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High\u2010grade serous ovarian carcinoma (HGSOC) is the most common subtype of ovarian cancer, characterized predominantly by copy number variations (CNVs). This study evaluated the clinical significance of EV\u2010DNA focusing on CNV profiles and exploring its potential as a companion biomarker for predicting therapeutic response and supporting diagnosis in HGSOC. Droplet digital polymerase chain reaction detected concordant CNVs between tumor DNA and EV\u2010DNA in ascites but not in serum. EV\u2010DNA showed higher concordance with the CNV status of tumor DNA than cell\u2010free DNA in ascites. The EV\u2010DNA amount in malignant ascites was significantly higher than that in ascites from benign ovarian tumors (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.05), and elevated EV\u2010DNA was observed even in cytology\u2010negative ovarian cancer, suggesting an increase early in disease development. Moreover, CNV profiles showed marked differences between responders and nonresponders to poly(ADP\u2010ribose) polymerase (PARP) inhibitors. An equation based on five genes (\n                    <jats:italic>ARID1A, NOTCH3, CSMD3, ELP4<\/jats:italic>\n                    , and\n                    <jats:italic>BARD1<\/jats:italic>\n                    ) showed strong predictive performance for olaparib response (area under the curve = 0.91). Collectively, these findings indicate that the CNV status of EV\u2010DNA may serve as a non\u2010invasive companion biomarker for patient stratification and therapeutic monitoring in HGSOC.\n                  <\/jats:p>","DOI":"10.1002\/jev2.70308","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:35:47Z","timestamp":1778866547000},"source":"Crossref","is-referenced-by-count":2,"title":["DNA Copy Number Profiling in Extracellular Vesicles as Clinical Biomarkers of High\u2010Grade Serous Ovarian Carcinoma"],"prefix":"10.1002","volume":"15","author":[{"given":"Ryosuke","family":"Uekusa","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine  Nagoya 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