Chapter 6A - In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?

Summary

Recently, cancer genetics and molecular profiling have revolutionized epithelial ovarian cancer (EOC) management due to the introduction in the clinical repertoire of therapies directed against specific molecular targets, including PARP inhibitors. While evaluation of BRCA1/2 genes has gained an undeniable role and homologous recombination repair (HRD) analysis is entering into clinical practice, the routine adoption of further molecular profiling is still debated. Even though EOC guidelines do not recommend systematically performing extended molecular panels at diagnosis yet, their routine employment should be considered since they effectively fulfill several purposes. The use of next generation sequencing (NGS) panels not only helps to deeply understand tumor biology, but it also identifies actionable alterations, is an instrument for prediction of prognosis and drug resistance and allows the access in alteration-directed clinical trials. Therefore, based on preliminary evidences, extended molecular profiling, not limited to BRCA and HRD analysis, should be routinely done in EOC.