Homologous recombination deficiency testing in patients with high grade ovarian cancer: factors influencing test success
Author(s)
Type
Journal Article
Abstract
Introduction
Testing for tumor BRCA mutations and homologous recombination deficiency (HRD) is recommended for all patients with advanced high-grade epithelial ovarian cancer. Delays in the HRD testing process can significantly affect the treatment offered to patients.
Methods
HRD testing pathways and sampling processes were analyzed for tests sent from a tertiary gynae-oncology referral center between December 2020 and January 2023.
Results
A total of 148 hRD tests were performed in 125 patients. The overall success rate of HRD testing was 69.6%. The success rates of obtaining results were: from diagnostic image-guided biopsy 66.7% (n = 40/60), at primary surgery 91.5% (n = 42/47), and at interval debulking surgery 51.2% (n = 21/41). The use of a larger 16-gauge needle used at image-guided biopsy produced a 100% success rate. Of 148 tests carried out, the median time for result was 28 days (range 14–158 days), with only 27% returned results in 21 or fewer days. In successful tests, 44.7% were classified as HRD-positive. 97% of patients with HRD-positive tumors treated at the center received a PARP inhibitor as part of their first-line maintenance treatment.
Conclusions
By optimizing the factors affecting HRD test success, we can obtain faster results and offer patients appropriate treatment at earlier time points to improve patient outcomes.
Testing for tumor BRCA mutations and homologous recombination deficiency (HRD) is recommended for all patients with advanced high-grade epithelial ovarian cancer. Delays in the HRD testing process can significantly affect the treatment offered to patients.
Methods
HRD testing pathways and sampling processes were analyzed for tests sent from a tertiary gynae-oncology referral center between December 2020 and January 2023.
Results
A total of 148 hRD tests were performed in 125 patients. The overall success rate of HRD testing was 69.6%. The success rates of obtaining results were: from diagnostic image-guided biopsy 66.7% (n = 40/60), at primary surgery 91.5% (n = 42/47), and at interval debulking surgery 51.2% (n = 21/41). The use of a larger 16-gauge needle used at image-guided biopsy produced a 100% success rate. Of 148 tests carried out, the median time for result was 28 days (range 14–158 days), with only 27% returned results in 21 or fewer days. In successful tests, 44.7% were classified as HRD-positive. 97% of patients with HRD-positive tumors treated at the center received a PARP inhibitor as part of their first-line maintenance treatment.
Conclusions
By optimizing the factors affecting HRD test success, we can obtain faster results and offer patients appropriate treatment at earlier time points to improve patient outcomes.
Date Issued
2025-01-01
Date Acceptance
2024-11-20
Citation
Future Oncology, 2025, 21 (3), pp.341-347
ISSN
1479-6694
Publisher
Taylor and Francis Group
Start Page
341
End Page
347
Journal / Book Title
Future Oncology
Volume
21
Issue
3
Copyright Statement
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/),which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39611711
Subjects
ARIEL3
BRCA1
BRCA2
CARCINOMA
genetic mutation
genomic testing
HRD
Life Sciences & Biomedicine
MAINTENANCE THERAPY
Oncology
OUTCOMES
Ovarian cancer
PARPi
PREDICTIVE BIOMARKER
RUCAPARIB
SAFETY
Science & Technology
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2024-11-29