OC04.06: A comparison of the homologous recombination deficiency test success rate using samples from ultrasound‐guided biopsies and those obtained during laparotomies in advanced ovarian cancer
Year: 2024
Type: article
Study design: Observational Study
Abstract: Testing for tumour homologous recombination deficiency (HRD) is recommended for all patients with advanced high-grade epithelial ovarian cancer and directs first-line treatment in these patients. We set out to identify the factors that influence HRD test success and the average time-to-result. We hypothesised that samples taken during surgery would result in a higher test success rate than those obtained using ultrasound (US) guided biopsy. We also hypothesised that diagnostic biopsies taken with a larger needle gauge would result in greater rates of test success. This was a retrospective cohort review of 125 patients with advanced high-grade epithelial ovarian cancer tested for HRD. Tissue for HRD testing was collected either at primary surgery, or from US-guided diagnostic biopsy if patients had upfront chemotherapy. In case of test failure at diagnostic biopsy, further tissue was obtained during interval debulking surgery. 85.6% of patients received a result from their first test. Including repeated tests (due to test failure), a total of 148 HRD tests were performed. The overall success rate of HRD testing was 69.6%. Chances of obtaining a result was 66.7% (n = 40/60) from diagnostic biopsy, 91.5% (n = 42/47) from primary surgery, and 51.2% (n = 21/41) from interval debulking surgery. At US-guided biopsy, needle gauge significantly affected the test success rate. There was a 100% success rate with 16-gauge (n = 14/14) versus 64.5% with 18-gauge needles (n = 20/31). Of 148 tests carried out, 27% returned results in ≤ 21 days (median 28 days, range 14-158 days). 84.6% of patients with HRD-positive tumours treated at our centre received PARP-inhibitors as part of their first-line maintenance treatment. At US-guided biopsy, test failure rates were higher if samples were taken using an 18-gauge needle versus 16-gauge needle. By optimising HRD testing, we can optimise treatment at the earliest timepoint possible.
DOI: 10.1002/uog.27747
Authors: D. Ditri, A. Hunt, A. Chadha, G. Keogh, J. Thompson, W. Loughborough, I. McNeish, J. Krell, J. McDermott, S. Ghaem‐Maghami, L. Tookman
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4402358378