Maintenance Therapy for Ovarian Cancer

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Maintenance therapy may be recommended for some people with ovarian cancer. This type of therapy is given to help prevent or delay a recurrence. A recurrence is when the cancer returns after a period of time in which there is no evidence of cancer. Experts estimate that 7 out of 10 people diagnosed with ovarian cancer will have a recurrence.1,2

The stage at diagnosis has a large impact on the likelihood of the cancer returning. About 25 percent of people experience a recurrence if they were diagnosed at an early stage. And around 80 percent of people experience a recurrence if they were diagnosed with late-stage ovarian cancer.3

Ovarian cancer that recurs is treatable, but it can rarely be cured. This means that preventing the cancer from returning is ideal.3

When is maintenance therapy needed?

Maintenance therapy is standard treatment for some types of cancer. Your doctor may recommend maintenance therapy even if your cancer disappeared after your initial treatment.1,4

Maintenance therapy also may be used in people whose cancer shrank but did not go away after treatment.1,4

Examples of maintenance therapy drugs

Several factors will determine which maintenance therapy drug your doctor recommends. This includes:1,4

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  • Results of your tumor or genetic testing
  • How well your cancer responded to your initial treatment
  • Your type of initial treatment

As of 2023, there are 2 types of drugs that are used for maintenance therapy for certain forms of ovarian cancer. These are angiogenesis inhibitors and PARP inhibitors.1,4

Angiogenesis inhibitors

Angiogenesis inhibitors are generally used as maintenance therapy for people who received this drug with chemotherapy following surgery for advanced epithelial ovarian cancer (stage III or IV).1

Examples of angiogenesis inhibitors include:5

  • Avastin® (bevacizumab)
  • Mvasi™ (bevacizumab-awwb)
  • Zirabev™ (bevacizumab-bvzr)
  • Vegzelma® (bevacizumab-adcd)
  • Alymsys® (bevacizumab-maly)

Mvasi, Zirabev, Vegzelma, and Alymsys are biosimilars of Avastin. Biosimilars are drugs that are similar in structure to known biologic drugs (drugs made in a living system like yeast or bacteria).5

PARP inhibitors

PARP inhibitors are generally used for maintenance therapy in people whose cancer disappeared or shrank following their most recent treatment with chemotherapy.4

These PARP inhibitors are used for maintenance therapy in certain forms of ovarian cancer:4

  • Lynparza® (olaparib)
  • Rubraca® (rucaparib)
  • Zejula® (niraparib)

The specific PARP inhibitor used for ovarian cancer maintenance therapy depends on several factors. This includes previous treatments and whether you have a genetic or tumor mutation.4

How long does maintenance therapy last?

The length of your therapy can vary depending on the drug you are taking and if your disease has recurred. Generally, maintenance therapy treatments are usually given for 1 to 3 years after initial treatment.6

Talk with your doctor about what your maintenance therapy plan looks like and what it will mean for you. If your cancer returns or worsens while on maintenance therapy, your doctor will talk to you about your treatment options.

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. Common side effects of angiogenesis inhibitors include:7-11

  • Nose bleeds
  • High blood pressure
  • Headache
  • High levels of protein in the urine
  • Dry skin
  • Changes in how things taste
  • Nausea
  • Diarrhea
  • Low blood counts
  • Extreme tiredness (fatigue)

Common side effects of PARP inhibitors include:12-14

  • Anemia
  • Vomiting
  • Diarrhea
  • Nausea
  • Fatigue
  • Abdominal pain

These are not all the possible side effects of maintenance therapy drugs. Talk to your doctor about what to expect when taking maintenance therapy drugs. You also should call your doctor if you have any changes that concern you when taking maintenance therapy drugs.

Other things to know

Maintenance therapy may not be right for everyone. Talk to your doctor about what treatment options are best for you and the possible side effects, risks, and benefits of these drugs.

Maintenance therapy drugs can harm an unborn baby. If you or your partner can become pregnant, use birth control during treatment and for some time after the last dose of your treatment. Do not breastfeed during treatment with maintenance therapy drugs and for some time after the last dose. Talk to your doctor about your options for birth control and breastfeeding while taking maintenance therapy drugs.7-14

Before beginning treatment for advanced ovarian cancer, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.