For patients with high-grade advanced epithelial ovarian cancer (HG-AOC), standard chemotherapy consists of carboplatin and paclitaxel, followed by maintenance treatment with bevacizumab, a PARP inhibitor, or both. The choice of maintenance strategy is influenced by homologous recombination deficiency (HRD) status and BRCA1/2 alterations. This analysis included individuals newly diagnosed with HG-AOC between December 2019 and December 2021. Tumor HRD status was determined using the Myriad myChoice® assay in all patients for whom HRD testing was clinically indicated, and germline BRCA1/2 evaluation was performed for all patients with the TruRisk® panel, according to national recommendations. HRD testing was ordered for 190 patients, and results were successfully obtained for 163 (85.8%). In 27 cases, testing failed due to inadequate tumor material. The median turnaround time for HRD results was 37 days (range 8–97). Among the 163 evaluable samples, HRD was identified in 44.7% (73/163), including 42.9% with a genomic instability score (GIS) ≥ 42 and three cases with tumor BRCA1/2 mutations despite a GIS < 42. Germline results were available for 148 patients, revealing pathogenic variants in 18 individuals (12.2%). Among the 27 patients without adequate tumor for HRD testing, germline BRCA1/2 results were available in 19 cases (70.4%), with two carrying a deleterious germline variant (7.4%). These findings indicate that implementing HRD testing in routine practice is practical, with most results returned within a timeframe compatible with treatment planning. Adequate tumor quantity is essential for the myChoice® assay, and concurrent tumor HRD and germline BRCA1/2 testing is advisable to support timely decisions regarding maintenance therapy and to ensure evaluation of patients whose tumor samples are nonevaluable.
