Treatment Options for Platinum-Resistant Ovarian Cancer
Published on June 5, 2026
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Most people with epithelial ovarian cancer — the most common type of ovarian cancer — receive chemotherapy that generally includes a platinum-based medication such as carboplatin (Paraplatin) or cisplatin (Platinol).
But if the cancer comes back or progresses within six months of finishing platinum-based treatment, it’s known as platinum-resistant ovarian cancer. In this case, the cancer is unlikely to respond to repeat platinum-based treatment, says Amita Kulkarni, MD, a gynecologic oncologist and assistant professor of obstetrics and gynecology at New York Medical College in Valhalla.
Platinum-resistant ovarian cancer has traditionally been difficult to manage because there were few treatment options, says Dr. Kulkarni, but new therapies, including immunotherapy combinations and targeted drugs, have become available.
Immunotherapy Combinations
In February 2026, the U.S. Food and Drug Administration (FDA) approved a new treatment for platinum-resistant ovarian cancer that combines immunotherapy and chemotherapy infusions: pembrolizumab (Keytruda) plus weekly paclitaxel (Taxol), with or without bevacizumab (Avastin).
Here is a breakdown of this drug combination:
- Pembrolizumab “is an immunotherapy that helps the immune system attack cancer by removing blockers that cancer uses to evade immune detection,” says David O’Malley, MD, director of the division of gynecologic oncology at the Ohio State University Comprehensive Cancer Center in Columbus. These blockers refer to the programmed death-ligand 1 (PD-L1) protein that cancer cells can use to connect with certain immune cells and avoid being recognized by the immune system.
- Paclitaxel is a chemotherapy drug that interferes with cancer cells’ ability to divide and multiply, which helps slow or stop their growth.
- Bevacizumab is a targeted therapy that blocks the growth of new blood vessels, essentially cutting off the tumors’ nutrient supply. Whether bevacizumab is included in this combination treatment depends on your health history and whether your oncology team feels it’s a safe option for you.
Together, these medications attack the tumor in different ways while also helping the immune system recognize and fight cancer cells, says Josephine Kim, MD, a gynecologic oncologist at City of Hope Orange County in Irvine, California.
What Research Found
Paclitaxel, given weekly and especially when combined with bevacizumab, was already a well-established treatment for platinum-resistant ovarian cancer before this approval, Dr. O’Malley says. Researchers wanted to see whether adding pembrolizumab could improve outcomes.
The approval was based on a clinical trial that included 643 people with platinum-resistant ovarian cancer who had already received one or two previous chemotherapy treatments. Among people whose tumors tested positive for PD-L1, those treated with the pembrolizumab combination lived a median of about 18 months, compared with 14 months for those who did not receive pembrolizumab. This combination treatment also helped slow the cancer's growth for a longer period of time.
Who May Be Eligible
This treatment is approved for people with platinum-resistant ovarian cancer who have already received one or two prior treatments and whose tumors test positive for the PD-L1 protein.
Testing the tumor for PD-L1 can help healthcare providers determine whether this immunotherapy combination may be an option, Dr. Kim says.
Side Effects
Because this treatment uses three types of medication, the side effects vary widely depending on which drug is causing them.
The following side effects were reported in the clinical trial:
- Anemia (low red blood cell count)
- Neutropenia (low white blood cell count, which can raise infection risk)
- Fatigue
- Hair loss
- Nausea or vomiting
- Peripheral neuropathy (numbness, tingling, or pain in the hands or feet)
Pembrolizumab can cause the immune system to attack healthy organs and tissues, leading to inflammation in the lungs, colon, liver, thyroid, or other organs. Depending on how severe the reaction is, your care team may pause or stop immunotherapy, says Kulkarni.
If bevacizumab is part of the treatment plan, there’s also a small risk of bleeding, blood clots, and rarely, serious intestinal problems, says Kim.
“While some side effects can be serious, they’re often manageable when identified early, which is why patients are monitored closely and encouraged to report new or worsening symptoms right away,” Kim says.
Cortisol-Blocking Combination Therapy
Relacorilant (Lifyorli), combined with nab-paclitaxel (Abraxane), received FDA approval for platinum-resistant ovarian cancer in March 2026.
Relacorilant, an oral medication, is a glucocorticoid receptor antagonist. It blocks cortisol, a hormone that the body produces naturally and that may help cancer cells resist chemotherapy.
Nab-paclitaxel is an infusion chemotherapy drug that works similarly to paclitaxel by stopping cancer cells from dividing and multiplying.
This combination helps make cancer cells more sensitive to chemotherapy while also directly slowing their growth.
What Research Found
The approval for this therapy was based on a clinical trial that included 381 people with platinum-resistant ovarian, fallopian tube, or primary peritoneal cancer who had already received one to three previous treatments, as well as previous bevacizumab treatment. Half of the participants received relacorilant plus nab-paclitaxel, and the other half received nab-paclitaxel alone.
Those who received the relacorilant combination lived a median of 16 months, compared with about 12 months for those who received nab-paclitaxel alone. The combination also helped keep the cancer under control longer.
Who May Be Eligible
You may qualify for this combination therapy if you have platinum-resistant ovarian cancer and have received one to three previous treatment regimens, one of which included bevacizumab. Unlike the pembrolizumab combination, this treatment does not require tumors to test positive for PD-L1, Kulkarni says.
But if you take corticosteroid medications regularly, such as prednisone (Deltasone, Predone, Sterapred) or dexamethasone (Decadron), this treatment may not be recommended for you. Corticosteroids are often used long term for conditions like autoimmune diseases or to prevent organ rejection after a transplant, and relacorilant can make those medications less effective.
Side Effects
In the study, commonly reported side effects included:
- Anemia
- Neutropenia
- Fatigue
- Nausea
- Diarrhea
- Low platelet count
- Rash
- Decreased appetite
Severe neutropenia and infection were among the more serious side effects, as well as adrenal insufficiency, a condition in which the body does not make enough cortisol. With adrenal insufficiency, you may experience extreme fatigue, dizziness, and nausea.
If you develop a fever, signs of infection, or symptoms of adrenal insufficiency, contact your care team right away.
Antibody-Drug Conjugates
Antibody-drug conjugates (ADCs) are a newer type of targeted treatment that combines a lab-made antibody with a chemotherapy drug to find certain proteins on cancer cells and deliver the chemotherapy into those cells.
Mirvetuximab soravtansine-gynx (MIRV), sold under the brand name Elahere, is an FDA-approved ADC for people with platinum-resistant ovarian cancer that’s also folate receptor-alpha (FR-α)-positive. This means that a protein called FR-alpha is present on 75 percent or more of tumor cells.
Once MIRV attaches to the FR-alpha protein on the cancer cell, it releases chemotherapy directly inside the cell. Unlike traditional chemotherapy, this targeted treatment generally causes fewer whole-body side effects like hair loss and immune suppression.
What Research Found
“In clinical studies, this targeted approach has shown improved outcomes compared with standard chemotherapy in selected patients,” says Kim.
In a clinical trial involving 453 people with platinum-resistant FR-alpha-positive ovarian cancer, MIRV helped shrink the cancer in about 42 percent of people, compared with 16 percent of those receiving standard chemotherapy. Those treated with MIRV also lived longer, a median of about 17 months, compared with nearly 13 months for those getting standard chemotherapy.
If you don’t meet the FR-alpha threshold to qualify for MIRV by itself, combining MIRV with bevacizumab is worth discussing with your care team. In a study of 94 people with platinum-resistant ovarian cancer who had FR-alpha present in at least 25 percent of their tumor cells, nearly half responded to the combination. This combination is now included in treatment guidelines as an option.
Who May Be Eligible
If you have platinum-resistant ovarian cancer that’s FR-alpha positive and have received one to three prior treatments, you may be a candidate for MIRV.
Side Effects
Most side effects of MIRV are manageable when caught early, so reporting any new or changing symptoms to your care team right away is important.
Side effects to watch for include:
- Blurred vision
- Dry eyes
- Light sensitivity
- Fatigue
- Nausea
- Peripheral neuropathy
Eye-related side effects are among the most important to monitor during treatment, which is why regular eye exams and preventive drops are part of care, Kim says.
Emerging Treatments
Different types of treatments for platinum-resistant ovarian cancer are currently in clinical trials. Many are next-generation ADCs designed to target cancer cells more precisely or carry different chemotherapy drugs that may improve how well they work, O’Malley says.
FDA Breakthrough Therapies
Two treatments have received the FDA's Breakthrough Therapy designation, which means early study results show the treatment may work much better than existing options. Neither is FDA-approved yet, but this designation can help speed up their development and review process.
- Raludotatug Deruxtecan This ADC therapy targets a protein called cadherin-6 (CDH6) found on some ovarian cancer cells. Researchers are studying this treatment in people with platinum-resistant ovarian cancer who have previously received bevacizumab.
- Sofetabart Mipitecan (LY4170156) This is an FR-alpha-targeted ADC treatment that may work in platinum-resistant ovarian tumors with a wider range of FR-alpha levels. A clinical trial is underway comparing it with existing treatment options.
FDA Fast Track Designation
Fast Track designation means the FDA believes that a treatment may help fill an unmet medical need for a serious condition, and it works more closely with the drug company to help speed development and review.
ZW191 received the FDA's Fast Track designation for platinum-resistant ovarian cancer in March 2026. It’s an FR-alpha-targeting ADC currently being studied in people with platinum-resistant ovarian cancer with all levels of FR-alpha expression. This could help fill the gap for people who have tumors that express FR-alpha at lower levels than the threshold required to be eligible for MIRV.
Other ADCs in Clinical Trials
Farletuzumab ecteribulin, an FR-alpha-targeting ADC, has shown early promise in clinical studies for platinum-resistant ovarian cancer. It’s currently being evaluated to determine the best dosage standards.
The number of new treatments being studied for platinum-resistant ovarian cancer is growing, and that’s meaningful news for people facing this diagnosis. “I strongly encourage offering every patient clinical trial access, particularly with a new diagnosis or whenever therapy changes, because trials provide the best opportunity to receive tomorrow’s therapies,” says O’Malley. If you’re interested in clinical trials, talk with your cancer care team about whether you may be a candidate and how to get started.
You can also search for studies through ClinicalTrials.gov, the National Cancer Institute, or major cancer centers like Memorial Sloan Kettering, Mayo Clinic, and Johns Hopkins.
The Takeaway
- Platinum-resistant ovarian cancer means the cancer has returned or continued to grow within six months of finishing platinum-based chemotherapy, making it unlikely to respond to those same drugs again.
- In February 2026, the FDA approved pembrolizumab plus paclitaxel, with or without bevacizumab, for some people with platinum-resistant ovarian cancer whose tumors test positive for programmed death-ligand.
- Other FDA-approved options include the cortisol-blocking drug relacorilant plus nab-paclitaxel, and mirvetuximab soravtansine-gynx for tumors that test positive for the folate receptor-alpha protein.
- Researchers are continuing to study new treatments and drug combinations for platinum-resistant ovarian cancer. Talk to your care team about whether you might be eligible for a clinical trial or newer targeted treatment.
Resources We Trust
Resources We Trust
- Cleveland Clinic: Antibody-Drug Conjugates (ADCs)
- Mayo Clinic: Ovarian Cancer: New Treatments and Research
- Ovarian Cancer Research Foundation: New FDA-Approved Treatment for Drug-Resistant Ovarian Cancers to Improve Survival
- American Cancer Society: Targeted Therapy for Ovarian Cancer
- National Ovarian Cancer Coalition: Breakthroughs in Ovarian Cancer Treatment and Clinical Trials
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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