Maintenance Therapy in Ovarian Cancer

Abstract Purpose of Review This report reviews foundational and recent literature on maintenance therapy in ovarian cancer, both in the frontline setting and in platinum-sensitive recurrence. Recent Findings Bevacizumab and PARP inhibitors have been well established as frontline maintenance for BRCA wild-type and BRCA mutated or homologous repair deficient disease, respectively. For platinum-sensitive recurrence, PARP inhibitors are reserved for BRCA mutated disease; Bevacizumab can be considered if used alongside chemotherapy in management of the recurrence. Summary Advanced epithelial ovarian cancer often responds well to initial chemotherapy and cytoreductive surgery, but rapid recurrence is common. Maintenance therapy with Bevacizumab or PARP inhibitors, in both frontline treatment and in platinum-sensitive recurrence, has improved progression-free survival. We review literature that informs recommendations for selection of maintenance regimens as well as recent findings narrowing some of their indications for use.