In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Giuseppe Caruso to discuss PARPi de-escalation in ovarian cancer. Dr. Caruso is a gynecologist, currently working as a research fellow at Mayo Clinic, Division of Gynecological Surgery, in Rochester (MN, USA) under the supervision of Professor William Cliby. He is also a PhD fellow in “Network Oncology and Precision Medicine” at Sapienza University of Rome in Italy and collaborates with the European Institution of Oncology in Milan (Italy) under the mentorship of Professor Nicoletta Colombo. His main areas of interest are ovarian cancer and precision oncology.   Highlights: Systemic therapy de-escalation is a new frontier in personalizing therapy for advanced ovarian cancer. PARPi are so effective that selected patients may require less systemic therapy to achieve the same outcomes. The fundamental key is to limit de-escalation to BRCAm/HRD-positive patients with R0 after surgery. Several de-escalation attempts are under investigation, but none is currently recommended outside of clinical trials.