title: Maintenance therapy in ovarian cancer.
abstract: OBJECTIVE
  Targeted therapies are being used as maintenance therapy to improve the outcome of ovarian cancer following standard treatment in the first-line setting and in recurrent disease. We review the different approaches being used, trial design, and the impact of maintenance treatment on survival and quality of life.
  
  
  RESULTS
  The greatest experience of maintenance therapy is with antiangiogenic agents. Several trials targeting vascular endothelial growth factor with bevacizumab or vascular endothelial growth factor receptor with oral tyrosine kinase inhibitors have demonstrated a prolongation in progression-free survival (PFS) following first or second-line treatment. Maintenance therapy with olaparib, a poly ADP ribose polymerase inhibitor given post-platinum therapy for recurrent disease, has led to a prolongation in PFS, particularly, in patients with a BRCA mutation. The results of immunotherapy maintenance studies, based on using cancer antigen 125 as an antigen, have been disappointing. A benefit in PFS often does not translate into overall survival improvement, largely because of crossover and postprogression therapies. This makes clinical interpretation of results more difficult.
  
  
  CONCLUSIONS
  The principle of using molecular targeted therapy to prolong the control of ovarian cancer has been clearly demonstrated. The greatest effect is on prolongation of PFS and, by adding to the effects of standard treatments, maintenance therapy is likely to help incrementally extend the 5-year survival of women with ovarian cancer.
authors.affiliation: aUCL Hospitals bMedical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London (UCL) cUCL Cancer Institute and UCL Hospitals, London, UK.
authors.forename: Saira
authors.initials: S
authors.lastname: Khalique
authors.forename: Jane M
authors.initials: JM
authors.lastname: Hook
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Ledermann
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D060046:Maintenance Chemotherapy; D058990:Molecular Targeted Therapy; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000276:immunology
chemical_list: D020533:Angiogenesis Inhibitors