Карцинома яєчників (переважно high-grade серозна)
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DIS-OVARIAN |
|---|---|
| Тип | Хвороба |
| Синоніми | Epithelial ovarian cancerOvarian carcinomaTubo-ovarian cancer (incl. fallopian tube + primary peritoneal)Карцинома яєчників (переважно high-grade серозна) |
| Статус | переглянуто 2026-04-26 | очікує клінічного підпису |
| Хвороби | Не вказано |
| Джерела | SRC-ESMO-OVARIAN-2024 SRC-NCCN-OVARIAN-2025 |
Інформаційна підтримка. Усі рекомендації має перевірити кваліфікований онколог. Технічні перевірки не є клінічною валідацією чи схваленням лікування.
| icd_o_3_morphology | 8441/3 |
|---|---|
| icd_o_3_topography | ["C56", "C57.0", "C48.1"] |
| icd_10 | C56 |
| who_classification | WHO Female Genital Tumours 5th ed (2020): High-grade serous carcinoma of tubo-ovarian / peritoneal origin |
Нотатки
Скафолд для партії #2: фокус на поширених стадіях (FIGO III-IV) high-grade серозної карциноми (HGSC) — перша лінія системної терапії та підтримуюча терапія. Включено 4 червоні прапори: статус debulking як тригер обговорення в MDT, актиабельність HRD, похилий вік / стареча астенія, периопераційний ризик VTE. Схеми лікування: основа карбоплатин (carboplatin) + паклітаксел (paclitaxel) ± бевацизумаб (bevacizumab); олапариб (olaparib) у підтримці при HRD+; нірапариб (niraparib) — all-comer підтримка; бевацизумаб у підтримці згідно PAOLA-1. Поза межами цього комміту: рідкісні гістологічні підтипи (світлоклітинна, ендометріоїдна, муцинозна, low-grade серозна — мають окремі парадигми); алгоритми ≥2L при рецидивному платиночутливому vs платинорезистентному перебігу; пограничні пухлини. Тестування HRD (BIO-HRD-STATUS) — центральний біомаркер, що визначає виграш від підтримуючої PARPi-терапії. Виявлення герміногенних та соматичних варіантів BIO BRCA1/2 — через рефлекторне тестування.
Де використовується
Algorithms
ALGO-AMSTERDAM-II-LYNCH- ALGO-AMSTERDAM-II-LYNCHALGO-BOADICEA-V6-BREAST-OVARIAN- ALGO-BOADICEA-V6-BREAST-OVARIANALGO-BRCAPRO- ALGO-BRCAPROALGO-MANCHESTER-BRCA- ALGO-MANCHESTER-BRCAALGO-OVARIAN-2L- ALGO-OVARIAN-2LALGO-OVARIAN-ADVANCED-1L- ALGO-OVARIAN-ADVANCED-1LALGO-PEUTZ-JEGHERS-CARRIER-SURVEILLANCE- ALGO-PEUTZ-JEGHERS-CARRIER-SURVEILLANCEALGO-PREMM5-LYNCH- ALGO-PREMM5-LYNCHALGO-TYRER-CUZICK-V8-BREAST- ALGO-TYRER-CUZICK-V8-BREAST
Handbook Chapters
HB-OVARIAN-MAINTENANCE-1L- Advanced ovarian cancer: HRD/BRCA first-line maintenance reasoning
Procedures
PROC-GENETIC-COUNSELING-PRE-TEST- Pre-test genetic counseling encounter for germline cancer-susceptibility testingPROC-PROPHYLACTIC-BSO-BRCA- Risk-reducing bilateral salpingo-oophorectomy in BRCA1/2 carriersPROC-PROPHYLACTIC-HYSTERECTOMY-LYNCH- Risk-reducing hysterectomy with or without BSO in Lynch syndrome carriers
Questionnaires
QUEST-OVARIAN-1L-STUB- Ovarian carcinoma — first line
Sources
SRC-ARIEL3-COLEMAN-2017- Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinu...SRC-AURELIA-PUJADE-LAURAINE-2014- Bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer: T...SRC-BERRY-BRCAPRO-1997- Probability of carrying a mutation of breast-ovarian cancer gene BRCA1 based on family hi...SRC-ESMO-OVARIAN-2024- ESMO Ovarian Cancer Clinical Practice GuidelineSRC-EVANS-MANCHESTER-BRCA-2017- The Manchester scoring system for predicting BRCA1 / BRCA2 mutation likelihood — refined...SRC-GOG0213-COLEMAN-2017- Bevacizumab and paclitaxel-carboplatin chemotherapy and secondary cytoreduction in recurr...SRC-LEE-BOADICEA-V6-2019- BOADICEA — a comprehensive breast cancer risk-prediction model incorporating genetic and...SRC-MIRASOL-MOORE-2024- Mirvetuximab Soravtansine in FRα-Positive, Platinum-Resistant Ovarian CancerSRC-NCCN-OVARIAN-2025- NCCN Ovarian CancerSRC-NOVA-MIRZA-2016- Niraparib Maintenance Therapy in Platinum-Sensitive, Recurrent Ovarian CancerSRC-OCEANS-AGHAJANIAN-2012- OCEANS: a randomized, double-blind, placebo-controlled phase III trial of chemotherapy wi...SRC-OVA-301-MONK-2010- Trabectedin plus pegylated liposomal Doxorubicin in recurrent ovarian cancerSRC-PAOLA1-RAY-COQUARD-2019- Olaparib plus Bevacizumab as First-Line Maintenance in Ovarian CancerSRC-PRIMA-GONZALEZ-MARTIN-2019- Niraparib in Patients with Newly Diagnosed Advanced Ovarian CancerSRC-SCHULTZ-DICER1-2018- DICER1 and Associated Conditions: Identification of At-Risk Individuals and Recommended S...SRC-SOLO1-MOORE-2018- Maintenance Olaparib in Patients with Newly Diagnosed Advanced Ovarian CancerSRC-SOLO2-PUJADE-LAURAINE-2017- Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ova...SRC-STEWART-DICER1-REVIEW-2019- Neoplasm Risk Among Individuals With a Pathogenic Germline Variant in DICER1
Клінічна застосовність
BMA-AMH-OVARIAN-RESERVE-BSO-TIMING- Anti-Müllerian Hormone (AMH) reflects primordial follicle pool size and is the best singl...BMA-BARD1-GERMLINE-OVARIAN- BARD1 germline pathogenic in EOC: rare; included in HRR panels; PARPi benefit extrapolate...BMA-BARD1-SOMATIC-OVARIAN- Somatic BARD1 in EOC: HRR panel inclusion variable; PARPi off-label consideration in HRD-...BMA-BRAF-V600E-OVARIAN- BRAF V600E is a recurrent driver in low-grade serous ovarian carcinoma (LGSOC) — ~30% of...BMA-BRCA1-GERMLINE-OVARIAN- BRCA1 germline pathogenic variants in advanced epithelial ovarian carcinoma (incl. fallop...BMA-BRCA1-SOMATIC-OVARIAN- Somatic BRCA1 loss-of-function variants in advanced EOC confer PARPi sensitivity equivale...BMA-BRCA2-GERMLINE-OVARIAN- BRCA2 germline pathogenic in advanced EOC: olaparib 1L maintenance (SOLO1) → median PFS n...BMA-BRCA2-SOMATIC-OVARIAN- Somatic BRCA2 loss-of-function in advanced EOC: PARPi (olaparib, niraparib, rucaparib) ap...BMA-BRIP1-GERMLINE-OVARIAN- BRIP1 (FANCJ) germline pathogenic in EOC: established moderate-risk gene (~RR 3-5); inclu...BMA-BRIP1-SOMATIC-OVARIAN- Somatic BRIP1 in EOC: HRR panel inclusion; PARPi consideration in HRD-positive context. E...BMA-CHEK1-SOMATIC-OVARIAN- Somatic CHEK1 loss-of-function in EOC: rare (<1%); included in some HRR panel definitions...BMA-DICER1-GERMLINE-PLEUROPULMONARY-BLASTOMA- DICER1 germline pathogenic variants cause DICER1 tumor predisposition syndrome — broad sp...BMA-FANCA-GERMLINE-OVARIAN- FANCA germline (heterozygous) in EOC: Fanconi-anemia-pathway gene; biallelic loss = Fanco...BMA-FANCL-GERMLINE-OVARIAN- FANCL germline (heterozygous) in EOC: Fanconi-anemia-pathway gene; biallelic loss = Fanco...BMA-HRD-STATUS-OVARIAN- HRD-positive high-grade serous ovarian carcinoma (~50% — encompassing BRCA1/2-mutated and...BMA-KRAS-G12C-OVARIAN- KRAS G12C in ovarian (mostly low-grade serous) is rare. Tissue- agnostic basket data (Cod...BMA-KRAS-G12D-OVARIAN- KRAS G12D in mucinous/low-grade serous ovarian — no approved drug; trial-only (MRTX1133).BMA-KRAS-G12V-OVARIAN- KRAS G12V in low-grade serous / mucinous ovarian — no approved targeted therapy.BMA-MLH1-GERMLINE-OVARIAN- MLH1 germline loss-of-function in ovarian produces dMMR/MSI-H phenotype. Pan- tumor MSI-H...BMA-MLH1-SOMATIC-OVARIAN- MLH1 somatic loss-of-function in ovarian produces dMMR/MSI-H phenotype. Pan- tumor MSI-H...BMA-MSH2-GERMLINE-OVARIAN- MSH2 germline loss-of-function in ovarian produces dMMR/MSI-H phenotype. Pan- tumor MSI-H...BMA-MSH2-SOMATIC-OVARIAN- MSH2 somatic loss-of-function in ovarian produces dMMR/MSI-H phenotype. Pan- tumor MSI-H...BMA-MSH6-GERMLINE-OVARIAN- MSH6 germline loss-of-function in ovarian produces dMMR/MSI-H phenotype. Pan- tumor MSI-H...BMA-MSH6-SOMATIC-OVARIAN- MSH6 somatic loss-of-function in ovarian produces dMMR/MSI-H phenotype. Pan- tumor MSI-H...BMA-PALB2-GERMLINE-OVARIAN- PALB2 germline pathogenic in EOC: rare (~1%); biologically HR-deficient. Niraparib NOVA n...BMA-PALB2-SOMATIC-OVARIAN- Somatic PALB2 in EOC: included in HRD-positive populations of niraparib/rucaparib trials....BMA-PMS2-GERMLINE-OVARIAN- PMS2 germline loss-of-function in ovarian produces dMMR/MSI-H phenotype. Pan- tumor MSI-H...BMA-PMS2-SOMATIC-OVARIAN- PMS2 somatic loss-of-function in ovarian produces dMMR/MSI-H phenotype. Pan- tumor MSI-H...BMA-RAD51B-GERMLINE-OVARIAN- RAD51B germline pathogenic in EOC: confers HR deficiency. RAD51C and RAD51D have establis...BMA-RAD51B-SOMATIC-OVARIAN- Somatic RAD51B loss-of-function in EOC: HRR panel inclusion (varies); PARPi consideration...BMA-RAD51C-GERMLINE-OVARIAN- RAD51C germline pathogenic in EOC: confers HR deficiency. RAD51C and RAD51D have establis...BMA-RAD51C-SOMATIC-OVARIAN- Somatic RAD51C loss-of-function in EOC: HRR panel inclusion (varies); PARPi consideration...BMA-RAD51D-GERMLINE-OVARIAN- RAD51D germline pathogenic in EOC: confers HR deficiency. RAD51C and RAD51D have establis...BMA-RAD51D-SOMATIC-OVARIAN- Somatic RAD51D loss-of-function in EOC: HRR panel inclusion (varies); PARPi consideration...BMA-RAD54L-GERMLINE-OVARIAN- RAD54L germline variants: rare; HR-pathway gene with limited clinical evidence. Included...BMA-RAD54L-SOMATIC-OVARIAN- Somatic RAD54L: very rare; biological HRR rationale only. ESCAT IV / OncoKB Level 4.BMA-TP53-MUT-OVARIAN- TP53 mutation is near-universal in high-grade serous ovarian (~96%). Not actionable per s...BMA-TP53-R175H-OVARIAN- TP53 hotspot in HGSOC — near-universal disease feature; not directly targeted. Hotspot R1...BMA-TP53-R248Q-OVARIAN- TP53 hotspot in HGSOC — near-universal disease feature; not directly targeted. Hotspot R2...BMA-TP53-R273H-OVARIAN- TP53 hotspot in HGSOC — near-universal disease feature; not directly targeted. Hotspot R2...- ... 1 ще
Показання
IND-BRIP1-CARRIER-PREVENTION-OBSERVATION- IND-BRIP1-CARRIER-PREVENTION-OBSERVATIONIND-BRIP1-CARRIER-PREVENTION-SURVEILLANCE- IND-BRIP1-CARRIER-PREVENTION-SURVEILLANCEIND-BRIP1-SUSPICION-PREVENTION-EMPIRICAL-SURVEILLANCE- IND-BRIP1-SUSPICION-PREVENTION-EMPIRICAL-SURVEILLANCEIND-BRIP1-SUSPICION-PREVENTION-TESTING- IND-BRIP1-SUSPICION-PREVENTION-TESTINGIND-OVARIAN-2L-PLAT-RES-MIRVETUXIMAB- IND-OVARIAN-2L-PLAT-RES-MIRVETUXIMABIND-OVARIAN-2L-PLAT-RES-PLD-BEV- IND-OVARIAN-2L-PLAT-RES-PLD-BEVIND-OVARIAN-2L-PLAT-RES-TOPOTECAN- IND-OVARIAN-2L-PLAT-RES-TOPOTECANIND-OVARIAN-2L-PLAT-RES-WEEKLY-PAC-BEV- IND-OVARIAN-2L-PLAT-RES-WEEKLY-PAC-BEVIND-OVARIAN-2L-PLAT-SENS-CARBO-GEM-BEV- IND-OVARIAN-2L-PLAT-SENS-CARBO-GEM-BEVIND-OVARIAN-2L-PLAT-SENS-CARBO-PLD-BEV- IND-OVARIAN-2L-PLAT-SENS-CARBO-PLD-BEVIND-OVARIAN-3L-POST-PARPi-POST-MIRVE- IND-OVARIAN-3L-POST-PARPi-POST-MIRVEIND-OVARIAN-3L-TRABECTEDIN-PLD- IND-OVARIAN-3L-TRABECTEDIN-PLDIND-OVARIAN-ADVANCED-1L-CARBO-PACLI-HRD-NEG- IND-OVARIAN-ADVANCED-1L-CARBO-PACLI-HRD-NEGIND-OVARIAN-ADVANCED-1L-CARBO-PACLI-HRD-OLAP- IND-OVARIAN-ADVANCED-1L-CARBO-PACLI-HRD-OLAPIND-OVARIAN-MAINT-BEV- IND-OVARIAN-MAINT-BEVIND-OVARIAN-MAINT-PARPI-BRCAM-OLAPARIB- IND-OVARIAN-MAINT-PARPI-BRCAM-OLAPARIBIND-OVARIAN-MAINT-PARPI-HRD-NIRAPARIB- IND-OVARIAN-MAINT-PARPI-HRD-NIRAPARIBIND-OVARIAN-MAINT-PARPI-RUCAPARIB- IND-OVARIAN-MAINT-PARPI-RUCAPARIBIND-OVARIAN-MAINTENANCE-OLAPARIB- IND-OVARIAN-MAINTENANCE-OLAPARIBIND-RAD51C-D-CARRIER-PREVENTION-OBSERVATION- IND-RAD51C-D-CARRIER-PREVENTION-OBSERVATIONIND-RAD51C-D-CARRIER-PREVENTION-SURVEILLANCE- IND-RAD51C-D-CARRIER-PREVENTION-SURVEILLANCEIND-RAD51C-D-SUSPICION-PREVENTION-EMPIRICAL-SURVEILLANCE- IND-RAD51C-D-SUSPICION-PREVENTION-EMPIRICAL-SURVEILLANCEIND-RAD51C-D-SUSPICION-PREVENTION-TESTING- IND-RAD51C-D-SUSPICION-PREVENTION-TESTINGIND-REPRODUCTIVE-ENDOMETRIOSIS-OVARIAN-PREVENTION-OBSERVATION- IND-REPRODUCTIVE-ENDOMETRIOSIS-OVARIAN-PREVENTION-OBSERVATIONIND-REPRODUCTIVE-ENDOMETRIOSIS-OVARIAN-PREVENTION-SURVEILLANCE- IND-REPRODUCTIVE-ENDOMETRIOSIS-OVARIAN-PREVENTION-SURVEILLANCE
Тривожна ознака
RF-BARD1-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in BARD1 (BRCA1-associated RING...RF-BARD1-FAMILY-HISTORY-SUSPICION- Family pedigree pattern suggestive of germline BARD1 heterozygous carrier state in an asy...RF-BRCA-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in BRCA1 or BRCA2 — the canonic...RF-BRCA-HBOC-FAMILY-HISTORY-SUSPICION- Family pedigree meeting criteria suggestive of Hereditary Breast and Ovarian Cancer (HBOC...RF-BREAST-OVARIAN-HRD-ASSAY-DISTINCTION- HRD assay platform mismatch in breast or ovarian cancer: HRD-positive call by Myriad myCh...RF-BRIP1-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in BRIP1 (BRCA1-interacting pro...RF-BRIP1-FAMILY-HISTORY-SUSPICION- Family pedigree pattern suggestive of germline BRIP1 heterozygous carrier state in an asy...RF-CASCADE-BRCA-FDR-POSITIVE- A first-degree relative of the patient (parent, sibling, or child) has a documented posit...RF-CASCADE-LYNCH-FDR-POSITIVE- A first-degree relative of the patient (parent, sibling, or child) has a documented posit...RF-DICER1-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in DICER1 (RNase III endonuclea...RF-LYNCH-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in a Lynch syndrome (MMR / EPCA...RF-LYNCH-FAMILY-HISTORY-SUSPICION- Family pedigree meeting criteria suggestive of hereditary nonpolyposis colorectal cancer...RF-OCC-ASBESTOS-MALIGNANCY-PREVENTION- Documented historical occupational exposure to asbestos fibres (chrysotile, amosite, croc...RF-OVARIAN-BRCA-MUT-ACTIONABLE- BRCA1 or BRCA2 pathogenic variant (germline OR somatic) in high-grade serous ovarian carc...RF-OVARIAN-FRA-HIGH-ACTIONABLE- Folate receptor alpha (FRα) high expression (≥75% of viable tumor cells with ≥2+ membrane...RF-OVARIAN-FRAILTY-AGE- Frailty profile precluding standard carbo+pacli + bev intensified induction in ovarian: E...RF-OVARIAN-HRD-ACTIONABILITY- HRD-positive (BRCA1/2 mutation OR Genomic Instability Score ≥42) high-grade serous ovaria...RF-OVARIAN-HRD-POSITIVE-ACTIONABLE- Homologous Recombination Deficiency (HRD)-positive high-grade serous ovarian carcinoma (B...RF-OVARIAN-INFECTION-SCREENING- Active or latent infection requiring resolution / prophylaxis before initiating carbo+pac...RF-OVARIAN-PERIOPERATIVE-VTE- High perioperative VTE risk in ovarian cancer: ascites + bulky pelvic mass + immobilizati...RF-OVARIAN-PLATINUM-RESISTANT- Platinum-resistant ovarian relapse — Platinum-Free Interval (PFI) <6 months from last pla...RF-OVARIAN-PLATINUM-SENSITIVE- Platinum-sensitive ovarian relapse — Platinum-Free Interval (PFI) >6 months from last pla...RF-OVARIAN-SUBOPTIMAL-DEBULKING- Suboptimal primary cytoreductive surgery (residual disease ≥1 cm) or unresectable at pres...RF-OVARIAN-TRANSFORMATION-PROGRESSION- Platinum-resistant or platinum-refractory ovarian cancer: progression during platinum-bas...RF-PALB2-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic monoallelic variant in PALB2 (heterozyg...RF-PALB2-FAMILY-HISTORY-SUSPICION- Family pedigree pattern suggestive of germline PALB2 heterozygous carrier state in an asy...RF-PAN-BRCA-SOMATIC-PARPI-CANDIDATE- Somatic (tumor-only) BRCA1 or BRCA2 pathogenic variant identified on tumor NGS — pan-tumo...RF-PEUTZ-JEGHERS-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in the STK11 (LKB1) gene — Peut...RF-PEUTZ-JEGHERS-FAMILY-HISTORY-SUSPICION- Family pedigree suggestive of Peutz-Jeghers syndrome (PJS): any of (a) a family member wi...RF-RAD51C-D-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in RAD51C OR RAD51D — RAD51 par...RF-RAD51C-D-FAMILY-HISTORY-SUSPICION- Family pedigree pattern suggestive of germline RAD51C or RAD51D heterozygous carrier stat...RF-REPRODUCTIVE-BREAST-ENDOMETRIAL-PREVENTION- Reproductive-history risk factors for hormone-driven cancers (breast + endometrial + ovar...RF-REPRODUCTIVE-ENDOMETRIOSIS-OVARIAN-PREVENTION- Long-standing endometriosis (especially endometrioma + deep infiltrating forms, duration...RF-REPRODUCTIVE-OCP-LONG-TERM- Long-term combined oral contraceptive use (≥10 cumulative years). Mixed cancer risk profi...
Хвороба
DIS-GRANULOSA-CELL- Adult granulosa cell tumor of the ovaryDIS-SERTOLI-LEYDIG-OVARIAN- Sertoli-Leydig cell tumor of the ovary