NEW PERSPECTIVES OF SELECTION TESTS FOR THE TREATMENT WITH PARP INHIBITORS OF OVARIAN CANCER PATIENTS: A MINI-REVIEW

The introduction of PARP inhibitors has revolutionized the treatment landscape for ovarian cancer patients, particularly those with germline mutations in BRCA1/2 genes.Nevertheless, not all patients respond to these treatments in the same way, which shows the necessity of appropriate patient selection to determine which individuals are most likely to benefit.Innovative tests that are more reliable at predicting treatment outcomes have emerged as a result of recent developments in molecular diagnostics and biomarker identification.This review focuses on the most recent information on selection tests for PARP inhibitor therapy in patients with ovarian cancer and explores the importance of genomic scar, genetic alterations, and homologous recombination (HR) deficiency (HRD) scores.HRD is a dynamic process that can be modified by chemotherapy; HRR may be restored by multiple mechanisms of resistance to PARPi or platinum agents.Differences between the test and the clinical response to PARPi can be attributed to these mechanisms of resistance, which genetic tests are unable to identify.The objective of this review is to describe different available methods to test homologous recombination functionality and to differences, weaknesses and straights of different tests.In addition, we want to describe a new academic functional assessment, RAD51 assay, which can detect the dynamicity of HR status, so it can help in the improvement of patient selection therapies.By introducing these new selection tests into the clinical practice, the management of patients with ovarian cancer employing PARP inhibitors can be improved, leading to better treatment outcomes, reduced unnecessary toxicity, and an overall development in patient care.