HRD-positives hochgradiges seröses Ovarialkarzinom (~50% — einschliesslich BRCA1/2-mutiertem und...
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| ID | BMA-HRD-STATUS-OVARIAN |
|---|---|
| Art | Therapeutische Relevanz |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Erkrankungen | DIS-OVARIAN |
| Quellen | SRC-ESMO-OVARIAN-2024 SRC-NCCN-OVARIAN-2025 |
Fakten zur Handlungsfähigkeit
| Biomarker | BIO-HRD-STATUS |
|---|---|
| Variante | HRD-positiv — BRCA1/2 Mutation oder genomischer Instabilitätspunkt (GIS) über validiertem Schwellenwert (Myriad MyChoice ≥42 oder gleichwertige FoundationOne CDx HRD Signatur); ~50% des hochgradigen serösen Eierstockkarzinoms |
| Erkrankung | DIS-OVARIAN |
| ESCAT-Stufe | IA |
| Empfohlene Kombinationen | olaparib monotherapy maintenance (1L BRCA1/2-mut per SRC-NCCN-OVARIAN-2025, SRC-ESMO-OVARIAN-2024), olaparib + bevacizumab maintenance (1L HRD-positive non-BRCA per SRC-NCCN-OVARIAN-2025), niraparib monotherapy maintenance (1L per SRC-NCCN-OVARIAN-2025, all-comers benefit, HRD-positive strongest), rucaparib monotherapy (2L maintenance / treatment per SRC-NCCN-OVARIAN-2025) |
| Zusammenfassung der Beweise | HRD-positive high-grade serous ovarian carcinoma (~50% — encompassing BRCA1/2-mutated and BRCA-WT/HRD+): PARP inhibitor maintenance after platinum response is FDA-approved 1L. Olaparib monotherapy maintenance for BRCA1/2-mutated newly-diagnosed advanced ovarian after CR/PR to platinum (SOLO-1 Moore NEJM 2018 — mPFS not reached vs 13.8 mo, HR 0.30) per SRC-NCCN-OVARIAN-2025, SRC-ESMO-OVARIAN-2024. Olaparib + bevacizumab maintenance for HRD-positive (BRCA-mut OR HRD-genomic) post-1L platinum + bevacizumab (PAOLA-1 Ray-Coquard NEJM 2019 — HRD subgroup mPFS 37 vs 17 mo, HR 0.33). Niraparib monotherapy maintenance is approved for all-comers (PRIMA Gonzalez-Martin NEJM 2019), with the strongest benefit in HRD-positive subgroup. |
Anmerkungen
ESCAT IA / OncoKB Level 1. HRD assays are not interchangeable — Myriad MyChoice CDx, FoundationOne CDx, and Caris all use different scoring models; FDA companion-diagnostic specificity matters. HRD- negative patients still derive smaller niraparib benefit (PRIMA all- comers) but ESMO 2024 explicitly de-prioritizes PARP maintenance in HRD-negative platinum-sensitive recurrence — documented disagreement with NCCN that lists niraparib for HRD-negative as well. Flagged for clinical-co-lead review. Bibliographic records SRC-SOLO1-MOORE-2018, SRC-PAOLA1-RAY-COQUARD-2019, and SRC-PRIMA-GONZALEZ-MARTIN-2019 are available; claim-level linkage requires clinical sign-off.
Verwendet von
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