Simple SummaryThis study aimed to determine the optimal maintenance therapy and selection criteria for patients with platinum-sensitive recurrent ovarian cancer (PSROC). The study collected retrospective data from 51 patients with PSROC and found that olaparib (Ola) was superior to bevacizumab (Bev) as a maintenance therapy, with a significantly prolonged recurrence-free survival (RFS) of 27 months in the Ola group compared to 9 months in the Bev group. The efficacy of Ola was independent of background factors, such as response to previous chemotherapy and homologous recombination status. These results suggest that Ola is a better treatment option than Bev for patients with PSROC, especially in Japanese and Asian populations.AbstractThe use of angiogenesis inhibitors and poly ADP-ribose polymerase inhibitors following multi-agent chemotherapy, including platinum-based agents, has become the standard treatment for platinum-sensitive recurrent ovarian cancer (PSROC). However, the optimal maintenance therapy and selection criteria for these patients remain unclear. Thus, this study aimed to optimize the treatment options and selection criteria for patients with PSROC. The clinical data of 51 patients with PSROC admitted to Nippon Medical School Chiba Hokusoh Hospital and Nippon Medical School Hospital were retrospectively collected. The log-rank test was used for the survival analysis, and Cox proportional hazard regression analysis was used for the multivariate survival analysis. Of the 51 patients, 17 received maintenance therapy with bevacizumab (Bev), and 34 received olaparib (Ola). Recurrence-free survival (RFS) was significantly prolonged in the Ola group (27 months; 95% confidence interval (CI), 19–NA months) compared with that in the Bev group (9 months; 95% CI, 5–22 months;p= 0.000103). The efficacy of Ola was independent of background factors, including response to previous chemotherapy, homologous recombination status, histological type, or laboratory data. Ola is superior to Bev as PSROC maintenance therapy, especially in Japanese and Asian populations.