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Ovarian Cancer: Maintenance Therapy

Maintenance therapy is a type of treatment given to people after they complete chemotherapy treatment to decrease the chance that the cancer will come back.

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for Ovarian Cancer

may be given to some people after they complete chemotherapy treatment to decrease the chance that the cancer will come back, or to delay the cancer from coming back. Two types of targeted therapies are used for , Avastin (bevacizumab) and PARP inhibitors.

The choice of for ovarian cancer depends on a few factors:

  • Whether you were initially treated with chemotherapy alone or chemotherapy plus Avastin:  Avastin may be used as in women who received the drug as part of their initial treatment.  
  • How well your cancer responded to chemotherapy:  is used for women whose cancer disappeared (complete response) or shrank (partial response) during their most recent chemotherapy treatment.
  • How many previous lines of chemotherapy treatment you have received:  or front-line is the first treatment given; second-line is used if the cancer returns; if the cancer comes back again, the next treatment regimen is called third-line, etc.
  • Results of genetic testing for an inherited mutation: some regimens are approved for women with an inherited mutation in or .
  • Results of tumor testing: some maintenance therapies are approved for women with a tumor mutation in or or a tumor called HRD-positive.

Avastin for

Avastin (bevacizumab) may be used as  for people who received Avastin with chemotherapy as part of their initial treatment and had a complete or partial response. There are two ways that Avastin may be used for maintenance therapy:

  • As or later-line used alone. Women do not need to have an inherited or tumor mutation or any type of in order to receive maintenance treatment with Avastin alone. 
  • As maintenance therapy combined with the Lynparza in people with a or inherited or tumor mutation or in women whose tumor is HRD-positive. 

PARP inhibitors for 

PARP inhibitors are a type of that can be used as treatment or as maintenance after treatment. PARP inhibitors are only used for to treat people who had a complete or partial response to their most recent treatment with chemotherapy. Three PARP inhibitors have received  approval for ovarian cancer maintenance therapy:

  • Lynparza ()
  • ()
  • ()

First-line:

  • Lynparza may be used alone or in combination with Avastin as  for women with an inherited mutation or a  mutation in their tumor.
  • Lynparza may also be used in combination with Avastin (see above) for women whose tumor is HRD-positive. 
  • is approved to be used as for any woman regardless of her or status. 

Second-line or higher 

  • Lynparza may be used as  for women with ovarian cancer who have received two or more lines of chemotherapy who had either a complete or partial response to the most recent line of recurrence therapy. Lynparza may be given to people with an inherited  mutation (found through genetic testing) or a tumor mutation (found through testing). 

Table of FDA-approved drugs

Open Table
Table of maintenance therapies for ovarian cancer: Table listing the drugs used for maintenance therapy in ovarian cancer

Name of Drug

Line of Treatment

Indication

Biomarker

Avastin (bevacizumab)

First-line

Used as a single agent for maintenance therapy for people who received Avastin with chemotherapy as part of their initial treatment

No biomarker required

Avastin (bevacizumab)

Second-line or later

Used as a single agent for maintenance therapy for people who received Avastin with chemotherapy as part of their most recent treatment

No biomarker required

Avastin (bevacizumab) and Lynparza (olaparib) combination

First-line

For people who received Avastin with chemotherapy for their initial treatment

  • Inherited (germline) mutation in BRCA1 or BRCA2
  • Tumor (somatic) mutation in BRCA1 or BRCA2

Avastin (bevacizumab) and Lynparza (olaparib) combination

First-line

For people who received Avastin with chemotherapy for their initial treatment

HRD-positive (homologous recombination deficiency)

Lynparza (olaparib)

First-line

Used as a single agent for people who had a complete or partial response to platinum chemotherapy

  • Inherited (germline) mutation in BRCA1 or BRCA2
  • Tumor (somatic) mutation in BRCA1 or BRCA2

Zejula (niraparib)

First-line

Used as a single agent for people who had a complete or partial response to platinum chemotherapy

No biomarker required

Lynparza
(olaparib)

Rubraca
(rucaparib)

Zejula
(niraparib)

Second-line or later

For people who had a complete or partial response to platinum chemotherapy

No biomarker required

Last updated July 22, 2024