{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:20:18Z","timestamp":1787721618642,"version":"build-2784847793"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The clinical value of immune checkpoint inhibitor (ICI)-based combinations in platinum-resistant or platinum-refractory recurrent ovarian cancer remains regimen-dependent and uncertain. We updated the evidence base and separated nonrandomized response evidence from randomized comparative evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to 23 July 2026, supplemented by reference and citation searching. Eligible reports were peer-reviewed prospective phase II or III trials of an ICI-containing combination in adults with platinum-resistant or platinum-refractory recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer. Front-line, maintenance-only, ICI-monotherapy, retrospective, phase I-only, protocol-only, and mixed platinum-status cohorts without extractable resistant\/refractory data were excluded. Objective response rate (ORR) and disease control rate (DCR) from compatible nonrandomized cohorts were synthesized as proportions using a logit random-effects model with Paule\u2013Mandel variance estimation and Hartung\u2013Knapp confidence intervals. Randomized hazard ratios were synthesized descriptively and were not pooled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one eligible prospective reports were included, comprising 14 nonrandomized reports and 7 randomized trials. Of the 14 nonrandomized reports, 13 provided compatible confirmed response data for the pooled ORR analysis, yielding 112 objective responses among 490 participants and a pooled ORR of 21.9% (95% CI, 13.1%\u201334.3%; I\u00b2 = 70.7%). The remaining nonrandomized report was retained for narrative synthesis only because it reported an unconfirmed response. Ten nonrandomized reports contributed 211 disease-control events among 354 participants, yielding a pooled DCR of 59.9% (95% CI, 46.4%\u201372.1%; I\u00b2 = 71.7%). The seven randomized trials were summarized separately and were not pooled with the nonrandomized reports. KEYNOTE-B96 demonstrated improved progression-free survival (HR, 0.70; 95% CI, 0.58\u20130.84) and overall survival (HR, 0.82; 95% CI, 0.69\u20130.97), whereas JAVELIN Ovarian 200, EORTC 1508, NRG-GY023, and AGO-OVAR 2.29 did not meet their primary efficacy objectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ICI-based combinations show measurable but highly heterogeneous activity in platinum-resistant\/refractory ovarian cancer. The evidence does not support a uniform class effect: a survival benefit is established for pembrolizumab plus weekly paclitaxel in KEYNOTE-B96, whereas several other randomized strategies were negative. Future trials should prioritize regimen-specific validation, biomarker enrichment, and harmonized toxicity reporting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1837967","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:47:27Z","timestamp":1787719647000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Immune checkpoint inhibitor\u2013based combination therapy for platinum-resistant or platinum-refractory recurrent ovarian cancer: a systematic review and meta-analysis of prospective trials"],"prefix":"10.3389","volume":"16","author":[{"given":"Jing","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Oncology, The Second School of Clinical Medicine, Guizhou University of Traditional Chinese Medicine","place":["Guiyang City, Guizhou, China"]},{"name":"Department of Oncology, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine","place":["Guiyang City, Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Second School of Clinical Medicine, Guizhou University of Traditional Chinese Medicine","place":["Guiyang City, Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Ying","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Second School of Clinical Medicine, Guizhou University of Traditional Chinese Medicine","place":["Guiyang City, Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Jing","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Second School of Clinical Medicine, Guizhou University of Traditional Chinese Medicine","place":["Guiyang City, Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Second School of Clinical Medicine, Guizhou University of Traditional Chinese Medicine","place":["Guiyang City, Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctarc.2026.101260","article-title":"CRI-CCTG-0003\/IND.240 an immunotherapy platform study in platinum-resistant high grade serous ovarian cancer (IPROC): Sub-studies A and B: Durvalumab (D) + mecbotamab vedotin (BA3011) or ozuriftamab vedotin (BA3021)","volume":"48","author":"MacKay","year":"2026","journal-title":"Cancer Treat Res Commun"},{"key":"B2","doi-asserted-by":"publisher","first-page":"544","DOI":"10.3390\/medicina59030544","article-title":"Ovarian cancer-insights into platinum resistance and 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