The Ovarian Cancer Care Advances Helping Thousands of Women
- Coretta Scott King’s legacy extends beyond civil rights; after her stage 3 ovarian cancer diagnosis in 2006, she helped raise national awareness about a disease affecting more than 21,000 women each year.
- Two decades later, ovarian cancer care has expanded with improved genetic testing, targeted therapies, advanced surgical options, and promising new treatments now under FDA review.
- Emerging research shows promise: adding the PD-1 inhibitor pembrolizumab (Keytruda) to weekly paclitaxel (chemotherapy)—with or without bevacizumab (a monoclonal antibody drug that stops tumors from forming new blood vessels)—significantly improved survival outcomes for patients with platinum-resistant recurrent ovarian cancer in the phase III ENGOT‑ov65/KEYNOTE‑B96 trial.
- Women with a BRCA mutation (increases chances of breast and ovarian cancer) have a tumor that is more responsive to treatment with a PARP inhibitor (olaparib, niraparib, and rucaparib), which work by preventing cancer cells from repairing their own DNA after it’s been damaged during chemotherapy.
- “There can be patients that are germline negative yet have a somatic mutation who would be candidates for PARP inhibitors as upfront maintenance,” Dr. Erin Salinas, a gynecologic oncologist at Compass Oncology,
- Dr. Amanda Fader at Johns Hopkins University notes that when imaging or testing shows the cancer has already reached other organs, doctors may recommend cytoreductive (debulking) surgery.
- Research from the American Cancer Society shows that patients who are optimally debulked—meaning no tumors larger than 1 cm remain—tend to have better outcomes than those left with larger residual disease.
Decades after helping cement her late husband’s legacy with the creation of a national holiday, Mrs. King entered a difficult chapter of her own. She suffered a stroke in August 2005 and, only a few months later, learned she had stage 3 ovarian cancer. In the years since her diagnosis, treatment options for women facing this disease have expanded dramatically, giving more patients stronger, more effective paths to fight back.
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WATCH: Ovarian Cancer – The Importance of Increasing Diversity in Clinical Trials
Dr. Chase adds that the sequencing of treatment matters when or if it is added to other treatment options.
“The sequencing of the treatment is really dependent on the patient’s tumor biomarker profile. We will need to take into consideration: biomarker profile, prior toxicities, patient’s performance status, and goals of treatment.” Depending on those three factors, doctors can best decide which treatment to pursue first
Ovarian cancer often begins in the fallopian tubes, where rogue cells migrate to the ovaries and form tumors.
Ovarian cancer has been called the “cancer that whispers” because women often don’t experience symptoms until their cancer has already reached its late stages. The symptoms that do appear at first are hard to identify as cancer.
“Ovarian cancer does not have any specific symptoms,” Dr. Beth Karlan, a gynecologic oncologist at UCLA Medical Center, told SurvivorNet.
The symptoms of ovarian cancer may include the following, according to SurvivorNet experts.
- A feeling of bloating or fullness
- Pain in the pelvis or abdomen
- Nausea
- Vomiting
- Changes in bowel habits
WATCH: How your ovarian cancer responds to certain types of chemotherapies guides your future treatments.
The standard of care for ovarian cancer patients is chemotherapy, which helps many patients reach remission.
In the years following Dr. King’s assassination in 1968, Coretta carried forward his mission while raising their four children. She founded the Martin Luther King Jr. Center for Nonviolent Social Change in Atlanta and played a pivotal role in establishing MLK Day as a national holiday.
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“[It] came as a tremendous shock to us,” her daughter Yolanda told The Washington Post.
She recalled her mother’s determination even as she recovered from the stroke: “She was walking with a cane, more erectly. But she was continuing to have clotting, which led to tests. She shed a few tears and said, ‘Okay, we’re going to face this.’”
According to The New York Times, Coretta was partially paralyzed from the stroke, and her cancer had spread to her intestines. She sought care at a clinic in Mexico known for offering treatments outside the standard of care. Coretta Scott King died from complications of her cancer on January 30, 2006.
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Twenty years later, her legacy endures—and so does the progress in ovarian cancer treatment, offering more women a fighting chance than ever before.
What’s Changed In Ovarian Cancer Care
- Early access to genetic and molecular testing is giving women clearer, more personalized information from the start of their diagnosis.
Homologous recombination deficiency (HRD)—a genetic feature sometimes linked to BRCA mutations but also found in other patients—helps determine how cancer cells repair DNA and can guide treatment decisions. - The targeted therapy Elahere (mirvetuximab soravtansine) is offering new hope for women with platinum‑resistant ovarian cancer, which returns within six months of platinum‑based chemotherapy.
- Advances in surgical techniques, including debulking procedures that may involve hysterectomy, ovary removal, and lymph node biopsies, remain critical when cancer has spread.
- Maintenance therapies such as olaparib (Lynparza), a PARP inhibitor, combined with bevacizumab (Avastin), an anti‑angiogenic drug, help extend remission by disrupting cancer cells’ ability to grow and repair.
- Emerging research shows promise: adding the PD‑1 inhibitor pembrolizumab (Keytruda) to weekly paclitaxel (chemotherapy)—with or without bevacizumab (a monoclonal antibody drug that stops tumors from forming new blood vessels)—significantly improved survival outcomes for patients with platinum‑resistant recurrent ovarian cancer in the phase III ENGOT‑ov65/KEYNOTE‑B96 trial, according to The ASCO Post. The FDA is expected to review this approach in early 2026.
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Genetic Testing In Ovarian Cancer Care
Genetic testing for ovarian cancer can lead to life-saving actions and screening tests for early detection. And when it comes to ovarian cancer, which is curable in over 90 percent of cases when diagnosed early enough, genetic testing can be a valuable option.
“Genetic testing can empower you with such important information,” Dr. Karlan says.
WATCH: How a Family History Matters to Cancer Risk
Mutations of the BRCA gene, like BRCA1 or BRCA2, can place people at a heightened risk for breast cancer or ovarian cancer. But in the U.S., 90 percent of people who carry a BRCA gene mutation aren’t aware of it until someone in their family gets cancer.
These gene mutations are commonly passed down among family members. Women can pass BRCA on to their children, which increases their children’s risk of developing certain cancers, particularly of the ovary.
Women with a BRCA mutation have a tumor that is more responsive to treatment with a PARP inhibitor.
PARP inhibitor drugs (olaparib, niraparib, and rucaparib), which work by preventing cancer cells from repairing their own DNA after it’s been damaged during chemotherapy.
PARP inhibitors have been shown to extend progression-free survival for some women. In BRCA carriers, some PARP inhibitors have been shown to have an overall survival benefit.
WATCH: The Importance of Genetic Testing For Ovarian Cancer Maintenance Therapy
“We’re often testing all of our patients for germline mutations, meaning inherited mutations specifically in BRCA, as well as somatic testing, meaning sending the tumor itself for molecular profiling to look for somatic mutations,” Dr. Erin Salinas, a gynecologic oncologist at Compass Oncology, tells SurvivorNet.
“There can be patients that are germline negative yet have a somatic mutation who would be candidates for PARP inhibitors as upfront maintenance. So we’re usually doing that testing in the primary setting. However, if that was not done in the recurrent setting, it’s also beneficial,” Dr. Salinas added.
Understanding the Homologous Recombination Deficiency
Building upon the idea that learning more about the ovarian cancer’s genetic profile, doctors can better tailor effective treatment for the patient.
Homologous recombination deficiency, or HRD, refers to a breakdown in one of the body’s key DNA‑repair systems. When this repair pathway falters, cells struggle to fix genetic damage, which can allow abnormalities to accumulate and eventually become cancer. The relationship also works in the opposite direction: certain genetic mutations found in cancer cells can cause HRD.
“Homologous recombination is the process that happens when our genes are being copied, and a cell divides into two daughter cells,” explains Dr. David Engle, a gynecologic oncologist at Baptist Medical Group in Memphis, Tennessee, in an interview with SurvivorNet.
If an error occurs during that copying process, he says, the cell relies on homologous recombination to correct it.
The body has a dedicated set of genes whose job is to scan for these mistakes and repair them by removing the abnormal sequence and replacing it with the correct one. But because this system depends on multiple genes working together, a defect in any one of them can weaken the entire repair process. When damaged DNA isn’t fixed properly, Dr. Engle notes, it can increase the risk of cancer because the “wrong codes” get passed along as cells divide.
HRD is sometimes found in women with BRCA gene mutations—the most well‑known inherited risk factor for ovarian cancer—but it can occur in others as well. Identifying HRD matters because it can shape treatment decisions. Research shows that women with HRD-positive ovarian cancer often respond more effectively to platinum-based chemotherapy, such as cisplatin or carboplatin, and to newer targeted treatments called PARP inhibitors.
Elahare’s for FRα-High, Platinum-Resistant Ovarian Cancer
Elahare’s FDA approval marks a significant advancement in treating advanced ovarian cancer, offering a new, effective option for patients who have exhausted other treatments.
The drug targets the folate receptor alpha (FRα) protein present on the tumor cell surface.
WATCH: Treatment Option For Ovarian Cancer Recurrence
“Having the option of a specific drug just for platinum-resistant ovarian cancer is fantastic. Up until this point, what we’ve been offering you for platinum resistant ovarian cancer is chemotherapy plus Bevacizumab or Avastin, and we know that the response rate with both of those is anywhere from about 10 to 15%,” Dr. Yasmin Lyons, assistant professor in the division of gynecologic oncology at The University of Texas Health Science Center at San Antonio, told SurvivorNet.
Ovarian cancer cells commonly carry folate receptor alpha (FRα) protein on their surface. Up to 80% of new and recurrent ovarian cancers may carry this protein. Generally, FRα levels tend to be high in more aggressive ovarian cancers.
WATCH: Elahare Giving Patients a Fighting Chance
Elahare acts as a biological missile. Dr. Lyons explains: “What that means is that the antibody part of the drug conjugate binds to the folate receptor on the tumor cells, and then that gets taken up into the tumor cell. And then the drug that it is conjugated with is the part that actually kills the tumor cells, by affecting the tumor cells’ ability to divide.”
To be eligible to receive Elahere, a woman would have to be on platinum therapy that has failed or for whom it did not work. So, to be eligible, patients must:
- Test positive for folate receptor-alpha (FRα) AND
- Have not responded to or are no longer responding to treatment with platinum-based chemotherapy AND
- Have received 1 to 3 prior types of chemotherapy.
Improved Surgery Techniques
Surgery remains a cornerstone of treatment for most ovarian cancers, but the extent of the operation depends on how far the disease has spread and on a patient’s overall health.
Dr. Amanda Fader, vice chair of gynecologic surgical operations at Johns Hopkins University, notes that when imaging or testing shows the cancer has already reached other organs, doctors may recommend cytoreductive (debulking) surgery.
“We’re not really doing a staging procedure, because we know the cancer is at a more advanced stage,” she explains.
“Our goal is to remove all or most of the visible disease,” which can involve a hysterectomy, removal of the ovaries, lymph node biopsies, and sometimes the removal of larger tumor deposits throughout the abdomen or pelvis.
Debulking surgery can affect multiple areas, including the small intestine, bladder, gallbladder, stomach, liver, or pancreas.
Research from the American Cancer Society shows that patients who are optimally debulked—meaning no tumors larger than 1 cm remain—tend to have better outcomes than those left with larger residual disease.
Dr. Fader emphasizes that chemotherapy, which many women receive after surgery, is far more effective against small or microscopic tumors. “If we can debulk most or all of those tumors,” she says, “we’re apt to see a much better response to chemotherapy.”
Maintenance Therapy for Ovarian Cancer Patients
Ovarian cancer recurrence happens in “almost 25 percent of cases with early-stage diseases and in more than 80 percent with more advanced stages,” according to research published in the “Gland Surgery” medical journal.
WATCH: Changing Landscape Of Ovarian Cancer Treatment
Determining the probability that a woman’s cancer will recur depends on the stage at which they were initially diagnosed. According to most data:
- Women with stage 1 ovarian cancer have a 10 percent chance of recurrence.
- Women in stage 2 have a 30 percent chance of recurrence.
- Women in stage 3 have a 70 to 90 percent chance of recurrence.
- Women in stage 4 have a 90 to 95 percent chance of recurrence.
With recurrence a strong possibility for this disease, especially in the later stages of ovarian cancer, certain drug treatments to deal with it are giving many women hope.
Maintenance therapy is continued treatment after the patient finishes their initial treatment. After an ovarian cancer patient completes a round of treatments — such as surgery and chemotherapy — her doctor may recommend some form of maintenance therapy to try and delay possible recurrence. Maintenance therapy can involve taking an oral pill (a PARP inhibitor) every day after chemotherapy and can keep cancer in remission longer.
A combination of drugs providing a maintenance therapy option for ovarian cancer includes olaparib plus bevacizumab. Olaparib (brand name Lynparza) is a PARP inhibitor, a drug that acts to kill cancer cells by preventing them from repairing damaged genetic material. Bevacizumab (brand name Avastin) is an anti-angiogenic drug that works by preventing the formation of new blood vessels, starving cancer cells of nutrients.
While initially women with a BRCA-1 or BRCA-2 genetic mutation had been shown to respond especially well to PARP inhibitors after recurrence, newer research has shown that women with the BRCA gene mutation (and indeed almost all women), can consider using PARP inhibitors throughout their treatment.
The type of treatment recommended for recurrence can depend on several factors:
- The period within which the cancer recurred
- The kind of chemotherapy the woman underwent in the past
- Side effects that came as a result of past treatments
- The length of time between the last treatment the woman underwent and the recurrence
- The specific mutations and molecular features of your cancer
If a woman’s time between remission and recurrence is more than six months, then the ovarian cancer is categorized as “platinum-sensitive” (that is, responsive to a platinum-based chemotherapy treatment), and that patient will be treated with chemotherapy and another platinum-based drug.
WATCH: How to Manage Recurrence in Ovarian Cancer
If the recurrence time happens less than six months into remission, the ovarian cancer is classified as “platinum-resistant.” At that point, women are usually treated with another type of chemotherapy and encouraged to enter a clinical trial. Alternatively, women might be platinum-refractory, which refers to a disease that grows while the patient is on chemotherapy and has a particularly poor prognosis.
Clinical trials are an option for women facing ovarian cancer with a high probability of recurrence.
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