OBJECTIVE: To investigate whether the combination of antiangiogenic therapy and poly-ADP-ribose polymerase inhibitors (PARPi) can enhance the effectiveness of maintenance therapy in patients with progressive ovarian cancer who are progressing after PARPi maintenance therapy. DESIGN: Retrospective cohort study. SETTING: Single-centre tertiary hospital in Beijing, China. POPULATION: Patients treated with combination therapy. METHODS: We retrospectively reviewed the clinicopathological data of patients with epithelial ovarian cancer. Telephone follow-ups were performed for eligible participants to verify disease progression and survival status. MAIN OUTCOME MEASURES: Clinical endpoints included objective response rate (ORR), disease control rate (DCR), time-to-symptomatic progression (TTSP), and progression-free survival. RESULTS: Overall, 25 patients were analysed. Overall confirmed ORR was 44%, and the DCR was 68%. The median TTSP was 12.0 months (95% CI: 2.05-24.73). In the progression-free interval (PFI) >
12 months group (n = 15), the ORR was 60% (9/15), and the DCR was 73.3%. In the PFI ≤ 12 months group (n = 10), the ORR was 20% (2/10), and the DCR was 60%. The median TTSP was not reached in the PFI >
12 months group and was 4.0 months (95% CI: 2.988-5.012) for the PFI ≤ 12 months group. The 6-month progression-free survival rates were 58% and 40%, respectively. Among the 10 patients who received subsequent chemotherapy, seven achieved partial response (PR), and one had stable disease. The respective ORR and DCR values were 70% and 80%. CONCLUSIONS: Combining antiangiogenic therapy with the original PARPi may benefit patients with ascites-free ovarian cancer and a low tumour burden who experience disease progression following PARPi maintenance therapy.