PARP inhibitors (PARPi) have reshaped the clinical management paradigm of multiple cancers, but none more than homologous recombination-deficient high-grade serous carcinoma (HGSC) of tubo-ovarian origin. In patients with HGSC that harbor BRCA1/2-mutations, PARPi maintenance therapy after first-line chemotherapy has resulted in significantly prolonged progression-free and overall survival. However, PARPi resistance is a major clinical challenge, and subsequent therapeutic options for patients with resistant disease remain limited. Whereas mechanisms of PARPi therapy have been described, there have been few clinical studies to translate these strategies into overcoming resistance.
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