Immune Checkpoint Inhibitor Combinations in Advanced Ovarian Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Simple Summary Immune checkpoint inhibitors (ICIs) are a promising cancer treatment; however, their effectiveness in ovarian cancer is limited when used alone. This study systematically reviewed nine phase III clinical trials involving 7381 patients to understand the performance of ICIs when combined with other therapies, such as PARP inhibitors, bevacizumab, or chemotherapy. Overall, ICI combination therapy reduced the risk of disease progression or death by approximately 17%. Our findings further suggest that the choice of combination partner influences the robustness of this benefit. Specifically, the combination of ICIs with bevacizumab showed a consistent benefit in slowing cancer progression, with moderate certainty of evidence. Combinations with PARP inhibitors also showed benefits, but with lower certainty, often depending on specific trial designs. However, ICIs combined with chemotherapy did not show any significant improvement. This highlights the importance of choosing the appropriate combination therapy and tailoring treatment to individual patients for better outcomes in ovarian cancer.