BRCA1 ou BRCA2 variante pathogène (germline OU somatique) dans la carc...
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| ID | RF-OVARIAN-BRCA-MUT-ACTIONABLE |
|---|---|
| Type | Signal d’alerte |
| État | reviewed 2026-04-27 | pending_clinical_signoff |
| Maladies | DIS-OVARIAN |
| Sources | SRC-ESMO-OVARIAN-2024 SRC-NCCN-OVARIAN-2025 SRC-SOLO1-MOORE-2018 SRC-SOLO2-PUJADE-LAURAINE-2017 |
Origine du drapeau rouge
| Définition | BRCA1 or BRCA2 pathogenic variant (germline OR somatic) in high-grade serous ovarian carcinoma — ~20-25% prevalence (15% germline + ~7% somatic). Olaparib maintenance after platinum-based 1L (SOLO-1 — mPFS 56.0 vs 13.8 mo BRCA-mut) is treatment-defining; rucaparib + niraparib alternatives. SOLO-2 — 2L+ relapse maintenance. |
|---|---|
| Direction clinique | intensifier |
| Catégorie | high-risk-biology |
| Algorithme de décalage | ALGO-OVARIAN-ADVANCED-1L, ALGO-OVARIAN-2L |
Logique de déclenchement
{
"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"
}
Notes
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.
Utilisé par
Algorithmes
ALGO-OVARIAN-2L- ALGO-OVARIAN-2LALGO-OVARIAN-ADVANCED-1L- ALGO-OVARIAN-ADVANCED-1L
Chapitres du manuel
HB-OVARIAN-MAINTENANCE-1L- Advanced ovarian cancer: HRD/BRCA first-line maintenance reasoning
Questions du manuel
HQ-OVARIAN-MAINTENANCE-1L-001- HQ-OVARIAN-MAINTENANCE-1L-001
Signal d’alerte
RF-OVARIAN-HRD-POSITIVE-ACTIONABLE- Homologous Recombination Deficiency (HRD)-positive high-grade serous ovarian carcinoma (B...RF-PAN-BRCA-SOMATIC-PARPI-CANDIDATE- Variante somatique (tumogène seulement) BRCA1 ou BRCA2 pathogène identifiée sur la tumeur NGS — pan-tumo...