The systemic treatment of recurrent ovarian cancer revisited

Ann Oncol. 2021 Jun;32(6):710-725. doi: 10.1016/j.annonc.2021.02.015. Epub 2021 Mar 3.


Treatment approaches for relapsed ovarian cancer have evolved over the past decade from a calendar-based decision tree to a patient-oriented biologically driven algorithm. Nowadays, platinum-based chemotherapy should be offered to all patients with a reasonable chance of responding to this therapy. The treatment-free interval for platinum is only one of many factors affecting patients' eligibility for platinum re-treatment. Bevacizumab increases the response to chemotherapy irrespective of the cytotoxic regimen and can be valuable in patients with an urgent need for symptom relief (e.g. pleural effusion, ascites). For patients with recurrent high-grade ovarian cancer, which responds to platinum-based treatment, maintenance therapy with a poly(ADP-ribose) polymerase inhibitor can be offered, regardless of the BRCA mutation status. Here we review contemporary decision-making processes in the systemic treatment of relapsed ovarian cancer.

Keywords: platinum re-treatment; platinum-based chemotherapy; poly(ADP-ribose) polymerase (PARP) inhibitor; recurrent ovarian cancer.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Carcinoma, Ovarian Epithelial / drug therapy
  • Carcinoma, Ovarian Epithelial / genetics
  • Female
  • Humans
  • Neoplasm Recurrence, Local / drug therapy
  • Ovarian Neoplasms* / drug therapy
  • Ovarian Neoplasms* / genetics
  • Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use


  • Antineoplastic Agents
  • Poly(ADP-ribose) Polymerase Inhibitors