Management of Advanced Ovarian, Fallopian Tube, and Primary Peritoneal Cancers

Abstract

Treatment approaches for advanced ovarian cancer should consider several factors. Among the most important are platinum sensitivity, the status of BRCA and homologous recombination deficiency (HRD), and the changing indications for PARP inhibitors in recurrent disease and maintenance. PARP inhibitors have demonstrated clear benefit in patients with BRCA mutated tumors, especially in the first-line setting, and HRD testing can guide their use for patients without BRCA mutations. A new antibody–drug conjugate, mirvetuximab soravtansine, has been approved for use in a subset of patients with platinum-resistant disease. Newly diagnosed patients with advanced-stage ovarian, fallopian tube, or primary peritoneal cancers should always be evaluated by a gynecologic oncologist if possible.