Ovarian cancer is the sixth most common cancer in UK women, with around 7,500 new cases and 4,000 deaths annually. It is often diagnosed at a late stage because early symptoms are vague. The last decade has seen transformative progress with PARP inhibitors (olaparib, niraparib) for BRCA-mutant and HRD-positive tumours. Now UK trials are pushing further — antibody-drug conjugates, immunotherapy combinations, CAR-T cell therapy, and novel targeted agents are expanding options for every ovarian cancer patient, regardless of BRCA status.
The UK has been at the centre of ovarian cancer research, with the NCRI Gynaecological Cancer Clinical Studies Group and Target Ovarian Cancer driving a strong trial portfolio. The landmark SOLO1 and SOLO2 trials (led partly from UK centres) established olaparib as a standard of care. The NHS Genomic Medicine Service now provides BRCA1/2 and HRD testing at diagnosis, enabling molecularly guided trial matching.
There are currently over 70 actively recruiting ovarian cancer trials in the UK, covering frontline, maintenance, and relapsed settings.
Types of Ovarian Cancer Trials
PARP Inhibitors
Olaparib, niraparib, and rucaparib targeting DNA damage repair in BRCA-mutant and HRD-positive tumours — now expanding beyond these groups.
Antibody-Drug Conjugates
Mirvetuximab soravtansine (anti-FRα), trastuzumab deruxtecan, and newer ADCs delivering chemotherapy directly to ovarian cancer cells.
Immunotherapy
Checkpoint inhibitors, bispecific antibodies, and cancer vaccines, often combined with PARP inhibitors or anti-angiogenic agents.
Novel Targets
AKT inhibitors, WEE1 inhibitors, anti-angiogenic combinations, and bispecific antibodies targeting new pathways in ovarian cancer.
PARP Inhibitors
PARP inhibitors are the biggest advance in ovarian cancer treatment this century, and UK trials continue to expand their use:
Olaparib (Lynparza) — approved as frontline maintenance for BRCA-mutant and HRD-positive ovarian cancer. UK trials now testing: in combination with immunotherapy (durvalumab), in earlier disease stages, and as treatment (not just maintenance) for recurrent disease
Niraparib (Zejula) — approved for maintenance regardless of BRCA/HRD status. UK trials exploring: frontline use for all patients, combination with anti-angiogenic agents (bevacizumab), and extended-duration treatment
Rucaparib (Rubraca) — for BRCA-mutant relapsed disease. UK trials testing combination strategies and use in earlier treatment lines
PARP inhibitor resistance — a major UK research focus. Trials targeting mechanisms of PARP resistance: reversing BRCA reversion mutations, combining with ATR or WEE1 inhibitors, and novel agents that restore PARP sensitivity
PARP beyond BRCA/HRD — trials testing whether PARP inhibitors combined with other agents can benefit patients without HRD (the majority of ovarian cancer patients)
Antibody-Drug Conjugates
ADCs are emerging as a powerful new approach in ovarian cancer:
Mirvetuximab soravtansine (Elahere) — anti-FRα (folate receptor alpha) ADC, the first ADC approved for ovarian cancer. FRα is overexpressed in ~80% of ovarian cancers. UK trials testing: in earlier lines, in combination with bevacizumab, and as frontline maintenance
Trastuzumab deruxtecan (T-DXd) — anti-HER2 ADC showing activity in HER2-low ovarian cancer (a much larger population than HER2-positive). UK Phase 2 trials ongoing
Upifitamab rilsodotin — anti-NaPi2b ADC targeting another ovarian cancer surface protein, in UK Phase 2/3 trials
Next-generation ADCs — newer ADCs with improved linker technology and more potent payloads, in UK early-phase trials
Immunotherapy
Ovarian cancer has been challenging for immunotherapy, but combination approaches are showing promise:
Checkpoint inhibitors + PARP inhibitors — the rationale: PARP inhibition increases tumour DNA damage, generating neoantigens that immune cells can recognise. UK trials combining pembrolizumab/durvalumab with olaparib/niraparib
Checkpoint inhibitors + anti-angiogenic agents — bevacizumab may normalise tumour vasculature and improve immune cell infiltration. UK trials testing anti-PD-1 + bevacizumab ± PARP inhibitor triplets
Bispecific antibodies — CD3×MUC16 (mucin-16/CA-125) bispecific T-cell engagers in early UK trials, redirecting T cells to ovarian cancer cells
Intraperitoneal immunotherapy — delivering checkpoint inhibitors or cytokines directly into the peritoneal cavity where ovarian cancer spreads, maximising local immune activation
Cancer vaccines — personalised neoantigen vaccines for ovarian cancer in UK Phase 1/2 trials, combined with checkpoint inhibition
Cell Therapy & Novel Approaches
Cell therapy is moving into ovarian cancer with innovative approaches:
CAR-T for ovarian cancer — targeting MUC16, mesothelin, and FRα. UK Phase 1 trials at UCL and the Christie, with novel approaches to overcome the immunosuppressive tumour microenvironment
TIL therapy — tumour-infiltrating lymphocyte extraction and expansion for ovarian cancer, following success in melanoma. Early UK studies
AKT inhibitors — capivasertib targeting the PI3K/AKT pathway (frequently activated in ovarian cancer). UK trials combining with chemotherapy and PARP inhibitors
WEE1 inhibitors — adavosertib targeting cell cycle checkpoint in p53-mutant ovarian cancer (most cases). UK trials showing promising activity in recurrent disease
Bispecific antibodies targeting DLL3 — exploring DLL3 expression in neuroendocrine-like ovarian cancer subtypes
Maintenance & Frontline Strategies
The biggest UK trials are reshaping frontline ovarian cancer treatment:
Frontline PARP + bevacizumab — the PAOLA-1 regimen (olaparib + bevacizumab maintenance after chemotherapy + bevacizumab). UK trials refining which patients benefit most and optimal duration
Neoadjuvant PARP — giving PARP inhibitors before debulking surgery to shrink tumours, in UK Phase 2 trials
Hyperthermic intraperitoneal chemotherapy (HIPEC) — heated chemotherapy at the time of surgery. UK trials expanding the indications and optimising the technique
Secondary debulking surgery trials — identifying which recurrent patients benefit from repeat surgery vs proceeding directly to systemic therapy
Who Can Participate?
Ovarian cancer trial eligibility depends on BRCA/HRD status, stage, and prior treatment:
PARP inhibitor trials — may require BRCA1/2 mutation or HRD positivity (for some studies), or may be open to all patients. Frontline trials typically require newly diagnosed stage III/IV disease after debulking surgery
ADC trials — require the target expression level (e.g., FRα positivity confirmed by IHC). May require specific prior treatment lines
Immunotherapy trials — often open to patients regardless of BRCA status. May require platinum-sensitive or platinum-resistant disease. PD-L1 expression may be assessed
Cell therapy trials — advanced or refractory disease, adequate organ function for leukapheresis or TIL extraction, and accessible tumour tissue
General criteria — ECOG performance status 0–2, adequate blood counts, no active infections, no other active malignancy, and willingness to attend regular monitoring
💡 Tip: Request BRCA and HRD Testing
If you have ovarian cancer, BRCA1/2 and HRD (homologous recombination deficiency) testing should be done at diagnosis — this is now standard NHS care. Around 15% of ovarian cancers are BRCA-mutant (inherited), and another 20–25% are HRD-positive. These results determine whether you qualify for PARP inhibitor treatment and trials. If your BRCA test is positive, ask about genetic counselling for your family members, who may also benefit from screening.
UK Ovarian Cancer Trial Locations
Major UK centres running ovarian cancer trials include:
London — Royal Marsden Hospital, UCLH, Guy's and St Thomas', Barts Health, Imperial College Healthcare
Manchester — The Christie NHS Foundation Trust
Birmingham — Queen Elizabeth Hospital Birmingham, Pan Birmingham Gynaecological Cancer Centre
Leeds — St James's University Hospital
Glasgow — Beatson West of Scotland Cancer Centre
Edinburgh — Western General Hospital
Cardiff — Velindre Cancer Centre
Cambridge — Addenbrooke's Hospital
How to Find Your Match
Use our Smart Matcher to find ovarian cancer trials tailored to your BRCA/HRD status, stage, and treatment history. Whether you are exploring frontline PARP combinations, ADC therapy for recurrent disease, immunotherapy combinations, or novel cell therapy, we can match you to actively recruiting studies.