In the era of targeted medicine, the use of poly (ADP-ribose) polymerase (PARP) inhibitors in homologous recombination deficient (HRD) tumors has represented the first clinically actionable mutation in gynecologic malignancies. The dramatic results seen across multiple clinical trials completely changed the landscape of epithelial ovarian cancer (EOC) treatments in both primary and recurrent settings. For many, it has spawned hope that additional biomarkers would soon be discovered that could find similarly spectacular results in different patient populations. However, molecular profiling’s efficacy in selecting targeted therapies and its economic practicality are difficult to justify.