First-line treatment with/without extended (maintenance) treatment
Progression Free Survival (months)
Median length of time before the cancer comes back or gets worse
Overall Survival (months)
The length of time where half the patients in the study are still alive
Maintenance after first-line therapy: Treatment to prevent relapse after complete or partial response to therapy
Progression Free Survival (months)
Median length of time before the cancer comes back or gets worse
Overall Survival (months)
The length of time where half the patients in the study are still alive
First-line treatment with/without extended (maintenance) treatment
For more detailed information, please click on the clinical trial ID number.
| Drug Class | Trial ID # | Phase | Drugs | Clinical Trial Title | Key Conclusion and Results |
|---|---|---|---|---|---|
| Standard of Care Targeted Drugs | |||||
| Angiogenesis Inhibitors: VEGF | NCT00262847; GOG-218 | III | Bevacizumab, Carboplatin, Paclitaxel Prescribing Information | A Phase III Trial of Carboplatin and Paclitaxel Plus Placebo Versus Carboplatin and Paclitaxel Plus Concurrent Bevacizumab (NSC # 704865) Followed by Placebo, Versus Carboplatin and Paclitaxel Plus Concurrent and Extended Bevacizumab, in Women With Newly Diagnosed, Previously Untreated, Stage III or IV Epithelial Ovarian, Primary Peritoneal or Fallopian Tube Cancer (GOG218) | Improved PFS, but no OS difference with addition of bevacizumab to carboplatin+paclitaxel; potential benefit for patients with stage IV disease CarboPt+Pac+Bev w/ Bev maint vs CarboPt+Pac+Bev vs CarboPt+Pac: All: Stage IV patients: pub 2019 |
| Angiogenesis Inhibitors: VEGF | NCT00483782; ICON7 | III | Bevacizumab, Carboplatin, Paclitaxel | ICON7 - A Randomised, Two-Arm, Multi-Centre Gynaecologic Cancer InterGroup Trial of Adding Bevacizumab to Standard Chemotherapy (Carboplatin and Paclitaxel) in Patients With Epithelial Ovarian Cancer | Improved PFS and OS with addition of bevacizumab to carboplatin+paclitaxel in high risk patients CarboPt+Pac+Bev w/ Bev maint vs CarboPt+Pac: All: pub 2011; 2015, 2020 |
| Angiogenesis Inhibitors: VEGF | NCT01462890; AGO-OVAR17 | III | Bevacizumab, Carboplatin, Paclitaxel | A Prospective Randomised Phase III Trial to Evaluate Optimal Treatment Duration of First-line Bevacizumab in Combination With Carboplatin and Paclitaxel in Patients With Primary Epithelial Ovarian, Fallopian Tube or Peritoneal Cancer | Longer treatment with bevacizumab for up to 30 months improves neither PFS nor OS in patients with newly diagnosed ovarian cancer. Therefore bevacizumab treatment duration of 15 months remains standard of care PFS: 24.2 vs 26.0 months pub 2023 |
| Drugs in Clinical Development | |||||
| DNA Damage Repair Pathway Inhibitors: PARP | NCT02470585; VELIA | III | Carboplatin, Paclitaxel, Veliparib | A Phase 3 Placebo-Controlled Study of Carboplatin/Paclitaxel With or Without Concurrent and Continuation Maintenance Veliparib (PARP Inhibitor) in Subjects With Previously Untreated Stages III or IV High-Grade Serous Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer | Veliparib added to chemotherapy and continued as maintenance significantly extends PFS in all newly diagnosed patients, but shows most benefit in BRCA MUT patients CarboPt+Pac+Vel w/Vel maint vs CarboPt+Pac+Vel vs CarboPt+Pac: All patients: pub 2019 |
| DNA Damage Repair Pathway Inhibitors: PARP | NCT03326193; OVARIO | II | Carboplatin, Paclitaxel, Bevacizumab, Niraparib | Phase 2, Single-arm, Open-label Study to Evaluate the Safety and Efficacy of Niraparib Combined With Bevacizumab as Maintenance Treatment in Patients With Advanced Ovarian Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer Following Front-line Platinum-based Chemotherapy With Bevacizumab | Niraparib + bevacizumab maintenance treatment does not appear to cause cumulative toxicities and shows promising PFS PFS (6 months): 90% pub 2022 |
| DNA Damage Repair Pathway Inhibitors: PARP | NCT00989651; GOG-9923 | I | Carboplatin, Cisplatin, Paclitaxel, Veliparib, Bevacizumab | A Phase I Study of Intravenous Carboplatin/Paclitaxel or Intravenous and Intraperitoneal Paclitaxel/Cisplatin in Combination With Continuous or Intermittent /CTEP-Supplied Agent ABT-888 (NSC #737664) and CTEP-Supplied Agent Bevacizumab (NSC #704865) in Newly Diagnosed Patients With Previously Untreated Epithelial Ovarian, Fallopian Tube or Primary Peritoneal Cancer | Patients receiving IP cisplatin + IV/IP paclitaxel show promising PFS and OS when compared to patients receiving IV carboplatin+paclitaxel, however differences may be reflective of selection bias toward patients enrolled on the IP chemotherapy arm IV vs weekly IV vs IP (all w/ Vel cont): PFS: 24.5 vs 23.5 vs 43.2 months pub 2020, abs Mar 2020 |
| Angiogenesis Inhibitors: VEGF | NCT00951496; GOG-252 | III | Carboplatin, Cisplatin, Paclitaxel, Bevacizumab | A Phase III Clinical Trial of Bevacizumab With IV Versus IP Chemotherapy in Ovarian, Fallopian Tube and Primary Peritoneal Carcinoma | Compared to the IV reference arm, PFS was not significantly increased with either IP regimen IV CarboPt+Pac+Bev w/ Bev maint vs IP CarboPt+Pac+Bev w/ Bev maint vs IP CisPt+Pac+Bev w/ Bev maint: PFS: 24.9 vs 27.4 vs 26.2 months stage II/III disease with no residual disease (R0): pub 2019, abs Mar 2022 |
| Immunotherapy: Checkpoint Inhibitors/PD-1 | NCT02766582 | II | Carboplatin, Paclitaxel, Pembrolizumab | Phase II Open Label Nonrandomized Trial of the Anti PD 1 Therapy Pembrolizumab With First Line Platinum Based Chemotherapy Followed by 12 Months Pembrolizumab Monotherapy for Patients With Stage III/IV Epithelial Ovarian Cancer | Pembrolizumab with carboplatin+paclitaxel on a weekly schedule is overall well tolerated and 12 months PFS is promising 28 patients abs Mar 2020 |
| Immunotherapy: Checkpoint Inhibitors/PD-L1 | NCT02718417; JAVELIN Ovarian 100 | III | Avelumab, Carboplatin, Paclitaxel | A Randomized, Open-Label, Multicenter, Phase 3 Study To Evaluate The Efficacy And Safety Of Avelumab (MSB0010718C) In Combination With And/Or Following Chemotherapy In Patients With Previously Untreated Epithelial Ovarian Cancer Javelin Ovarian 100 | Avelumab addition to carboplatin+paclitaxel and/or continued as maintenance therapy for newly diagnosed ovarian cancer patients does not improve PFS; PD-L1, CD8, and gBRCA1/2 status did not predict differential clinical benefit CarboPt+Pac+Ave+Ave maint vs CarboPt+Pac+Ave maint vs CarboPt+Pac: ORR: 36.0 vs 30.4 vs 30.4% pub 2021 |
| Immunotherapy: Checkpoint Inhibitors/PD-L1 | NCT03038100; IMagyn050 | III | Atezolizumab, Bevacizumab, Carboplatin, Paclitaxel | A Phase III, Multicenter, Randomized, Study of Atezolizumab Versus Placebo Administered in Combination With Paclitaxel, Carboplatin, and Bevacizumab to Patients With Newly-Diagnosed Stage III or Stage IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer | Atezolizumab does not significantly improve PFS or OS in the ITT or PD-L1+ population, but the poor prognostic subgroup of patients (unfavorable KELIM score and sub-optimal surgery), might derive a significant PFS benefit from the treatment intensification with atezolizumab CarboPt+Pac+Bev+Ate vs CarboPt+Pac+Bev+Placebo: w/ unfavorable KELIM score and sub-optimal surgery: pub 2021, 2023, abs Mar 2024 |
| Immunotherapy: Checkpoint Inhibitors/PD-L1 | NCT03737643; DUO-O | III | Bevacizumab, Carboplatin, Durvalumab, Olaparib, Paclitaxel | A Phase III Randomised, Double-Blind, Placebo-Controlled, Multicentre Study of Durvalumab in Combination With Chemotherapy and Bevacizumab, Followed by Maintenance Durvalumab, Bevacizumab and Olaparib in Newly Diagnosed Advanced Ovarian Cancer Patients (DUO-O). | CarboPt+Pac+Bev+Dur followed by maintenance Bev+Dur+Ola in patients with newly diagnosed non-BRCA MUT advanced OC shows a statistically significant and clinically meaningful improvement in PFS vs CarboPt+Pac+Bev followed by maintenance Bev ITT (excl. tBRCA MUT): HRD+ (excl. tBRCA MUT): HRD-: abs Jun 2023 and presentation, abs Mar 2024 |
Maintenance after first-line therapy: Treatment to prevent relapse after complete or partial response to therapy
For more detailed information, please click on the clinical trial ID number.
| Drug Class | Trial ID # | Phase | Drugs | Clinical Trial Title | Key Conclusion and Results |
|---|---|---|---|---|---|
| Standard of Care Targeted Drugs | |||||
| DNA Damage Repair Pathway Inhibitors: PARP | NCT01844986; SOLO-1 | III | Olaparib Prescribing Information | A Phase III, Randomised, Double Blind, Placebo Controlled, Multicentre Study of Olaparib Maintenance Monotherapy in Patients With BRCA Mutated Advanced (FIGO Stage III-IV) Ovarian Cancer Following First Line Platinum Based Chemotherapy (SOLO-1) | Considerably improved PFS and OS for BRCA MUT patients with olaparib maintenance treatment; the benefit derived from 2 years of maintenance olaparib is sustained beyond the end of treatment Ola maint vs Placebo: PFS: 56.0 vs 13.8 months* pub 2018, 2021, 2022 |
| DNA Damage Repair Pathway Inhibitors: PARP | NCT02477644; PAOLA-1 | III | Bevacizumab, Carboplatin, Olaparib, Paclitaxel Prescribing Information | Randomized, Double-Blind, Phase III Trial Olaparib vs. Placebo Patients With Advanced FIGO Stage IIIB-IV High Grade Serious or Endometrioid Ovarian, Fallopian Tube, or Peritoneal Cancer Treated Standard First-Line Treatment | Dual maintenance therapy with olaparib and bevacizumab improves PFS and OS compared with bevacizumab maintenance alone for BRCA MUT and HRD+ high and low clinical risk patients Ola vs Placebo: All patients: HRD+ (incl. BRCA MUT) BRCA MUT: HRD+ (excl. BRCA MUT): HRD-: pub 2019, pub 2022, abs Sep 2022 and presentation, pub 2023, pub 2024 |
| DNA Damage Repair Pathway Inhibitors: PARP | NCT02655016; PRIMA | III | Niraparib Prescribing Information | A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study of Niraparib Maintenance Treatment in Patients With Advanced Ovarian Cancer Following Response on Front-Line Platinum-Based Chemotherapy | Considerably improved PFS for all patients that received niraparib maintenance treatment, but no OS benefit. In the HRD+ population, patients alive at 5 years were two times as likely to be progression free with niraparib treatment than placebo Nir maint vs Placebo: All patients: pub 2019, pub 2022, pub 2023, pub 2024 |
| DNA Damage Repair Pathway Inhibitors: PARP | NCT03709316; PRIME | III | Niraparib Prescribing Information | A Randomized, Double-Blind, Placebo-Controlled, Multi-Center, Phase III Clinical Trial Evaluating the Efficacy and Safety of ZL-2306 (Niraparib) for Maintenance Treatment in Patients With Advanced Ovarian Cancer, Fallopian Tube Carcinoma or Primary Peritoneal Cancer (Collectively Referred to as Ovarian Cancer) Who Have Achieved Effective Response After First-line Platinum-containing Chemotherapy | Niraparib with individually starting dose (ISD regimen) significantly improves PFS compared with placebo and is associated with a better safety profile PFS: pub 2023 |
| Drugs in NCCN Guidelines | |||||
| DNA Damage Repair Pathway Inhibitors: PARP | NCT03522246; ATHENA/GOG-3020 | III | Rucaparib | ATHENA (A Multicenter, Randomized, Double-Blind, Placebo- Controlled Phase 3 Study in Ovarian Cancer Patients Evaluating Rucaparib and Nivolumab as Maintenance Treatment Following Response to Front-Line Platinum-Based Chemotherapy) | Rucaparib monotherapy is effective as first-line maintenance, conferring significant benefit versus placebo in patients with advanced ovarian cancer with and without HRD Ruc maint vs Placebo: All patients: HRD+ (incl. tBRCA MUT): BRCA MUT: BRCA WT/LOH high: BRCA WT/LOH low: pub 2022, abs Mar 2024 |
| Hormonal Therapy: Anti-Estrogens | Retrospective Study: Hormonal Maintenance in LGSC | II | Anastrozole, Letrozole, Tamoxifen | Retrospective analysis of Hormonal Maintenance Therapy for Patients With LGS Ovarian Cancer | Significantly longer PFS with hormonal maintenance therapy (HMT) vs. observation (OBS) in Low Grade Serous OC patients HMT vs OBS: PFS: 64.9 vs 26.4 months* pub 2017 |
| Drugs in Clinical Development | |||||
| Hormonal Therapy: Aromatase | Letrozole University Hospital Basel | Single-site | Letrozole | Letrozole may be a valuable maintenance treatment in high-grade serous ovarian cancer patients | Promising activity with minimal toxicity of letrozole maintenance in ER-positive patients Let vs Placebo: All patients: Patients w/o residual disease: Patients w/ residual disease: pub 2018 |
| Immunotherapy: Checkpoint Inhibitors/PD-1 | NCT03522246; ATHENA/GOG-3020 | III | Nivolumab, Rucaparib | ATHENA (A Multicenter, Randomized, Double-Blind, Placebo- Controlled Phase 3 Study in Ovarian Cancer Patients Evaluating Rucaparib and Nivolumab as Maintenance Treatment Following Response to Front-Line Platinum-Based Chemotherapy) | Nivolumab in combination with rucaparib does not add to the PFS benefit of rucaparib observed in ATHENA-MONO Ruc+Niv vs Ruc+Placebo: PFS: 15.0 vs 20.2 months abs Sep 2024 and presentation |
| Immunotherapy: Vaccine/TGFbeta | NCT01309230 | II | Gemogenovatucel-T | Open-label Phase II Trial of Adjuvant bishRNAfurin and GMCSF Augmented Autologous Tumor Cell Vaccine (FANG™) for High Risk Stage III/IV Ovarian Cancer | FANG vaccine shows encouraging anti-tumor activity and increased RFS with remarkable safety FANG vs Placebo: RFS (from time of procurement, mean/median): pub 2016 |
| Immunotherapy: Vaccine/TGFbeta | NCT02346747; VITAL | II | Gemogenovatucel-T | A Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial of Vigil Engineered Autologous Tumor Cell Immunotherapy in Subjects With Stage IIIb-IV Ovarian Cancer in Clinical Complete Response Following Surgery and Primary Chemotherapy | Vigil immunotherapy as maintenance after first-line therapy in stage III–IV ovarian cancer is well tolerated and shows clinical benefit, particularly for BRCA WT and HRP patients that have high levels of CD39 RNA VIGIL vs Placebo: BRCA WT patients: HRP patients: HRP and CD39 RNA levels above median: pub 2020, pub 2021, pub 2022 |