Ovarian cancer treatment aims to remove tumor tissue, control disease progression, and improve quality of life. Options range from established surgical and chemotherapy approaches to innovative therapies being tested in clinical trials, with treatment plans tailored to each patient’s stage, type, and overall health.

How Treatment Helps Women With Ovarian Cancer

When ovarian cancer is diagnosed, the main goal of treatment is to remove as much cancer as possible, stop it from spreading, and manage symptoms that affect daily life. Ovarian cancer treatment focuses on helping women live longer, maintain their ability to do the things they enjoy, and reduce discomfort caused by the disease.^[1][8]

Treatment choices depend on several important factors. The stage of the cancer—which describes how far it has spread—plays a crucial role in deciding what therapies to use. The grade, which tells doctors how abnormal the cancer cells look under a microscope, also helps guide treatment decisions. Doctors also consider a woman’s age, overall health, and whether she has other medical conditions that might affect how well she tolerates certain treatments.^[8][9]

Most women receive a combination of surgery and chemotherapy. Some may also benefit from newer treatments such as targeted therapy or hormone therapy. Medical guidelines from professional societies help doctors choose the best treatment approach based on years of research and clinical experience.^[10][12]

Importantly, researchers continue to explore new therapies through clinical trials. These studies test whether experimental treatments are safe and effective, offering hope for better outcomes in the future. Women may have the opportunity to participate in these trials and access treatments not yet widely available.^[12][13]

Surgery: The First Step in Treating Ovarian Cancer

Surgery is the primary treatment for most women with ovarian cancer. The main purpose is to remove as much of the cancer as possible. Doctors call this debulking or cytoreductive surgery. The more cancer tissue that can be removed, the better the chances that other treatments will work well afterward.^[8][12]

The type of surgery depends on how far the cancer has spread. For women whose cancer is found early and has not spread beyond the ovaries, surgeons may remove both ovaries and both fallopian tubes. This procedure is called a bilateral salpingo-oophorectomy. In many cases, doctors also remove the uterus and cervix in a procedure known as a hysterectomy.^[11]

When ovarian cancer has spread to other parts of the body, surgery becomes more complex. Surgeons may need to remove parts of the bowel, tissue from the abdomen, or other affected organs to eliminate as much cancer as possible. The goal is to leave behind no visible tumor or only very small amounts, as this improves how well chemotherapy works later.^[8][11]

During surgery, doctors may also perform a biopsy, which involves taking small samples of tissue to examine under a microscope. This helps confirm the diagnosis and determine the exact type and grade of ovarian cancer. Sometimes the diagnosis is only confirmed during the operation itself.^[8][9]

Another surgical technique used in some cases is laparoscopy, a minimally invasive approach where surgeons make small incisions and use a camera and special tools to view and remove tissue. This method may be used for diagnosis or, in select cases, for treatment.^[9]

Chemotherapy: Medicines That Fight Cancer Cells

Chemotherapy is a cornerstone of ovarian cancer treatment. These powerful medicines work by killing cancer cells or stopping them from growing and dividing. Chemotherapy is usually given after surgery to destroy any remaining cancer cells that could not be removed. This is called adjuvant chemotherapy. In some cases, chemotherapy may be given before surgery to shrink tumors and make them easier to remove.^[8][12]

The most common chemotherapy combination for ovarian cancer includes two types of drugs: a platinum-based drug, usually carboplatin, and a taxane-based drug, usually paclitaxel. Carboplatin works by damaging the DNA inside cancer cells, preventing them from multiplying. Paclitaxel interferes with the structures that help cells divide. Together, these drugs are highly effective, and approximately 80 percent of women with ovarian cancer respond well to this treatment initially.^[10][14]

Chemotherapy is typically given in cycles. A cycle might involve receiving the drugs once every three weeks, with rest periods in between to allow the body to recover. Treatment usually lasts for several months, often involving six cycles in total. The exact duration depends on how well the cancer responds and how well a woman tolerates the side effects.^[10]

Chemotherapy can be given in different ways. Most commonly, it is delivered through a vein in the arm, a method called intravenous chemotherapy. In some cases, doctors may deliver chemotherapy directly into the abdomen, known as intraperitoneal chemotherapy, which allows higher concentrations of the drugs to reach cancer cells in that area.^[10]

Unfortunately, chemotherapy affects not only cancer cells but also healthy cells that divide quickly, such as those in the hair, digestive system, and blood. This leads to side effects. Common side effects include nausea, vomiting, fatigue, loss of appetite, hair loss, and increased risk of infection due to lower white blood cell counts. Some women experience peripheral neuropathy, a condition causing numbness, tingling, or pain in the fingers and toes. Muscle and joint aches are also reported.^[18]

Many of these side effects improve after treatment ends, but some, like neuropathy, may persist for months or even become permanent. Women often describe experiencing “chemo brain,” a term for memory and concentration difficulties that can last for a year or more after finishing chemotherapy.^[18]

For women whose cancer returns or does not respond to the initial platinum-based treatment, doctors may try other chemotherapy drugs. However, cancers that become platinum-resistant are harder to treat, and the benefit of additional chemotherapy is often more limited.^[14]

Targeted Therapy: Precision Medicine for Ovarian Cancer

Targeted therapies are a newer class of treatments that attack specific features of cancer cells, causing less harm to healthy cells compared to traditional chemotherapy. These drugs work by interfering with molecules or pathways that cancer cells need to grow and survive.^[12][14]

One important type of targeted therapy for ovarian cancer is bevacizumab, sold under the brand name Avastin. Bevacizumab is a monoclonal antibody that targets a protein called VEGF, which helps tumors form new blood vessels. By blocking this protein, bevacizumab prevents the tumor from getting the blood supply it needs to grow. This drug is approved for women with newly diagnosed ovarian cancer and for those whose cancer has returned after previous treatment.^[14]

Another type of targeted therapy involves PARP inhibitors. PARP stands for poly (ADP-ribose) polymerase, an enzyme that helps cells repair damaged DNA. Cancer cells with certain genetic mutations, particularly those in the BRCA1 or BRCA2 genes, have difficulty repairing DNA damage. PARP inhibitors block the enzyme that normally helps with this repair, causing cancer cells to die. These drugs are used as maintenance therapy after chemotherapy to delay the cancer from returning. Maintenance therapy with PARP inhibitors has been shown to significantly extend the time women remain in remission, especially for those with BRCA mutations.^[18][14]

Genetic testing is important to determine whether a woman is eligible for PARP inhibitors. If a blood test shows a BRCA1 or BRCA2 mutation, or if the tumor itself has certain characteristics such as homologous recombination deficiency, PARP inhibitors may be recommended. Women with these genetic changes have a much higher chance of benefiting from this type of treatment.^[8]

Another targeted drug, mirvetuximab soravtansine (Elahere), is an antibody-drug conjugate. This medication combines an antibody that recognizes a protein called folate receptor alpha, which is found on many ovarian cancer cells, with a toxic drug that kills the cells. The antibody delivers the toxic drug directly to the cancer cells, sparing healthy cells. This drug is approved for certain women with advanced ovarian cancer.^[14]

Immunotherapy: Helping the Immune System Recognize Cancer

Immunotherapy is a type of treatment that helps the body’s own immune system fight cancer. The immune system normally defends the body against infections and diseases, but cancer cells can sometimes hide from immune detection. Immunotherapy drugs help the immune system recognize and attack cancer cells.^[12][14]

The most commonly used immunotherapy drugs for ovarian cancer are checkpoint inhibitors. These drugs block proteins that prevent immune cells from attacking cancer. Two checkpoint inhibitors approved for certain ovarian cancer patients are pembrolizumab (Keytruda) and dostarlimab (Jemperli). Both target a pathway called PD-1/PD-L1, which cancer cells use to avoid being attacked by the immune system.^[14]

However, these drugs are only approved for women whose tumors have specific characteristics. One such characteristic is high microsatellite instability (MSI-H), which occurs when the DNA repair system in cells is not working properly. Another is DNA mismatch repair deficiency (dMMR). Only a small percentage of ovarian cancers have these features, so testing is necessary to determine whether immunotherapy is an option.^[14]

Immunotherapy is not effective for most ovarian cancers, but research is ongoing to find ways to make more tumors responsive to this approach. Clinical trials are testing combinations of immunotherapy with chemotherapy or other targeted therapies to improve results.^[13][14]

Hormone Therapy and Radiation: Less Common Options

Some ovarian cancers need the hormone estrogen to grow. In these cases, hormone therapy may be used to block estrogen production or prevent cancer cells from using it. Hormone therapy is not commonly used for ovarian cancer but may be an option for certain types, especially those that recur and do not respond well to chemotherapy. These treatments are rarely the first choice and are considered when other options are limited.^[10][11]

Radiation therapy, which uses high-energy rays to kill cancer cells, is also rarely used for ovarian cancer. It may be considered in specific situations, such as treating cancer that has spread to a particular area or relieving symptoms like pain or bleeding. Because ovarian cancer often spreads throughout the abdomen, radiation is not practical for treating the entire area. However, targeted radiation to a specific spot can help manage symptoms in advanced disease.^[11][12]

Promising Therapies Being Tested in Clinical Trials

Clinical trials are research studies that test new treatments to see if they are safe and effective. For ovarian cancer, many innovative therapies are currently being studied, offering hope for better outcomes in the future. Participating in a clinical trial may give women access to cutting-edge treatments not yet available to the general public.^[12][13]

Clinical trials are conducted in phases. Phase I trials focus on safety, testing a new treatment in a small number of people to determine the best dose and identify side effects. Phase II trials look at whether the treatment works and continues to evaluate safety in a larger group. Phase III trials compare the new treatment to the current standard of care to see if it is better. Only treatments that pass all these phases are considered for approval by regulatory agencies.^[12]

One exciting area of research is the development of vaccines for ovarian cancer. Scientists are working on a vaccine that would train the immune system to recognize and attack ovarian cancer cells. Early-stage trials are exploring whether such vaccines can prevent the disease in high-risk women or stop it from returning after treatment.^[13]

Another promising approach involves cellular therapies, such as CAR T-cell therapy. In this treatment, a patient’s own immune cells are collected, modified in the laboratory to better recognize cancer cells, and then infused back into the body. This approach has shown success in certain blood cancers and is now being tested in ovarian cancer trials.^[13]

Researchers are also exploring new combinations of existing drugs. For example, combining PARP inhibitors with immunotherapy or with drugs that target other pathways involved in cancer growth is being studied. These combinations aim to make treatments more effective, especially for cancers that have become resistant to standard therapies.^[13]

Clinical trials for ovarian cancer are being conducted in many locations, including the United States, Europe, and other regions. Women interested in participating should talk to their healthcare team about whether a trial is appropriate for them and how to find one. Eligibility depends on factors such as the type and stage of cancer, previous treatments, and overall health.^[12]

Most Common Treatment Methods

• Surgery
  • Bilateral salpingo-oophorectomy removes both ovaries and fallopian tubes
  • Hysterectomy removes the uterus and cervix
  • Debulking surgery removes as much tumor tissue as possible, including from the bowel and abdomen if cancer has spread
  • Laparoscopy is a minimally invasive surgical approach using small incisions
• Chemotherapy
  • Combination of platinum-based drug (carboplatin) and taxane-based drug (paclitaxel) is the standard first-line treatment
  • Given in cycles, usually every three weeks for about six cycles
  • Can be delivered intravenously or directly into the abdomen (intraperitoneal chemotherapy)
  • Other chemotherapy drugs may be used if cancer returns or becomes resistant
• Targeted Therapy
  • Bevacizumab (Avastin) blocks blood vessel formation in tumors by targeting the VEGF pathway
  • PARP inhibitors used as maintenance therapy after chemotherapy, especially effective for women with BRCA mutations
  • Mirvetuximab soravtansine (Elahere) is an antibody-drug conjugate targeting folate receptor alpha
• Immunotherapy
  • Pembrolizumab (Keytruda) and dostarlimab (Jemperli) are checkpoint inhibitors targeting the PD-1/PD-L1 pathway
  • Approved only for tumors with high microsatellite instability (MSI-H) or DNA mismatch repair deficiency (dMMR)
• Hormone Therapy
  • Blocks estrogen production or prevents cancer cells from using estrogen
  • Used in select cases, particularly for recurrent disease not responsive to chemotherapy
• Radiation Therapy
  • Uses high-energy rays to kill cancer cells
  • Rarely used for ovarian cancer but may help manage symptoms or treat specific areas where cancer has spread