Fig. 1: Study flowchart and outcomes including radiologic and pathologic responses, progression-free survival, and overall survival after neoadjuvant pembrolizumab plus chemotherapy.

a Study flowchart. 33 previously untreated stage IV high-grade serous ovarian cancer patients received pembro after one cycle of standard neo-adjuvant carboplatin-paclitaxel. Pembro was added to subsequent chemo cycles and continued as monotherapy up to one year. Surgery was planned after three chemo cycles. ctDNA circulating tumor DNA, PBMC peripheral blood mononuclear cells, PARP Poly (ADP-ribose) polymerase. b Radiological best change (%) in target lesions during neoadjuvant treatment with carboplatin-paclitaxel plus pembrolizumab. Patients whose tumor burden was considered too extensive to achieve complete interval cytoreduction were re-evaluated after four to six cycles of neoadjuvant therapy. c Progression-free survival (PFS); median PFS was 14.2 months (95%CI 11.1-30.2); 3-year PFS was 19% (95%CI 8.8-40). d Overall survival (OS); median OS was 32.0 months (95%CI 21.5-not reached (NR)); 3-year OS was 46% (95%CI 31-68). e Kaplan–Meier of OS for major pathologic responders in the study cohort (green), major pathologic responders in the historical cohort (orange), minor pathologic responders in the study cohort (dark blue), and minor pathologic responders in the historical cohort (light blue). Source data are provided as a Source Data file.