The FZOCUS‑1 study, led by Professor Lingying Wu and co‑corresponding author Professor Ning Li of the Cancer Hospital of the Chinese Academy of Medical Sciences, was published in January in CA: A Cancer Journal for Clinicians. It is the journal's first clinical research articleof gynecologic oncology.

Ovarian cancer is the most lethal malignancies and carries the worst prognosis among gynecologic malignancies. Approximately 70% of patients are diagnosed at advanced stages, with a 5‑year survival rate of 30‑40%. With the approval of poly(adenosine diphosphate ribose) polymerase (PARP) inhibitors and anti-angiogenic drugs for first-line maintenance therapy for advanced ovarian cancer, the survival has been significantly improved. However, which patients should receive monotherapy or combination therapy based on different biomarker status is unclear. For example, the options of maintenance treatment for patients with breast cancer susceptibility gene (BRCA) mutations include PARP inhibitor monotherapy and PARP inhibitor combined with bevacizumab, but whether the combined therapy is better than the single drug PARP inhibitor, there is still no research to explore globally. The FZOCUS-1 study answered this questionfor the first time, providing high-levelevidence for biomarker-based treatment options for advanced ovarian cancer patients.

The FZOCUS-1 study evaluated the efficacy and safety of the PARP inhibitor fuzuloparib monotherapy andfuzuloparib combined with the anti-angiogenic agent apatinib in first-line maintenance therapy for advanced ovarian cancer. Designed in 2019, the research protocol was forward-looking and scientific. Moreover, the dual oral regimenofferedbetter convenience.The study adopted a 2:2:1 randomization ratio, with only 20% of participants assigned to placebo. More importantly, as the first head‑to‑head trial comparing PARPi monotherapy with PARPi plus anti‑angiogenic therapy in first‑line maintenance, it provided critical evidence for subgroup‑oriented strategies.

Prior data suggestedhomologous recombination deficiency (HRD)‑positive patients, including those with BRCA mutations could receive PARP‑inhibitor‑based maintenance after responding to primary surgery and chemotherapy. Combination regimens brought more toxicities and financial burdens, without confirmed incremental benefits. FZOCUS‑1 showed that adding apatinib to fuzuloparib offered no additional PFS benefit for BRCA‑mutated or HRD‑positive patients, indicating that the addition of an anti‑angiogenic agent is unnecessary for these subgroups. For HRP patients, the combination showed a promising PFS trend, suggesting combination therapy may be worthwhile for this hard‑to‑treat population.

This study represents a remarkable breakthrough in ovarian cancer research by a Chinese team and provids robust evidence for global practice. CA: A Cancer Journal for Clinicians, published by the American Cancer Society since 1950, is a top‑tier oncology journal with a 2025 impact factor of 685.2.