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Ovarian cancer begins in or near the ovaries. About 9 in 10 cases are epithelial, and most of those are high grade serous tumors that research now shows usually start in the fallopian tubes rather than the ovary. Rarer types begin in the egg cells or in hormone producing cells. It is hard to catch early. The ovaries sit deep in the pelvis, and early symptoms like bloating, pelvic or back pain, feeling full quickly, and urinary urgency are vague and common. The most frequent sign at diagnosis is abdominal swelling from fluid, which means the cancer is already advanced.
Treatment has changed. Surgery to remove as much tumor as possible, followed by platinum chemotherapy, is still the foundation. Since 2014 PARP inhibitor pills have been used to delay recurrence in BRCA mutated and similar tumors, and testing every patient for these mutations is now standard. In 2022 the first antibody drug conjugate for ovarian cancer was approved for platinum resistant disease, with full approval in 2024. Prevention has moved too. Because most cancers start in the tubes, removing only the fallopian tubes during other pelvic surgery is being tested as a way to prevent cancer without early menopause.
Ovarian cancer shares its inherited risk genes with breast, pancreatic, and prostate cancer. Our cancer treatment guide explains how targeted therapies work.
Trials for platinum resistant disease. The largest group. Antibody drug conjugates aimed at folate receptor alpha, PTK7, and other targets, plus new combinations for cancer that has stopped responding to platinum chemotherapy.
Maintenance and first line trials. New PARP inhibitor combinations, immunotherapy added to chemotherapy, and studies of how long maintenance should last.
Immunotherapy and cell therapy trials. Ovarian cancer has resisted checkpoint inhibitors, so trials test engineered T cells, oncolytic viruses that infect tumor cells, and vaccines, often in early phase.
Prevention and hereditary risk trials. Studies of fallopian tube removal with delayed ovary removal in women with BRCA mutations, and programs to improve genetic counseling and testing in families.
Early detection studies. Blood markers including CA125 patterns, imaging, and new tests aimed at the screening problem that no approach has yet solved.
Quality of life and survivorship studies. Managing chemotherapy related cognitive changes, fertility preservation in young women, and long term follow up.
With a pelvic exam, a transvaginal ultrasound, and a CA125 blood test, followed by a CT scan if something is found. A definite diagnosis requires tissue, usually obtained during surgery. There is no screening test for women at average risk; the US Preventive Services Task Force recommends against screening because it has not reduced deaths and leads to unnecessary surgery.
Most treatment trials enroll women with epithelial ovarian, fallopian tube, or primary peritoneal cancer, which are treated as one disease, at a specific point: newly diagnosed before or after surgery, in remission for maintenance studies, or recurrent, with platinum sensitive and platinum resistant disease usually studied separately. Many require tumor testing for BRCA, homologous recombination deficiency, or folate receptor alpha. Rare types such as germ cell and stromal tumors have separate studies. Prevention trials enroll women with inherited mutations but no cancer, and detection studies often enroll women at average or high risk with no diagnosis. Eligibility always varies by study.
Stage I. Confined to one or both ovaries or fallopian tubes. Five year survival for localized disease is 92 percent, but only 23 percent of cases are found here. Surgery, sometimes fertility sparing, is the main treatment, and trials focus on who needs chemotherapy afterward.
Stage II. Spread within the pelvis. Treated with surgery and chemotherapy.
Stage III. Spread to the abdominal lining or lymph nodes. The most common stage at diagnosis. Surgery to remove all visible tumor, chemotherapy, and often PARP inhibitor maintenance; the main setting for first line and maintenance trials.
Stage IV. Spread beyond the abdomen, to the liver, lungs, or distant nodes. Five year survival about 32 percent. Treated like stage III, and where most trials for recurrent and platinum resistant disease recruit.
Beyond stage, trials sort by platinum sensitivity: whether the cancer returned more than six months after platinum chemotherapy (sensitive) or sooner (resistant). Your stage, your platinum status, and your BRCA and biomarker results tell you at a glance which studies fit.
Identify your trial. Use the filters. Titles name the setting (newly diagnosed, maintenance, platinum resistant) and often a biomarker such as BRCA or folate receptor alpha. Match to your pathology and genetic reports.
Select your preferred location. Enter your city or state. Trials run at gynecologic oncology centers, which are fewer than general cancer centers, so widening the radius often helps.
Explore study details. Click "Learn More" for eligibility, including platinum status, required biomarker tests, prior lines of treatment, and the visit schedule.
Complete the health profile. Click "Get started" to begin the 5-step application. Have three things ready: your stage and cancer type, your BRCA and other biomarker results, and the list of treatments you have had with the approximate date your cancer last returned.
Submit the application. A clinical trial coordinator reviews it and contacts you. Nothing is decided until informed consent, and participation is voluntary at every step.