Advances in the Treatment of Recurrent Ovarian Cancer and Rare Malignant Ovarian Germ Cell Tumors

Most patients with epithelial ovarian cancer will experience recurrence. Treatment at the time of recurrence is largely guided by platinum sensitivity, symptom burden, prior toxicities, and patient preferences. For patients with a first platinum-sensitive recurrence, platinumbased doublets remain the preferred treatment approach. However, changes to care in the United States include the withdrawal of FDA approvals for PARP inhibitors in the recurrent setting for patients without BRCA-mutated disease. The treatment landscape has expanded with the approval of 2 antibody–drug conjugates—mirvetuximab soravtansine-gynx and fam-trastuzumab deruxtecan-nxki—which represent an exciting new class of therapeutics in the oncology pipeline. In contrast, for the rare malignant ovarian germ cell tumors, recurrence is uncommon and cure with up-front treatment is likely. Although progress in this subtype has been slower, treatment in this area is advancing.