This retrospective cohort study evaluated whether the pathology-based Chemotherapy Response Score (CRS) at interval debulking surgery (IDS) predicts benefit from PARP inhibitor (PARPi) maintenance therapy in 169 patients with high-grade epithelial ovarian cancer who received neoadjuvant chemotherapy followed by IDS between January 2016 and September 2022 at a single academic center.
Among patients with CRS 2-3 (moderate/marked response), PARPi maintenance was associated with improved PFS (20 vs. 15 months, p=0.029); no PFS benefit was seen in CRS 1 (minimal/no response) patients (p=0.27). CRS 1 was also linked to lower rates of complete cytoreduction (44.1% vs. 69.3%, p<0.0001) and inferior PFS regardless of PARPi use.
- Single-center retrospective design limits generalizability and introduces selection bias. - CRS was not reported for 44 of 213 eligible patients, creating potential ascertainment bias. - Only 47 patients received PARPi maintenance, limiting statistical power, especially in the CRS 1 subgroup.
Consider CRS at IDS as a practical counseling tool for PARPi maintenance decisions — particularly in BRCA-wildtype patients or settings where HRD testing is unavailable. Patients with CRS 1 may not derive PFS benefit from PARPi maintenance and warrant individualized discussion.
Explore related topics
