Ovarian cancer
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Follow-up after treatment
Laboratory tests
- CA 125if neededOnly if the initial surgery was complete (no macroscopic residual disease) and the general condition is good (ECOG 0): from 6 months after the end of treatment, at the pace of the follow-up visits [2].
Do not order
- CA 125 (alone or with ultrasound) to screen for ovarian cancer in a woman without symptoms: in a large randomised trial, this screening did not reduce mortality [3]; the French laboratory fee schedule (NABM) covers CA 125 only for treatment monitoring [4]. Woman with symptoms or raised CA 125 found: see the page “Raised tumour marker outside cancer follow-up (CEA, CA 19-9, CA 125, AFP)”.
- Surveillance CA 125 in a patient with residual tumour or an impaired general condition: French recommendations reserve paraclinical investigations for patients operated on without residual disease and in good general condition [2].
Maintenance treatment with a PARP inhibitor (olaparib, niraparib)
Laboratory tests
- FBC
- Olaparib: before treatment, then monthly for the first 12 months, then periodically.
- Niraparib: weekly for the first month, then monthly for the next 10 months, then regularly.
- CA 125 (to monitor the efficacy of maintenance treatment, every 3 months)if needednon-French guidelineDuring maintenance treatment, the German S3 guideline (2026) provides for a tumour marker measurement every 3 months, in addition to the tests specific to the drug; it distinguishes this monitoring of treatment efficacy from surveillance after treatment, where it advises against routine measurement [6]. In France, the 2019 recommendation concerns CA 125 in surveillance after the end of treatment [2]. CA 125 is covered for treatment monitoring [4].
Sources (12)
- Institut national du cancer. Panorama des cancers en France, édition 2026 (remplace l'édition 2023 : « Panorama des cancers en France, l’Institut national du cancer publie l’édition 2023 rassemblant les données les plus récentes »).
- Sénéchal C, Akladios C, Bendifallah S, Ouldamer L, Lecuru F, Rousset-Jablonski C. Suivi des patientes traitées pour un cancer épithélial de l'ovaire, place du traitement hormonal de la ménopause et de la contraception : recommandations FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY, labellisées par l'INCa. Gynecol Obstet Fertil Senol. 2019;47(2):250-262.
- Duffy MJ. Tumor markers in clinical practice: a review focusing on common solid cancers. Med Princ Pract. 2013;22(1):4-11.
- Assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 : acte 7325 (antigène CA 125).
- COMMISSION DE LA TRANSPARENCE. Haute Autorité de santé, avis du 21 avril 2021 : olaparib (LYNPARZA), nouvelle indication dans le cancer de l'ovaire.
- Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). S3-Leitlinie Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren, Langversion 6.1, janvier 2026, registre AWMF 032-035OL, sections 3.4 et 10.1.2 (tableau 23).
- National Cancer Institute. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®), Health Professional Version, mise à jour du 14 mai 2025.
- National Institute for Health and Care Excellence. Ovarian cancer: recognition and initial management (CG122). Publiée le 27 avril 2011, dernière mise à jour le 15 avril 2026.
- Agence européenne des médicaments. LYNPARZA (olaparib), résumé des caractéristiques du produit (annexe I de l'EPAR), rubriques 4.2 et 4.4, version française consultée le 13/10/2026.
- Agence européenne des médicaments. ZEJULA (niraparib), résumé des caractéristiques du produit (annexe I de l'EPAR), rubriques 4.2 et 4.4, version française consultée le 13/10/2026.
- US Food and Drug Administration. LYNPARZA (olaparib) tablets, prescribing information, révision 07/2025 (DailyMed, setid 741ff3e3-dc1a-45a6-84e5-2481b27131aa), rubriques 2 et 5.
- US Food and Drug Administration. ZEJULA (niraparib) tablets, prescribing information, version DailyMed du 6 août 2026 (setid b7f675e2-159c-490c-b6f4-3f16d9492b7d), rubriques 2 et 5.