Identification of BRCA mutations and/or HRD status in clinical specimens is critical to selecting EOC patients for PARPi treatment, which has been evaluated in several clinical trials ( 10– 15). Evaluating homologous recombination deficiency (HRD) in tumor cells as a potential predictor of the response to a PARPi is an important clinical issue. In the era of precision medicine, it is important to select the appropriate patients to benefit from the targeted therapy. Maintenance therapy with PARPis has rewritten the management of EOC in newly diagnosed and recurrent disease ( 10– 15). ![]() ![]() Based on the evidence to date, antiangiogenic agents and poly-adenosine diphosphate ribose polymerase (PARP) inhibitors (PARPis) are the most promising targeted therapies for EOC in the past decade ( 8, 9). The primary standard treatment, debulking surgery, and adjuvant chemotherapy with a platinum and paclitaxel regimen, can achieve good initial response rates, but the majority of ovarian cancer patients eventually relapse ( 7). Due to a lack of specific symptoms and biological markers for early diagnosis, most ovarian cancer patients are diagnosed at an advanced stage in which the disease has spread beyond the pelvis, with an associated 5-year survival of less than 50% ( 6). In this review, we introduce the concept of synthetic lethality, the rationale of using PARPi when HRD is present in tumor cells, the clinical trials of PARPi incorporating the HRD assays for EOC, the current HRD assays, and other HRD assays in development.Įpithelial ovarian cancer (EOC) is a major cause of death in women worldwide ( 1– 5). However, the currently available HRD assays are not perfect predictors of the clinical response to PARPis in EOC patients. Identification of BRCA mutations and/or homologous recombination deficiency (HRD) is critical for selecting patients for PARPi treatment. In recent years, promising survival benefits from maintenance therapy with poly(ADP-ribose) polymerase (PARP) inhibitor (PARPi) has changed the management of EOC in newly diagnosed and recurrent disease. 5Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, TaiwanĮpithelial ovarian cancer (EOC) patients are generally diagnosed at an advanced stage, usually relapse after initial treatments, which include debulking surgery and adjuvant platinum-based chemotherapy, and eventually have poor 5-year survival of less than 50%.4Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.3Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei, Taiwan.2Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan.1Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.Ying-Cheng Chiang 1, Po-Han Lin 2,3 and Wen-Fang Cheng 1,4,5*
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