Update of randomized trials in recurrent disease

In the absence of significant advance in first-line therapy until recently, the increased knowledge of how to manage relapse accounts for most of the advances observed in ovarian cancer during the last 10 years. In addition, a large number of new drugs, mostly in the category of 'targeted therapy', are currently being tested in the setting of recurrent ovarian and are expected to change the course of the disease in the near future. The acknowledgement of the platinum-free interval (PFI) as the major criterion predicting therapy success in ovarian cancer relapse has allowed the development of distinct therapeutic strategies according to the PFI length. This update will indicate the pivotal trials that have led to the largest steps in the management of recurrent ovarian cancer during the last 10 years. Future advances in ovarian cancer treatment need randomized phase II or phase III trials in the recurrent disease setting before being tested in first line. The main ongoing randomized trials in relapsed disease will be reviewed, focusing on phase II or phase III trials.