82). [16]
  • Birth weight and comparative body size at age 10 years were robustly associated with invasive mucinous and overall ovarian cancer, respectively. [16]
  • The NCCN Guidelines Insights summarize recommendations regarding criteria for high-penetrance genes beyond BRCA1/2 and genetic testing for the purpose of systemic therapy decision-making. [34]
  • A recent meta-analysis reports that AI-based approaches using blood biomarkers show satisfactory performance for ovarian cancer diagnosis. [27]
  • A multicenter retrospective study integrating 20 base AI models was reported to have performed well internally and externally and to have outperformed the CA125 and HE4 biomarkers in identifying ovarian cancer. [27]
  • A meta-analysis of AI-assisted ovarian cancer diagnosis using blood samples included a total of 40 studies; among these, 36 of 40 (90%) were classified as machine learning and 4 of 40 (10%) as deep learning, most studies (36/40, 90%) validated their algorithms while only some (7/40, 18%) carried out external validation, the blood samples were mainly serum (27/40, 68%), the biomarker type was mainly protein (25/40, 62%), and the meta-analysis used a bivariate diagnostic random effects model to compute summary receiver operating characteristics for sensitivity, specificity, and area under the curve (AUC); the source states that, in general, an AUC greater than 0.80 is considered good. [27]
  • Adult BMI was consistently linked to a higher risk of overall and invasive ovarian cancer, with meta-analysis suggesting 8% higher odds per SD (OR 1.08, 95% CI 1.002–1.15, P-value = .043). [16]
Standard management20 points

Key figures

Survival & outcomes
OutcomeValue95% CI
median overall survival (PDS arm) · no clear difference29 vs 30 months—
complete gross resection rate · favors the studied regimen43.3 vs 41%—
median overall survival in patients treated by low-volume clinicians · favors the comparator32.8 vs 41.9 months—
Prognostic factors
FactorEffectHR (95% CI)p
adjusted hazard ratio for mortality associated with low-volume clinicians vs higher-volume clinicians▲ worse1.25 (1.08–1.43)—
Source quotes
  • “The EORTC-55971 trial showed that in women with stage IIIC or IV ovarian cancer, primary debulking surgery followed by at least six cycles of platinum-based chemotherapy or three cycles of platinum-based NAC, followed by interval debulking surgery, and then at least three more cycles of platinum-based chemotherapy, achieved the same OS (29 months PDS vs 30 months NAC)”
  • “High-volume hospitals also had higher rates of complete gross resection (43.3%) compared to low- (41.0%) and intermediate-(41.6%) volume centers and, after adjustments, patients in low- and intermediate-volume centers had lower odds of complete resection (OR, 0.85 [95% CI, 0.74 to 0.97] and OR, 0.90 [95% CI, 0.82 to 0.99], respectively).67”
  • “Worse survival outcomes were observed for patients treated by low-volume clinicians (median OS, 32.8 months) compared to medium-(41.9 months) and high-volume clinicians (42.1 months; P < .01), with low-volume clinicians associated with higher mortality rates (adjusted hazard ratio [HR], 1.25 [95% CI, 1.08 to 1.43]) and lower chemotherapy compliance (64.5% v 72.2% and 71.7%, P = .02).66”
  • Visible residual disease after cytoreduction is a major prognostic factor with an important negative impact on survival, and therefore the goal of cytoreductive surgery is to obtain complete cytoreduction. [5][9][3]3 sources
  • Sources suggest neoadjuvant chemotherapy followed by interval cytoreductive surgery when complete cytoreduction is unlikely due to unresectable metastatic disease (per imaging/laparoscopy/laparotomy) or when poor performance status/comorbidities increase perioperative risk; selection between PCS and NACT depends on the likelihood of complete cytoreduction and the patient’s risk profile. [3][20]
  • Accurate pretreatment imaging is integral to determining appropriate first-line therapy and to inform decisions about primary cytoreduction or need for neoadjuvant chemotherapy; diffusion-weighted imaging (DWI) demonstrates high pooled sensitivity and specificity for differentiating benign from malignant ovarian lesions and should be considered a promising non-invasive, not standalone diagnostic tool. [35][36]
  • Surgery for ovarian cancer is recommended to be performed by experienced, specially trained gynecologic oncologists in specialised cancer centres; laparoscopic and/or radiological staging can help prognosticate the possibility of complete cytoreduction (CC0) and reduce unnecessary laparotomies. [6][7]
  • Recent guideline updates include the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) and note the role of PARP inhibitors and bevacizumab as maintenance therapy options in select patients who have completed primary chemotherapy; intraperitoneal chemotherapy and CA‑125 monitoring have also been discussed in guideline updates. [1][8]
  • Clinical guidelines address fertility‑sparing strategies and follow-up, and define multidisciplinary protocols for managing tubo‑ovarian and other gynecological cancers during pregnancy. [37][38]
  • Women with adnexal masses should be assessed for personal risk factors, history, and physical findings to triage management and referral; guidelines on benign ovarian masses encourage conservative management and provide criteria for referral of patients with ultrasound findings suggestive of a malignant mass to a gynaecologic oncologist; ovarian cancer outcomes are improved when initial surgery is performed by a gynaecologic oncologist, likely due to complete surgical staging and optimal cytoreduction. [39][40]
  • High-volume hospitals had higher rates of complete gross resection (43.3%) compared to low- (41.0%) and intermediate- (41.6%) volume centres, and after adjustment patients in lower-volume centres had lower odds of complete resection; patients treated by low-volume clinicians had worse survival (median OS 32.8 months) and higher mortality (adjusted HR 1.25 [95% CI, 1.08 to 1.43]). [20]
  • Standard first‑line chemotherapy should include paclitaxel (175 mg/m2) and carboplatin (AUC 5–7.5) every 3 weeks for six cycles. [7]
  • Intraperitoneal chemotherapy, when part of the chemotherapy is administered directly into the peritoneal cavity, has been found in multiple randomized studies and a meta‑analysis to improve progression‑free and overall survival but is associated with increased toxicity. [7]
  • The EORTC‑55971 trial showed that in women with stage IIIC or IV ovarian cancer, primary debulking surgery followed by at least six cycles of platinum‑based chemotherapy or three cycles of platinum‑based neoadjuvant chemotherapy followed by interval debulking and then at least three more cycles achieved the same overall survival (29 months PDS vs 30 months NAC). [7]
  • The USPSTF recommends against screening for ovarian cancer in asymptomatic women who are not known to have a high‑risk hereditary cancer syndrome. [29]
  • Aggregated studies report high diagnostic odds ratios for [68Ga]Ga‑FAPI PET in detecting primary tumors and lymph node metastases in breast, ovarian, and cervical cancers. [41]
  • A recent review described current therapies for ovarian cancer as unsatisfactory. [42]
  • The NCCN selection includes updated algorithms addressing less common ovarian histopathologies (LCOHs) such as clear cell, mucinous, and low-grade serous/endometrioid carcinomas. [43]
  • Obstetrician-gynecologists play an important role in the identification and management of women with hereditary breast and ovarian cancer syndrome. [22]
  • NCCN genetic/familial high‑risk assessment guidelines are intended to guide decisions related to genetic testing and facilitate multidisciplinary care for individuals at increased hereditary risk. [33]
  • The NCCN Guidelines focus on aspects of primary treatment including primary surgery, adjuvant therapy, and maintenance therapy options (including PARP inhibitors) after completion of first-line chemotherapy. [25]
  • A systematic review and meta-analysis reported that CNN-based algorithms achieve high diagnostic accuracy for ovarian cancer detection across multiple imaging modalities. [44]
  • A 2024 meta-analysis stated that while minimally invasive surgery (MIS) is a viable option, varied case selection and surgical procedures suggest potential bias and require further validation studies. [28]
Treatments & compounds studied56 treatments

Chemotherapy

  • carboplatin-gemcitabine-bevacizumab: Recurrent or later-line · platinum-sensitiveA randomized trial adding bevacizumab to carboplatin-gemcitabine in platinum-sensitive relapse demonstrated a significant improvement in progression-free survival without impact on overall survival, and this regimen is described as a standard option in that population. [7]
  • carboplatin + pegylated liposomal doxorubicin (PLD): For patients not eligible to receive a taxane (specifically paclitaxel), the combination of carboplatin and pegylated liposomal doxorubicin (PLD) is presented as an alternative option. [7]
  • Carboplatin plus paclitaxel · 3 findings
    • Neoadjuvant (before surgery)Carboplatin plus paclitaxel was the platinum-based regimen used for neoadjuvant chemotherapy in the included trials, with doses described as 5–6 mg/mL/min carboplatin and 175 mg/m² paclitaxel. [2]
    • A Japanese study evaluated dose-dense weekly paclitaxel with carboplatin and reported benefit in progression-free and overall survival whereas the MITO-7 trial did not confirm this, leading to a conclusion that dose-dense regimens cannot be consistently recommended in Caucasian populations. [7]
    • First-line (advanced disease)Paclitaxel plus carboplatin every 3 weeks for six cycles is recommended as standard first-line chemotherapy. [7]
  • Cisplatin: First-line (advanced disease)Among the trials that incorporated intraoperative HIPEC, cisplatin was used in two studies at 75 mg/m² and in one study at 100 mg/m². [2]
  • gemcitabine: Gemcitabine is listed as a non‑platinum single-agent palliative option for patients with progression-free interval less than 6 months. [7]
  • Intraperitoneal chemotherapy · 2 findings
    • Intraperitoneal chemotherapy was one of the specific topics discussed in the 2013 NCCN Guidelines insights for ovarian cancer. [8]
    • Intraperitoneal chemotherapy has been reported in randomized studies to improve PFS and OS in some trials, but recent evidence and consensus indicate IP chemotherapy is not currently a standard of care. [5]
  • Neoadjuvant chemotherapy (NACT) · chemotherapy · 2 findings
    • Neoadjuvant (before surgery)Neoadjuvant chemotherapy followed by interval cytoreductive surgery was reported in randomized trials and meta-analyses to be noninferior to primary cytoreductive surgery for survival outcomes and to reduce perioperative complications. [20]
      suboptimal cytoreduction rate 2 vs 11.1% vs CT
      Source quote
      • “A lower suboptimal cytoreduction rate in the laparoscopy group (2.0%) versus in the CT group (11.1%) has been reported,51 and laparoscopy had a higher AUC (0.955) compared to CT (0.755) in predicting optimal cytoreduction.60”
    • Neoadjuvant (before surgery)Neoadjuvant chemotherapy (NACT) followed by interval cytoreductive surgery is presented as an alternative strategy for some patients with advanced ovarian cancer. [2]
  • paclitaxel: Single-agent paclitaxel is listed as a non‑platinum palliative option for patients with progression-free interval less than 6 months. [7]
  • pegylated liposomal doxorubicin (PLD) · pegylated liposomal doxorubicin: Pegylated liposomal doxorubicin (PLD) is listed as a non‑platinum single-agent palliative option for patients with progression-free interval less than 6 months. [7]
  • platinum-based chemotherapy: First-line (advanced disease)Combination platinum-based chemotherapy is described as part of the primary treatment associated with the best outcomes when given with complete resection of all visible disease. [1]
  • platinum-based combination chemotherapy: Platinum-based combination chemotherapy is described as the standard systemic therapy following cytoreductive surgery for advanced ovarian cancer. [7]
  • topotecan: Topotecan is listed as a non‑platinum single-agent palliative option for patients with progression-free interval less than 6 months. [7]
  • trabectedin + pegylated liposomal doxorubicin (PLD): Recurrent or later-lineA subgroup analysis of a randomized trial reported that patients with a progression-free interval of 6–12 months at relapse obtained an increment in overall survival when treated with trabectedin plus PLD compared with PLD alone. [7]
  • carboplatin: Adjuvant (after surgery)Carboplatin monotherapy is reported as a potentially appropriate adjuvant option in selected early-stage patients. [13]

Targeted therapy

  • bevacizumab · 3 findings
    • MaintenanceBevacizumab is noted as a maintenance therapy option in select patients who have completed primary chemotherapy. [1][7]
    • Adjuvant (after surgery)Bevacizumab in combination with chemotherapy was discussed as a topic in the NCCN Guidelines updates for primary adjuvant treatment. [45]
    • MaintenanceBevacizumab added to initial chemotherapy followed by maintenance improved progression‑free survival in GOG-218 and ICON7, and the SEOM guideline states bevacizumab (15 mg/kg or 7.5 mg/kg every 3 weeks for up to 15 months) should be considered in addition to carboplatin and paclitaxel, especially for patients with stage III and residual disease or stage IV. [5]
  • niraparib · 2 findings
    • First-line (advanced disease)Niraparib is reported from a Phase III trial in newly diagnosed advanced ovarian cancer with an overall progression-free survival hazard ratio of 0.62. [11]
      HR 0.62 vs placeboHR 0.3 vs placebotime to progression 9.5 months
      Source quotes
      • “González-Martín et al. (35)Phase III RCTNewly diagnosed advanced OC733NiraparibPlaceboPFSHR 0.62 (overall)”
      • “Moore et al. (34) Phase III RCTNewly diagnosed BRCA-mut OC391OlaparibPlaceboPFSHR 0.30”
      • “Pan et al. (27)RetrospectiveRecurrent OC (sBRCA/HRm)20Olaparib/Niraparib/RucaparibNoneTTP9.5 mo”
    • biomarker-selectedNiraparib after response to first‑line platinum‑based chemotherapy is reported as recommended for BRCA‑mutated patients and can be considered in HRD and some HR‑proficient subgroups according to SEOM. [5]
  • olaparib · 2 findings
    • First-line (advanced disease) · BRCA-mutOlaparib is reported in randomized and cohort studies of BRCA-mutated ovarian cancer and a Phase III trial in newly diagnosed BRCA-mutated disease is listed with progression-free survival hazard ratio 0.30. [11]
      HR 0.62 vs placeboHR 0.3 vs placebotime to progression 9.5 months
      Source quotes
      • “González-Martín et al. (35)Phase III RCTNewly diagnosed advanced OC733NiraparibPlaceboPFSHR 0.62 (overall)”
      • “Moore et al. (34) Phase III RCTNewly diagnosed BRCA-mut OC391OlaparibPlaceboPFSHR 0.30”
      • “Pan et al. (27)RetrospectiveRecurrent OC (sBRCA/HRm)20Olaparib/Niraparib/RucaparibNoneTTP9.5 mo”
    • biomarker-selectedOlaparib (with or without bevacizumab) or niraparib after response to first‑line platinum‑based chemotherapy are reported as recommended for BRCA‑mutated patients according to the SEOM guideline. [5]
  • PARP inhibitors · 2 findings
    • biomarker-selectedPARP inhibitors are described as available for the treatment of ovarian cancer patients independently of the presence of a BRCA pathogenic variant. [10][11]
      HR 0.62 vs placeboHR 0.3 vs placebotime to progression 9.5 months
      Source quotes
      • “González-Martín et al. (35)Phase III RCTNewly diagnosed advanced OC733NiraparibPlaceboPFSHR 0.62 (overall)”
      • “Moore et al. (34) Phase III RCTNewly diagnosed BRCA-mut OC391OlaparibPlaceboPFSHR 0.30”
      • “Pan et al. (27)RetrospectiveRecurrent OC (sBRCA/HRm)20Olaparib/Niraparib/RucaparibNoneTTP9.5 mo”
    • MaintenanceMaintenance treatment with PARP inhibitors after response to first‑line platinum‑containing chemotherapy increased median progression‑free survival in high‑grade serous ovarian cancer in four randomized phase III trials (SOLO‑1, PRIMA, PAOLA‑1, VELIA). [5]
  • rucaparib · 2 findings
    • Recurrent or later-lineRucaparib received FDA approval for treatment of g/sBRCA recurrent disease in 2016. [4]
      HR for PFS olaparib vs placebo (SOLO1) 0.3 (95% CI 0.23–0.41) vs placebomedian PFS (niraparib vs placebo) overall population 13.8 vs 8.2 months vs placeboHR for PFS niraparib vs placebo (PRIMA) 0.62 (95% CI 0.5–0.76), p < .001 vs placebomedian PFS (olaparib + bevacizumab vs placebo + bevacizumab) ITT 22.1 vs 16.6 months, p < .0001 vs placebo + bevacizumabHR for PFS olaparib + bevacizumab vs placebo + bevacizumab (PAOLA-1) 0.59 (95% CI 0.49–0.72), p < .0001 vs placebo + bevacizumabmedian PFS (veliparib induction + maintenance vs placebo) overall population 23.5 vs 17.3 months, p < .001 vs placeboHR for PFS veliparib vs placebo (VELIA) 0.68 (95% CI 0.56–0.83), p < .001 vs placebo
      Source quotes
      • “The trial showed that maintenance with olaparib improved PFS compared with placebo (hazard ratio [HR], 0.30; 95% CI, 0.23 to 0.41).”
      • “In the overall population, a significant benefit in median duration of PFS was seen with niraparib over placebo (13.8 months v 8.2 months; HR, 0.62; 95% CI, 0.50 to 0.76; P < .001).”
      • “In the overall population, a significant benefit in median duration of PFS was seen with niraparib over placebo (13.8 months v 8.2 months; HR, 0.62; 95% CI, 0.50 to 0.76; P < .001).”
      • “A statistically significant improvement in PFS was demonstrated in the ITT population compared with placebo (median PFS, 22.1 months v 16.6 months; HR, 0.59; 95% CI, 0.49 to 0.72; P < .0001).”
      • “A statistically significant improvement in PFS was demonstrated in the ITT population compared with placebo (median PFS, 22.1 months v 16.6 months; HR, 0.59; 95% CI, 0.49 to 0.72; P < .0001).”
      • “In the overall population, the median PFS was 23.5 months in the induction and maintenance veliparib group compared with 17.3 months in those receiving placebo (HR, 0.68; 95% CI, 0.56 to 0.83; P < .001).”
      • “In the overall population, the median PFS was 23.5 months in the induction and maintenance veliparib group compared with 17.3 months in those receiving placebo (HR, 0.68; 95% CI, 0.56 to 0.83; P < .001).”
    • Recurrent or later-line · sBRCA/HRmRucaparib is listed among PARP inhibitors assessed in retrospective studies of recurrent ovarian cancer reporting a time-to-progression of 9.5 months in a small series. [11]
      HR 0.62 vs placeboHR 0.3 vs placebotime to progression 9.5 months
      Source quotes
      • “González-Martín et al. (35)Phase III RCTNewly diagnosed advanced OC733NiraparibPlaceboPFSHR 0.62 (overall)”
      • “Moore et al. (34) Phase III RCTNewly diagnosed BRCA-mut OC391OlaparibPlaceboPFSHR 0.30”
      • “Pan et al. (27)RetrospectiveRecurrent OC (sBRCA/HRm)20Olaparib/Niraparib/RucaparibNoneTTP9.5 mo”
  • talazoparib: biomarker-selectedTalazoparib is listed among PARP inhibitors considered in the systematic review search strategy for BRCA-mutated ovarian cancer. [11]
    HR 0.62 vs placeboHR 0.3 vs placebotime to progression 9.5 months
    Source quotes
    • “González-Martín et al. (35)Phase III RCTNewly diagnosed advanced OC733NiraparibPlaceboPFSHR 0.62 (overall)”
    • “Moore et al. (34) Phase III RCTNewly diagnosed BRCA-mut OC391OlaparibPlaceboPFSHR 0.30”
    • “Pan et al. (27)RetrospectiveRecurrent OC (sBRCA/HRm)20Olaparib/Niraparib/RucaparibNoneTTP9.5 mo”
  • veliparib: In Stage III–IV OC, addition of veliparib to chemotherapy was reported in a Phase III randomized trial with a PFS hazard ratio of 0.68 in the intent-to-treat population. [11]
    HR 0.68 vs placebo (with chemotherapy)
    Source quote
    • “Coleman et al. (36)Phase III RCTStage III–IV OC1140Veliparib + chemoPlaceboPFSHR 0.68 (ITT)”
  • olaparib + bevacizumab: MaintenanceOlaparib given with bevacizumab as first-line maintenance was reported to improve median PFS to 22.1 months versus 16.6 months with placebo and bevacizumab (HR, 0.59; 95% CI, 0.49 to 0.72; P < .0001) in the PAOLA-1 trial. [4]
    HR for PFS olaparib vs placebo (SOLO1) 0.3 (95% CI 0.23–0.41) vs placebomedian PFS (niraparib vs placebo) overall population 13.8 vs 8.2 months vs placeboHR for PFS niraparib vs placebo (PRIMA) 0.62 (95% CI 0.5–0.76), p < .001 vs placebomedian PFS (olaparib + bevacizumab vs placebo + bevacizumab) ITT 22.1 vs 16.6 months, p < .0001 vs placebo + bevacizumabHR for PFS olaparib + bevacizumab vs placebo + bevacizumab (PAOLA-1) 0.59 (95% CI 0.49–0.72), p < .0001 vs placebo + bevacizumabmedian PFS (veliparib induction + maintenance vs placebo) overall population 23.5 vs 17.3 months, p < .001 vs placeboHR for PFS veliparib vs placebo (VELIA) 0.68 (95% CI 0.56–0.83), p < .001 vs placebo
    Source quotes
    • “The trial showed that maintenance with olaparib improved PFS compared with placebo (hazard ratio [HR], 0.30; 95% CI, 0.23 to 0.41).”
    • “In the overall population, a significant benefit in median duration of PFS was seen with niraparib over placebo (13.8 months v 8.2 months; HR, 0.62; 95% CI, 0.50 to 0.76; P < .001).”
    • “In the overall population, a significant benefit in median duration of PFS was seen with niraparib over placebo (13.8 months v 8.2 months; HR, 0.62; 95% CI, 0.50 to 0.76; P < .001).”
    • “A statistically significant improvement in PFS was demonstrated in the ITT population compared with placebo (median PFS, 22.1 months v 16.6 months; HR, 0.59; 95% CI, 0.49 to 0.72; P < .0001).”
    • “A statistically significant improvement in PFS was demonstrated in the ITT population compared with placebo (median PFS, 22.1 months v 16.6 months; HR, 0.59; 95% CI, 0.49 to 0.72; P < .0001).”
    • “In the overall population, the median PFS was 23.5 months in the induction and maintenance veliparib group compared with 17.3 months in those receiving placebo (HR, 0.68; 95% CI, 0.56 to 0.83; P < .001).”
    • “In the overall population, the median PFS was 23.5 months in the induction and maintenance veliparib group compared with 17.3 months in those receiving placebo (HR, 0.68; 95% CI, 0.56 to 0.83; P < .001).”

Radiotherapy

  • radiation therapy · radiotherapy: Recurrent or later-lineRadiation therapy is listed among treatment choices for recurrent disease when confirmed by imaging or clinical examination. [46]

Repurposed drugs

  • metformin: Metformin was evaluated in a meta-analysis of five randomized controlled trials across gynecologic malignancies and the pooled analysis showed no significant difference in progression-free survival (HR = 0.76, 95% CI: 0.55–1.03, p = 0.180). [47]
  • statins: Genetically indexed HMG-CoA reductase inhibition (a genetic proxy for statin use) was associated with a 34% lower odds of ovarian cancer per SD increase (OR 0.66, 95% CI 0.53–0.82). [16]

Procedures & devices

  • cytoreductive surgery: First-line (advanced disease)Cytoreductive surgery (complete resection of all visible disease) is described as part of primary treatment associated with the best outcomes and surgical management is stated to have a significant impact on overall survival and progression-free survival. [6][1]
  • hyperthermic intraperitoneal chemotherapy (HIPEC) · hyperthermic intraperitoneal chemotherapy · 3 findings
    • Hyperthermic intraperitoneal chemotherapy (HIPEC) at interval cytoreductive surgery has been evaluated in trials that the guideline authors assessed as being at low risk of bias. [20]
      suboptimal cytoreduction rate 2 vs 11.1% vs CT
      Source quote
      • “A lower suboptimal cytoreduction rate in the laparoscopy group (2.0%) versus in the CT group (11.1%) has been reported,51 and laparoscopy had a higher AUC (0.955) compared to CT (0.755) in predicting optimal cytoreduction.60”
    • Neoadjuvant (before surgery)A randomized phase III trial reported better overall survival with HIPEC after interval debulking surgery, but the trial has methodological criticisms and HIPEC is not considered standard and should not be offered outside clinical trials. [5]
    • First-line (advanced disease)Hyperthermic intraperitoneal chemotherapy (HIPEC) is described as combining intraperitoneal chemotherapy with hyperthermia, and during HIPEC heat is reported to exert direct cytotoxic effects on tumor cells and enhance drug uptake. [2]
  • IDS with intraoperative HIPEC: First-line (advanced disease)The network meta-analysis ranked IDS plus intraoperative HIPEC highest for overall and disease-free survival (SUCRA = 0.99). [2]
  • Interval cytoreductive surgery (IDS): Neoadjuvant (before surgery)Interval cytoreductive surgery (IDS) denotes the group of patients treated with neoadjuvant chemotherapy followed by surgery in the trials included in the review. [2]
  • Primary debulking surgery (PDS): First-line (advanced disease)Primary debulking surgery (PDS) is described as the initial cytoreductive procedure performed prior to chemotherapy and is a specific type of cytoreductive surgery. [2]
  • risk-reducing bilateral salpingo-oophorectomy: Risk-reducing bilateral salpingo-oophorectomy is reported to be associated with an expected risk reduction of up to 90% in women predisposed to hereditary breast and ovarian cancer (HBOC). [48]
    risk reduction 90%
    Source quote
    • “We may expect a risk reduction of up to 90% in women predisposed to HBOC who undergo risk-reducing bilateral salpingo-oophorectomy.”
  • secondary cytoreductive surgery: Secondary cytoreduction may be appropriate in selected patients despite there being no level 1 evidence demonstrating a survival advantage. [7]
  • lymphadenectomy: In primary fully resected advanced ovarian cancer with clinically negative lymph nodes, lymphadenectomy is no longer recommended. [13]
  • fertility-preserving surgery: Fertility-preserving surgery may be considered in stage IA or IC disease with unilateral ovarian involvement and low histologic grade. [13]
  • risk-reducing bilateral salpingo-oophorectomy / hysterectomy / mastectomy: Guideline documents address risk‑reducing operations including bilateral salpingo‑oophorectomy, hysterectomy and mastectomy as part of management of hereditary cancer predisposition. [49]
  • Minimally invasive surgery · 4 findings
    • Minimally invasive surgery for primary staging surgery (PSS) in early-stage epithelial ovarian cancer was associated with similar overall survival compared with abdominal surgery (PSS: OR 1.02, 95% CI 0.75-1.37, P > 0.05). [28]
    • Neoadjuvant (before surgery)Minimally invasive surgery after neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) was associated with similar overall survival compared with abdominal surgery (NACT-IDS: OR 0.93, 95% CI 0.25-3.44, P > 0.05). [28]
    • First-line (advanced disease)Minimally invasive surgery for upfront primary debulking surgery (PDS) in advanced-stage epithelial ovarian cancer was associated with similar overall survival compared with abdominal surgery (PDS: OR 0.66, 95% CI 0.36-1.22, P > 0.05). [28]
    • Adjuvant (after surgery)Minimally invasive surgery showed perioperative complication rates comparable to those of abdominal surgery (intraoperative and postoperative, all treatment types P ≥ 0.05). [28]
  • Abdominal (open) surgery: Abdominal (open) surgery was the comparator to MIS and was reported to have similar overall survival to MIS across PSS, NACT-IDS, and PDS cohorts in the meta-analysis. [28]
Show 1 lab & early-research entry
  • modulated electro-hyperthermia (mEHT): Modulated electro-hyperthermia (mEHT) was reported in a small institutional case series of four ovarian cancer patients with FIGO III–IV tumors, in which the median overall survival after mEHT was 17.77 months. [50]
    median overall survival 17.77 months
    Source quote
    • “median overall survival was 17.77 months.”

Other

  • maintenance therapy: MaintenanceThe guideline states that patients with epithelial ovarian cancer should be offered FDA-approved maintenance treatments after primary therapy. [20]
    suboptimal cytoreduction rate 2 vs 11.1% vs CT
    Source quote
    • “A lower suboptimal cytoreduction rate in the laparoscopy group (2.0%) versus in the CT group (11.1%) has been reported,51 and laparoscopy had a higher AUC (0.955) compared to CT (0.755) in predicting optimal cytoreduction.60”
  • neoadjuvant chemotherapy · chemotherapy: Neoadjuvant (before surgery)The EORTC55971 and CHORUS trials found similar progression-free and overall survival for stage IIIC/IV patients undergoing neoadjuvant chemotherapy plus interval debulking surgery compared with primary debulking surgery. [13][3]
  • tumour NGS: Tumour next-generation sequencing is recommended by ESMO for patients with advanced ovarian cancer to guide precision-medicine decisions. [51]
Staging & risk5 points
  • The FIGO staging system, last revised in 2014, is the currently recommended system for ovarian, fallopian tube, and primary peritoneal cancers and relies on surgical exploration to determine stage. [9][13][5]3 sources
  • Contrast-enhanced CT of the abdomen and pelvis (and chest where indicated) is the imaging modality of choice for the initial staging evaluation, for preoperative staging, and to assess the extent/detection of recurrent disease. [46][19]
  • NCCN guidelines provide recommendations for diagnostic workup and staging of ovarian, fallopian tube, and primary peritoneal cancers; the ESMO-ESGO consensus panel developed recommendations addressing early-stage and borderline tumours, advanced-stage disease, and recurrent disease. [24][52]
  • Fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT and MRI may be appropriate for problem-solving purposes, particularly when lesions are present on CT but considered indeterminate. [46]
  • Surgery is the cornerstone in staging and treatment of ovarian cancer; standard staging procedures should comprise thorough inspection and palpation of all peritoneal surfaces, total hysterectomy and bilateral salpingo-oophorectomy (TH + BSO), omentectomy, pelvic and bilateral aortic lymphadenectomy up to the renal vessels, biopsies of pelvic peritoneum, paracolic gutters and right infra diaphragmatic area, and sampling of ascites or peritoneal washing for cytology when no ascites is found. [7]
Prognosis10 points
  • Sources state that surgical management in epithelial ovarian cancer has a significant impact on overall survival and progression-free survival. [6][7]
  • An optimal medical image–based AI model integrating radiomics with clinical parameters achieved a pooled sensitivity of 0.81, pooled specificity of 0.79, and pooled AUC of 0.86 for noninvasive prediction of ovarian cancer metastasis; medical image–based AI models demonstrate strong performance, supporting their potential clinical utility. [53]
  • Less than half of patients with epithelial ovarian cancer live more than five years from diagnosis. [1]
  • Approximately 70–80% of patients diagnosed with epithelial ovarian cancer will suffer a relapse after receiving first-line chemotherapy based on platinum and taxane. [7]
  • A network meta-analysis reports that IDS_HIPEC ranked highest in probability of benefit for both overall survival and disease-free survival according to SUCRA values. [2]
  • Across PARP inhibitor studies, overall survival outcomes were described as less definitive, with OS data often immature or not statistically significant at reporting. [11]
  • Ovarian cancer is described as one of the most lethal malignancies in females, mainly because of aggressive metastasis at late stage. [42]
  • High-grade serous carcinoma is the most common histologic subtype of ovarian cancer, and most patients present with advanced-stage disease at diagnosis. [9]
  • Favorable survival for ovarian cancer is generally encountered in early-stage disease. [26]
  • The meta-analysis authors noted that higher CRP levels remained a significant prognostic indicator of poor overall survival irrespective of FIGO stage, cutoff value, or survival analysis type (p < 0.05). [21]
Safety & interactions8 points
  • The USPSTF found that screening for ovarian cancer does not reduce ovarian cancer mortality and that the harms from screening are at least moderate and may be substantial, including unnecessary surgery for women who do not have cancer. [29]
  • Based on available data, there does not appear to be a meaningful increased risk of invasive ovarian cancer following the use of fertility drugs. [54]
  • The trials included in the systematic review reported numbers of grade 3 and 4 adverse events occurring after surgery as an extracted outcome. [2]
  • In a Phase III trial of niraparib in newly diagnosed advanced ovarian cancer, anemia was reported in 31% of participants. [11]
  • Primary cytoreductive surgery can be associated with substantial surgical morbidity including pleural effusion, anastomotic leakage, wound opening, and intra-abdominal abscess. [20]
  • Prophylaxis of venous thromboembolism in advanced epithelial ovarian cancer patients receiving systemic therapy should be discussed with each patient considering their specific risk factors. [13]
  • All approvals of PARP inhibitors to date are predicated on the absence of prior exposure to PARPis. [4]
Show 1 lab & early-research finding
  • In the institutional mEHT case series two ovarian cancer patients experienced mild adverse events described as a burning sensation and a slight inguinal swelling that resolved. [50]
What we don't know yet18 points

Key figures

Survival & outcomes
OutcomeValue95% CI
non-evaluable associations805—
Source quotes
  • “Of the total associations investigated, 805 (40.99%) were non-evaluable (13.25% of them were based on a single or two SNPs, when other MR methods could not be technically applied).”
  • Sources report that heterogeneity and variability in study quality highlight the need for more prospective, standardized, and externally validated imaging AI studies; another review notes the diagnostic value of AI-derived blood biomarkers for ovarian cancer remains inconsistent. [53][27]
  • Because robust scientific evidence is limited, guideline recommendations were developed by expert consensus or review: ESGO/INCIP pregnancy guidelines were based on expert consensus, and ESMO-ESGO recommendations were developed by expert review and represent consensus based on the best available evidence. [38][52]
  • In the Mendelian randomisation review, of the total associations investigated 805 (40.99%) were non-evaluable, indicating many exposures remain insufficiently assessed. [16]
  • Research efforts are focused on primary neoadjuvant treatments that may improve resectability and on systemic therapies that may provide improved long-term survival. [1]
  • The use of neoadjuvant chemotherapy followed by interval cytoreductive surgery in advanced ovarian cancer is described as controversial, and systematic comparative studies evaluating efficacy and risks among different treatment strategies for primary advanced ovarian cancer are limited. [2]
  • Sources highlight uncertainty regarding the overall effectiveness and long-term outcomes of PARP inhibitor therapy and note the need for further studies to optimize treatment strategies. [11]
  • Sources note that, in ovarian tumors, available knowledge on modulated electro-hyperthermia is minimal and that applicability and efficacy studies are urgently needed. [50]
  • More genes are being discovered that impart varying risks of breast cancer, ovarian cancer, and other types of cancer, and new technologies are being developed for genetic testing. [12]
  • In instances where evidence is lacking or equivocal for imaging or treatment procedures, expert opinion may supplement the available evidence to recommend imaging or treatment. [30]
  • Future research should standardize exposure assessments and include diverse Asian subpopulations to refine prevention guidelines. [15]
  • Increasing understanding of metabolic interactions could enable development of innovative metabolism-targeting interventions. [42]
  • The TRUST trial is expected to clarify the optimal timing of cytoreductive surgery by comparing primary cytoreductive surgery followed by adjuvant chemotherapy versus neo-adjuvant chemotherapy followed by interval cytoreductive surgery, with results anticipated by the end of 2024. [9]
  • Therapeutic options in the setting of recurrence remain limited, highlighting a substantial unmet need. [13]
  • Further validation is required before polygenic risk scores (PRS) are routinely used in diagnostic hereditary breast and ovarian cancer services. [32]
  • The Colombian consensus notes controversy about the potential use of HIPEC and uncertainty about drug choice, dose, dwell time, ideal temperature and perfusion duration for intraperitoneal chemotherapy. [3]
  • Currently available HRD tests are useful for predicting likely magnitude of benefit from PARPis but lack negative predictive value, inadequately address the complex and dynamic nature of the HRD phenotype, and better biomarkers are urgently needed to more accurately identify current homologous recombination proficiency status and to stratify HGSC management. [18]
  • Substantial heterogeneity across DWI studies was observed (I2 > 75%) and was not explained by study design, MRI field strength, or ADC thresholds. [36]
  • Screening with pelvic ultrasound may be appropriate for select high‑risk patients, but existing data are limited and large randomized trials have not been performed. [26]
Biology & pathways6 points
  • Epithelial ovarian cancer is composed of a diverse group of tumors that can be classified by distinctive morphologic and molecular features. [7]
  • PARP inhibitors are described as exploiting synthetic lethality by targeting tumor cells lacking functional homologous recombination repair, such as those with BRCA1/2 mutations or HRD. [11]
  • Ovarian cancer cells exhibit metastatic behavior distinct from many other epithelial tumors, primarily spreading within the peritoneal cavity. [42]
  • A recent review describes multiple metabolic features of the ovarian cancer microenvironment: cancer-associated fibroblasts and adipocytes act synergistically to support metastasis through metabolic interactions; metabolic reprogramming of immune cells can impact metastatic progression; the microbiome and cellular senescence alter the metabolic landscape; and recent clinical trials have targeted metabolic pathways. [42]
  • A broad range of repair genes, genomic scars, mutational signatures and functional assays are associated with a history of HRD. [18]
  • The ESMO-ESGO consensus conference reviewed pathology and molecular biology as one of the core areas in developing recommendations for ovarian cancer. [52]

Sources

Every statement above is drawn from these reviewed sources. This page reports what they describe. Sources last checked June 19, 2026.

  1. GuidelineNCCN Guidelines Insights: Ovarian Cancer, Version 1.2019 · 2019
  2. Systematic reviewComparative efficacy and safety of different treatment strategies for primary advanced ovarian cancer: a systematic review and network meta-analysis of randomized control trials · 2026
  3. GuidelineExpert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer · 2024
  4. GuidelinePARP Inhibitors in the Management of Ovarian Cancer: ASCO Guideline · 2020
  5. GuidelineSEOM clinical guideline in ovarian cancer (2020) · 2021
  6. GuidelineSurgery in ovarian cancer - Brazilian Society of Surgical Oncology consensus · 2018
  7. GuidelineSEOM guideline in ovarian cancer 2014 · 2014
  8. GuidelineOvarian cancer, version 2.2013 · 2013
  9. GuidelineOvarian cancer staging and follow-up: updated guidelines from the European Society of Urogenital Radiology female pelvic imaging working group · 2025
  10. GuidelineRecommendations for the implementation of BRCA testing in ovarian cancer patients and their relatives · 2019
  11. Systematic reviewThe effect of PARP inhibitor-based targeted therapy on BRCA-mutated ovarian cancer: systematic literature review · 2026
  12. GuidelinePractice Bulletin No 182: Hereditary Breast and Ovarian Cancer Syndrome · 2017
  13. GuidelineSEOM-GEICO clinical guideline on epithelial ovarian cancer (2023) · 2024
  14. Systematic reviewThe association of pregnancy complications/risk factors with the development of cancer in women: an umbrella review · 2026
  15. Meta-analysisPhysical activity, sedentary behavior and ovarian cancer risk in Asian populations: a scoping review and meta-analysis · 2026
  16. Meta-analysisRisk factors of ovarian cancer: a systematic review and meta-analysis of Mendelian randomiation studies · 2026
  17. Meta-analysisBreast and gynecological cancer risk in systemic lupus erythematosus: A meta-analysis of cohort studies · 2025
  18. GuidelineESMO recommendations on predictive biomarker testing for homologous recombination deficiency and PARP inhibitor benefit in ovarian cancer · 2020
  19. GuidelineESUR guidelines: ovarian cancer staging and follow-up · 2010
  20. GuidelineNeoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: ASCO Guideline Update · 2025
  21. Meta-analysisPrognostic and clinicopathological significance of C-reactive protein in patients with ovarian cancer: a meta-analysis · 2024
  22. GuidelinePractice Bulletin No. 182 Summary: Hereditary Breast and Ovarian Cancer Syndrome · 2017
  23. Review articleESGO Consensus Statement on endometrial cancer prevention, risk reduction strategies, and management of women with Lynch syndrome · 2026
  24. GuidelineNCCN Guidelines® Insights: Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer, Version 3.2024 · 2024
  25. GuidelineOvarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology · 2021
  26. GuidelineACR Appropriateness Criteria® Ovarian Cancer Screening: 2024 Update · 2025
  27. Meta-analysisAI-Derived Blood Biomarkers for Ovarian Cancer Diagnosis: Systematic Review and Meta-Analysis · 2025
  28. Meta-analysisEfficacy and safety of minimally invasive surgery versus open laparotomy for epithelial ovarian cancer: A systematic review and meta-analysis · 2024
  29. GuidelineScreening for Ovarian Cancer: US Preventive Services Task Force Recommendation Statement · 2018
  30. GuidelineACR Appropriateness Criteria(®) Ovarian Cancer Screening · 2017
  31. GuidelineACOG Practice Bulletin No. 103: Hereditary breast and ovarian cancer syndrome · 2009
  32. GuidelineEMQN best practice guidelines for genetic testing in hereditary breast and ovarian cancer · 2024
  33. GuidelineNCCN Guidelines® Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, and Prostate, Version 2.2026 · 2026
  34. GuidelineNCCN Guidelines Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 1.2020 · 2020
  35. GuidelineACR Appropriateness Criteria® Staging and Follow-Up of Ovarian Cancer: 2025 Update · 2025
  36. Meta-analysisDiagnostic value of diffusion-weighted MRI as an imaging biomarker for ovarian cancer: A systematic review and meta-analysis · 2026
  37. GuidelineFertility-sparing treatment and follow-up in patients with cervical cancer, ovarian cancer, and borderline ovarian tumours: guidelines from ESGO, ESHRE, and ESGE · 2024
  38. GuidelineESGO/INCIP Guidelines for the management of patients with gynecological cancers during pregnancy · 2025
  39. GuidelineGuideline No. 403: Initial Investigation and Management of Adnexal Masses · 2020
  40. GuidelineGuideline No. 404: Initial Investigation and Management of Benign Ovarian Masses · 2020
  41. Meta-analysisPerformance of [68Ga]Ga-FAPI PET in Breast, Ovarian, and Cervical Cancers: A Systematic Review and Meta-Analysis · 2026
  42. Systematic reviewEmerging perspectives on metabolic reprogramming in the microenvironment of ovarian cancer metastasis · 2026
  43. GuidelineOvarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology · 2016
  44. Meta-analysisDiagnostic accuracy of ovarian cancer using convolutional neural network: a systematic review and meta-analysis · 2026
  45. GuidelineOvarian cancer, version 3.2012 · 2012
  46. GuidelineACR Appropriateness Criteria(®) Staging and Follow-Up of Ovarian Cancer · 2018
  47. Systematic reviewEfficacy of metformin as an adjuvant therapy in gynecologic malignancies: a meta-analysis of randomized controlled trials · 2026
  48. GuidelineNo. 366-Gynaecologic Management of Hereditary Breast and Ovarian Cancer · 2018
  49. GuidelineCancer risk-reducing surgery: Brazilian society of surgical oncology guideline part 1 (gynecology and breast) · 2022
  50. Meta-analysisSurvival Difference in Advanced-Stage Cervical and Ovarian Cancer Patients Treated with Concomitant Modulated Electro-Hyperthermia in Comparison to Classic Treatment Modalities: Results of a Pilot Study and Meta-Analysis · 2026
  51. GuidelineRecommendations for the use of next-generation sequencing (NGS) for patients with advanced cancer in 2024: a report from the ESMO Precision Medicine Working Group · 2024
  52. GuidelineESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease† · 2019
  53. Meta-analysisA systematic review and meta-analysis of medical image-based artificial intelligence models for predicting metastasis in ovarian cancer · 2026
  54. GuidelineFertility drugs and cancer: a guideline · 2016

What supports this page

The kinds of sources behind this page, strongest at the top. Faint rungs show what is not here yet.

Guideline
60
Meta-analysis
204
Systematic review
39
Randomized trial
14
Clinical trial
42
Observational
13
Case report
81
Review
1640
Preclinical
0
Other
40

Living document — last change June 19, 2026: Cancer page updated. 7 recent updates logged.

Pooled evidence across studies

PubMed
  • OS: 74.7% (64–85 across studies) · (regimen unspecified)
    4 studies · 100% agree · consistent34602286
  • ORR (subgroup): 21% (19–27 across studies) · cofetuzumab pelidotin
    3 studies · 67% agree · moderate34083232
  • DFS: HR 3.25 (0.59–5.52 across studies) · (regimen unspecified)
    3 studies · 33% agree · heterogeneous4122004234169090
  • ASCVD incidence: HR 1.56 (0.91–2.8 across studies) · (regimen unspecified)
    3 studies · 33% agree · heterogeneous40445187
  • OS: 14.1 months (12.2–16 across studies) · Tumor Treating Fields (TTFields) + paclitaxel
    2 studies · 100% agree · consistent40010134
  • 5-year OS: 47.55% (42.5–52.6 across studies) · (regimen unspecified)
    2 studies · 100% agree · consistent38072401
  • OS: HR 1.03 (0.75–1.31 across studies) · (regimen unspecified)
    2 studies · 0% agree · heterogeneous34169090
  • OS: HR 0.8400000000000001 (0.67–1.01 across studies) · Tumor Treating Fields (TTFields) + paclitaxel
    2 studies · 0% agree · heterogeneous40010134

Numbers pooled deterministically across 165 published studies that passed our figure-accuracy checks — a quick synthesis, not a formal meta-analysis. Updated 9/19/2026.

Compounds compared by evidence

PubMed

How to read this: Ranked by the strength and volume of the evidence — NOT by how well a treatment works. A higher rank means a compound has been studied more, or in stronger study designs (e.g. randomized trials over lab studies), not that it produces better outcomes. The effect column shows the largest pooled figure reported, not a head-to-head comparison.

#CompoundEvidence strengthStudiesLargest pooled effect
1Bevacizumab Targeted therapyHuman trial / meta-analysis5—
2Rucaparib Targeted therapyHuman trial / meta-analysis5—
3Cisplatin ChemotherapyHuman trial / meta-analysis4—
4Olaparib Targeted therapyHuman trial / meta-analysis4—
5Paclitaxel ChemotherapyHuman trial / meta-analysis4—
6Relacorilant Targeted therapyHuman trial / meta-analysis4—
7Nivolumab †Rx ImmunotherapyHuman trial / meta-analysis1—
8Mirvetuximab Soravtansine Targeted therapyHuman · observational4—
9Carboplatin ChemotherapyInsufficient evidence2—
10Gemcitabine ChemotherapyInsufficient evidence2—
11Anastrozole Hormonal therapyInsufficient evidence1—
12Docetaxel ChemotherapyInsufficient evidence1—
13Fuzuloparib Targeted therapyInsufficient evidence1—
14Genistein Supplements & natural agentsInsufficient evidence1—
15Irinotecan ChemotherapyInsufficient evidence1—
16Liposomal Doxorubicin ChemotherapyInsufficient evidence1—
17Niraparib †Rx Targeted therapyInsufficient evidence1—
18Tamoxifen Hormonal therapyInsufficient evidence1—
19Topotecan ChemotherapyInsufficient evidence1—

Ranked across 19 compounds with published studies for this cancer. Updated 9/19/2026.

Medicines & supplements studied for Ovarian Cancer

PubMedFDAClinicalTrials.gov

Every drug, supplement, and other agent the published studies cover for Ovarian Cancer, ranked by how strong the evidence is — what studies report, not a recommendation. Tap any to see its full profile.

Medicines · 18

BevacizumabHuman trial / meta-analysisMixed results2 human

Includes human trial or meta-analysis evidence.

Largest credible effect: PFS hazard ratio 0.484 [0.388–0.605], p < .0001, n=484 PMID 22529265 · median-survival values 10.4–22.6 across 3 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

Findings conflict across studies · Effect sizes reported in only 2 of 5 studies.
Targeted therapyFDA approvedPhase 35 studiesFull profile →
RucaparibHuman trial / meta-analysisMixed results2 human

Includes human trial or meta-analysis evidence.

Largest credible effect: ORR 0.331 [0.221–0.449] PMID 39266137 · response rates 0.331–98.7 across 10 studies

Most authoritative study: ESMO Clinical Practice Guideline Express Update on the management of epithelial ovarian cancer

Findings conflict across studies · Effect sizes reported in only 1 of 5 studies.
Targeted therapyFDA approvedPhase 35 studiesFull profile →
CisplatinHuman trial / meta-analysisMixed results1 human1 animal

Includes human trial or meta-analysis evidence.

Largest credible effect: stratified hazard ratio for overall survival 0.73 [0.56–0.96], p=0.024, n=415 PMID 39549720 · response rates 10–49 across 5 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

Findings conflict across studies · Effect sizes reported in only 2 of 4 studies.
ChemotherapyFDA approvedPhase 34 studiesFull profile →
OlaparibHuman trial / meta-analysisReported positive2 human

Includes human trial or meta-analysis evidence.

Largest credible effect: hazard ratio for disease progression or death 0.3 [0.23–0.41], p <0.001, n=391 PMID 30345884 · effect sizes 6–18 across 2 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

Effect sizes reported in only 3 of 4 studies.
Targeted therapyFDA approvedPhase 34 studiesFull profile →
PaclitaxelHuman trial / meta-analysisMixed results1 human

Includes human trial or meta-analysis evidence.

Largest credible effect: nominal HR for OS in PLD-naive patients 0.67 [0.49–0.94], p=0.03 PMID 40010134 · median-survival values 12.2–16 across 2 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

Findings conflict across studies · Effect sizes reported in only 2 of 4 studies.
ChemotherapyFDA off-labelPhase 34 studiesFull profile →
RelacorilantHuman trial / meta-analysisMixed results3 human

Includes human trial or meta-analysis evidence.

Largest credible effect: progression-free survival hazard ratio 0.7 [0.54–0.91], p p=0.0076, n=381 PMID 40473448 · hazard ratios 0.36–0.7 across 5 studies

Most authoritative study: Relacorilant and nab-paclitaxel in patients with platinum-resistant ovarian cancer (ROSELLA): an open-label, randomised, controlled, phase 3 trial

Findings conflict across studies · Effect sizes reported in only 2 of 4 studies.
Targeted therapyFDA approvedPhase 34 studiesFull profile →
Nivolumab †RxHuman trial / meta-analysisInconclusive1 human

Includes human trial or meta-analysis evidence.

Most authoritative study: ATHENA (GOG-3020/ENGOT-ov45): a randomized, phase III trial to evaluate rucaparib as monotherapy (ATHENA-MONO) and rucaparib in combination with nivolumab (ATHENA-COMBO) as maintenance treatment following frontline platinum-based chemotherapy in ovarian cancer

No numeric effect sizes reported · Based on a single study.
ImmunotherapyPhase 31 studyFull profile →
Mirvetuximab SoravtansineHuman · observationalMixed results2 human

Human observational evidence only — no trials.

Largest credible effect: average age 62.4, n=5 PMID 30379722 · effect sizes 2–62.4 across 7 studies

Most authoritative study: Analysis of real world FRα testing in ovarian, fallopian tube, and primary peritoneal cancers

Findings conflict across studies · Effect sizes reported in only 2 of 4 studies.
Targeted therapyFDA approved4 studiesFull profile →
CarboplatinInsufficient evidenceReported positive

No primary experimental studies yet.

Largest credible effect: adjuvant chemotherapy courses 6, n=1 PMID 37592269 · effect sizes 6–18 across 2 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · Effect sizes reported in only 1 of 2 studies · All studies are small (n < 30).
ChemotherapyFDA approved2 studiesFull profile →
GemcitabineInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported.
ChemotherapyFDA approved2 studiesFull profile →
AnastrozoleInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
Hormonal therapyFDA off-label1 studyFull profile →
DocetaxelInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
Chemotherapy1 studyFull profile →
FuzuloparibInsufficient evidenceReported positive

No primary experimental studies yet.

Most authoritative study: Fuzuloparib: First Approval

No human studies yet · No numeric effect sizes reported · Based on a single study.
Targeted therapy1 studyFull profile →
IrinotecanInsufficient evidenceMixed results

No primary experimental studies yet.

Most authoritative study: Therapeutic strategies in epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
Chemotherapy1 studyFull profile →
Liposomal DoxorubicinInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
Chemotherapy1 studyFull profile →
Niraparib †RxInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
Targeted therapy1 studyFull profile →
TamoxifenInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
Hormonal therapyFDA off-label1 studyFull profile →
TopotecanInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
ChemotherapyFDA off-label1 studyFull profile →

Supplements & natural agents · 1

GenisteinInsufficient evidenceReported positive

No primary experimental studies yet.

Most authoritative study: Biological activities and therapeutic potential of soy isoflavones: a focus on anticancer activity

No human studies yet · No numeric effect sizes reported · Based on a single study.
Supplements & natural agents1 studyFull profile →

What recent studies report in Ovarian Cancer

These are reviewed studies whose abstracts concern Ovarian Cancer. Each describes only what that study reported. This is not a claim by OncoForge that any compound helps or harms Ovarian Cancer. Most are early lab, animal, or small human studies, and findings often conflict.

60 studies22 human2 animal⚠ Conflicting evidenceMechanism (21)Trial (10)Supportive care (1)

Tracking 60 published studies of Ovarian Cancer: 22 in humans, 2 in animals, 36 reviews/other.

Reported direction across studies: 23 positive, 17 mixed, 20 inconclusive.

Findings conflict — both supportive and negative/mixed results exist (see below). Human evidence is limited.

These counts summarize what the studies reported; they are not a measure of whether anything works for Ovarian Cancer.

Compounds with studies mentioning Ovarian Cancer

Relacorilant (4)Rucaparib (3)Cisplatin (3)Paclitaxel (3)Bevacizumab (3)Mirvetuximab soravtansine (2)Olaparib (2)Carboplatin (2)Genistein (1)Liposomal doxorubicin (1)Tamoxifen (1)Anastrozole (1)Gemcitabine (1)Topotecan (1)Docetaxel (1)Niraparib (1)
ReviewReported positiveLimited evidenceTier 4 · clinical

Relacorilant: First Approval

Drugs · Jun 2026 · regulatory approval summary

Relacorilantepithelial ovarian cancerfallopian tube cancerprimary peritoneal cancerpancreatic cancerprostate cancer

Relacorilant is a non-steroidal, selective glucocorticoid receptor antagonist being developed for several solid tumours and Cushing syndrome. The article reports that relacorilant received its first approval in the USA on 25 March 2026 for use in combination with nab-paclitaxel for adults with platinum-resistant epithelial ovarian, fallopian tube or primary peritoneal cancer after 1-3 prior systemic regimens (at least one including bevacizumab). The article summarizes development milestones leading to this approval.

Studied with: nab-paclitaxel.

Key findings
  • Relacorilant is a non-steroidal, selective glucocorticoid receptor II antagonist developed by Corcept Therapeutics.
  • Relacorilant received first approval in the USA on 25 March 2026.
  • Approval is for use in combination with nab-paclitaxel for adults with platinum-resistant epithelial ovarian, fallopian tube or primary peritoneal cancer who have received 1-3 prior systemic treatment regimens, at least one of which included bevacizumab.
  • Relacorilant is being developed for various solid tumours including ovarian, fallopian tube, peritoneal, pancreatic and prostate cancers, as well as for Cushing syndrome.
  • The article summarizes milestones in the development of relacorilant leading to this approval.
Limitations: Abstract provides no efficacy or safety outcome data or numeric results from trials.; No trial design, sample size, or methods are reported in the abstract.; This is an approval/summary article, not primary trial data.; Geographic scope limited to a USA approval; supporting evidence is not detailed in the abstract..

AI summary of the abstract, human-reviewed · Jul 2026. Describes what this study reported, not medical advice. View on PubMed

ReviewReported positivePreclinical onlyTier 1 · lab

Biological activities and therapeutic potential of soy isoflavones: a focus on anticancer activity

Molecular biology reports · May 2026 · narrative review

Genisteinbreast cancerovarian cancerprostate cancergliomaneuroblastomahepatocellular carcinomalung cancerbladder cancerosteosarcomarhabdomyosarcoma

This is a narrative review of the biological activities and potential therapeutic roles of soy isoflavones (including genistein and daidzein). The authors summarize proposed anticancer mechanisms (estrogen receptor modulation, apoptosis, anti-angiogenesis, epigenetic effects, etc.) and report that in vitro and in vivo studies have shown promising results across a range of tumor types. They conclude that further research—especially studies combining isoflavones with established chemotherapeutics—is needed.

Studied with: chemotherapeutic agents.

Key findings
  • Soy isoflavones (genistein, daidzein) have estrogenic and non-estrogenic activities including anti-inflammatory, antioxidant, and immunomodulatory effects.
  • Proposed anticancer mechanisms include modulation of estrogen receptors, copper ion-dependent induction of cell death, promotion of apoptosis, inhibition of angiogenesis and metastasis, regulation of epigenetic processes, and effects on platelet function.
  • Because of estrogen receptor interactions, isoflavones have been studied particularly in hormone-dependent cancers such as breast, ovarian, and prostate cancer.
  • In vitro and in vivo studies have reported promising results in multiple malignancies (gliomas, neuroblastoma, hepatocellular carcinoma, lung and bladder cancers, osteosarcoma, rhabdomyosarcoma).
  • Authors recommend further investigation, particularly combining isoflavones with established chemotherapeutics, to evaluate potential synergy.
Limitations: This article is a narrative review and does not present new clinical trial data.; The evidence summarized is primarily preclinical (in vitro and in vivo) with no clinical trial data provided in the abstract.; Mechanistic proposals are not proven clinical effects and require further experimental and clinical validation.; Safety and efficacy in patients, optimal dosing, and interactions with standard therapies are not established in this review..

AI summary of the abstract, human-reviewed · Jul 2026. Describes what this study reported, not medical advice. View on PubMed · Full text

Human · observationalMechanismReported positiveLimited evidenceTier 3 · early humann = 33

Serous borderline ovarian tumor and low-grade serous ovarian cancer

Abdominal radiology (New York) · Mar 2026

low-grade serous ovarian cancer (LGSOC)high-grade serous ovarian cancer (HGSOC)serous borderline ovarian tumor (SBOT)epithelial ovarian cancer (EOC)

This review summarizes the pathology, molecular biology, treatment options, and imaging appearances of low-grade serous ovarian cancer (LGSOC) and serous borderline ovarian tumors (SBOT). The authors present imaging of primary and metastatic LGSOC from a cohort of 33 pathologically proven patients and describe differences between LGSOC and high-grade serous ovarian cancer (HGSOC).

Key findings
  • Low-grade serous ovarian cancer (LGSOC) represents 2-5% of ovarian carcinomas and 5-10% of serous ovarian carcinoma.
  • LGSOC and HGSOC are now considered distinct entities with different molecular biology and clinical course.
  • Because LGSOC is uncommon, published data on its imaging findings are limited.
  • The paper presents imaging appearances of primary tumor and metastasis in a cohort of 33 patients with pathologically proven LGSOC.
  • Since LGSOC often arise from serous borderline ovarian tumors (SBOT), the imaging appearances of SBOT are described and contrasted with LGSOC.
Limitations: Review article with a small cohort (33 patients) reported — limited sample size.; Low prevalence of LGSOC leads to limited available data on imaging findings.; Abstract does not report prospective design or standardized imaging protocol, limiting generalizability.; No quantitative diagnostic performance metrics or outcomes reported in the abstract..

AI summary of the abstract, human-reviewed · Jul 2026. Describes what this study reported, not medical advice. View on PubMed

Human · observationalReported positiveModerate evidenceTier 3 · early humann = 675901

Longer-term aspirin use and subsequent ovarian cancer risk in the Ovarian Cancer Cohort Consortium

International journal of epidemiology · Feb 2026 · pooled analysis of 10 prospective cohort studies

ovarian cancer

Investigators pooled data from 10 prospective cohorts including 675,901 participants (5,528 ovarian cancer cases) to examine repeat self-reported aspirin use and ovarian cancer risk. Overall, ever frequent aspirin use was not associated with ovarian cancer, but long-term use (>6 years) was associated with a lower risk (OR 0.86). The reduction was stronger among people with at least three ovarian cancer risk factors and was observed for long-term low-dose aspirin use but not for regular-dose aspirin.

Reported effects: ever frequent aspirin use OR 0.97 [0.91–1.03], n=675901 · long-term aspirin use (>6 years) OR 0.86 [0.77–0.97], n=675901 · +6 more

Key findings
  • Ever frequent aspirin use was not associated with ovarian cancer (OR 0.97; 95% CI: 0.91-1.03).
  • Long-term aspirin use (>6 years) was associated with a 14% lower ovarian cancer risk (OR 0.86; 95% CI: 0.77-0.97).
  • The long-term use risk reduction was evident among individuals with at least three ovarian cancer risk factors (OR 0.65; 95% CI: 0.50-0.85) but not among those with fewer than three risk factors (OR 0.94; 95% CI: 0.82-1.08); P-interaction = .02.
  • Reduced risks were also observed for low-dose aspirin (ever low-dose OR 0.90; 95% CI: 0.80-1.01; long-term low-dose OR 0.75; 95% CI: 0.56-0.99) but not for ever regular-dose use (OR 1.09; 95% CI: 0.94-1.27).
Limitations: Observational design — cannot establish causality and subject to residual confounding.; Aspirin use was self-reported, which can lead to misclassification.; Definitions and numeric dosing of 'low-dose' versus 'regular-dose' are not specified in the abstract.; Although multiple time-updated exposure metrics were used, unmeasured or time-varying confounders may remain..

AI summary of the abstract, human-reviewed · Jul 2026. Describes what this study reported, not medical advice. View on PubMed · Full text

OtherReported positiveModerate evidenceTier 4 · clinical

ESMO Clinical Practice Guideline Express Update on the management of epithelial ovarian cancer

ESMO open · Feb 2026 · practice_guideline

Rucaparibepithelial ovarian cancerrecurrent high FRα ovarian cancer

This is an Express Update to the ESMO clinical practice guideline prompted by approval of rucaparib and MIRV. The update adds rucaparib as a first-line PARP inhibitor maintenance option for epithelial ovarian cancer and recommends MIRV for recurrent, high FRα ovarian cancer after 1–3 prior therapies with a platinum-free interval under 6 months. Updated treatment algorithms to support personalised therapy are also noted.

Key findings
  • This Express Update has been issued in response to the approval of rucaparib and MIRV.
  • It includes rucaparib as a first-line PARPi maintenance option in EOC.
  • MIRV is recommended for recurrent, high FRα ovarian cancer after 1-3 prior therapies and platinum-free interval of <6 months.
  • Updated treatment algorithms support personalised therapy in newly diagnosed and recurrent EOC.
Limitations: Abstract is an Express Update and provides no primary data, numerical outcomes, or details of the evidence reviewed.; No dosing, safety, or comparative efficacy data are reported in the abstract.; Short abstract format limits assessment of the strength and scope of recommendations..

AI summary of the abstract, human-reviewed · Sep 2026. Describes what this study reported, not medical advice. View on PubMed · Full text

Animal studyMixed resultsPreclinical onlyTier 2 · animal

High-throughput drug screening identifies EGFR/MAPK pathway targeting sensitivities in organoid models of ovarian carcinosarcoma

Journal of experimental & clinical cancer research : CR · Jan 2026 · High-throughput drug screening in organoid models performed in presence of cisplatin or eribulin, with validation of top combinations in OCS cell line, organoid and PDX models including in vivo PDX experiments.

Cisplatinovarian carcinosarcomahigh-grade serous ovarian cancer (HGSOC)

The authors performed high-throughput drug screens in ovarian carcinosarcoma (OCS) organoid models and validated top combinations in a unique OCS cell line, organoid and PDX models. Eribulin combined with either an EGFR inhibitor (erlotinib) or a MEK inhibitor (mirdametinib/PD0325901) produced synergistic effects in some in vitro models, and modest survival improvements in vivo, but several PDX models exhibited resistance mechanisms (high ABCB1 expression or KRAS mutation) limiting efficacy.

Reported effects: models_with_synergy 2, n=4 · PDX_models_with_resistance 2, n=3

Studied with: erlotinib, mirdametinib, PD0325901, cisplatin.

Key findings
  • High-throughput screens identified eribulin-based combinations as most effective in OCS organoid models, while cisplatin-based combinations were more effective in HGSOC models.
  • Eribulin plus erlotinib or eribulin plus a MEK inhibitor (mirdametinib/PD0325901) were the most effective combinations in OCS models, with synergy seen in two out of four models for each combination.
  • OCS models appear particularly reliant on EGFR and MAPK signalling in vitro, especially in tumours with TP53 mutation.
  • In vivo (PDX) experiments showed only modest survival improvements for eribulin plus erlotinib, and two of three PDX models had resistance mechanisms (high ABCB1 or KRAS activating mutation).
  • KRAS-mutant OCS cell lines and organoids were sensitive to dual EGFR/MAPK targeting, with greater synergy when eribulin was added as a third agent.
Limitations: Preclinical study using in vitro organoids, cell lines and PDX models; no human clinical data reported.; Only modest in vivo survival benefit reported.; Synergy was observed in a subset of models (e.g., two of four organoid models), indicating heterogeneity and limited generalizability.; A small number of PDX models were tested (three), and two showed resistance mechanisms limiting efficacy.; No doses, schedules, or safety/toxicity data in humans provided..

AI summary of the abstract, human-reviewed · Sep 2026. Describes what this study reported, not medical advice. View on PubMed · Full text

Human · observationalMechanismReported positiveLimited evidenceTier 3 · early human

Transcriptomic landscape of coexisting ovarian clear cell carcinoma and endometriosis: Insights into malignant transformation

Cancer treatment and research communications · Jan 2026 · Spatial transcriptomics profiling integrated with single-cell RNA sequencing (scRNA-seq) of tissues containing coexisting endometriosis and ovarian clear cell carcinoma regions

endometriosisovarian clear cell carcinomahigh-grade serous ovarian cancer

This study used spatial transcriptomics combined with single-cell RNA sequencing to compare molecular profiles of coexisting endometriosis and ovarian clear cell carcinoma (OCCC) regions in human tissue. The authors report shared molecular features between EMS and OCCC, greater transcriptomic similarity of severe uterine EMS to OCCC than to HGSOC, and classification of OCCC-specific genes into EMS epithelial cell-specific and tumor microenvironment-related groups that are associated with pathways linked to progression, invasion, and metabolic reprogramming.

Key findings
  • Spatial transcriptomic profiling revealed shared molecular features between OCCC and EMS, including overexpression of genes related to tissue development and apoptosis.
  • Integration with scRNA-seq data showed severe uterine EMS exhibited greater transcriptomic similarities to OCCC than to non-EAOC ovarian cancer subtypes such as HGSOC.
  • OCCC-specific genes were classified into EMS epithelial cell-specific and tumor microenvironment-related categories.
  • Identified gene sets and categories are associated with pathways implicated in tumor progression, invasion, and metabolic reprogramming.
  • Findings support a transcriptomic progression pathway from EMS to OCCC and provide molecular insights relevant to etiology, diagnostics, and potential targeted strategies.
Limitations: Sample size and cohort details are not reported in the abstract.; Observational, transcriptomic profiling only — correlative data that cannot establish causal malignant transformation.; No functional validation experiments (e.g., in vitro/in vivo perturbation) are reported in the abstract to confirm mechanistic roles of identified genes or pathways.; Generalizability is unclear because the abstract does not describe the number or diversity of patients/tissues analyzed..

AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed

ReviewInconclusiveLimited evidenceTier 4 · clinical

Genomics of ovarian cancers and the potential of precision medicine

Therapeutic advances in medical oncology · Dec 2025 · review

epithelial ovarian cancerhigh-grade serous ovarian cancerovarian clear cell carcinomaendometrioid ovarian carcinomamucinous ovarian carcinomalow-grade serous ovarian carcinomaovarian carcinosarcoma

This review describes the main genomic subtypes of epithelial ovarian cancer and how those differences may help match patients to targeted therapies. It highlights PARP inhibitors, MAPK pathway inhibitors, cell cycle checkpoint inhibitors, immune checkpoint inhibitors, and antibody-drug conjugate approaches that are being investigated for specific ovarian cancer types. The article also notes that resistance to PARP inhibitors remains a problem and that more evidence is needed for effective combination therapies.

Key findings
  • High-grade serous ovarian cancer is linked mainly to homologous recombination repair gene alterations such as BRCA1 and BRCA2.
  • Ovarian clear cell carcinoma is associated with ARID1A and PIK3CA alterations; endometrioid ovarian carcinoma with PIK3CA and KRAS; mucinous ovarian carcinoma with CDKN2A and KRAS; and low-grade serous ovarian carcinoma with MAPK pathway genes such as BRAF and KRAS.
  • PARP inhibitor therapy has improved survival for women with homologous recombination repair defects in high-grade serous ovarian cancer, but acquired resistance remains an issue.
  • The review emphasizes that genomically targeted combination therapies are urgently needed and that some reported responses are preliminary.
Limitations: Review article only; no new experimental or clinical data presented in the abstract.; No quantitative outcomes or effect sizes are reported in the abstract.; The abstract is broad and does not provide trial-level details, sample sizes, or follow-up durations.; Some therapies discussed are preliminary and require further evidence..

The article is about ovarian cancer genomics and targeted therapies, not a single compound experiment.

AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text

Meta-analysisMechanismMixed resultsModerate evidenceTier 4 · clinicaln = 1510

TCGA molecular subtypes in endometriosis-associated ovarian cancer: a systematic review and meta-analysis

Annals of medicine · Dec 2025 · systematic review and meta-analysis

endometrioid ovarian cancer (ENOC)clear cell ovarian cancer (CCOC)

This systematic review and meta-analysis pooled data from studies of TCGA molecular subtypes in endometriosis-associated ovarian cancers (ENOC and CCOC). It included 6 studies with 1,133 ENOC patients and 4 studies with 377 CCOC patients. ENOC showed higher frequencies of the POLEmut and MMRd subtypes and lower frequencies of NSMP and p53abn compared with CCOC. The p53abn subtype was associated with worse disease-free and progression-free survival in ENOC and worse disease-free survival in CCOC.

Reported effects: POLEmut frequency (ENOC vs CCOC) 2.29 [1.03–5.11], p=0.043 · MMRd frequency (ENOC vs CCOC) 3.54 [2.05–6.11], p 0.000 · +5 more

Key findings
  • Six studies (1,133 ENOC patients) and four studies (377 CCOC patients) were included.
  • ENOC had a higher frequency of the POLEmut subtype compared with CCOC (OR = 2.29).
  • ENOC had a higher frequency of the MMRd subtype compared with CCOC (OR = 3.54).
  • ENOC had a lower frequency of the NSMP subtype compared with CCOC (OR = 0.55).
  • The frequency of the p53abn subtype did not differ significantly between ENOC and CCOC (OR = 0.97).
  • In ENOC, the p53abn subtype was associated with reduced DFS (HR = 3.25) and reduced PFS (HR = 4.11).
  • In CCOC, the p53abn subtype was associated with reduced DFS (HR = 5.52).
Limitations: Only a small number of studies were included (6 for ENOC, 4 for CCOC).; Meta-analysis relies on published study-level data; individual patient data were not reported.; Potential heterogeneity across included studies (staging, methods for subtype assignment) is not detailed in the abstract.; Prognostic associations are observational and may be subject to residual confounding..

AI summary of the abstract, published automatically under the strong-evidence tier · Sep 2026; an editor has not yet reviewed it. Describes what this study reported, not medical advice. View on PubMed · Full text

ReviewMixed resultsModerate evidenceTier 4 · clinical

Surgery for Recurrent Ovarian Cancer

Hematology/oncology clinics of North America · Dec 2025 · literature review

ovarian cancer

This review summarizes evidence about secondary cytoreductive surgery before chemotherapy for recurrent ovarian cancer. It reports that complete gross resection is the most important factor associated with benefit and that selection criteria to predict this outcome have been developed and validated. Three recent multicenter randomized trials reported mixed results, but a meta-analysis suggests a benefit, particularly in patients with complete gross resection.

Studied with: chemotherapy.

Key findings
  • Use of secondary cytoreductive surgery before standard chemotherapy in recurrent ovarian cancer is controversial.
  • Patient and disease factors that correlate with benefit from surgery have been identified.
  • Complete gross resection of disease is the most important factor for benefit.
  • Selection criteria have been developed and validated to predict likelihood of complete gross resection.
  • Three parallel multicenter randomized controlled trials of secondary cytoreduction have shown mixed results.
  • A meta-analysis suggests a benefit, particularly in those with complete gross resection of disease.
Limitations: This is a literature review rather than primary experimental data.; The randomized controlled trials summarized are reported as having mixed results, reducing certainty.; Apparent benefit is concentrated in patients achieving complete gross resection, which may limit generalizability to all recurrent ovarian cancer patients.; No quantitative results or trial details (sample sizes, effect sizes, p-values) are provided in the abstract..

AI summary of the abstract, human-reviewed · Jul 2026. Describes what this study reported, not medical advice. View on PubMed

ReviewMechanismMixed resultsModerate evidenceTier 4 · clinical

Molecular Pathology of Ovarian Endometrioid Carcinoma: A Review

Oncology research · Nov 2025 · narrative review

ovarian endometrioid carcinomaepithelial ovarian cancer

This narrative review summarizes contemporary evidence about ovarian endometrioid carcinoma (OEC), applying the endometrial cancer molecular taxonomy (POLE‑ultramutated, MMRd, p53‑abnormal, NSMP) to OEC. The authors report that OEC is enriched for Lynch syndrome and recommend routine MMR testing; POLEmut/MMRd tumors generally have favorable outcomes and may be candidates for de‑escalation or immunotherapy, while p53‑abnormal/high‑grade tumors have poorer prognosis and may need intensified management or HRD‑directed strategies.

Reported effect: proportion_of_epithelial_ovarian_cancers 10%

Studied with: immune checkpoint inhibitors, HRD-directed strategies.

Key findings
  • Ovarian endometrioid carcinoma (OEC) accounts for ~10% of epithelial ovarian cancers and displays broad morphologic diversity that complicates diagnosis and grading.
  • The endometrial cancer molecular taxonomy (POLE‑ultramutated, MMRd, p53‑abnormal, NSMP) also applies to OEC.
  • OEC is enriched for Lynch syndrome‑associated tumors, supporting routine MMR testing.
  • Integrating morphology with molecular classification refines diagnosis and prognostication.
  • POLEmut/MMRd subsets generally have excellent outcomes and are candidates for de‑escalation or immunotherapy.
  • p53abn/high‑grade tumors carry a poorer prognosis and may warrant intensified management and trials of HRD‑directed strategies.
  • Routine MMR immunohistochemistry with reflex germline testing improves Lynch detection.
  • Future priorities include prospective validation and multi‑omics to refine NSMP and identify new targets.
Limitations: Narrative review rather than primary research; no new patient‑level data reported.; Recommendations (e.g., de‑escalation, therapeutic strategies) lack prospective validation in OEC as noted by the authors.; Broad morphologic diversity and diagnostic/grading challenges in OEC may limit generalizability of some recommendations.; NSMP group remains heterogeneous and requires further molecular refinement per the authors..

AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text

ReviewInconclusiveLimited evidenceTier 4 · clinical

Ovarian Cancer: Many Diseases Under One Name

Journal of insurance medicine (New York, N.Y.) · Oct 2025

ovarian cancer

This narrative review summarizes current knowledge about ovarian cancer, noting it is a heterogeneous group of diseases with the most common subtype being high-grade serous epithelial tumors. It highlights genetic risk factors (BRCA1/BRCA2 and mismatch repair genes), the lack of effective screening leading to advanced-stage diagnosis, and that management commonly involves specialized surgery and combination chemotherapy; prognosis varies by stage, grade, and histologic subtype.

Studied with: surgery, combination chemotherapy.

Key findings
  • Ovarian cancer is heterogeneous with multiple types and subtypes.
  • The most common variety is the high-grade serous epithelial tumor (reported as 70%-80% of cases).
  • Positive family history and susceptibility genes (BRCA1, BRCA2, and mismatch repair genes) increase risk.
  • Effective screening tools are lacking, so most cancers are diagnosed at advanced stages.
  • Diagnosis and accurate staging usually require tissue sampling and extensive debulking surgery performed by gynecologic oncology specialists.
  • Combination chemotherapy is commonly used before or after surgery, or as primary treatment for advanced disease.
  • Mortality rates vary by stage, grade, and tumor type; some less common subtypes (sex cord stromal, germ cell, borderline epithelial) have better survival.
Limitations: Narrative review rather than original research; no new primary data reported in the abstract.; Abstract does not specify methods (systematic search, inclusion criteria), so potential for selection bias in reviewed literature.; No quantitative outcomes, effect sizes, or detailed evidence levels are provided in the abstract..

AI summary of the abstract, human-reviewed · Jul 2026. Describes what this study reported, not medical advice. View on PubMed

Browse all studies mentioning Ovarian Cancer →

Where the evidence is

What has been studied, and how strong it is, by topic. A dashed cell means no studies were found for that combination — a gap, not evidence of no effect. Open a row to see its studies.

CompoundHuman evidenceMechanismSafetyTrial
Bevacizumab23—4
Rucaparib25—2
Cisplatin13—2
Olaparib24—3
Paclitaxel14—2
Relacorilant34—3
Nivolumab †Rx11—1
Mirvetuximab Soravtansine231—
Carboplatin—2—1
Gemcitabine—2—1
Anastrozole—1—1
Docetaxel—1—1
Fuzuloparib—1—1
Genistein—1——
Irinotecan—1——
Liposomal Doxorubicin—1—1

Study mix

165 published studies by what they were done in. Lab and animal findings often do not carry over to people.

50 Human5 Animal1 Lab109 Review/other
Reported directionReported positive63Mixed results35Reported negative8Inconclusive59

Compounds with reported-positive results in Ovarian Cancer

Where at least one study reported a positive result, shown with the full picture, not just the wins. Positive results are more likely to be published, and most of these are early lab or animal studies that may not translate to people. This reports what studies found, not what works.

Human evidence

Olaparib3 positive2 human
Limitations: Single-patient case report (n=1) limits generalizability.; No control or comparison group to assess treatment effect.; Relatively short follow-up (reported disease-free status at 18 months only).; No dosing details provided for chemotherapy or olaparib in the abstract.; Overall survival difference did not reach statistical significance (p=0.054).; Overall survival was unadjusted for subsequent PARP inhibitor therapy in 38% of placebo patients, which may confound interpretation..
Cited positive studies (3)
Relacorilant2 positive1 negative/mixed3 human
Limitations: Abstract provides no efficacy or safety outcome data or numeric results from trials.; No trial design, sample size, or methods are reported in the abstract.; This is an approval/summary article, not primary trial data.; Geographic scope limited to a USA approval; supporting evidence is not detailed in the abstract.; Open-label design; Overall survival result was based on a planned interim analysis.
Cited positive studies (2)
Bevacizumab2 positive2 negative/mixed2 human
Limitations: Relatively small randomized sample (100 patients).; Primary endpoint was investigator-assessed PFS (no central review stated).; Overall survival and longer-term outcomes not reported in the abstract.; Single-country (China) population may limit generalizability to other populations.; Adverse-event denominators reported in the abstract are inconsistent with the randomized-arm counts, which complicates interpretation of safety rates.; Progression-free survival was the primary endpoint; overall survival results are not reported in the abstract..
Cited positive studies (2)
Cisplatin1 positive2 negative/mixed1 human1 animal
Limitations: Open-label design (no blinding).; Increased perioperative grade 3+ toxicity with HIPEC compared with no HIPEC.; Eligibility limited to patients with a first relapse ≥6 months after platinum-based chemotherapy who were amenable to complete cytoreduction; results may not generalise to other patient groups.; Optional use of bevacizumab and later planned PARP inhibitor use introduce heterogeneity in systemic therapy.; Conducted at specialist centres; generalisability to non-specialist settings is uncertain..
Cited positive studies (1)
Preclinical only: lab / animal (6)
Rucaparib2 positive1 negative/mixed2 human
Limitations: Abstract is an Express Update and provides no primary data, numerical outcomes, or details of the evidence reviewed.; No dosing, safety, or comparative efficacy data are reported in the abstract.; Short abstract format limits assessment of the strength and scope of recommendations.; Abstract is a regulatory/approval announcement and does not present original trial data, efficacy outcomes, or safety/adverse event data.; No sample size, dosing, comparator, or follow-up duration reported in the abstract.; Cannot assess magnitude of benefit or harms from this abstract alone..
Cited positive studies (2)
Mirvetuximab Soravtansine2 positive2 negative/mixed2 human
Limitations: This is a review article and does not present new, individual patient-level data.; FRα expression heterogeneity across histologic subtypes and tumor sites may limit generalizability of biomarker-based selection.; IHC technical factors and pre-analytical variables can affect assessment of FRα and thus patient selection.; The companion diagnostic and demonstrated benefit apply specifically to patients with high FRα expression (≥75%), so findings may not extend to lower expressors.; Narrative review with no original data or methods reported in the abstract.; No quantitative results, patient numbers, or trial phase data are provided in the abstract..
Cited positive studies (2)
Genistein1 positive
Limitations: This article is a narrative review and does not present new clinical trial data.; The evidence summarized is primarily preclinical (in vitro and in vivo) with no clinical trial data provided in the abstract.; Mechanistic proposals are not proven clinical effects and require further experimental and clinical validation.; Safety and efficacy in patients, optimal dosing, and interactions with standard therapies are not established in this review..
Cited positive studies (1)
Paclitaxel1 positive2 negative/mixed1 human
Limitations: Single-patient case report (n=1) limits generalizability.; No control or comparison group to assess treatment effect.; Relatively short follow-up (reported disease-free status at 18 months only).; No dosing details provided for chemotherapy or olaparib in the abstract..
Cited positive studies (1)
Carboplatin1 positive
Limitations: Single-patient case report (n=1) limits generalizability.; No control or comparison group to assess treatment effect.; Relatively short follow-up (reported disease-free status at 18 months only).; No dosing details provided for chemotherapy or olaparib in the abstract..
Cited positive studies (1)
Fuzuloparib1 positive
Limitations: Review article; no original study data in the abstract.; No efficacy or safety results are reported in the abstract.; No comparator, sample size, or quantitative outcomes are provided..
Cited positive studies (1)

Evidence at a glance: compounds studied in Ovarian Cancer

A deterministic grade of what published studies report for each: strength of evidence, the reported direction, and the largest credible effect, strongest-evidence first. This summarizes findings; it is not a claim that anything works.

BevacizumabHuman trial / meta-analysisMixed results2 human

Includes human trial or meta-analysis evidence.

Largest credible effect: PFS hazard ratio 0.484 [0.388–0.605], p < .0001, n=484 PMID 22529265 · median-survival values 10.4–22.6 across 3 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

Findings conflict across studies · Effect sizes reported in only 2 of 5 studies.
RucaparibHuman trial / meta-analysisMixed results2 human

Includes human trial or meta-analysis evidence.

Largest credible effect: ORR 0.331 [0.221–0.449] PMID 39266137 · response rates 0.331–98.7 across 10 studies

Most authoritative study: ESMO Clinical Practice Guideline Express Update on the management of epithelial ovarian cancer

Findings conflict across studies · Effect sizes reported in only 1 of 5 studies.
CisplatinHuman trial / meta-analysisMixed results1 human1 animal

Includes human trial or meta-analysis evidence.

Largest credible effect: stratified hazard ratio for overall survival 0.73 [0.56–0.96], p=0.024, n=415 PMID 39549720 · response rates 10–49 across 5 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

Findings conflict across studies · Effect sizes reported in only 2 of 4 studies.
OlaparibHuman trial / meta-analysisReported positive2 human

Includes human trial or meta-analysis evidence.

Largest credible effect: hazard ratio for disease progression or death 0.3 [0.23–0.41], p <0.001, n=391 PMID 30345884 · effect sizes 6–18 across 2 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

Effect sizes reported in only 3 of 4 studies.
PaclitaxelHuman trial / meta-analysisMixed results1 human

Includes human trial or meta-analysis evidence.

Largest credible effect: nominal HR for OS in PLD-naive patients 0.67 [0.49–0.94], p=0.03 PMID 40010134 · median-survival values 12.2–16 across 2 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

Findings conflict across studies · Effect sizes reported in only 2 of 4 studies.
RelacorilantHuman trial / meta-analysisMixed results3 human

Includes human trial or meta-analysis evidence.

Largest credible effect: progression-free survival hazard ratio 0.7 [0.54–0.91], p p=0.0076, n=381 PMID 40473448 · hazard ratios 0.36–0.7 across 5 studies

Most authoritative study: Relacorilant and nab-paclitaxel in patients with platinum-resistant ovarian cancer (ROSELLA): an open-label, randomised, controlled, phase 3 trial

Findings conflict across studies · Effect sizes reported in only 2 of 4 studies.
Nivolumab †RxHuman trial / meta-analysisInconclusive1 human

Includes human trial or meta-analysis evidence.

Most authoritative study: ATHENA (GOG-3020/ENGOT-ov45): a randomized, phase III trial to evaluate rucaparib as monotherapy (ATHENA-MONO) and rucaparib in combination with nivolumab (ATHENA-COMBO) as maintenance treatment following frontline platinum-based chemotherapy in ovarian cancer

No numeric effect sizes reported · Based on a single study.
Mirvetuximab SoravtansineHuman · observationalMixed results2 human

Human observational evidence only — no trials.

Largest credible effect: average age 62.4, n=5 PMID 30379722 · effect sizes 2–62.4 across 7 studies

Most authoritative study: Analysis of real world FRα testing in ovarian, fallopian tube, and primary peritoneal cancers

Findings conflict across studies · Effect sizes reported in only 2 of 4 studies.
CarboplatinInsufficient evidenceReported positive

No primary experimental studies yet.

Largest credible effect: adjuvant chemotherapy courses 6, n=1 PMID 37592269 · effect sizes 6–18 across 2 studies

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · Effect sizes reported in only 1 of 2 studies · All studies are small (n < 30).
GemcitabineInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported.
AnastrozoleInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
DocetaxelInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
FuzuloparibInsufficient evidenceReported positive

No primary experimental studies yet.

Most authoritative study: Fuzuloparib: First Approval

No human studies yet · No numeric effect sizes reported · Based on a single study.
GenisteinInsufficient evidenceReported positive

No primary experimental studies yet.

Most authoritative study: Biological activities and therapeutic potential of soy isoflavones: a focus on anticancer activity

No human studies yet · No numeric effect sizes reported · Based on a single study.
IrinotecanInsufficient evidenceMixed results

No primary experimental studies yet.

Most authoritative study: Therapeutic strategies in epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
Liposomal DoxorubicinInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
Niraparib †RxInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
TamoxifenInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.
TopotecanInsufficient evidenceInconclusive

No primary experimental studies yet.

Most authoritative study: Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer

No human studies yet · No numeric effect sizes reported · Based on a single study.

What the research shows for Ovarian Cancer

A plain-language summary of the reviewed studies OncoForge tracks for Ovarian Cancer. It reports what those studies described, not a claim that any compound or therapy helps or harms Ovarian Cancer. Most of this evidence is early, and findings often conflict.

  • Randomized phase III trials have shown that olaparib as maintenance therapy in BRCA‑mutated, platinum‑sensitive ovarian cancer prolongs progression‑free survival in selected trial populations, and some analyses have reported overall‑survival signals. Fuzuloparib has been described in review articles and is approved in China for germline‑BRCA platinum‑sensitive recurrent disease, but the available evidence in these sources is review‑based and limited to the approved indication and population.
  • A phase III trial reported that adding bevacizumab to gemcitabine plus carboplatin in platinum‑sensitive recurrent ovarian cancer improved progression‑free survival and response rates; this finding is also reflected in expert consensus recommendations.
  • Multiple clinical studies evaluated relacorilant plus nab‑paclitaxel in platinum‑resistant ovarian cancer: some trials reported improved progression‑free survival (and an interim overall survival improvement in one phase III report), while other reports were mixed or still ongoing, indicating variable results across studies and schedules.
  • Biomarker and translational work in these studies includes a retrospective analysis showing folate receptor alpha expression in roughly one‑third of ovarian tumors, and several reviews summarizing molecular pathways (microRNAs, IDO/TDO2, genomic subtypes) as potential biomarkers or targets; much of this is observational or preclinical.
  • Overall the body of evidence in these reports is a mixture of large randomized trials for specific agents/subgroups and earlier-stage, observational, or review-level analyses for biomarkers and newer combinations.

Compounds studied in Ovarian Cancer

Fuzuloparib1 study
These studies report fuzuloparib, an oral PARP inhibitor, based on a review of clinical-trial data that led to regulatory approval in China for platinum‑sensitive recurrent ovarian/fallopian tube/primary peritoneal cancer in patients with germline BRCA mutations; the evidence cited is review-based and limited to the approved indication and population.
Bevacizumab2 studies
These studies report bevacizumab added to platinum‑based chemotherapy (gemcitabine plus carboplatin) was associated with longer progression‑free survival and higher response rates in a phase III trial of platinum‑sensitive recurrent disease and is discussed in expert consensus guidance; the findings focus on PFS and specific trial populations rather than universal benefit.
Olaparib3 studies
These studies report olaparib as maintenance therapy in randomized phase III trials for BRCA‑mutated and other selected patients with platinum‑sensitive ovarian cancer, showing consistent progression‑free survival benefits and some analyses reporting longer overall survival in trial populations; most data come from randomized clinical trials in molecularly selected groups.
Relacorilant3 studies
These studies report relacorilant combined with nab‑paclitaxel showed improved progression‑free survival (and an interim overall survival signal in one phase III report) in platinum‑resistant ovarian cancer in some trials, while other phase II/III reports were mixed or ongoing, indicating results vary by schedule and study.
Mirvetuximab Soravtansine1 study
These studies report a retrospective analysis finding folate receptor alpha (FRα) expression in about 36% of ovarian/fallopian tube/primary peritoneal tumor samples (more common in high‑grade serous tumors), a biomarker observation rather than direct evidence of clinical benefit from the antibody–drug conjugate.
Gemcitabine1 study
These studies report gemcitabine was used as part of the chemotherapy backbone (with carboplatin) in a phase III trial where adding bevacizumab improved progression‑free survival and response rates; the independent effect of gemcitabine apart from the combination was not isolated in these reports.
Carboplatin1 study
These studies report carboplatin was part of the standard chemotherapy regimen (gemcitabine plus carboplatin) in a phase III trial that evaluated adding bevacizumab and found longer progression‑free survival and higher response rates with the addition; the results reflect the combination context used in the trial.
Paclitaxel1 study
These studies report nab‑paclitaxel (albumin‑bound paclitaxel) was used in combination with relacorilant in phase II and phase III studies of platinum‑resistant ovarian cancer, with some reports of improved progression‑free survival for the combination; interpretation is limited to the combination regimens and specific trial schedules.

Supportive & alternative options discussed

  • Exercise / prehabilitation: Also discussed as a supportive option to help maintain physical function and well‑being for people with ovarian cancer, though these studies did not evaluate exercise interventions.
  • Acupuncture: Also discussed as a supportive option for symptom management (for example, pain or nausea) in ovarian cancer care; the studies provided here did not assess acupuncture.
  • Mind–body (MBSR / CBT): Also discussed as a supportive approach (stress reduction, quality‑of‑life support) for people with ovarian cancer, but not studied in the reports summarized above.
  • Ketogenic / metabolic therapy: Also discussed by some as a complementary dietary approach in oncology contexts, but the studies summarized here do not provide evidence on ketogenic diets for ovarian cancer.

What we don’t know yet

  • Do the observed progression‑free survival benefits translate into consistent, long‑term overall survival and quality‑of‑life improvements across broader, unselected ovarian cancer populations?
  • Which biomarkers beyond germline BRCA reliably predict benefit from PARP inhibitors, and which patients are most likely to benefit from agents like relacorilant or mirvetuximab‑soravtansine?
  • What are the optimal dosing schedules, sequencing, and patient selection criteria for combinations such as relacorilant plus nab‑paclitaxel?
  • How generalizable are trial findings to diverse real‑world populations, and what are the longer‑term safety and toxicity profiles of newer combinations?
  • For biomarker‑targeted approaches (e.g., FRα for mirvetuximab‑soravtansine), how well do retrospective prevalence data predict clinical benefit in prospective treatment studies?
Overall, these studies include several large randomized trials that provide moderate‑to‑strong evidence for certain agents in selected subgroups (for example, PARP inhibitors and bevacizumab), but many questions remain and much supporting information is early‑stage, subgroup‑limited, observational, or still under study.

Clinical trials in Ovarian Cancer

50 ongoing · 120 completed · tracked from ClinicalTrials.gov. Recruiting is not the same as proven, and completed is not the same as positive — read the results. Not a recommendation.

Completed
37 stopped (terminated / withdrawn / suspended)

Search all trials on ClinicalTrials.gov →

Getting care & support

Nonprofit / Gov

Practical, vetted help for Ovarian Cancer — advocacy, paying for treatment, second opinions, and caregivers.

If you’re struggling emotionally, you don’t have to wait.

Advocacy & community

No dedicated organization for this specific cancer is curated yet — these general organizations can help in the meantime.

Financial help

  • PAN Foundation ↗ — Copay assistance funds by diagnosis (funds open and close as money allows). · status changes often — check the fund’s site
  • HealthWell Foundation ↗ — Copay and premium assistance funds by disease. · status changes often — check the fund’s site
  • CancerCare — financial assistance ↗ — Limited grants plus free financial counseling. · status changes often — check the fund’s site
  • Family Reach ↗ — Help with everyday living costs (rent, transport, food) during treatment. · status changes often — check the fund’s site
  • NeedyMeds ↗ — Searchable directory of drug patient-assistance and discount programs. · status changes often — check the fund’s site
What you’ll typically need to apply
  • Your diagnosis and, if you have it, the specific drug/treatment name (from your care team).
  • Insurance details — your member ID card, or a note that you're uninsured (some funds require active insurance, some don't).
  • Proof of income and household size (recent pay stubs, a tax return, or a benefits letter) — most funds are income-based.
  • Your prescriber's contact information; some programs need the clinic to submit part of the application.
  • Apply early and re-check: funds open and close as money is available, so a closed fund may reopen.

General guidance — each program sets its own eligibility. Confirm requirements on the program’s site.

Help paying for the medicines on this page

Second opinions

Caregiver support

We list only non-profit and government resources — never product sellers — and take no affiliate fees. If a link is broken or a resource doesn't meet that bar, tell us.

Interactions & safety to check: Ovarian Cancer

This is not a complete interaction check. It only covers the compounds we track and the signals reported in studies. A drug or supplement not listed here is not therefore safe. Bring your full medication and supplement list to your pharmacist and oncologist before changing anything.

Potential interactions: highest-stakes first

  • Niraparib †Rx×CYP1A2 inhibitorshigh-stakeslow
    Monitor: Modest exposure increase (e.g., fluvoxamine).
  • Niraparib †Rx×P-gp substrateshigh-stakeslow
    Monitor: Potential competition (e.g., digoxin).
  • Nivolumab †Rx×immunosuppressantshigh-stakeshigh
    Avoid: Blunts efficacy (e.g., chronic steroids).
  • Nivolumab †Rx×Ipilimumabmoderate
    Synergize: Higher irAE but OS gains in melanoma.
  • Niraparib †Rx×Bevacizumablow
    Synergize: Complementary PFS extension in ovarian.
  • Nivolumab †Rx×corticosteroidslow
    Use For IrAE: High-dose for toxicity; low-dose physiologic OK.

Safety considerations

Heading to an appointment? Get a printable one-page summary — studied compounds, open trials, interactions, and questions to ask.
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