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Tumor-Stroma Proportion as a Predictive Biomarker of Resistance to Platinum-Based Chemotherapy in Patients With Ovarian Cancer Standard treatment for ovarian cancer is platinum-based chemotherapy; however, 15% to 30% of patients with ovarian cancer have primary platinum-resistant or refractory disease. Resistance to platinum-based chemotherapy is a clinical designation, assessed by time to recurrence or progression of malignant disease within 6 months after cessation of platinum-based treatment.1 Refractory disease is defined as recurrence of disease during the course of platinum-based chemotherapy. There is evidence to support the hypothesis that stromatous components of malignant tumors stimulate growth and proliferation of malignant components of invasive tumors2; higher stromal content, referred to as high tumor-stroma proportion, has been associated with worse prognosis in many epithelial cancers.3-5 We report the results of a prospective observational study examining tumor-stroma proportion as a predictive biomarker of chemoresistance in women diagnosed with ovarian cancer.