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Background: Patient derived organoids (PDOs) are in increasing use as pre-clinical models for high-grade serous ovarian cancer (HGSOC) and other solid malignancies given their proven phenotypic and genotypic similarities with in vivo tumor. Furthermore, their use as putative predictive biomarkers in clinical trials is being explored. We sought to characterize the extent of inter- and interpatient heterogeneity in PDOs from multiple sites in HGSOC patients undergoing primary cytoreductive surgery. Methods: Multi-site samples from within the peritoneal cavity were obtained from HGSOC patients undergoing primary cytoreductive surgery and processed for PDO growth. PDOs were grown using pre-existing published protocols with/without supplementation of the Wnt agonist R-spondin. Once established, PDOs responses to conventional and targeted therapeutics using IC₅₀ and AUC were assessed. RNA …