BRCA1 oder BRCA2 pathogene Variante (germline ODER somatisch) in hochwertigen serösen ovariellen Karzinome...

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ID	`RF-OVARIAN-BRCA-MUT-ACTIONABLE`
Art	Warnhinweis
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Erkrankungen	`DIS-OVARIAN`
Quellen	`SRC-ESMO-OVARIAN-2024` `SRC-NCCN-OVARIAN-2025` `SRC-SOLO1-MOORE-2018` `SRC-SOLO2-PUJADE-LAURAINE-2017`

Ursprung der Roten Flagge

Begriffsbestimmung	BRCA1 oder BRCA2 pathogene Variante (germline OR somatic) bei hochgradigem serösen Ovarialkarzinom — ~20-25% Prävalenz (15% Keimlinie + ~7% Somatic). Olaparib-Wartung nach platinbasiertem 1L (SOLO-1 — mPFS 56.0 vs. 13,8 mo BRCA-mut) ist behandlungsdefinierend; Rucaparib + Niraparib-Alternativen. SOLO-2 — 2L+ Rezidiv-Wartung.
Klinische Richtung	Intensivierung
Kategorie	high-risk-biology
Schaltet Algorithmus	ALGO-OVARIAN-ADVANCED-1L, ALGO-OVARIAN-2L

Logik auslösen

{
  "any_of": [
    {
      "finding": "brca1_brca2_pathogenic",
      "value": true
    },
    {
      "finding": "brca1_status",
      "value": "pathogenic"
    },
    {
      "finding": "brca2_status",
      "value": "pathogenic"
    },
    {
      "finding": "brca1_brca2_tumor",
      "value": "pathogenic"
    },
    {
      "finding": "brca1_brca2_germline",
      "value": "pathogenic"
    }
  ],
  "type": "biomarker"
}

Anmerkungen

Tumor-tissue testing identifies somatic BRCA missed by germline-only testing — both germline (blood) AND tumor BRCA testing recommended at diagnosis for all newly diagnosed advanced ovarian. Germline finding triggers cascade testing of relatives + risk-reducing surgery counseling. Olaparib + bevacizumab (PAOLA-1) extended benefit in HRD-positive (incl. BRCA-mut) cohort. RF coexists with RF-OVARIAN-HRD-ACTIONABILITY — BRCA-mut is the BRCA-specific subset; HRD covers both BRCA + GIS-positive non-BRCA cases.

Verwendet von

Algorithmen

ALGO-OVARIAN-2L - ALGO-OVARIAN-2L
ALGO-OVARIAN-ADVANCED-1L - ALGO-OVARIAN-ADVANCED-1L

Kapitel des Handbuchs

HB-OVARIAN-MAINTENANCE-1L - fortgeschrittener Eierstockkrebs: HRD/BRCA First-Line-Wartungshygienische

Handbuchfragen

HQ-OVARIAN-MAINTENANCE-1L-001 - HQ-OVARIAN-MAINTENANCE-1L-001

Warnhinweis

RF-OVARIAN-HRD-POSITIVE-ACTIONABLE - Homologes Rekombinationsmangel (HRD)-positives hochgradiges seröses Ovarialkarzinom (B...
RF-PAN-BRCA-SOMATIC-PARPI-CANDIDATE - Somatische (Tumor-nur) BRCA1 oder BRCA2 pathogene Variante auf Tumor NGS identifiziert — Pan-Tumor...