{"entity":{"id":"caution-pd1-first-line-ovarian","kind":"pairing","name":"Caution: checkpoint inhibitors in first-line ovarian cancer","aka":[],"tldr":"Immunotherapy added to first-line chemotherapy has failed to extend survival in ovarian cancer in every large trial so far; its only win is in PD-L1-positive platinum-resistant disease.","summary":"IMagyn050 (atezolizumab), JAVELIN Ovarian 100 (avelumab), and DUO-O (durvalumab ± olaparib) showed no OS benefit in newly diagnosed disease. KEYNOTE-B96 (pembrolizumab + weekly paclitaxel) is the exception, in PD-L1-positive platinum-resistant relapse. Ovarian cancer is immunologically 'cold' with low TMB.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03737643: DUO-O / ENGOT-ov46","url":"https://clinicaltrials.gov/study/NCT03737643"},{"label":"ClinicalTrials.gov NCT05116189: KEYNOTE-B96 / ENGOT-ov65","url":"https://clinicaltrials.gov/study/NCT05116189"}],"tags":[],"related":[],"cancers":["ovarian"],"sections":[],"technologies":[],"targets":["pd1","pdl1"],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["duo-o","keynote-b96"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"checkpoint-inhibitor","b":"ovarian","rationale":"Low neoantigen burden, immunosuppressive ascites, and myeloid-rich microenvironment blunt T-cell responses; chemotherapy-induced priming appears necessary for benefit.","evidence":"Three negative first-line phase 3 trials; one positive relapsed-setting trial.","pairingType":"caution"},"route":"/pairings/caution-pd1-first-line-ovarian/","neighbours":{"cancer":[{"id":"ovarian","kind":"cancer","name":"Ovarian cancer","route":"/cancers/ovarian/"}],"target":[{"id":"pd1","kind":"target","name":"PD-1","route":"/targets/pd1/"},{"id":"pdl1","kind":"target","name":"PD-L1","route":"/targets/pdl1/"}],"trial":[{"id":"duo-o","kind":"trial","name":"DUO-O / ENGOT-ov46","route":"/trials/duo-o/"},{"id":"keynote-b96","kind":"trial","name":"KEYNOTE-B96 / ENGOT-ov65","route":"/trials/keynote-b96/"}],"technology":[{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"}]}}