Ovarian cancer remains a significant clinical burden in women with an estimated 21,750 new cases and 13,940 deaths in 2020 in the United States.1 Ovarian cancer is 4 times more deadly than breast cancer.2

Approximately 80% of patients diagnosed with ovarian cancer present with regional or distant disease, and over half of high-grade serous ovarian cancers exhibit homologous recombination deficiency (HRD).2,3 Although approximately 1 in 4 women with advanced ovarian cancer has a breast cancer susceptibility gene (BRCA) mutation detected by tumor testing, women without a BRCA mutation may still have tumors with HRD.4,5 In fact, approximately 1 in 2 women with advanced ovarian cancer has a tumor with HRD.3

High-Grade Serous Ovarian Cancer Cases

High Grade Serous Ovarian Cancer Cases
High Grade Serous Ovarian Cancer Cases

BRCA, breast cancer susceptibility gene; HRD, homologous recombination deficiency; HRRm, homologous recombination repair mutation.

Guidelines for Ovarian Cancer Testing6

National Comprehensive Cancer Network (NCCN) Guidelines® for Ovarian Cancer: Germline Testing

Which patients with ovarian cancer should have germline testing?

Any patient with pathologically confirmed ovarian, fallopian tube, or primary peritoneal cancer (if not previously done)

Which genes should be tested?

BRCA1 and BRCA2

NCCN Guidelines® for Ovarian Cancer: Tumor Testing

Which patients with ovarian cancer should have tumor testing?

Any patient with pathologically confirmed ovarian, fallopian tube, or primary peritoneal cancer (if not previously done)

What should be tested?
  • BRCA1 and BRCA2
  • In the absence of a BRCA1/2 mutation, homologous recombination status may provide information on the magnitude of benefit of PARP inhibitor maintenance therapy after first-line chemotherapya

FDA, US Food and Drug Administration; PARP, poly (ADP-ribose) polymerase.
aRecommendations in the NCCN Guidelines® are not limited to FDA-approved indications.

HRD Mutation
HRD Mutation

Learn More About Testing for HRD

Mutations of BRCA1 and/or BRCA2 or other homologous recombination genes result in HRD and the impaired ability to effectively repair double-strand breaks (DSBs) in DNA.3,7,8 As a result, DSBs persist or may be repaired via the error-prone nonhomologous end joining mechanism, resulting in genomic instability, the accumulation of genetic alterations, and chromosomal abnormalities leading to carcinogenesis.7

1. American Cancer Society. Cancer Facts & Figures 2020. American Cancer Society; 2020. Accessed October 20, 2020. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf. 2. National Cancer Institute. Cancer stat facts: ovarian cancer. Accessed October 20, 2020. https://seer.cancer.gov/statfacts/html/ovary.html. 3. Frey MK, et al. Gynecol Oncol Res Pract. 2017;4:4. 4. Konstantinopoulos P, et al. Cancer Discov. 2015;5(11):1137-1154. 5. Pennington KP, et al. Clin Cancer Res. 2014;20(3):764-775. 6. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer V.1.2021. ©National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed February 26, 2021. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 7. Konecny GE, Kristeleit RS. Br J Cancer. 2016;115(10):1157-1173. 8. O’Sullivan CC, et al. Front Oncol. 2014;4:42.