Homologous Recombination Deficiency (HRD)-positive high-grade serous ovarian carcinoma (B...

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ID	`RF-OVARIAN-HRD-POSITIVE-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-NOVA-MIRZA-2016` `SRC-PRIMA-GONZALEZ-MARTIN-2019`

Origine du drapeau rouge

Définition	Homologous Recombination Deficiency (HRD)-positive high-grade serous ovarian carcinoma (BRCA1/2 mutation OR Genomic Instability Score ≥42). PARPi maintenance after platinum-based induction is treatment-defining: niraparib (PRIMA — mPFS 21.9 vs 10.4 mo HRD-pos), olaparib + bevacizumab (PAOLA-1 — mPFS 37.2 vs 17.7 mo HRD-pos).
Direction clinique	intensifier
Catégorie	high-risk-biology
Algorithme de décalage	ALGO-OVARIAN-ADVANCED-1L, ALGO-OVARIAN-2L

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "hrd_status",
      "value": "HRD-positive"
    },
    {
      "finding": "hrd_status",
      "value": "positive"
    },
    {
      "comparator": ">=",
      "finding": "genomic_instability_score",
      "threshold": 42
    }
  ],
  "type": "biomarker"
}

Notes

HRD assays: Myriad myChoice CDx (companion for olaparib + bev, niraparib), FoundationOne CDx HRD. GIS captures BRCAness (LOH + TAI + LST signatures) in tumors WT for BRCA1/2. HRD-negative HGSC has minimal PARPi maintenance benefit (PRIMA mPFS 8.1 vs 5.4 mo) — bev maintenance preferred. Coexists with RF-OVARIAN-BRCA-MUT-ACTIONABLE (BRCA-mut subset is HRD-positive by definition); RF-OVARIAN-HRD-ACTIONABILITY is the older composite version.

Utilisé par

Algorithmes

ALGO-OVARIAN-2L - ALGO-OVARIAN-2L
ALGO-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-002 - HQ-OVARIAN-MAINTENANCE-1L-002