Ovarian Cancer Symptoms, Stages and Treatment
In this article
What Is Ovarian Cancer?
Ovarian cancer is among the most distinctive and challenging gynecological cancers — both because it is usually diagnosed at an advanced stage and because systemic treatment has transformed incredibly rapidly over the past decade. This guide particularly emphasizes that systemic ovarian cancer treatment was almost completely rewritten between 2018-2026 — the arrival of PARP inhibitors (olaparib, niraparib, rucaparib), followed by long-term survival data testing some of this drug class and the withdrawal of certain uses, the introduction of a new class of antibody-drug conjugates (mirvetuximab soravtansine), and immunotherapy's largely unsuccessful performance in this cancer, contrary to expectations — all occurred in this brief period. This guide comprehensively and currently covers everything from anatomy and staging to the systemic treatment landscape (including 2026).
Female Reproductive Organ Anatomy
The female internal reproductive organs — vagina, uterus, fallopian tubes and ovaries — together perform vital functions such as egg production, hormone secretion and establishing pregnancy. The ovaries are oval glands approximately 3-5 cm long on either side of the uterus; they produce and mature egg cells (oocytes) and secrete reproductive hormones such as estrogen and progesterone. The fallopian tubes are thin, long structures connecting the ovaries and uterus; fertilization generally occurs here. This anatomical proximity directly relates to an important scientific development discussed below: most high-grade serous ovarian cancers are now understood to originate from the fimbriae at the end of the fallopian tube rather than the ovary itself.
Histological Classification: Ovarian Cancer Subtypes
Epithelial ovarian cancer accounts for approximately %90 of all ovarian cancers and arises from the ovarian surface epithelium or fallopian tube epithelium. The remaining %10 comprises rarer types such as germ cell and stromal tumors.
| Subtype | Approximate Proportion | Features |
|---|---|---|
| High-grade serous carcinoma (HGSC) | %70-75 | The most common and aggressive subtype; almost universal TP53 mutation; genomically unstable ("Type II") |
| Endometrioid carcinoma | ~%10 | Some develop in the setting of endometriosis; may be associated with Lynch syndrome |
| Clear cell carcinoma | ~%10 | Significantly more common in East Asian populations; generally develops in the setting of endometriosis |
| Low-grade serous carcinoma (LGSC) | ~%5 | More common in younger patients, slower-growing, less sensitive to chemotherapy than HGSC |
| Mucinous carcinoma | ~%3 | Primary ovarian origin is rare; metastasis from another organ (such as the bowel) generally must be excluded first |
| Borderline (borderline malignant potential) tumors | A separate category | Behavior between cancer and benign disease; generally a good prognosis |
For many years, ovarian cancer was thought to arise from the ovary's own surface epithelium. However, evidence accumulated over the past decade and a half (Nature Communications, 2017 and 2019) showed that the vast majority of high-grade serous ovarian cancers actually originate from precursor lesions called serous tubal intraepithelial carcinoma (STIC) in the fimbriae at the end of the fallopian tube — ovarian surface epithelium may also be a less frequent alternative origin. This paradigm shift is not merely academic: it directly laid the groundwork for developing preventive surgical strategies in women with BRCA mutations (such as removing only the fallopian tubes and delaying ovarian removal until later).
How Common Is It? (Current Statistics)
According to the International Agency for Research on Cancer's (IARC) "Global cancer statistics 2024" report (Sung H, et al., CA: A Cancer Journal for Clinicians, 2026, DOI: 10.3322/caac.70090), worldwide data for 2024 reported approximately 330.731 new ovarian cancer cases (ranking 18. in incidence among all cancers) and 203.850 deaths due to ovarian cancer — high mortality relative to incidence directly reflects the usual advanced-stage diagnosis. %54,8 of cases occur in Asia and %21,3 in Europe; the highest incidence is reported in Eastern and Northern European countries (Latvia highest, 14,2 per 100.000).
According to the American Cancer Society's "Cancer Statistics, 2026" report (Siegel RL, et al., CA: A Cancer Journal for Clinicians, 2026, DOI: 10.3322/caac.70043), the USA is expected to have approximately, in 2026, 21.010 new ovarian cancer cases and 12.450 deaths . Lifetime risk of diagnosis is approximately 1 in 91 women, and risk of death from this disease approximately 1 in 143 women. The median age at diagnosis is generally 63 or older. Encouragingly, ovarian cancer mortality since 1976 has decreased by %45 — largely since the middle of the 2000 decade, corresponding precisely to the systemic treatment advances on which this guide focuses.
The current US Preventive Services Task Force (USPSTF) recommendation opposes ovarian cancer screening (with transvaginal ultrasound, CA-125 or both) in asymptomatic, average-risk women — current evidence shows no reduction in mortality but real harms such as unnecessary surgery due to false-positive results. This is the main reason ovarian cancer is frequently diagnosed at an advanced stage. This recommendation does not cover women with known hereditary risk, such as BRCA or Lynch syndrome — this group requires a different, intensified surveillance approach (discussed below).
In Türkiye, as worldwide, ovarian cancer is relatively rare but tends to be diagnosed at an advanced stage. The absence of effective screening leads to detection predominantly after symptoms appear, at an advanced stage, in Türkiye as worldwide — therefore, genetic counseling and close surveillance are particularly important for women with risk factors (such as BRCA/Lynch syndrome discussed below).
Risk Factors
- Older age — half of cases are diagnosed at 63 or older
- Never having given birth / low fertility
- History of endometriosis (particularly associated with clear cell and endometrioid subtypes)
- Obesity (BMI ≥30)
- Fertility drug (clomiphene citrate) use for more than a year, particularly without pregnancy
- Estrogen-only hormone therapy in menopause (increased risk with long-term use)
- Family history of ovarian, breast or uterine cancer
- Personal history of breast cancer
- Smoking (particularly associated with the mucinous subtype)
Genetics: BRCA, Other HRR Genes and the HRD Concept
Approximately %10-15 of ovarian cancer cases are hereditary. Considering germline and somatic mutations together, BRCA1/2 alterations are found in approximately %20-25 of high-grade serous ovarian cancers.
| Gene | Lifetime Ovarian Cancer Risk |
|---|---|
| BRCA1 | %35-50 |
| BRCA2 | %10-25 |
| RAD51C, RAD51D, BRIP1, PALB2 (other HRR genes) | 5-7-fold higher risk than the general population; cumulative risk with RAD51D may reach ~%12 by age 80 |
| Lynch syndrome (MLH1, MSH2, MSH6, PMS2) | Approximately %4-14 (varies by gene); generally associated with non-serous (endometrioid, clear cell) histology and frequently concurrent uterine cancer |
Approximately half of high-grade serous ovarian cancers have a DNA repair defect arising from causes independent of BRCA mutations (for example, BRCA1 promoter methylation), called homologous recombination deficiency (HRD) . Thus, determining who may respond to PARP inhibitor treatment now depends centrally not only on BRCA testing but on HRD tests such as Myriad myChoice CDx or FoundationOne CDx — these tests combine BRCA status with a genomic instability score to classify tumors as HRD-positive or HR-proficient (HRP). This distinction forms the basis of first-line maintenance treatment decisions, detailed below.
Germline BRCA testing is recommended for women with a family history of ovarian, breast or pancreatic cancer, women diagnosed with ovarian or breast cancer at a young age (under 50), and people with a known BRCA mutation carrier in the family. If a mutation is found, genetic counseling, intensified screening (transvaginal ultrasound and CA-125 blood testing) and risk-reducing surgery are considered (particularly salpingo-oophorectomy around ages 35-40 after childbearing is completed — which may reduce ovarian cancer risk by approximately %90). Fertility preservation options such as egg/embryo freezing for reproductive-age women are also part of this counseling process.
Symptoms
Early-stage ovarian cancer usually causes no symptoms, or symptoms are so mild/nonspecific that they can be confused with other conditions (such as irritable bowel syndrome or urinary tract infection). It is important to consult a doctor if symptoms are new, frequently recurring and last longer than 2 weeks:
- Abdominal or pelvic pain
- Bloating, abdominal fullness
- Early satiety, loss of appetite
- Frequent urination or a feeling of incomplete bladder emptying
- Changes in bowel habits (constipation/diarrhea)
- Unexplained weight loss or abdominal swelling
- Persistent fatigue
- Postmenopausal vaginal bleeding
In advanced disease with abdominal fluid accumulation (ascites), marked abdominal swelling, shortness of breath and persistent pelvic pressure become more prominent.
How Is It Diagnosed?
When assessing a suspicious ovarian mass, transvaginal ultrasonography is the first-line imaging method. CA-125 blood testing can aid diagnosis — it is elevated in only approximately %50 of early-stage and %85 of advanced-stage disease; however, it is not diagnostic alone because benign conditions such as endometriosis and pelvic infection can also raise it. Contrast-enhanced computed tomography (CT), MRI when needed (particularly for surgical planning) and PET-CT (for assessing metastases, not routine screening) are used for definitive staging. Definitive diagnosis and staging generally rely on tissue sampling obtained during surgery.
Staging: The FIGO System
Ovarian cancer is staged using the system developed by the International Federation of Gynecology and Obstetrics (FIGO), forming the basis for treatment planning.
IA: Tumor is confined to one ovary or fallopian tube; no tumor on the surface, capsule intact, and no malignant cells in abdominal fluid.
IB: Tumor is confined to both ovaries or fallopian tubes; no tumor on the surface and no malignant cells in abdominal fluid.
IC: Tumor is on the ovarian/fallopian tube surface, the capsule ruptured before/during surgery, or malignant cells were found in abdominal fluid.
Cancer affects one or both ovaries/fallopian tubes and has spread to other pelvic organs.
IIA: Tumor has spread to the uterus or fallopian tubes.
IIB: Tumor has spread to other pelvic organs such as the bladder or rectum.
IIIA: Microscopic spread to the abdominal lining (peritoneum) is present; regional lymph nodes may be involved.
IIIB: Macroscopic peritoneal metastases smaller than 2 cm are present; regional lymph nodes may be involved.
IIIC: Macroscopic peritoneal metastases larger than 2 cm or involvement of the diaphragm surface are present; regional lymph nodes may be involved.
IVA: Malignant cells are present in fluid surrounding the lungs (pleural effusion). IVB: Metastases are present in distant organs such as liver/splenic parenchyma or distant lymph nodes.
As a general rule, a lower stage means a better prognosis; however, ovarian cancer treatment decisions depend not only on FIGO stage but also histological subtype and — as detailed below — molecular/genetic features (BRCA/HRD status).
Surgical Treatment: When Surgery First, When Chemotherapy First?
There are two main approaches in advanced-stage (Stage III-IV) ovarian cancer: primary cytoreductive surgery (surgery first, followed by chemotherapy) or neoadjuvant chemotherapy + interval cytoreduction (tumor shrinkage with chemotherapy first, followed by surgery). Key studies (EORTC 55971, CHORUS, JCOG0602) and pooled analyses showed that in appropriately selected patients, the neoadjuvant approach compared with primary surgery provides equivalent efficacy but lower postoperative complication rates .
The updated ASCO guideline published in February 2025 (Wright AA, et al., Journal of Clinical Oncology, 2025, DOI: 10.1200/JCO-24-02589) further clarified patient selection: primary surgery is preferred when complete or near-complete cytoreduction appears possible with acceptable morbidity, while neoadjuvant chemotherapy + interval surgery is preferred with extensive disease burden, low performance status or a low likelihood of complete cytoreduction. Decisions are individualized through imaging, laparoscopic assessment when needed, and joint assessment by the multidisciplinary gynecological oncology team.
HIPEC (hyperthermic intraperitoneal chemotherapy), administering heated (42°C) chemotherapy into the abdomen during surgery, has gained further support when used during interval cytoreductive surgery from over 10 years of OVHIPEC-1 follow-up (Lancet Oncology, 2023/2024): median overall survival was 44,9 months with HIPEC + surgery versus 33,3 months with surgery alone (HR 0,70), and 10-year survival was %16,1 versus %10,9. This is strong surgical evidence confirmed by over a decade of follow-up, rare in ovarian cancer treatment; it is an option for suitable patients in current guidelines.
Systemic Treatment: First-Line
The backbone of first-line systemic treatment is given after surgery (or as neoadjuvant/adjuvant treatment), the carboplatin + paclitaxel combination (generally 6 cycles). In many patients, this combination includes bevacizumab (based on GOG-218 and ICON7), continued afterward as maintenance.
One of the most transformed areas of systemic ovarian cancer treatment is treatment after first-line chemotherapy, maintenance therapy — this decision now depends largely on BRCA/HRD status:
| Biomarker Status | Current Standard Maintenance Approach |
|---|---|
| BRCA-mutated (germline or somatic) | Olaparib monotherapy (based on SOLO-1, December 2018 approval) OR olaparib + bevacizumab (based on PAOLA-1, May 2020 approval, if bevacizumab was added to first-line chemotherapy) |
| HRD-positive, BRCA wild-type | Olaparib + bevacizumab (PAOLA-1) has the strongest evidence; niraparib monotherapy (based on PRIMA) is also an option |
| HR-proficient (HRP) / biomarker-negative | Niraparib monotherapy (approved for all-comers based on PRIMA) or bevacizumab maintenance alone may be considered |
The final overall survival analysis of PRIMA, the basis for niraparib's all-comer first-line maintenance approval, published in 2024 (Ledermann J, et al., Annals of Oncology, 2024), showed after approximately 6 years of follow-up in the general population no overall survival (OS) difference (HR 1,01) — even in HRD-positive patients, the difference was almost negligible (HR 0,95). The progression-free survival (PFS) advantage persists at 5 years (%22 versus %12 in the general population), but its failure to translate into overall survival is an important counseling point to share with patients — "longer remission" and "longer life" are not always the same.
The Major Test of 2022: Withdrawal of Later-Line PARP Inhibitor Approvals
This is the most important and most misunderstood recent development in ovarian cancer treatment — therefore, it is addressed in a separate, detailed section. After PARP inhibitors (olaparib, niraparib, rucaparib) achieved major success in first-line maintenance between 2018-2020, their later-line uses produced unexpected long-term follow-up results, and some indications of all three drugs were withdrawn between 2022-2024. This is an important example of how accelerated approval works and how science corrects itself — it should be seen as confidence-building scientific honesty, not cause for alarm.
Rucaparib's third-line monotherapy indication (direct treatment, not maintenance) was voluntarily withdrawn by the manufacturer after the confirmatory phase 3 ARIEL4 found, compared with chemotherapy, shorter overall survival (median overall survival 19,4 months in the rucaparib arm versus 25,4 months with chemotherapy), in 2022. Rucaparib's second-line maintenance indication (based on ARIEL3, after a platinum response) was unaffected and remains approved.
Olaparib's accelerated approval granted in 2014 for monotherapy (direct treatment, not maintenance) in germline BRCA-mutated patients after 3 or more prior chemotherapy lines met a similar fate: SOLO3's final overall survival data (shared July 14, 2022) suggested possibly shorter survival in olaparib-treated patients in this subgroup. The process continued with the FDA's official request in July 2022 and the manufacturer's voluntary withdrawal request in January 2023, and formally concluded in the Federal Register on March 26, 2024. Olaparib's first-line maintenance (SOLO-1) and olaparib+bevacizumab (PAOLA-1) indications were unaffected and remained approved.
For niraparib's second-line (or later) maintenance indication, in patients with no germline BRCA mutation, long-term NOVA data showed no significant overall survival benefit but a possible harm signal (HR 1,06). After its initial warning letter in May 2022, the FDA requested on November 11, 2022 that this indication be restricted to germline BRCA-mutated patients — non-BRCA-mutated patients can no longer receive this specific use (second-line maintenance). Niraparib's first-line maintenance indication (based on PRIMA, in all-comers) was unaffected by this narrowing.
In all three cases, the withdrawn/narrowed indications were not the drugs' first-line maintenance use but, in more heavily pretreated patients, later-line monotherapy — and in every case withdrawal occurred because long-term follow-up revealed an unexpected survival signal, not because the drug was ineffective. This shows accelerated approval working exactly as designed: early promising data provide early patient access, followed by mandatory confirmatory studies testing the actual long-term benefit/harm balance, with corrections when needed. Outdated sources may still list these drugs as later-line monotherapy options; this guide reflects the current situation as of August 2026.
Treatment in Recurrent Disease: Platinum-Sensitive vs. Platinum-Resistant
Treatment selection in recurrent ovarian cancer depends on the time to recurrence after the last platinum-based treatment:
Retreatment with platinum-based combination chemotherapy (± bevacizumab) is standard. Maintenance PARP inhibitor use is now largely limited to BRCA-mutated patients with no prior PARP inhibitor — because the vast majority receiving first-line maintenance today have already been exposed to a PARP inhibitor, using one again at recurrence is becoming less common/off-label. This is an important point requiring updates to older treatment algorithms.
Sequential single-agent chemotherapy (weekly paclitaxel, pegylated liposomal doxorubicin, topotecan, gemcitabine) ± bevacizumab (based on AURELIA) remains the main approach. However, a truly positive recent development in this setting is mirvetuximab soravtansine (discussed in detail below).
Mirvetuximab Soravtansine (Elahere): The Arrival of a New Drug Class
Mirvetuximab soravtansine is an antibody-drug conjugate (ADC) targeting folate receptor-alpha (FRα) — the antibody binds a cancer cell-specific target and delivers a cytotoxic agent directly inside the cell. It represents a completely new drug class entering ovarian cancer treatment.
Based on SORAYA, mirvetuximab soravtansine received accelerated FDA approval on November 14, 2022 for FRα-high, platinum-resistant ovarian/fallopian tube/primary peritoneal cancer. The confirmatory phase 3 MIRASOL showed significant overall survival superiority to chemotherapy (median overall survival 16,5 versus 12,7 months; HR 0,67; median PFS 5,6 versus 4,0 months; response rate %42 versus %16) — based on these results, it was converted to full approval on March 22, 2024. This is the opposite of the PARP inhibitor story above: accelerated approval successfully became full approval after confirmatory evidence of an overall survival gain. Treatment eligibility requires a companion diagnostic measuring FRα expression.
Immunotherapy: Tried, but Largely Unsuccessful
Checkpoint inhibitors (pembrolizumab, nivolumab, atezolizumab, avelumab) have not shown meaningful benefit alone or in combinations in unselected/biomarker-unselected ovarian cancer — unlike endometrial (uterine) cancer, where immunotherapy was groundbreaking. IMagyn050 (atezolizumab+bevacizumab+chemotherapy, first-line) failed its primary PFS endpoint; JAVELIN Ovarian 100 (first-line) and JAVELIN Ovarian 200 (platinum-resistant recurrence) were negative with avelumab, and its ovarian cancer development program was stopped. The only exception, accounting for just ~%2-3 of all ovarian tumors and generally associated with Lynch syndrome, is the MSI-H/dMMR subgroup — tumor-agnostic pembrolizumab approval applies to this narrow group.
Developments on the Horizon
The phase 3 ROSELLA study of the glucocorticoid receptor antagonist relacorilant with nab-paclitaxel in platinum-resistant ovarian cancer showed significant superiority in progression-free survival (HR 0,70) and overall survival (median 16,0 versus 11,9 months; HR 0,65) in results published in 2025-2026. As of August 2026, when this guide was prepared, the combination has not yet received FDA approval, and the FDA decision date (PDUFA) is expected around July 2026 — readers are advised to follow the current approval status.
Side Effects of Treatment
| Treatment | Main Side Effects |
|---|---|
| Cytoreductive surgery | Bleeding, infection, bowel/urinary tract complications, lengthy recovery |
| Carboplatin + paclitaxel | Myelosuppression, peripheral neuropathy, alopecia, nausea and vomiting, allergic reaction risk |
| Bevacizumab | Hypertension, proteinuria, bleeding risk, gastrointestinal perforation (rare but serious), delayed wound healing |
| PARP inhibitors (olaparib, niraparib, rucaparib) | Nausea, fatigue, anemia, thrombocytopenia; rarely myelodysplastic syndrome/acute leukemia (with long-term use) |
| Mirvetuximab soravtansine | Blurred vision/keratopathy (requires eye examination), peripheral neuropathy, fatigue, gastrointestinal side effects |
| HIPEC | Risk of temporary renal dysfunction and electrolyte imbalance in addition to standard cytoreductive surgery |
Global Approval and Evidence History
Olaparib maintenance received FDA approval in newly diagnosed advanced BRCA-mutated ovarian cancer — the first major first-line victory of the PARP inhibitor era.
Received FDA approval for first-line maintenance in all patients regardless of biomarker status.
Olaparib+bevacizumab maintenance was approved in HRD-positive disease — currently among the maintenance regimens with the strongest evidence.
Rucaparib's 3. line monotherapy (ARIEL4 OS signal) was voluntarily withdrawn; niraparib's 2. line maintenance was restricted to BRCA-mutated patients (November 11); withdrawal of olaparib's later-line monotherapy approval began.
Based on SORAYA, a new drug class (antibody-drug conjugates) arrived in FRα-high, platinum-resistant disease.
The survival advantage of HIPEC during interval cytoreduction was confirmed by over a decade of follow-up.
The confirmatory phase 3 study showed overall survival superiority (HR 0,67) — an example of a healthy transition from accelerated to full approval.
Based on SOLO3, the 3+ line monotherapy indication was formally withdrawn in the Federal Register.
Patient selection criteria between primary surgery and neoadjuvant chemotherapy + interval surgery were updated.
A new combination showing overall survival superiority in platinum-resistant disease; an FDA approval decision is expected around July 2026.
The Situation in Türkiye: TİTCK Licensing and SGK Reimbursement
Carboplatin and paclitaxel, standard first-line chemotherapy, are long-established generic drugs widely accessible under SGK coverage in Türkiye.
Bevacizumab (Altuzan, Zirabev) is licensed by TİTCK in Türkiye and reimbursed by SGK for some indications such as colorectal cancer, glioblastoma and cervical cancer — however, our research found no primary source explicitly confirming inclusion of ovarian cancer in this coverage; legal sources describe patients pursuing litigation to access it for ovarian cancer. Therefore, SGK reimbursement of bevacizumab in ovarian cancer should be considered uncertain.
Olaparib (Lynparza) was licensed by TİTCK on November 21, 2018 for maintenance in platinum-sensitive, BRCA-mutated recurrent ovarian cancer. However, according to drozdogan.com's own source, "Lynparza has not yet entered the Social Security Institution's Health Implementation Communiqué (SUT)" — meaning SGK provides no reimbursement for any indication. This research also could not confirm whether the Turkish license was expanded to include first-line (SOLO-1) or bevacizumab combination (PAOLA-1) indications, now international standards — an important gap needing clarification.
Niraparib (Zejula) was licensed by TİTCK in 2023; according to legal sources, the approved indication covers HRD-positive recurrent disease after at least 3 previous chemotherapy lines (this definition may not fully align with the international BRCA restriction of 2022 — clarification is needed). As with olaparib, SGK does not reimburse niraparib for any indication and patients must pursue litigation for access.
Unlike olaparib and niraparib, no legal source on rucaparib litigation/reimbursement in Türkiye was found — an indirect sign that the drug is not prescribed to a meaningful extent in Türkiye or may be unlicensed, but this could not be verified through a primary TİTCK source.
The situation in Türkiye for this new drug is unclear — some sources mention a narrow TİTCK approval, while others state it is available only through named-patient import and Ministry of Health approval for off-label drug use. At least one patient is known to have obtained SGK reimbursement through an administrative court stay of execution. This shows that its full FDA approval (March 2024) has not yet become standard licensing and reimbursement in Türkiye.
This research could not verify which laboratories in Türkiye offer HRD testing (Myriad myChoice CDx or similar), central to PARP inhibitor treatment decisions, or whether SGK covers it — a practical issue patients should clarify directly with their treatment centers.
Türkiye's ovarian cancer treatment landscape shows a clear pattern: decades-old generic drugs such as carboplatin and paclitaxel are readily available, while newer drugs developed after 2018 such as PARP inhibitors and mirvetuximab soravtansine may sometimes have TİTCK licenses but largely lack SGK reimbursement, and patients frequently must pursue litigation for access. This research also found no recent (2024-2026) Court of Cassation decision specific to ovarian cancer.
Frequently Asked Questions
- A Relative Uses a PARP Inhibitor. Does This Mean Their Drug Is No Longer Safe?
- No. Withdrawn/narrowed indications are limited to certain later-line monotherapy uses. First-line maintenance (based on SOLO-1, PRIMA, PAOLA-1) was unaffected and remains standard in current guidelines. If you have concerns, always speak with the physician managing treatment.
- Are HRD and BRCA Testing the Same?
- No. BRCA testing examines only mutations in BRCA1/2. HRD testing is broader — combining BRCA status with tumor genomic instability to identify tumors likely to respond to a PARP inhibitor even without a BRCA mutation.
- Who Is Suitable for Mirvetuximab Soravtansine?
- This drug is suitable for patients with platinum-resistant recurrent ovarian cancer whose tumors highly express folate receptor-alpha (FRα). Eligibility is determined by a specific tissue test.
- Why Is There No Regular Ovarian Cancer Screening?
- Current evidence shows that transvaginal ultrasound or CA-125 screening in average-risk women does not reduce mortality but can lead to unnecessary surgery due to false-positive results. Women with hereditary risk such as BRCA or Lynch syndrome receive a different, intensified surveillance approach.
- I Have Heard of Fallopian Tube Cancer — How Does It Differ from Ovarian Cancer?
- According to current scientific understanding, most high-grade serous ovarian cancers actually originate at the end of the fallopian tube. Thus, "ovarian cancer," "fallopian tube cancer" and "primary peritoneal cancer" are generally treated similarly today as different manifestations of the same disease family.
- Sung H, et al. Global cancer statistics 2024. CA Cancer J Clin. 2026. DOI: 10.3322/caac.70090.
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- USPSTF. Ovarian Cancer: Screening (Grade D recommendation).
- Fallopian tube origin: Nature Communications. 2017 and 2019.
- Pooled HRR gene analysis. J Ovarian Res. 2020. DOI: 10.1186/s13048-020-00654-3.
- Banerjee S, et al. SOLO-1 7-year overall survival data. J Clin Oncol. 2022. DOI: 10.1200/JCO.22.01549.
- Ledermann J, et al. PRIMA final overall survival analysis. Ann Oncol. 2024.
- Tew WP, et al. ASCO Rapid Guideline Update (PARP inhibitors). J Clin Oncol. 2022. DOI: 10.1200/JCO.22.01934.
- Federal Register 2024-06298. Olaparib approval withdrawal, March 26, 2024.
- Matulonis UA, et al. Mirvetuximab soravtansine (SORAYA). NEJM. 2023. DOI: 10.1056/NEJMoa2309169.
- FDA. Mirvetuximab soravtansine full approval (MIRASOL), March 22, 2024.
- Moore KN, et al. IMagyn050. J Clin Oncol. 2021. DOI: 10.1200/JCO.21.00306.
- Wright AA, et al. ASCO neoadjuvant chemotherapy guideline update. J Clin Oncol. 2025. DOI: 10.1200/JCO-24-02589.
- OVHIPEC-1 10-year follow-up. Lancet Oncology. 2023/2024.
- ROSELLA study (relacorilant+nab-paclitaxel). Lancet. 2025-2026.
- Relevant articles of Türkiye's Health Implementation Communiqué (SUT), TİTCK drug license lists.
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