Modern methods for determining homologous recombination deficiency in ovarian cancer: A literature review

Abstract

Relevance: As scientists continue to explore and deepen their understanding of cancer genomics, they are increasingly able to identify broader molecular “ fingerprints” characteristic of various forms of cancer. One such marker is homologous recombination deficiency (HRD), which is gaining importance in understanding the biology of different cancer types.
The study aimed to review the available methods used in clinical practice to assess homologous recombination deficiency status in ovarian cancer.
Methods: This review utilized various literature sources, including scientific articles and reviews. Literature search was conducted in databases such as PubMed, Cochrane Library, Scopus, and Web of Science using keywords like “ovarian cancer,” “homologous recombination deficiency”, and “homologous recombination repair”. Articles were included in the review based on their content and relevance to the research topic. The search covered a period of 5 years (2020-2025).
Results: Each method presented in the review has specific advantages and disadvantages. It is important to compare the available tests with the gold standard (BRCA1/2, GIS) in clinical trials to better characterize their prognostic value and integrate them into treatment regimens. The combination of multiple tests may provide higher prognostic value. It is crucial to consider the technical heterogeneity that characterizes internal HRD tests. Variations in certain technical characteristics (e.g., reference range, analyzed genomic markers, panel expansion) highlight the importance of harmonizing analytical procedures before implementing internal HRD tests.
Conclusion: HRD status analysis is essential in treating ovarian cancer. However, several pre-analytical and analytical factors can influence its clinical testing in surgical pathology laboratories. In recent years, numerous HRD tests have appeared on the market, but their clinical implementation is still far from routine practice. Multicenter efforts should determine the best approaches to ensure adequate HRD testing for all patients with HGSOC.