Ovarian Cancer Clinical Trials

About Ovarian Cancer trials

Ovarian cancer trials are stratified by histology and by the DNA repair status of the tumor. BRCA1 and BRCA2 are tested both somatically and as germline mutations, and define eligibility for PARP inhibitor trials in both metastatic and maintenance settings. About 15% of ovarian cancer patients carry a germline BRCA mutation, with another 6% having somatic BRCA alterations. CCNE1 amplification flags a replication-stress phenotype that defines a separate trial space for Wee1 and ATR inhibitor trials. ARID1A loss is most common in clear cell and endometrioid ovarian cancer and gates a distinct trial set targeting dependency pathways. HER2 (ERBB2) testing is increasingly relevant as ADC trials open enrollment for HER2-positive ovarian tumors. MMR deficiency is uncommon in high-grade serous but more common in endometrioid and clear cell histologies, and qualifies the patient for immunotherapy trials. PD-L1 (CD274) is used in some IO trial designs.

Trial design in ovarian cancer turns on platinum sensitivity and treatment line. Front-line trials test combinations of platinum chemotherapy with PARP, bevacizumab, immunotherapy, or all three, with maintenance strategies tailored to BRCA and HRD status. Recurrent platinum-sensitive trials test retreatment and new maintenance approaches. Recurrent platinum-resistant trials are an active space, with ADCs targeting folate receptor alpha including approved mirvetuximab soravtansine and newer FRα-directed agents in development. HRD-positive trials enroll patients with BRCA mutations or other homologous recombination repair alterations, often in combination with IO or anti-angiogenic agents. CCNE1-amplified trials test cell cycle inhibitors. Clear cell ovarian cancer has its own trial set focused on ARID1A-driven dependencies. Low-grade serous ovarian cancer trials test MEK inhibitor combinations. HER2-amplified or expressing trials test anti-HER2 ADCs.

What ovarian cancer trials gate on most often: histology, platinum sensitivity status, and prior maintenance therapy. Histology confirmation: most trials are subtype-specific (high-grade serous, clear cell, endometrioid, low-grade serous, or mucinous). Platinum sensitivity classification (platinum-sensitive, partially platinum-sensitive, resistant, refractory) gates many trials and defines the line. Prior PARP exposure is increasingly a defining factor as PARP enters earlier lines and as post-PARP trials emerge. Prior bevacizumab exposure matters for some trials. Prior ADC exposure (especially anti-FRα agents) is becoming a relevant criterion. BRCA or HRD status for PARP-related trials, with germline and somatic testing accepted. Folate receptor alpha (FRα) expression status gates FRα-directed trials. ECOG of 0 or 1 is standard. Recent bowel obstruction or symptomatic ascites can exclude patients from many trials.

Biomarkers tested in Ovarian Cancer trials

These are the molecular markers most commonly required or evaluated in Ovarian Cancer eligibility criteria. OncoMatch extracts them from each trial's protocol and matches them against your test results.