Optimizing Homologous Recombination Deficiency (HRD) Testing Paradigms in Ovarian Cancer

Thomas Herzog, MD, Thomas Krivak, MD, and Ian Hagemann, MD, PhD open their discussion by introducing themselves and the objectives of the program.

Experienced clinicians explain the role of the homologous recombination repair (HRR) pathway in DNA repair and how mutations in HRR-related genes, including BRCA1 and BRCA2, can cause homologous recombination deficiency (HRD) and contribute to the development and progression of ovarian cancer (OC).

Dr Hagemann explains how loss of heterozygosity (LOH), large-scale state transitions (LSTs), and telomeric allelic imbalance (TAI) can also contribute to HRD.

The panel reviews commercially available HRD tests and expand upon factors that may influence test choice, such as clinical performance, institutional availability, turnaround time, and cost.

Discussion centered around data from the PAOLA-1 trial, highlighting the prevalence of BRCA1/2 mutations and HRD status in ovarian cancer, and how patients with these alterations may benefit from PARP inhibitor treatment.

Panelists discuss clinical guidelines recommendations for HRD testing in ovarian cancer and how they inform their practice.