{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:56:14Z","timestamp":1792691774366,"version":"4.5.0"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec id=\"ab-coi260027-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>A subset of patients with platinum-sensitive recurrent ovarian cancer (PS-ROC) treated with maintenance poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors have exceptional response. Although licensing recommends continuing PARP inhibitors until progression or unacceptable toxic effects, the optimal duration of PARP inhibitors, and the risks of late progression, myelodysplastic syndrome (MDS), or acute myeloid leukemia (AML) in patients with exceptional response are unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260027-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the long-term outcomes of patients with PS-ROC who have exceptional response to PARP inhibitors, and to explore genotype-phenotype associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260027-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This was an international, multicenter, retrospective cohort study of patients with exceptional response to PARP inhibitors, defined as patients with PS-ROC and progression-free survival (PFS) of 5 years or longer from PARP inhibitor commencement. The study was conducted across 41 sites in 14 countries from January 11, 2023, to November 10, 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260027-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Treatment with PARP inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260027-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary end point was PFS, and secondary end points included overall survival, toxic effects, and dose reductions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260027-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 320 patients with exceptional response (mean [SD] age, 56.4 [9.4] years) were included, with a median follow-up of 6.8 years (95% CI, 6.6-7.0 years). The median (IQR) PARP inhibitor duration was 75.0 (64.0-91.0) months. Of patients with exceptional response, 211 (65.9%) received continuous PARP inhibitors, but 109 (34.1%) discontinued: 34 (10.6%) due to physician recommendation, 2 (7.5%) had disease progression beyond 5 years, 22 (6.9%) had toxic effects, 17 (5.3%) for patient preference, and 12 (3.8%) for another reason. The 7.5-year and 10-year PFS rates were 88.8% (95% CI, 84.5%-93.3%) and 78.7% (95% CI, 70.5%-87.9%), respectively. Among the patients, 85 (26.6%) discontinued PARP inhibitors for reasons other than disease progression, with a 10-year PFS of 90.1% (95% CI, 80.6%-100%) vs 72.5% (95% CI, 60.3%-87.2%) for those who continued taking PARP inhibitors. Five patients (1.6%) were diagnosed with late-onset MDS\/AML. Patients with exceptional response were enriched for variants in the\n                      <jats:italic toggle=\"yes\">BRCA1<\/jats:italic>\n                      RING domain and the\n                      <jats:italic toggle=\"yes\">BRCA2<\/jats:italic>\n                      DNA-binding domain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260027-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this cohort study, most patients with exceptional response to PARP inhibitors remained progression free, including those who discontinued PARP inhibitors without progression. The risk of late-onset MDS\/AML was low. These results can guide counseling on the duration of maintenance PARP inhibitors in patients with exceptional response and suggest that functional cure may be possible in patients with PS-ROC and exceptional response to PARP inhibitors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoncol.2026.1924","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:30:27Z","timestamp":1782401427000},"page":"845","source":"Crossref","is-referenced-by-count":2,"title":["Long-Term Outcomes in Patients With Recurrent Ovarian Cancer and Exceptional Response to PARP Inhibitors"],"prefix":"10.1001","volume":"12","author":[{"given":"Lucy","family":"Haggstrom","sequence":"first","affiliation":[{"name":"Prince of Wales Hospital and Royal Hospital for Women, Sydney, New South Wales, Australia"},{"name":"School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeh Chen","family":"Lee","sequence":"additional","affiliation":[{"name":"Prince of Wales Hospital and Royal Hospital for Women, Sydney, New South Wales, Australia"},{"name":"School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Pilar","family":"Barretina-Ginesta","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 d\u2019Oncologia Girona, IDIBGI-CERCA, Girona, Spain"},{"name":"Spanish Gynecological Cancer Research Group (GEICO), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Jaeger","sequence":"additional","affiliation":[{"name":"AGO Studiengruppe, Wiesbaden, Germany"},{"name":"University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linn","family":"Woelber","sequence":"additional","affiliation":[{"name":"AGO Studiengruppe, Wiesbaden, Germany"},{"name":"University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Woopen","sequence":"additional","affiliation":[{"name":"North-Eastern-German Society of Gynaecologic Oncology (NOGGO), Berlin, Germany"},{"name":"Department of Gynecology with Centre for Oncological Surgery, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Rhind","sequence":"additional","affiliation":[{"name":"British Columbia Cancer Agency, Vancouver, British Columbia, 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