At the 27th European Congress on Gynaecological Oncology (ESGO26), held 26-28th February in Copenhagen, researchers delivered long-awaited data from pivotal ovarian cancer studies that explored surgery timing, chemotherapy scheduling, immunotherapy combinations and real-world patterns of care. Investigators tackled some of the most persistent questions in advanced ovarian cancer: when to operate, how best to schedule chemotherapy and whether immunotherapy can finally shift outcomes in platinum-resistant disease. Four major studies took centre stage — TRUST, ICON8B, ENGOT-ov65/KEYNOTE-B96 and SUROVA. Below, we break down the key take-home messages from each presentation.
The TRUST phase III trial addressed the optimal timing of cytoreduction in resectable stage IIIB–IVB ovarian cancer.1 In this international randomized study, 688 patients (median age: 63y) were assigned to primary cytoreductive surgery (PCS) followed by six chemotherapy cycles or three cycles of neoadjuvant chemotherapy (NACT) plus interval surgery (ICS). Complete resection was achieved in 68%/70% (PCS) versus 79%/85% (ICS). Median progression-free survival (PFS) was 22.1 vs 19.7 months (HR 0.80; p=0.02). Median overall survival (OS) was 54.3 vs 48.3 months (HR 0.89; p=0.24). Although OS was not significantly different, PCS significantly improved PFS, particularly in stage III disease. The phase III ICON8B trial reports overall survival benefit with dose-dense weekly paclitaxel plus bevacizumab in high-risk advanced ovarian cancer.2 In this 1:1:1 randomized study, 579 patients with stage III–IV epithelial ovarian cancer received either standard three-weekly carboplatin–paclitaxel–bevacizumab (B1) or three-weekly carboplatin with weekly paclitaxel plus bevacizumab (B3). After a median follow-up of 72.0m, median OS was 49.8m (95% CI 43·7-54.5m) in B3 versus 39.6m (95% CI 34·7-45·0m) in B1 (HR 0·79, 95% CI 0·65-0·95, p=0·010). The 10.2m improvement supports weekly paclitaxel with carboplatin and bevacizumab as a first-line standard-of-care option in this high-risk population. In the phase III ENGOT-ov65/KEYNOTE-B96 trial, 643 participants with platinum-resistant recurrent ovarian cancer were randomized 1:1 to receive pembrolizumab 400 mg every 6 weeks or placebo, each with weekly paclitaxel ± bevacizumab, until progression or unacceptable toxicity.3 At a median follow-up of 32.7 months, pembrolizumab–paclitaxel significantly improved overall survival (OS) versus placebo–paclitaxel: median OS 17.7 vs 14.0 months; HR 0.82; 95% CI 0.69–0.97; p=0.0115. Progression-free survival (PFS) benefits persisted in both ITT (HR 0.73 [95% CI 0.62–0.87]) and PD-L1 CPS ≥1 populations (HR 0.76 [95% CI 0.62–0.93]). Grade ≥3 adverse events occurred in 67.8% vs 55.3%. These results confirm clinically meaningful OS and PFS benefits with pembrolizumab. In a retrospective analysis of 923 ECOG 0–1 patients with advanced ovarian cancer achieving complete cytoreduction during interval debulking surgery (IDS) from the international SUROVA study, 130 received HIPEC and 793 did not. Baseline characteristics were similar, though the HIPEC group had higher intraoperative PCI (13.0 ± 7.0 vs 7.8 ± 5.9; p < 0.001) and increased postoperative complications (48.5% vs 21.4%; major complications 16.9% vs 8.1%; p ≤ 0.003). HIPEC significantly improved disease-free survival (HR = 0.639; 95% CI 0.510–0.801; p < 0.001) and overall survival (HR = 0.398; 95% CI 0.267–0.593; p < 0.001), with comparable 30-day mortality. The study concludes HIPEC offers meaningful survival benefit despite higher morbidity in selected patients. CLICK HERE for the full conference abstract list References Citation: Ovarian cancer round-up: What ESGO26 told us. touchONCOLOGY. 4th March, 2026. Disclosure: This article was created by the touchONCOLOGY team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article. Editor: Sophie Nickelson (Editorial Director). Already registered? Login below.
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