TEST:

Myriad myChoice® CDx

Using MyChoice CDx as reference, commercially available assays showed concordance in detecting HRD, genomic instability, and BRCA mutations, indicating their potential clinical utility in identifying appropriate treatment options for ovarian cancer.

The HGOC HRD-GIS determined by the MyChoice HRD+ CDx assay provides statistically robust evidence for BRCA1 and BRCA2 variant interpretation. This approach may refine variant classification, particularly for variants of uncertain significance, and enhance clinical decision-making in hereditary and tumor-based cancer risk assessment.

Although HBOC-related genetic testing and preventive strategies are widely implemented in Japan, this nationwide survey revealed critical structural and evidence gaps, particularly in institutional capacity and the management of evidence-limited scenarios such as STIC, underscoring the need for system-level improvement.

MSBM enables robust HRD evaluation from a whole-exome sequencing assay. Olaparib monotherapy demonstrated clinical benefit for first-line maintenance in HRD-positive ovarian cancer without bevacizumab.

Cost-effectiveness analyses further support the integration of HRD testing at diagnosis, highlighting its role in guiding optimal use of PARP inhibitors and improving healthcare resource allocation. This review summarizes the biological rationale, diagnostic methods, therapeutic implications, and economic considerations of HRD in EOC, with a focus on first-line maintenance strategies and future directions in precision oncology.

P2, N=188, Active, not recruiting, Nordic Society of Gynaecological Oncology - Clinical Trials Unit | Recruiting --> Active, not recruiting | Trial primary completion date: Dec 2026 --> May 2026

This first comprehensive analysis of Romanian ovarian cancer patients suggests that integrating sWGS-based genomic instability assessment with BRCA testing can improve HRD detection and reflects the heterogeneity of HR-pathway variants. Preliminary clinical observations were consistent with known HRD-associated treatment responses, although larger studies are needed to confirm these findings.

Neither inconclusiveness nor discordance were associated with sample related factors. These findings indicate that the SOPHiA HRD assay can provide results broadly interchangeable with Myriad myChoice, though caution is warranted when assigning HRD status to borderline GI values.

Its combined format and accessibility render it well-suited for real-world use in personalized ovarian cancer care. Its additional capacity to reveal more extensive tumor genomic alterations improves clinical decision-making and underscores the importance of integrating HRD scoring with comprehensive molecular profiling in personalized oncology.

LT response to olaparib for primary maintenance is common, and more frequently observed in patients with a complete response to platinum-based chemotherapy. BRCA2 mutations conferred exceptional benefit to olaparib. Durable benefit was more commonly observed in patient's receiving frontline maintenance olaparib.

Regional variations (e.g., Asian cohorts) and disparities in access underscore the need for standardized, cost-effective diagnostics. Future priorities include validating novel biomarkers (SBS39, miR-622) and combination therapies (PARPi with ATR inhibitors) to overcome resistance and broaden HRD's applicability across cancers.

The Geneva HRD test predicts PFS and OS benefit from olaparib + bevacizumab. The potential detrimental effect of olaparib + bevacizumab on OS in the HRD-negative population is hypothesis-generating and needs to be confirmed prospectively.