Current therapeutic strategies remain largely experimental, focusing on antifibrotic agents such as pirfenidone, TGF-β inhibitors and modulation of oxidative stress, alongside emerging interventions such as stem cell therapies, which are offer potential avenues for intervention in the ovary. This review synthesizes current insights into the cellular and molecular mechanisms driving ovarian fibrosis, its association with reproductive disorders, and emerging therapeutic strategies. It underscores key knowledge gaps and emphasizes the need for future research focused on fibroblast activation, inflammatory signaling and immune-ECM interactions to facilitate the development of targeted, long-term interventions aimed at preventing or reversing ovarian fibrosis and preserving female fertility.

P=N/A, N=232, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Nov 2025 --> Nov 2027 | Trial primary completion date: Nov 2025 --> Nov 2027

These findings demonstrate that serum tumor markers and pulmonary function parameters reflect disease heterogeneity between PF and PF+LC, with Cyfra21-1, FVC, DLCO, age, and fibrosis type serving as important survival determinants. Additionally, pirfenidone therapy may reduce lung cancer-related mortality, underscoring its potential therapeutic benefit in managing PF+LC.

P3, N=106, Active, not recruiting, Bristol-Myers Squibb | Trial primary completion date: Jan 2026 --> Oct 2025

P2, N=160, Recruiting, Takeda | Trial completion date: Oct 2030 --> Oct 2031

Drugs designed to promote erythropoiesis in MDS patients include erythropoiesis-stimulating agents such as recombinant human erythropoietin and TGF-β inhibitors such as luspatercept, which is approved for the treatment of anemia associated with MDS or β-thalassemia...Our findings demonstrate that GATA1 binds to the UBE2O promoter, thereby regulating UBE2O transcription and expression. Although further studies are needed to explore the implications of UBE2O in MDS treatment, our work provides potential strategies for novel therapeutic approaches in MDS.

P2, N=135, Recruiting, Takeda | Trial completion date: Jan 2029 --> Feb 2030 | Trial primary completion date: Dec 2026 --> Feb 2028

P4, N=60, Recruiting, Peking University Sixth Hospital; Peking University Sixth Hospital

Several recent targeted drug approvals including luspatercept and imetelstat have greatly expanded the treatment arsenal for lower-risk MDS. Standard of care therapy options for high-risk MDS, in particular TP53-mutated, remain limited beyond HMAs and transplant and are an active area of investigation.

Notable findings include PFD-mediated downregulation of pro-fibrotic miRNAs, hypermethylation of TGFB1, and inhibition of JMJD2B histone demethylase. Together, these findings suggest that PFD not only targets fibrotic and inflammatory pathways but also acts as a novel epigenetic regulator, positioning it as a promising therapeutic candidate for MASLD, MASH, and HCC.

P2, N=87, Recruiting, LISCure Biosciences | Not yet recruiting --> Recruiting | Initiation date: Mar 2025 --> Nov 2025

P4, N=85, Active, not recruiting, Bristol-Myers Squibb | N=60 --> 85 | Trial completion date: Apr 2026 --> Dec 2028 | Trial primary completion date: Apr 2026 --> Dec 2028