{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:48:28Z","timestamp":1777009708798,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Poly (ADP\u2010ribose) polymerase inhibitors (PARPi) have reshaped the maintenance treatment of ovarian cancer. However, a significant proportion of patients exhibit primary resistance, highlighting the need for real\u2010world efficacy data and predictive biomarkers, especially in underrepresented populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study analyzed 152 Chinese patients with platinum\u2010sensitive ovarian cancer who received maintenance therapy with olaparib or niraparib, either in the first\u2010line (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200971) or second\u2013\/later\u2010line (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200981) setting. Progression\u2010free survival (PFS), progression\u2010free interval (PFI), and overall survival (OS) were estimated using the Kaplan\u2013Meier method. An objective, data\u2010driven definition of PARPi sensitivity\/resistance was established using receiver operating characteristic (ROC) curve analysis of PFS. Exploratory transcriptomic sequencing and immunohistochemistry (IHC) were performed on a subset of tumors to identify molecular correlates of response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the first\u2010line maintenance cohort, median PFS (mPFS) was 54.35\u2009months and median PFI (mPFI) was 49.57\u2009months. In the second\u2010\/later\u2010line group, mPFS was 42.53\u2009months and mPFI was 34.87\u2009months. Based on ROC\u2010defined cutoffs (PFS of 11.6 and 11.8\u2009months, respectively), 22.5% and 24.7% of patients were classified as PARPi\u2010resistance in the first\u2010 and second\u2010\/later\u2010line groups. Patients classified as sensitive consistently demonstrated superior PFS, PFI, and OS. Exploratory molecular analysis implicated the ferroptosis and HIF\u20101 signaling pathways in the response mechanism, and IHC validation confirmed differential protein expression of TFRC (lower in resistance tumors) and PRNP (higher in resistance tumors).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PARPi maintenance therapy demonstrates substantial clinical benefit in real\u2010world Chinese patients with ovarian cancer. However, over 20% exhibit primary resistance. TFRC and PRNP represent promising biomarkers for predicting PARPi sensitivity and warrant further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71850","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:17:43Z","timestamp":1777004263000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Survival Outcomes and Sensitivity of PARP Inhibitors in Platinum\u2010Sensitive Ovarian Cancer: A Retrospective Study"],"prefix":"10.1002","volume":"15","author":[{"given":"Xiu","family":"Zhang","sequence":"first","affiliation":[{"name":"The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital  Changsha Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhibin","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital  Changsha Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhui","family":"Gu","sequence":"additional","affiliation":[{"name":"The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital  Changsha Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huihui","family":"Fang","sequence":"additional","affiliation":[{"name":"The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital  Changsha Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital  Changsha Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9898-4893","authenticated-orcid":false,"given":"Chao","family":"Fang","sequence":"additional","affiliation":[{"name":"The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital  Changsha Hunan China"},{"name":"Hunan Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations Changsha Medical University  Changsha China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5242-3206","authenticated-orcid":false,"given":"Nayiyuan","family":"Wu","sequence":"additional","affiliation":[{"name":"The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital  Changsha Hunan China"},{"name":"Hunan Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations Changsha Medical University  Changsha China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ebiom.2022.104001","article-title":"Multi\u2010Omics Approaches for Biomarker Discovery in Early Ovarian Cancer Diagnosis","volume":"79","author":"Xiao Y.","year":"2022","journal-title":"eBioMedicine"},{"issue":"8","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"512","DOI":"10.6004\/jnccn.2024.0052","article-title":"NCCN Guidelines Insights: Ovarian Cancer\/Fallopian Tube Cancer\/Primary Peritoneal Cancer, Version 3.2024","volume":"22","author":"Liu J.","year":"2024","journal-title":"Journal of the National Comprehensive Cancer Network"},{"issue":"3","key":"e_1_2_11_4_1","first-page":"229","article-title":"Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"74","author":"Bray F.","year":"2024","journal-title":"CA: A Cancer Journal for Clinicians"},{"issue":"7","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1136\/ijgc-2022-004202","article-title":"Validation of the Integrated Prediction Model Algorithm for Outcome of Cytoreduction in Advanced Ovarian Cancer","volume":"33","author":"Piedimonte S.","year":"2023","journal-title":"International Journal of Gynecological Cancer"},{"issue":"3","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1200\/OP.22.00461","article-title":"Current Issues in the Management of Patients With Newly Diagnosed Advanced\u2010Stage High\u2010Grade Serous Carcinoma of the Ovary","volume":"19","author":"Penn C. A.","year":"2023","journal-title":"JCO Oncology Practice"},{"issue":"7","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1200\/JCO-24-02589","article-title":"Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: ASCO Guideline Update","volume":"43","author":"Gaillard S.","year":"2025","journal-title":"Journal of Clinical Oncology"},{"issue":"1","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s12943-024-01967-3","article-title":"Drug Resistance in Ovarian Cancer: From Mechanism to Clinical Trial","volume":"23","author":"Wang L.","year":"2024","journal-title":"Molecular Cancer"},{"issue":"2","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1200\/JCO.23.01771","article-title":"Treatment Approaches for Platinum\u2010Resistant Ovarian Cancer","volume":"42","author":"St Laurent J.","year":"2024","journal-title":"Journal of Clinical Oncology"},{"issue":"3","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1200\/JCO.22.01549","article-title":"Overall Survival With Maintenance Olaparib at a 7\u2010Year Follow\u2010Up in Patients With Newly Diagnosed Advanced Ovarian Cancer and a BRCA Mutation: The SOLO1\/GOG 3004 Trial","volume":"41","author":"DiSilvestro P.","year":"2023","journal-title":"Journal of Clinical Oncology"},{"issue":"12","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1016\/S1470-2045(21)00531-3","article-title":"Maintenance Olaparib for Patients With Newly Diagnosed Advanced Ovarian Cancer and a BRCA Mutation (SOLO1\/GOG 3004): 5\u2010Year Follow\u2010Up of a Randomised, Double\u2010Blind, Placebo\u2010Controlled, Phase 3 Trial","volume":"22","author":"Banerjee S.","year":"2021","journal-title":"Lancet Oncology"},{"issue":"26","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"2495","DOI":"10.1056\/NEJMoa1810858","article-title":"Maintenance Olaparib in Patients With Newly Diagnosed Advanced Ovarian Cancer","volume":"379","author":"Moore K.","year":"2018","journal-title":"New England Journal of Medicine"},{"issue":"11","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.annonc.2024.08.2241","article-title":"Niraparib First\u2010Line Maintenance Therapy in Patients With Newly Diagnosed Advanced Ovarian Cancer: Final Overall Survival Results From the PRIMA\/ENGOT\u2010OV26\/GOG\u20103012 Trial","volume":"35","author":"Monk B. J.","year":"2024","journal-title":"Annals of Oncology"},{"issue":"1","key":"e_1_2_11_14_1","article-title":"Fuzuloparib With or Without Apatinib as Maintenance Therapy in Newly Diagnosed, Advanced Ovarian Cancer (FZOCUS\u20101): A Multicenter, Randomized, Double\u2010Blind, Placebo\u2010Controlled Phase 3 Trial","volume":"76","author":"Wu L.","year":"2026","journal-title":"CA: A Cancer Journal for Clinicians"},{"issue":"9","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1016\/S1470-2045(17)30469-2","article-title":"Olaparib Tablets as Maintenance Therapy in Patients With Platinum\u2010Sensitive, Relapsed Ovarian Cancer and a BRCA1\/2 Mutation (SOLO2\/ENGOT\u2010Ov21): A Double\u2010Blind, Randomised, Placebo\u2010Controlled, Phase 3 Trial","volume":"18","author":"Pujade\u2010Lauraine E.","year":"2017","journal-title":"Lancet Oncology"},{"issue":"11","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1200\/JCO.19.02745","article-title":"Olaparib Versus Nonplatinum Chemotherapy in Patients With Platinum\u2010Sensitive Relapsed Ovarian Cancer and a Germline BRCA1\/2 Mutation (SOLO3): A Randomized Phase III Trial","volume":"38","author":"Penson R. T.","year":"2020","journal-title":"Journal of Clinical Oncology"},{"issue":"5","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/S1470-2045(19)30029-4","article-title":"Niraparib Monotherapy for Late\u2010Line Treatment of Ovarian Cancer (QUADRA): A Multicentre, Open\u2010Label, Single\u2010Arm, Phase 2 Trial","volume":"20","author":"Moore K. N.","year":"2019","journal-title":"Lancet Oncology"},{"issue":"25","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1056\/NEJMoa1910962","article-title":"Niraparib in Patients With Newly Diagnosed Advanced Ovarian Cancer","volume":"381","author":"Gonz\u00e1lez\u2010Mart\u00edn A.","year":"2019","journal-title":"New England Journal of Medicine"},{"issue":"4","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.annonc.2020.12.018","article-title":"Niraparib Maintenance Therapy in Patients With Platinum\u2010Sensitive Recurrent Ovarian Cancer Using an Individualized Starting Dose (NORA): A Randomized, Double\u2010Blind, Placebo\u2010Controlled Phase III Trial(\u2606)","volume":"32","author":"Wu X. H.","year":"2021","journal-title":"Annals of Oncology"},{"issue":"9","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1001\/jamaoncol.2023.2283","article-title":"Treatment With Niraparib Maintenance Therapy in Patients With Newly Diagnosed Advanced Ovarian Cancer: A Phase 3 Randomized Clinical Trial","volume":"9","author":"Li N.","year":"2023","journal-title":"JAMA Oncology"},{"issue":"1","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.ygyno.2020.10.005","article-title":"Olaparib Maintenance Therapy in Patients With Newly Diagnosed Advanced Ovarian Cancer and a BRCA1 and\/or BRCA2 Mutation: SOLO1 China Cohort","volume":"160","author":"Wu L.","year":"2021","journal-title":"Gynecologic Oncology"},{"issue":"8","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1136\/jmedgenet-2020-106970","article-title":"Prevalence of BRCA1\/BRCA2 Pathogenic Variation in Chinese Han Population","volume":"58","author":"Dong H.","year":"2021","journal-title":"Journal of Medical Genetics"},{"issue":"1","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1186\/s12885-025-14302-w","article-title":"Identifying the Germline Variation Spectrum and Predisposition Genes in Chinese Ovarian Cancer Using Whole Exome Sequencing","volume":"25","author":"Guan X.","year":"2025","journal-title":"BMC Cancer"},{"issue":"1","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s13048-024-01362-y","article-title":"PARP Inhibitor Era in Ovarian Cancer Treatment: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials","volume":"17","author":"Barad\u00e1cs I.","year":"2024","journal-title":"Journal of Ovarian Research"},{"issue":"20","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"4644","DOI":"10.1158\/1078-0432.CCR-24-1225","article-title":"Effectiveness of PARP Inhibitor Maintenance Therapy in Ovarian Cancer by BRCA1\/2 and a Scar\u2010Based HRD Signature in Real\u2010World Practice","volume":"30","author":"Richardson D. L.","year":"2024","journal-title":"Clinical Cancer Research"},{"issue":"16","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"2957","DOI":"10.1158\/1078-0432.CCR-23-0563","article-title":"Assessment of Homologous Recombination Deficiency in Ovarian Cancer","volume":"29","author":"Garg V.","year":"2023","journal-title":"Clinical Cancer Research"},{"issue":"1","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/s12943-024-02025-8","article-title":"PARP1\u2010DOT1L Transcription Axis Drives Acquired Resistance to PARP Inhibitor in Ovarian Cancer","volume":"23","author":"Liu C.","year":"2024","journal-title":"Molecular Cancer"},{"issue":"7","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","DOI":"10.1002\/ctm2.70422","article-title":"Spatially Resolved Proteomics Surveys the Chemo\u2010Refractory Proteins Related to High\u2010Grade Serous Ovarian Cancer","volume":"15","author":"Fan L.","year":"2025","journal-title":"Clinical and Translational Medicine"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71850","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.71850","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71850","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:06:48Z","timestamp":1777007208000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.71850"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/cam4.71850"],"URL":"https:\/\/doi.org\/10.1002\/cam4.71850","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-10-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71850"}}